bluuebunny/crossref_metadata_2025 huggingface dataset:
Do you See What I See? Nonprofit and Resident Perceptions of Urban Neighborhood Problems
Authors: Kissane Rebecca J. , Gingerich Jeff
Published: April 2004

Using 85 qualitative interviews collected in three low-income Philadelphia neighborhoods as part of the Manpower Demonstration Research Corporation’s (MDRC) Project on Devolution and Urban Change, nonprofit directors and poor residents’ views of neighborhood problems, other residents, and services needed were examined. In doing so, the assumption that local nonprofit leadership is in touch with the resident population that they serve was questioned. Nonprofit directors described neighborhood problems related to unemployment and education, whereas residents focused on crime and safety issues. Both groups agreed that drugs were a major problem in the community. Additionally, the resident group conveyed a more negative view of other neighborhood residents than the nonprofit directors did. Lastly, nonprofit directors wanted to add job placement and training services, whereas residents wanted to add youth programs. Overall, nonprofit directors across neighborhoods held more similar views with each other than they did with residents within their own communities.
Underestimating the Power of Nonprofit Governance
Authors: McCambridge Ruth
Published: April 2004

Much of the dialogue around nonprofit boards has focused on secondary or transactional issues rather than on the question of what good governance must include in a nonprofit setting. This serves to rob the nonprofits of creativity, rigor, power, and the kind of finely tuned understanding of accountability the public should expect. By focusing on the central questions and principles of nonprofit governance rather than on structural concerns, the possibilities for a wider variation in governance models open up. All organizations are set in a larger social context, so we cannot end our reflection at the individual nonprofit level. These questions are particularly pertinent during a period when our attention is focused on governance from Wall Street to Baghdad. Some believe that public governance is overly affected by corporate interests, and we are now seeing case after case of scandals exposing ethical problems in the governance of corporations that only recently were seen as exemplary. This puts the interests of ordinary and particularly marginalized people at risk. In a democracy, the nonprofit sector is there to ensure that people have a voice in our future—at the community, national, and global levels. If we accept this as our primary role, it has implications for what should be present as constants in our governance structures.
International Development NGOS: Agents of Foreign Aid or Vehicles for International Cooperation?
Authors: Edwards Michael
Published: April 2004

What is the future for development NGOs who work internationally but are based in and governed from the industrialized world? Are they destined for redundancy as NGOs and other organizations rooted in southern societies take over their roles and replace their expertise, or will they retain a legitimate place on the world stage in the 21st century? This article looks at the changing context for international NGOs and lays out three alternative routes into the future: incremental change (which is probably unsustainable), global market brands, and international social movements. The implications of each strategy are presented, and some overall conclusions drawn. The fundamental question facing all NGOs is how to move from their current position—as agents of a foreign aid system in decline—to vehicles for international cooperation in the emerging global arena.
Coping With Globalization: A Profile of the Northern NGO Sector
Authors: Salm Janet
Published: April 2004

Northern NGOs are facing unprecedented challenges posed by globalization. This article is a profile of the northern international relief and development sector and how it is coping with these challenges, based on a study of 10 major organizations. Their concerns center on changing internal organizational culture to stay at the cutting edge, becoming more effective and exploring competition and cooperation. Externally, these organizations are developing strategies for improved north-south relations, advocacy, and autonomy.
Grappling With Globalization, Partnership, and Learning: A Look Inside Oxfam America
Authors: Offenheiser Raymond , Holcombe Susan , Hopkins Nancy
Published: April 2004

This article explores some of the current challenges facing Oxfam America, a Boston-based international development and relief organization. Looking outward, Oxfam America is faced with an increasingly competitive private fundraising market, tensions and opportunities posed by its affiliation with the global Oxfam International structure, the need to revitalize its partnership concept, unprecedented opportunities to link local realities and global policy formulation through advocacy, and the need to respond to changing programming contexts with new funding arrangements and strategic alliances. From an internal perspective, the organization is grappling with building a learning organization, creating more constructive labor-management relations, creating more flexible and entrepreneurial conditions of employment, institutionalizing strategic thinking and planning, and embracing diversity as a transformative management principle. Through creative yet pragmatic responses to these challenges, Oxfam America is striving to position itself as one of the most effective, forward-looking NGOs of the next century.
Declining State Capacity, Voluntarism, and the Globalization of the Not-for-Profit Sector
Authors: Lindenberg Marc
Published: April 2004

