bluuebunny/crossref_metadata_2025 huggingface dataset:
Should Health Care be Rationed by Age?
Authors: Nilstun Tore , Ohlsson Rolf
Published: February 2009

Can rationing of health care by chronological age be justified on ethical grounds? The principles of equality, solidarity, liberty and efficiency are used as value premises in the discussion. Health care rationing by age is inconsistent with the principles of equality and liberty. But in some situations such rationing has support from the principles of solidarity and efficiency.

The compromise suggested is that, as a rule, rationing by age should not be permitted, except in situations with intrinsic scarcity (as is the case with transplantation) and in situations with temporary extrinsic scarcity (as was the case with dialysis for a period of time). However, the main purpose is not to defend this position, but to identify and analyze the ethical conflicts such rationing gives rise to.
Differences in Cancer Incidence and Mortality Among Socio-Economic Groups
Authors: van Loon A. Jeanne M. , Burg Johannes , Goldbohm R. Alexandra , van den Brandt Piet A.
Published: February 2009

Objectives: In this article studies on the association between socioeconomic status (SES) and risk for cancer at different sites are reviewed. Methods: The review is restricted to studies conducted in affluent societies, after 1970. Only studies using income, education and/or occupation as SES indicators are included. Results: A more or less consistent positive association between SES and cancer risk was found for colon and breast cancer. More or less consistent inverse associations were found for lung, stomach, oropharyngeal and esophageal cancer. Inconsistent associations were reported for cancer of the rectum and pancreas. Possible explanations for SES differences in cancer risk are discussed with special emphasis on lifestyle variables related to cancer risk. Conclusions: It is concluded that it is still unclear whether the reported associations can be (partially) attributed to lifestyle related risk factors for cancer such as smoking, nutritional habits, drinking habits and reproductive factors.
The age-dependent incidence of injuries due to road traffic accidents in Odense, Denmark from 1980 to 1992
Authors: Larsen Lars B. , Poulsen Thomas K. , Johannsen Hans G.
Published: February 2009

The study was based on data concerning persons treated at Odense University Hospital as a result of road traffic accidents in the period 1980-92. Incidence rates of road traffic accident injuries were calculated on the basis of the population in Odense municipality. The study group included persons older or even 65 years of age, while persons younger than 65 years of age were used as a reference group.
Psychosomatic symptoms in human service work
Authors: Söderfeldt Björn , Söderfeldt Marie , Ohlson Carl-Göran , Warg Lars-Erik
Published: February 2009

This study reports on subjective health of personnel in human services and other occupations. A mail questionnaire was sent to 8296 employees in the Social Insurance Organization (SIO) and the Individual and Family Care (IFC) in social welfare agencies. The response rate was 69.1% or 5730 persons. Perceived health was measured by a standard form widely used in occupational health services, FHV004D, here split into four principal components, indicating psycho-vegetative, musculo-sceletal, immunological, and gastro-intestinal health. In relation to reference data on other human service personnel (nurses, teachers) and white collar workers (bank and insurance personnel), the studied groups scored much higher on psycho-vegetative symptoms (OR:s about 3), higher on musculo-sceletal symptoms (OR:s about 1.7), but had equal scores on the other symptom types. It is concluded that self-reported psychove-getative and musculosceletal health is especially problematic in SIO and IFC, indicating stress in human service work. It is hypothesized that an adversary relation to clients can be an aggravating factor in that context.
Palpitations and lifestyle
Authors: Lochen Maja-Lisa , Rasmussen Knut
Published: February 2009

On the basis of a questionnaire in a population study in the county of Nordland, Norway, the prevalence of palpitations and its associations to some lifestyle factors, depression and self-rated health were analysed. All the 10,497 residents aged 40 to 42 years were invited to participate, 82% attended, 87% of the attenders returned a questionnaire by mail, and 6436 subjects were included in this report. The prevalence of palpitations was 15% in men and 25% in women. Palpitations were significantly associated with coffee consumption, smoking, alcohol intoxication, physical inactivity, depression and poor self-rated health in the univariate analyses. In a logistic regression analysis, the relations between palpitations and lifestyle were weakened. Significant predictors for palpitations were depression and poor self-rated health in both sexes, in addition to heavy coffee drinking and physical inactivity in men and alcohol intoxication in women. In conclusion, palpitations were more firmly linked to depression and self-evaluated health than to lifestyle.
Appraisal, coping, motivational factors and gender in vocational rehabilitation
Authors: Andersson Sven Ingmar
Published: February 2009