Since the 1970s, a profound shift has taken place in the roles of the public, private, and not-for-profit sectors. In the wake of fiscal crisis, ideological attacks, and privatization, the scope and capacity of governments has declined. A growing global not-for-profit sector has emerged, which has begun to fill the humanitarian vacuum left by the corporate sector and the nation-state. Changes have been profound, raising new issues about the role and future of voluntarism in a world where governments retreat from their social welfare responsibilities and where the solutions to global poverty continue to elude us. This article explores the rapid growth and internationalization of the NGO sector and addresses why the rapid growth of this sector is taking place, the structural forms this process is taking, and what future structural forms may emerge. In addition, the author analyzes issues that arise as the NGO sector globalizes, and discusses recommendations for constructive roles for policy makers and the northern international not-for-profit sector for promoting global voluntarism in the future.
New Dimensions of Global Advocacy
Authors: Bryer David , Magrath John
Published: April 2004

This article argues that globalization impels NGOs to engage further in advocacy work, and that globalization provides important new opportunities as well as significant challenges. In particular, NGOs both north and south will have to form strategic alliances. The article uses Oxfam GB's history of advocacy to examine options open to NGOs and to suggest future directions and possible criteria for effective advocacy.
Print, Video, or the Ceo
Authors: O’Connell David J. , McCarthy John F. , Hall Douglas T.
Published: April 2004

Case teaching has the potential to involve students in complex decision settings, enhancing their identification with protagonists facing difficult challenges. This article explores the impact of teaching a printed leadership case study with and without the appearance of the CEO in class—by video or in person. Our investigation shows, via qualitative and quantitative means, that the leader’s presence, even through video, significantly affects student engagement and can substantially enhance impressions of leadership effectiveness. We offer implications for teachers and propose future research directions.
Using Stories to Reframe the Social Construction of Reality: A Trio of Activities
Authors: Morgan Sandra , Dennehy Robert F.
Published: April 2004

This article first presents the theoretical grounding for both storytelling and the social construction of reality. A sequence of classroom-tested tools for combining stories with reality construction is then described. Two tools for framing reality are offered: One is an actual frame that students take out of the classroom to frame a scene in different ways; the other requires students to frame two different segments of a photographic advertisement. In both exercises, students tell (either orally or in writing) the two different stories (perceptions of reality) they discovered. The third activity involves requiring students to gather stories and then retell them to classmates from the original story-teller’s perspective thus experiencing the reality of the original teller as well as discovering what their storytelling partner heard. The article concludes with a discussion of student responses.
Examining the Evidence on Environmental Regulations and Industry Location
Authors: Brunnermeier Smita B. , Levinson Arik
Published: April 2004

This article offers a review and critique of the large literature on the pollution havens hypothesis. This hypothesis refers to the notion that certain jurisdictions can become pollution havens as dirty industries relocate or expand in response to differences in regulatory stringency. The early literature, based on cross-sectional analyses, typically concludes that environmental regulations have an insignificant effect on firm location decisions. However, recent studies that use panel data to control for unobserved heterogeneity, or instruments to control for endogeneity, find statistically significant pollution haven effects of reasonable magnitude. Furthermore, this distinction appears regardless of whether the studies look across countries, states, counties, or industries, or whether they examine plant locations, investment, or international trade patterns.
Mexico’s Irrigation Management Transfer Program: Notes for a Policy Research Agenda
Authors: Prado Luz Nereida Pérez
Published: April 2004

This article addresses three interconnected questions related to Mexico’s irrigation management transfer program. These are the political construction of the management transfer policy, the political process of generating consent for the program among water users in irrigation districts, and the view of water rights as a commodity and the role of the judicial system in the resolution of water disputes. It illustrates that the interconnectedness among the actions before, during, and after legislation render meaningless the distinction between politics, policymaking, and implementation.
The Social Vulnerability of Irrigated Vegetable Farming Households in Central Puebla
Authors: Eakin Hallie
Published: April 2004

Irrigation development has been frequently mentioned in the climate change literature as a possible means for vulnerable agricultural populations to adapt to climatic variability and climatic change. In facilitating year-round intensive production, irrigation can also enable farmers access to competitive commercial markets. In Mexico, the production of irrigated vegetables has expanded over the past decades as a response to both new commercial opportunities and the climatic limitations of rainfed production. The case study presented here illustrates that for some smallholders, irrigated vegetable production does not, in itself, necessarily address farmers’ sensitivity to climatic hazards. Furthermore, the interaction of market uncertainty and price volatility with climatic risk in some cases may actually exacerbate the vulnerability of these households.
From Litigation to Legislation: Challenges to Binational Water Infrastructure Development in the San Diego-Tijuana Bioregion
Authors: Saldaña Lori
Published: April 2004

This article examines the changing roles of crossborder civil society during the development of water and wastewater infrastructure projects in the San Diego-Tijuana region. It reviews the legislation and policies that defined the projects’ goals and funding options, describes changes in collaboration between crossborder agencies and community organizations, and suggests there has been an increased level of transparency and public participation during 10 years of binational project developments. Finally, the article argues that these changes are leading to new models of community-based project development and resource management that may improve opportunities for shared decision making, funding, and long-term sustainable planning in the border region.
Development Challenges on the Baja California Peninsula: The Escalera Náutica
Authors: Pesenti Chris , Dean Kama S.
Published: April 2004

The primary allure of the Baja California peninsula is its unspoiled natural beauty. For decades, the region has struggled to balance conservation of its natural resources with ever-increasing pressures to generate economic development. Tourism projects, often looked to as the answer to maintaining this balance, face the inherent challenge of exploiting the peninsula’s precious natural landscapes without endangering their often fragile existence for use by future generations. The Escalera Náutica project, a plan to develop a chain of 24 marinas to provide North American yachters with the means and motivation to make the long journey south to Baja California and Baja California Sur, faces the challenge described previously on an unprecedented scale. Without careful scrutiny, expansion of institutional infrastructure, and enforcement of existing environmental laws, development of this magnitude and the resulting influx of people will undermine the rare ecology and stark natural beauty that make the peninsula unique.
Relationship of Purported Measures of Pathological and Nonpathological Dissociation to Self-Reported Psychological Distress and Fantasy Immersion
Authors: Levin Ross , Spei Ekaterina
Published: April 2004

In order to investigate both the psychometric structure of the Dissociative Experiences Survey (DES) and the discriminant validity of the DES-Taxon (Waller, Putnam, & Carlson, 1996) as a specific marker of pathological dissociation, 376 non-clinical community based respondents completed the DES and a battery of psychopathology and imaginative involvement self-report measures. The DES was scored for both the Taxon and the DES-Absorption subscale. A DES subscale purported to tap normative dissociative processes. The two DES subscales demonstrated substantial overlap, both with each other (r=.80) and with the self-report measures with both DES scales comparably associated with high levels of psychological distress. Both DES subscales were also associated with elevated levels of “normative” imaginative involvement (fantasy proneness, absorption, daydreaming immersion). We conclude that both DES scales are largely indistinguishable from each other in relation to other self-report measures of psychopathology and fantasy access.
Overview of the Community Care Network Demonstration Program and Its Evaluation
Authors: Hasnain-Wynia Romana
Published: April 2004

This article provides an overview of the evaluation of the National Community Care Network Demonstration Program,which began with 25 public-private partnerships selected from a diverse range of communities across the United States to address problems of lack of insurance,limited access to health care, and the health status of their most disadvantaged residents. The 25 public-private partnerships included an array of individual organizations representing health care providers,public health and human service agencies, local governments,community-based organizations, and religious and educational institutions. The specific findings of the evaluation are the focus of the articles in this issue. This overview article supplies the underpinnings of the evaluation,including the conceptual framework,methodological challenges, and a brief discussion of each of the papers and how they are linked.
Sustainability of Collaborative Capacity in Community Health Partnerships
Authors: Alexander Jeffrey A. , Weiner Bryan J. , Metzger Maureen E. , Shortell Stephen M. , Bazzoli Gloria J. , Hasnain-Wynia Romana , Sofaer Shoshanna , Conrad Douglas A.
Published: April 2004

Sustainability is a key requirement for partnership success and a major challenge for such organizations. Despite the critical importance of sustainability to the success of community health partnerships and the many threats to sustainability, there is little evidence that would provide partnerships with clear guidance on long-term viability. This article attempts to (1) develop a conceptual model of sustainability in community health partnerships and (2) identify potential determinants of sustainability using comparative qualitative data from four partnerships from the Community Care Network (CCN) Demonstration Program. Based on a grounded theory examination of qualitative data from the CCNevaluation, the authors hypothesize that there are five primary attributes/ activities of partnerships leading to consequential value and eventually to sustainability of collaborative capacity. They include outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. The context in which the partnership operates provides the conditions for determining the appropriateness and relative impact of each of the factors related to creating consequential value in the partnership.
Community Care Networks: Linking Vision to Outcomes for Community Health Improvement
Authors: Conrad Douglas A. , Cave Sarah H. , Lucas Martha , Harville Jennifer , Shortell Stephen M. , Bazzoli Gloria J. , Hasnain-Wynia Romana , Sofaer Shoshanna , Alexander Jeffrey A. , Casey Elizabeth , Margolin Frances
Published: April 2004