The applicability of a model of appraisal and coping was studied in vocational rehabilitation patients ( n = 31 :16 men, 15 women); the selection of patients aimed at obtaining a representative patient group for studying coordinated rehabilitation within various health care districts in southern Sweden. There were four phases of data collection and model adjustment. An initial, semi-structured interview concerned various key topics (program evaluation; causal attribution regarding the problem or disease; life-crises, threats, mobbing and unjust treatment; feeling of control; current situation; future; how the interview was experienced). The second phase involved a questionnaire study of hypochondriacal and depressive symptomatology, the third the analysis of patient records, and the fourth outcome data on sickness allowances and disability pensions at a 2-year follow-up. The results indicate the importance for rehabilitation of attending to motivational factors that influence the patients' coping strategies and appraisal, and to cultural (immigrant) and gender perspectives.
Foreign- and Swedish-born diabetic patients — a population-based study of prevalence, glycaemic control and social position
Authors: Hjelm Katarina , Isacsson Ake , Apelqvist Jan , Sundquist Jan , Nyberg Per
Published: February 2009

In this study foreign- and Swedish-born individuals with diabetes mellitus were compared regarding prevalence and characteristics. In a Swedish county 1,568 patients aged 20-64 years were identified, of whom 97.4% were included (143 foreign- and 1,384 Swedish-born) in the study of medical records. There was no difference in prevalence of diabetes (1.4% (95% CI 1.2-1.7%) vs 1.5% (95% CI 1.4-1.6%)) but diagnosis at or after the age of 30 years was more common in foreign-born patients ( p<0.001). They were also less often treated with insulin ( p<0.001), had shorter duration of diabetes ( p<0.001), were more often classified as having a low social position in Sweden ( p<0.001) and less often controlled in specialized diabetes care departments ( p<0.001, 18% vs 43%). There was a higher occurrence of albuminuria among foreign-born women ( p<0.05). No differences were found in glycaemic control, but low social position was related to poor glycaemic control independent of being foreign- or Swedish-born, and it seems to be more important than place of birth.
Physical disease among 21 suicide cases
Authors: Hörte Lars Gunnar , Stensman Richard , Sundqvist-Stensman UllaBritt
Published: February 2009

In an earlier study made in Uppsala, it was found that in 17% of suicide cases there was a correlation between the suicidal act and serious physical disease. To obtain a deeper knowledge of this, an interview study among relatives and/or friends of 21 patients who had committed suicide was performed. Variables studied were: demographic data, somatic diagnoses, psychiatric diagnoses, contact with the medical sector, earlier suicidal signals, and the correlation between the suicidal act and the physical disease. The provision of inadequate medical treatment was sought. The persons who had committed suicide were allocated to one of three groups according to the degree of correlation between suicidal act and physical disease. “Very strong” correlation was found for five persons, “rather strong” for nine persons, and “weak” for five persons. We found that physical disease was seldom decisive for the suicidal act. Medical treatment was experienced as inadequate in nine cases. Since there is reason to believe that physical disease is an important complicating risk factor for suicide, it is important to be aware of anxiety in patients and their relatives, give plenty of time for information, show empathy and give the care-providers a sense of security to avoid suffering and reduce suicidal acts.
Outcome of aged patients in Finnish supervised home care
Authors: Karppi Pertti , Tilvis Reijo
Published: February 2009

The purpose of this stydy was to identify predictors of mortality and institutionalization in aged patients receiving Finnish supervised home care. The study was carried out in Central Finland, whose area and population is 5% of the total of the country. The subjects consisted of a sample of 312 patients (65 years or more). They were originally assembled to assess the effectiveness of a geriatric inpatient unit, the results of which have been published previously. Deaths were ascertained over at least three years and long-term care institutionalization over two years. The most powerful predictor of mortality was impaired ADL functioning. Predictors of long-term institutional care were impaired ADL functioning, impaired cognition and depression. These data may be helpful in resource allocation and targeting patients for the supervised home care programmes.
Incidence of falls in three different types of geriatric care
Authors: Nyberg Lars , Gustafson Yngve , Janson Anders , Sandman Per-Olof , Eriksson Sture
Published: February 2009