This article examines the relationship between progress toward the Community Care Network (CCN) vision and “intermediate outcomes” of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward theCCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions—access and health—noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.
Nursing Homes with Persistent High and Low Quality
Authors: Grabowski David C. , Castle Nicholas G.
Published: April 2004

This article examines the concentration of low- and high-quality care within particular nursing facilities over time. The authors explore three different explanations for persistent low and high quality over time including the level of public reimbursement, the presence of bed constraint policies such as certificate-of-need and construction moratoria, and the role of consumer information. Using 1991 through 1999 data from the On-Line Survey, Certification, and Reporting system, the authors show that both low- and high-quality nursing home care is concentrated in certain facilities over time. Their results further show that public reimbursement and asymmetric information are both important factors in explaining why low quality persists over time in certain facilities.
The Sensitivity of Medicare Billing Claims Data for Monitoring Mammography Use by Elderly Women
Authors: Mouchawar Judy , Byers Tim , Warren Meghan , Schluter W. William
Published: April 2004

Mammography use is monitored through Medicare billing claims; however, the sensitivity of this data source has not been previously described. This study included 10,852 Colorado women ages 65 and older with a mammogram in 1998 as registered by the Colorado Mammography Project who were Medicare fee-for-service (FFS) enrollees. These records were matched to Medicare billing data to assess the proportion of those mammograms submitted for payment to Medicare. The overall sensitivity of the FFS Medicare billing data for screening mammography was 85 percent. Medicare billing claims were less sensitive for younger women, African Americans, women with some college education, and women with supplementary private insurance. In Colorado, the Medicare FFS billing claims understates mammography usage by 15 percent. Care must be taken when comparing mammography use derived from Medicare billing claims, as the sensitivity of billing data can vary substantially by age, race, and socioeconomic status.
Decreased Home Health Use: Does It Decrease Satisfaction?
Authors: McCall Nelda , Korb Jodi , Petersons Andrew , Moore Stanley
Published: April 2004

This study investigates differences in satisfaction and quality of life for Medicare beneficiaries using home health care services before and after implementation of the Interim Payment System (IPS) as part of the Balanced Budget Act (BBA) of 1997. Data are from surveys conducted pre- and post-BBA. Multivariate analyses estimate the effect of being in the post-BBA period controlling for beneficiary, agency, and community characteristics. Sixteen dependent variables measure satisfaction with the agency, and two measure life quality. Despite dramatic utilization decreases, differences were not found for overall agency satisfaction, satisfaction with discharge, or with the nursing and therapist care received. Decreases in satisfaction were found for some interpersonal aspects of staff interaction and, for the group of respondents who received services in the agencies that participated in both the pre- and postperiods, with the decreasedprovision of personal care services. A large increase was found in staff encouraging independence.
Bias in the News
Authors: Niven David
Published: April 2004

Support is surfacing in the popular media, and in some cases the scholarly press, for allegations that the media's perspective is tinted by partisanship and negativity. Despite great attention to these matters, analyses subjecting these claims to objective testing, using meaningful baselines with which to compare coverage, have been lacking. By studying coverage of unemployment, an issue for which outcomes are known and quantified, this research offers comparisons of coverage when presidents of both parties have produced the same results and when the unemployment rate has fallen or risen by a comparable margin. The results, utilizing a fair baseline from which to evaluate media coverage, provide no evidence of any meaningful partisan bias while offering strong evidence that the media cover bad outcomes far more than good.
Between the Government and the Press
Authors: el-Nawawy Mohammed , Kelly James D.
Published: April 2004

Although the source-reporter relationship forms the focal point of newsgathering in any political conflict, most of the source-reporter literature focuses on the routines and values of the reporter. This is the first study that investigates the power dynamics involved in the relationship between the Western correspondents stationed in Egypt and Israel and the official press relations practitioners in the two countries. Approximately 88 percent of the Western correspondents in Egypt and Israel and three government press relations directors were interviewed in late 1998 to determine their role perceptions within the context of two theoretical models: the news-making model and the public relations two-way asymmetric model. Correspondents said analysis of complex issues was their primary role, and public relations officials said theirs was provision of information to correspondents. Correspondents said Israeli officials were far more accessible than their Egyptian counterparts. This makes them easier to work with but makes correspondents more skeptical of the information they provide. The news-making model best describes the relationship.
Changing Campaign Communications: A Party-Centered Theory of Professionalized Campaigning
Authors: Gibson Rachel , Römmele Andrea
Published: April 2004

Models explaining the rise of American-style or so-called postmodern campaigning have focused primarily on changes taking place at the systemic level. While these models help explain variance across countries where these techniques are used, they do not explain variations among individual parties. Given that not all parties adopt these tactics and techniques at the same time, the authors argue that there are party-specific variables that need to be taken into account when understanding the shift to the new campaigning era. Building on the existing literature, the authors identify the key traits of what they term professionalized campaigning and the variables that prime a party to adopt it. The article goes on to develop a causal model, based on external and internal party events or shocks, that explains why a particular party would embrace this new style of campaigning. Finally, the authors operationalize their theory and develop indicators to measure the key variables for empirical testing.
Capitalism as World-Ecology
Authors: Moore Jason W.
Published: April 2004

This essay considers the relevance of Fernand Braudel’s world-historical studies for the theory and practice of environmental history. Arguing against the conventional viewthat Braudel regarded the environment as a backdrop, the essay points to his sophisticated layering of time, space, and nature in which society and ecology actively shape each other. Braudel’s greatest historical-geographical insight is the idea that world-economies are not simply social constructions but also ecological projects. In this fashion, Braudel implicitly suggests the concept “world-ecology.” Although never spelled out in precisely these terms, the idea that ecogeographical processes permeate the ever-shifting relations of region, state, and world-economy runs like red thread through Braudel’s corpus. Braudel understood nature in terms of transitory but identifiable socio-ecological moments that shape and are shaped by a world-ecological whole. Unfortunately, Braudel’s underconceptualized approach prevented him fromidentifying with greater specificity capitalism’s world-ecological contradictions. To build effectively upon Braudel’s ecohistorical insights, we might turn to Marx and Engels’ ecological critique of capitalism.
Campaigns Against Dams in Japan and the Nagara River Estuary Dam
Authors: Toshiko Niikura
Published: April 2004

This article reports on the tenacious citizen protest against the construction of the Nagara River Estuary Dam, which was planned by the Japanese government, and also on how the campaign has expanded into a symbol of a nationwide environmental movement to give sufficient stimulus to enliven new campaigns against dam construction projects all over Japan. The author points out that, most problematically, once the public works projects have started, there is no system to alter or stop them, even if the situation has changed. This awareness led the citizens to set up a nongovernmental organization to review public works. The campaign is still active and in progress.
Communicating Cardiovascular Disease Risk Due to Elevated Homocysteine Levels: Using the EPPM to Develop Print Materials
Authors: McKay Diane L. , Berkowitz Judy M. , Blumberg Jeffrey B. , Goldberg Jeanne P.
Published: April 2004

Improving the effectiveness of written information to promote compliance with therapeutic regimens is essential, particularly among older adults. Guiding their development and evaluating their effectiveness with an accepted communication theory or model may help. A preliminary test of written materials developed within the context of the Extended Parallel Process Model (EPPM) to motivate compliant behaviors among older adults at risk for cardiovascular disease is described. Participants who were not previously following the recommendations felt more confident in their ability to do so after reading a high-threat/high-efficacy message. Advanced age, lower education level, an existing chronic illness, and a higher initial homocysteine level were factors associated with lower levels of perceived threat and/or fear and may have attenuated the effectiveness of the message. This study’s results contribute to our understanding of the usefulness of theory-guided written materials in motivating compliant health behaviors. Recommendations for using this model are provided.
Teacher Relocation
Authors: Joslin Pamela
Published: April 2004

This article explores the range of cultural dimensions associated with the process of teacher relocation to an international school outside the ‘home’ country. Reflecting on her own wide-ranging experience, and relevant literature, the author explores the impact of one’s own cultural heritage and professional culture on the relocation process, as well as the notion that successful cultural adaptation is most likely to arise from an ongoing process against a background of continual self-learning which incorporates the development of in-depth understanding of one’s own culture, beliefs and values.
Cultural Borderlands
Authors: Allan Michael
Published: April 2004

This article describes an ethnographic case study carried out in an international school in the Netherlands. Using a model borrowed from school improvement theory, it examines the process factors in an international education leading to both pragmatic and ideological outcomes. The study finds that a largely monocultural school culture, as is found in many international schools, can not only cause problems for students from minority cultures but can also inhibit the intercultural learning of those from the majority student culture.
Developing a Plan for Routine 3-Dimensional Surface Rendering in Obstetrics
Authors: Andrist Laurinda S. , Katz Vern L. , Elijah Rebecca , Farmer Richard M.
Published: April 2004