The incidence and consequences of falls were investigated in three different types of Swedish geriatric care clinics: a geriatric rehabilitation clinic, a psychogeriatric clinic and a nursing home. Falls were prospectively registered by the nursing staff. The incidence rate (and 95% confidence interval) of falls per 10,000 patient days of the psychogeriatric clinic was 171 (146–196), compared with 92 (72–112) at the geriatric rehabilitation clinic, and 31 (22–41) at the nursing home. Most falls (62%) did not result in injury, while major injuries occurred in 5%. We conclude that accidental falls are a major problem in geriatric care in Sweden, but there is a considerable difference in incidence rates between different types of institutions.
Prevalence and trends in homosexual behaviour in Norway
Authors: Marit B Veierød , Anne Eskild , Hein Stigum , Johannes Thorvaldsen , Per Magnus
Published: February 2009

The three main objectives of this study were to estimate the proportion of the Norwegian population with experience of homosexual behaviour, to study the degree of change in sexual practices among homosexual men during a 5-year period and to study the degree of change in sexual practices reported by HIV positive homosexual men from before to after awareness of HIV-positivity. The data comes from two questionnaire surveys (in 1987 and 1992) of sexual behaviour in the general population of Norway and a questionnaire study of sexual behaviour before and after awareness of HIV-positivity among HIV-positive homosexual men taking part in a cohort study starting in 1988 (the Oslo HIV cohort study). Estimation of the proportion of subjects with homosexual experience was made as well as a trend analysis of the number of male sexual partners per year, number of intercourses per month, condom use and anal sex.

Among men aged 18 to 60 from the general population, 3.8% reported homosexual practice during lifetime and 1.2% during the past 3 years. Among women, the same percentages were 3.1 and 1.0. In the surveys, the number of male partners per year decreased significantly for men with current homosexual experience from a yearly median of 1.0 in 1987 to 0.3 in 1992 ( p = 0.02). Among HIV-positives, the number of male partners decreased from a yearly median of 4.3 before to 1.6 after awareness of HIV-seropositivity ( p<0.01). Among HIV-positives, a significant increase in the use of condoms, a decrease in the number of intercourses and a decrease in the frequency of anal sex was found. The results show that some changes in sexual practice may have occurred among homosexual men in general in the period from 1987 to 1992, and that more significant changes may have occurred for HIV-positive men. The present data do not support other findings of a relapse to more unsafe sex, but suggest that there is still a need to keep modifying behaviour in order to stop the spread of HIV among men who have sex with other men.
Psychic and socioeconomic consequences with diabetes compared to other chronic conditions
Authors: Wändell Per E , Brorsson Bengt , Åberg Hans
Published: February 2009

The present study relies on data for the years 1988 and 1989 from the Swedish continuous Surveys of Living Conditions (SLC), which are based on random samples from the population among individuals aged 16 through 84 years. We compared the rates of self-reported mental health for subjects reporting diabetes ( n = 361), a musculoskeletal condition but without diabetes ( n = 2187), hypertension but without diabetes ( n = 980), and healthy free from any medical condition ( n = 6654). Comparisons are based on age- and gender-standardized rates, using the diabetes group as standard. The results show that more diabetic respondents had psychic symptoms and long-standing psychiatric disorders than the healthy respondents, with otherwise no differences compared to the other chronic conditions. The diabetic respondents had lower mean disposable income, and a higher rate of disability pension than the respondents with hypertension, and than the healthy. They also reported more sick leave days than the healthy respondents.
Occupation-specific morbidity of musculoskeletal disease in Norway
Authors: Brage Søren , Bjerkedal Tor , Bruusgaard Dag
Published: February 2009

The aim of this study was to investigate the occupation-specific prevalence of musculoskeletal disease in Norway. A cross-sectional interview survey of a representative sample of households in Norway in 1985, including 6,681 persons, 16 to 66 years old was carried out. Age-standardised, occupation-specific prevalence ratios for musculoskeletal disease were calculated.

Musculoskeletal diseases were more frequent in women (20.6%) than men (17.3%), and increased markedly with age. In men, the prevalence was highest for construction carpenters; in women, for manufacturing/construction workers. In both male and female occupations, the highest prevalence of musculoskeletal diseases was approximately two-fold that of the lowest. Health-related exits from the labour force, and mobility between occupations influenced the results. It is suggested that the high disability pensioning and sickness absence rates observed in some occupations are related to occupation-specific consequences of disease in addition to higher morbidity.
Health-related social mobility
Authors: Rahkonen Ossi , Arber Sara , Lahelma Eero
Published: February 2009

Selective health-related social mobility has been suggested as one possible explanation for health inequalities. The aim of this paper is to examine the size and significance of the contribution which health-related social mobility makes to social class differences in health. We do this by examining the association between intergenerational social mobility and health among currently employed men and women in Britain and Finland. We used comparable nationally representative interview surveys from Britain and Finland. The British data is derived from the General Household Survey for 1988 and 1989, and the Finnish data from the 1986 Survey on Living Conditions. Health measures included limiting long-standing illness and self-assessed health as below good. Social mobility was measured comparing the respondent's class of origin (father's occupation) with his/her class of destination (own current occupation). Social structural changes and related social mobility have been more dramatic in Finland than in Britain during the last few decades. Downward mobility has been relatively rare, and mobility has taken place predominantly upwards. In Finland downward mobility from upper non-manual to manual worker was associated with a somewhat higher risk of limiting long-standing illness than expected among men as well as women. However, there was no statistically significant interaction effect on health between the respondent's father's occupational class and his/her own current class. In Britain, neither self-assessed health nor limiting long-standing illness were related to social mobility. Some weak evidence for health-related downward social mobility was found for currently employed Finnish men and women, but not for their British counterparts. Moreover, the evidence is weaker for self-assessed health than for limiting long-standing illness. Where social mobility may have been health-related, it concerns very rare and small groups; therefore health inequalities among the currently employed cannot be explained by intergenerational health-related social mobility.
Social support and the smoking behaviour of parents with preschool children
Authors: Eriksen Willy , Sandvik Leiv , Bruusgaard Dag
Published: February 2009

In a study of the relationship between social support and smoking behaviour, 1046 parents coming with their children for well-child control at health centres in Oslo, Norway, completed a questionnaire. The prevalence of daily smoking increased with decreasing social support. However, this association did not remain significant when adjusting for demographic and household characteristics. Among smoking parents, indoor smoking at home was related to medium (OR=1.97; CI: 1.01-3.81) and low social support (OR=2.35; CI: 1.19-4.63) when adjusting for demographic and household characteristics. Smoking parents smoked more cigarettes per day when they had low social support. However, this association was only seen in parents with several children. In this group, smoking 10 cigarettes per day or more was strongly related to medium (OR = 5.05; CI: 1.66-15.35) and low social support (OR=7.81; CI: 2.44-25.01).
Why is prevention so difficult and slow?
Authors: Allander Erik , Lindahl B. I. B.
Published: February 2009

abundance of perceived “possibilities” for prevention rasts sharply with the difficulties that face preventive grammes. We argue that this situation has emerged from incomplete understanding of the process of prevention, Iving a mixture of biological factors, human decisioning and time perspectives. Based on examples, anlysis of the factors in the prevention process is presented.
Associations of health-related behaviors, school type and health status to physical activity patterns in 16 year old boys and girls
Authors: Aarnio M. , Kujala U. M. , Kaprio J.
Published: February 2009

Sedentary behavior often begins in childhood and is associated with the development of risk factors for many chronic diseases in adulthood. Physical activity is considered important in the prevention of unfavorable changes in the risk factors. We investigated whether health-related behaviors, school type and health status are associated to physical activity among adolescents. A questionnaire was sent to all Finnish 16-year-old twins in 1991–93. A total of 3,254 twins responded. The response rate was 88%. Physical activity was classified into five categories (very active, active, moderately active, hardly active, inactive) based on self-reported frequency and intensity of physical activity. The analysis considered all subjects as individuals. Smoking was strongly associated with physical activity among girls and boys. Those who smoked regularly were less active. The type of school was also associated with physical activity. In general, those who attended comprehensive school or high school were physically more active, while those in vocational schools, particularly boys, were less active. Girls in lower physical activity groups reported more psychosomatic symptoms. Associations of self-reported health-related behaviors, school type and health status to physical activity seem to be the same among boys and girls. However, as the more active students are in comprehensive school or high school and the less active in vocational school, and physical inactivity is related to smoking and use of alcohol, health education should be tailored by school type.
Regional differences in long-term mortality among hospital-treated asthma and COPD patients
Authors: Tuuponen Tuili , Keistinen Timo , Kiveläa Sirkka-Liisa
Published: February 2009