Objective. To evaluate and describe normal fetal anatomy with surface-rendered 3-dimensional (3D) ultrasound imaging and to try to assess the feasibility and content of a routine 3D examination. Additionally, to determine what standards should be established for routine 3D examination protocols and guidelines for the current technology. Methods. One hundred ten obstetric patients underwent ultrasound examinations using conventional ultrasound equipment adapted for 3D surface imaging. After 84 women were examined, criteria were established for a standard initial 3D screening examination, which was performed on the remaining 26 women. Results. Gestational age ranged from 15 to 33 weeks. Mean examination time was 40 minutes with a range of 30 to 50 minutes. Between 16% and 79% of the targeted structures were successfully visualized per patient. Mean identification was 49%. Conclusion. Three-dimensional ultrasound may become a useful diagnostic tool for routine fetal evaluation in the future. At this time, routine 3D ultrasound examinations would be prohibitive due to lengthy additional examination time and a low percentage of consistent structures visualized.
Pseudoreversal of the Atrioventricular Valves E and A Points
Authors: Drose Julia A. , Hobbins John C. , Shaffer Elizabeth M.
Published: April 2004

Pulsed Doppler evaluation of the atrioventricular valves is standard in a fetal echocardiogram. In the normal fetal mitral and tricuspid valve waveforms, the E point, which reflects passive ventricular filling, is always lower in velocity than the A point, which reflects atrial contraction. In the setting of intrauterine growth retardation, the E and A point relationship may be reversed, with the E point displaying a higher velocity than the A point. It should be borne in mind, however, that improper Doppler interrogation angle may cause a pseudo-reversal of these 2 points. Therefore, meticulous attention should be paid to interrogation angle to avoid the potential of an erroneous diagnosis.
Subdiaphragmatic Extralobar Pulmonary Sequestration
Authors: Bak Darlene Moore , Vest Terri , Hodges Sharon
Published: April 2004

This is a case report of a prenatal observation of subdiaphragmatic extralobar pulmonary sequestration. There are two types of pulmonary sequestration, intralobar and extralobar. Only 10% of extralobar sequestrations are reported to be subdiaphragmatic.
Time Saving and Sonographer Acceptance of PACS in an Ultrasound Department
Authors: Smith Angela M. , Benson Carol B. , Sophis John , Khorasani Ramin
Published: April 2004

To determine the impact on sonographers of converting an ultrasound facility from one that uses film to one that uses a picture archiving and communication system (PACS). Method. This study was conducted in two parts, part 1 to assess sonographer acceptance of PACS and part 2 to measure how much time was spent dealing with film before and after PACS installation. Results. PACS was well received by the sonographers prior to turning off film, and even better received after cessation of printing film. Significant time savings were gained. Four weeks after conversion, the results of the questionnaire were similar to that after cessation of film printing, indicating that the gains as a result of PACS were realized immediately at the time film printing was stopped. Conclusion. Transition to a filmless PACS was well received by sonographers and improved department efficiency. Significant time savings are realized once film printing stopped.
Adrenal Pathology Seen During Pregnancy
Authors: Sanghvi Mahesh
Published: April 2004

Benign pseudocyst of adrenal gland (Ag) during pregnancy can turn into complication of pregnancy when it grows large and ruptures. There are very few cases reported as far as the size and the complex echo pattern seen in the case reported here. We assessed the usefulness of routine ultrasonography for the right upper quadrant (RUQ) and back pain symptoms during pregnancy. Cat scan (CT) was also useful in making the surgical treatment diagnosis in this case. Ultrasonography is a readily available imaging modality that is useful in guiding the correct treatment, localizing, and identifying the mass and the echo pattern before turning to CT scan or any other imaging modality. In this case, although the size and the complex echo pattern of the mass did not make it difficult to diagnose, careful scanning made the correct diagnosis.
Stretch Exercises
Authors: Christenssen Wendy D.
Published: April 2004

Repetitive strain injuries and the signs and symptoms of a musculoskeletal injury are widely recognized as serious hazards for echocardiographers. The aim of this research project was to design, implement, and evaluate an appropriate exercise program and to reduce the reported levels of signs and symptoms that echocardiographers experience in their entire upper body during a working day. Ergonomic task assessments were performed on a group of echocardiographers. The specific muscles that were used were identified, and a stretch exercise program was designed to target those areas. A single blind research study was undertaken with two small groups of echocardiographers with similar work practices. The experimental group was trained in the stretch exercise program and was interviewed monthly while the 12-week study was taking place. The control group was given no information concerning the stretch exercises. Both groups completed pre and post questionnaires and signs and symptoms surveys. At the end of the study, the experimental group reported positive feedback on the stretch exercises and found them very beneficial. A longer, double blind study with more echocardiographers with similar workloads will have to be considered to properly test the designed stretch exercise program and to confirm that it will reduce the reported levels of signs and symptoms of musculoskeletal injury to which echocardiographers are susceptible.
Uterine Fibroid Embolization
Authors: Vitale Jyotsna , Zambuto Domenic
Published: April 2004