Chronic obstructive pulmonary diseases, which have increased due to smoking and ageing of the population, constitute a national health problem, the treatment of which can be expected to arouse considerable discussion in health care organisations currently preoccupied with economic problems. Although extensive medication and easy access to treatment are often regarded as therapeutically desirable, it may be questioned whether they have any impact on objective measures such as mortality. International recommendations for the early treatment of asthma have met with satisfaction and the asthma situation can be said to be under control, even though occurrences tend to be on the increase. It should be noted, however, that the COPD treatment recommendations still remain to be tested and the general attitude towards treatment is still reserved, even pessimistic. By combining data from the Finnish national hospital discharge register and register of deaths with findings regarding the use of medications, differences in the survival of asthmatic and COPD patients can be discerned between areas with different treatment practices. Stressing the fact that effect-differences between different treatment strategies can not be proven on the basis register data and that random clinical trials are needed to gain further knowledge in the field, our results show that extensive medication and easy access to treatment are characteristic of areas where the survival of asthmatics and COPD patients is better.
Holism reconsidered
Authors: Nordenfelt Lennart
Published: February 2009

In his article Weak and Strong Holism, Inge-Bert Täljedahl criticises some modern theories of health which define health without reference to disease. As an alternative he suggests a kind of theory called Strong holism which emphasises the lawful interrelations between all ontological layers in the human being. In this reply it is argued (1) that Taljedahl does not accurately describe the contents and intentions of the criticised theories and (2) that he does not put forward any alternative theory of health. Strong holism, as characterised by Täljedahl, is a general biological and social-biological research programme, which is very fruitful for scientific research projects, but which does not suggest any particular theory of health.
Reliability and validity assessments of measures of social networks, social support and control — results from the Malmö Shoulder and Neck Study
Authors: Hanson Bertil S. , östergren Per-Olof , Elmståhl Sölve , Isacsson Sven-Olof , Ranstam Jonas
Published: February 2009

The reliability and validity of methods to assess social networks, social support and control were investigated in a population of 12,009 females and males born between 1926 and 1945 (the “Malmö Shoulder and Neck Study”). This study demonstrated an overall reliability with kappa coefficients between 0.70 and 0.47, but the reliability was more varying among females and lower in the youngest age group. The analysis of the construct validity indicated that the different indices measure different aspects of the psychosocial environment, but both theoretical and methodological problems were identified, when the validity of multidimensional concepts are to be determined. The validity of such indices can best be judged by combining quantitative and qualitative methods. Potential validity problems must be kept in mind when these indices are used in epidemiological research. The results from the reliability analysis call for repeated assessments and the sample size must be adjusted vis-à-vis the reliability.
Spatial statistical analysis of Chinese cancer mortality
Authors: Lai Dejian
Published: February 2009

In this paper, we study a nonparametric spatial pattern test statistic, the D statistic. The D statistic is an effective test statistic for testing spatial patterns in regional health data. Comparison studies of the D statistic with fixed weights and random weights are illustrated on the atlas of the Chinese cancer mortality rates and on other cancer atlas. Some social, economic and environmental reasons for statistically significant spatial autocorrelations of the Chinese cancer mortality rates were given in the discussion section. The method for calculating the mean and the variance of the randomly weighted D statistic is given in the appendix.
Psychosocial resources and persistent alcohol consumption in early pregnancy — a population study of women in their first pregnancy in Sweden
Authors: Dejin-Karlsson Elisabeth , Hanson Bertil S , östergren Per-Olof
Published: February 2009

The aim of the study was to test the impact of psychosocial resources on pregnant women, regarding continued alcohol consumption. The study is based on a one-year cohort of nulliparas followed during pregnancy. From a total of 994 invited women 872 (87.7%) agreed to participate in the study. All women who reported any alcohol consumption within the twelve months prior to the administration of the questionnaire were included in this study population ( n = 692, 79.4%). 32.8% of the alcohol consumers continued to drink during pregnancy even though the alcohol intake was moderate. In spite of the official Swedish alcohol recommendation for total abstinence during pregnancy, more socially active, and more highly educated women continued drinking alcohol, with wine being the beverage of choice, maybe more as social behavior rather than to cope with stress caused by insufficient psychosocial resources. Younger women or those with fewer years of education tended to stop drinking to a higher degree, but those who continued to drink tended to drink beer or to binge.
Daughters and sons as caregivers for their demented and non-demented elderly parents. A part of a population-based study carried out in Sweden
Authors: Jansson Wallis , Grafström Margareta , Winblad Bengt
Published: February 2009