Uterine artery embolization is emerging as a primary treatment for symptomatic uterine fibroids. This procedure is performed electively but occasionally is performed emergently in the setting of life-threatening hemorrhage. Most interventional radiologists performing this procedure use ultrasound or magnetic resonance imaging (MRI) for preprocedure evaluation and follow-up. Two case studies report the sonographic and color flow Doppler findings before, immediately after, and 3 months after uterine fibroid embolization (UFE) in an emergent UFE and an elective case. Angiographic and MRI correlation are also provided.
Persistent Cloaca
Authors: Baier Steven R. , Tank Edward S. , Watson Peter T.
Published: April 2004

Hydrometrocolpos is a rare congenital disorder in which excessive mucus secretions accumulate from a genital tract obstruction resulting in cystic dilatation of the vagina and uterus. The spectrum of hydrometrocolpos is broad, ranging from mild cases undetected until adolescence to more severe conditions described prenatally as a large pelviabdominal cystic mass. The authors describe the prenatal sonographic detection of a double cystic pelvic mass subsequently proven to be hydrometrocolpos in a fetus with marked ascites, pyelocaliectasis, pulmonary hypoplasia, and uterine duplication.
Thoracic Abdominal Aortic Dissection as an Incidental Finding on a Routine Renal Ultrasound for Hypertension
Authors: Dempsey Rich
Published: April 2004

Aortic dissection is more common than aortic aneurysmal rupture. Affecting a younger age group than atherosclerotic aneurysms, it is closely associated with hypertension and collagen disorders. Ultrasound is not the primary imaging modality; however, clinically silent aortic dissections may first be detected on routine sonography, initiating a further diagnostic evaluation.
Specialist palliative care needs of whole populations: a feasibility study using a novel approach
Authors: Currow David C , Abernethy Amy P , Fazekas Belinda S
Published: April 2004

Background: Defining whether people with life-limiting illnesses (PLLI) who do not access specialized palliative care services (SPCS) have unmet needs is crucial in planning and evaluating palliative care. This study seeks to establish the viability of a whole-of-population method to help characterize SPCS access through proxy report. Methods: Questions were included in a piloted annual face-to-face health survey of 3027 randomly selected South Australians on the need for, uptake rate of, and satisfaction with SPCS in 2000. The survey was representative of the cross-section of South Australians by age, gender, socioeconomic status and region. Results: One in three people surveyed (1069) indicated that someone ’close to them‘ had died of a terminal illness in the preceding five years. Of those who identified that a palliative service had not been used (38%, 403), reasons cited included family/friends provided the care (34%, 136) and the service was not wanted (21%, 86). Respondents with income Í / AU$60 000 per year were more likely to report that a SPCS had been used (P3/4 / 0.01). People who had cancer as their life-limiting illness were more likely to access SPCS (PB / 0.001). The results generate a model comparing SPCS utilization with client benefit. The survey was acceptable to interviewees. Discussion: Uptake rates of SPCS in this survey are consistent with other South Australian whole population estimates of SPCS utilization. Although there are limitations in this survey approach and the questions asked, this method can be developed to improve our understanding of the characteristics and needs of PLLI and their carers.
An Australian casemix classification for palliative care: technical development and results
Authors: Eagar Kathy , Green Janette , Gordon Robert
Published: April 2004

Objectives: To develop a palliative care casemix classification for use in all settings including hospital, hospice and home-based care. Sample: 3866 palliative care patients who, in a three-month period, had 4596 episodes of care provided by 58 palliative care services in Australia and New Zealand. Method: A detailed clinical and service utilization profile was collected on each patient with staff time and other resources measured on a daily basis. Each day of care was costed using actual cost data from each study site. Regression tree analysis was used to group episodes of care with similar costs and clinical characteristics. Results: In the resulting classification, the Australian National Sub-acute and Non-acute Patient (AN-SNAP) Classification Version 1, the branch for classifying inpatient palliative care episodes (including hospice care) has 11 classes and explains 20.98% of the variance in inpatient palliative care phase costs using trimmed data. There are 22 classes in the ambulatory palliative care branch that explains 17.14% variation in ambulatory phase cost using trimmed data. Discussion: The term ‘subacute’ is used in Australia to describe health care in which the goal — a change in functional status or improvement in quality of life — is a better predictor of the need for, and the cost of, care than the patient's underlying diagnosis. The results suggest that phase of care (stage of illness) is the best predictor of the cost of Australian palliative care. Other predictors of cost are functional status and age. In the ambulatory setting, symptom severity and the model of palliative care are also predictive of cost. These variables are used in the AN-SNAP Version 1 classification to create 33 palliative care classes. The classification has clinical meaning but the overall statistical performance is only moderate. The structure of the classification allows for it to be improved over time as models of palliative care service delivery develop.
A rapid, non-destructive scanning method for detecting distal tephra layers in peats
Authors: Caseldine Chris , Baker Andy , Barnes William L.
Published: April 2004

Rapid, automatic scanning of reflectance variations along peat profiles from Corlea, central Ireland, known to contain prehistoric tephra layers dated to around 2300 cal. bc, has enabled the detection of these layers by non-destructive means. By using both light reflectance and luminescence properties it is believed that very thin and often discontinuous distal tephras characteristic of the Late Quaternary in northwest Europe may be detected within peat profiles.
Plant macrofossils and pollen in goat/sheep faeces from the Neolithic lake-shore settlement Arbon Bleiche 3, Switzerland
Authors: Akeret Örni , Haas Jean Nicolas , Leuzinger Urs , Jacomet Stefanie
Published: April 2004

Over 300 goat/sheep faeces from the Neolithic lake-shore settlement of Arbon Bleiche 3 (3384–3370 bc) were analysed for macrofossils and 22 of them for pollen. Two main types of fodder could be detected, which were both consumed in winter. The more frequent type is characterized by remains of blackberry ( Rubus fruticosus s. l.) probably showing the use of pasture in the near surroundings of the settlement. The second type is dominated by leaf fragments of silver fir ( Abies alba) and by pollen and anthers of early-flowering shrubs such as hazel ( Corylus avellana) and alder ( Alnus sp.), pointing in the latter cases to additional foddering of twigs to livestock inside the settlement in times of shortage. Comparison with other Neolithic sites of Switzerland reveals differences that may indicate local adaptations in the keeping of goats or sheep.
The establishment of Fagus sylvatica at the stand-scale in southern Sweden
Authors: Björkman Leif
Published: April 2004

Pollen analysis was carried out on peat profiles from small forest hollows at four sites in southern Sweden in order to investigate the establishment of Fagus sylvatica at the stand-scale. Viewed on a continental scale the migration pattern of Fagus can be correlated with climatic change, but at finer scales such a correlation is weaker. At the stand-scale there are factors other than climate that are crucial for the establishment of Fagus(e.g., disturbance, seed dispersal, human activities). The establishment of Fagus does not show any regional coherence in southern Sweden, and this may imply that climate was not the limiting factor for its establishment. Fagus seeds are highly dependent on ground disturbance for successful establishment. A semi-open cultural landscape may be optimal for Fagus establishment, as cultural activities may create conditions particularly suitable for its regeneration. At two of the studied sites cultural activities probably created conditions that favoured the establishment of Fagus at 400 and 900 BP respectively. At the other sites the local forest stands were relatively unaffected by cultural activities prior to the establishment of Fagus at 950 BP and 1450 BP respectively, where, fires (natural?) or slight human influence were effective. The present-day distribution of Fagus in southern Sweden suggests migration with a discontinuous front and outlying populations, and this model probably applies to its past distribution. This type of migration means that the landscape becomes filled in by dispersal from outlying stands. The timing of stand-scale establishment is then largely influenced by site-specific factors and chance. Fagus may still be migrating northwards in Sweden. It grows well in its outlying area, and it seems that present-day land use, not climate, is the limiting factor for the local expansion of Fagus. The northern distribution limits of Fagus probably still represent an active front, and outlying stands act as‘infection centres’.
A modern analogue of western United States summer palaeoclimate at 6000 years before present
Authors: Mock Cary J. , Brunelle-Daines Andrea R.
Published: April 2004

A modern summer-climate analogue of western United States 6 ka palaeoclimate, based on broad-scale patterns from proxy data and general-circulation-model simulations, provides details concerning its sum mer synoptic climatology. August 1955 serves as a close analogue, featuring an amplified subtropical ridge aloft and anticyclonic flow near the surface over the central United States and stronger westerly flow along the Canadian/northwest United States border. The August 1955 summer-temperature pattern, similar to those from general-circulation-model simulations, exhibits positive anomalies throughout most of the continental interior. The August 1955 precipitation pattern corresponds very closely with patterns of effective moisture from proxy data, showing widespread aridity and some stronger monsoonal activity in the Southwest. The analogue suggests that the amplified subtropical ridge is a very important feature of 6 ka palaeoclimate, with the circulation pattern differing from that in the early Holocene, implying interactions between both Milankovitch and sub-Milankovitch forcing factors.