The study focuses on adult children ( n = 81) having the main responsibility for parents with dementia (study group). They were compared with children ( n = 102) of non-demented parents (reference group). The children were interviewed about burden experienced. The interviews also secured information about the children's co-operation with the informal and formal network and their willingness to remain as caregivers during the progression of the disease or ageing process. The results showed that the daughters reported feeling more affection in their caregiving role than the sons. About one third of the participants in the study could not get relief from someone else. Eighty-nine per cent of the children in the study group and 76% of the children in the reference group were not willing to care for their parents in the family home during the progression of the disease, even if they were employed as caregivers.
Prediction of Polyethylene Molecular Weight and Molecular Weight Distribution Using Capillary Rheometer
Authors: Todd William G. , Olenius Victor L. , Merrick-Mack Jean A.
Published: February 2009

Polyethylene is characterized by molecular weight (MW), molecular weight distribution (MWD), and density. Melt index (MI2) is measured in the quality control (QC) lab and is used as an indication of resin MW. Melt flow ratio (MFR or MI20/MI2) is a calculated QC lab number, which is used as an indication of MWD. Density is a measure of crystallinity. This article shows that a capillary rheometer can provide a fast and reliable method on a production line to control MW and MWD by predicting MI2 and MI20 for a resin within specific ranges of density, melt index and equipment/catalysts.
Control of the Thickness Distribution of Blown Film By Changing the Flow Channel Gap of the Die Over the Circumference
Authors: Gross Heinz G.
Published: February 2009

The thickness distribution of blown film is conventionally controlled by either changing the temperature or the velocity of the cooling air. This technique cannot be used for the double bubble process, where the film is cooled by water before being reheated and blown up in a second step. A new technique to alter the localized gap of the flow channel at the exit of the die has been developed. It can be used to control the thickness over the circumference of the blown film for both the conventional and double bubble process. The technology is explained and initial test results achieved are presented herein.
Novel Polycaprolactone Nanocomposites Containing Thymol of Interest in Antimicrobial Film and Coating Applications
Authors: Sanchez-Garcia M.D. , Ocio M.J. , Gimenez E. , Lagaron J.M.
Published: February 2009

It is well-known that the nanocomposites technology can significantly enhance, among others, the thermal, mechanical, and barrier properties of plastics. It is also known that most bioplastics, including the thermoplastic biopolymers, have lower than desired levels for certain properties which makes their use in certain packaging applications problematic. The combination of active technologies such as antimicrobials and nanotechnologies such as nanocomposites can synergistically lead to bioplastic formulations with balanced properties and functionalities for their implementation in packaging applications. The present work presents the development and characterization of novel nanocomposites of polycaprolactone with enhanced barrier properties and with controlled-release of the biocide natural extract thymol. The antimicrobial nanocomposites of biodegradable materials were prepared in solution by a casting method. The morphology of the biocomposites was visualized by transmission electron microscopy and by atomic force microscopy, the thermal properties were investigated by differential scanning calorimetry and the relative uptake (solubility) and kinetics (diffusion) of the released biocide were determined by Attenuated Total Reflection Fourier Transformed Infrared spectroscopy. Water, oxygen, and limonene barrier properties were also enhanced in the biocomposites.
Leveraged Buyouts and Private Equity
Authors: Kaplan Steven N , Strömberg Per
Published: February 2009

In a leveraged buyout, a company is acquired by a specialized investment firm using a relatively small portion of equity and a relatively large portion of outside debt financing. The leveraged buyout investment firms today refer to themselves (and are generally referred to) as private equity firms. We describe and present time series evidence on the private equity industry, considering both firms and transactions. We discuss the existing empirical evidence on the economics of the firms and transactions. We consider similarities and differences between the recent private equity wave and the wave of the 1980s. Finally, we speculate on what the evidence implies for the future of private equity.
Microfinance Meets the Market
Authors: Cull Robert , Demirgüç-Kunt Asli , Morduch Jonathan
Published: February 2009

In this paper, we examine the economic logic behind microfinance institutions and consider the movement from socially oriented nonprofit microfinance institutions to for- profit microfinance. Drawing on a large dataset that includes most of the world's leading microfinance institutions, we explore eight questions about the microfinance “industry”: Who are the lenders? How widespread is profitability? Are loans in fact repaid at the high rates advertised? Who are the customers? Why are interest rates so high? Are profits high enough to attract profit-maximizing investors? How important are subsidies? The evidence suggests that investors seeking pure profits would have little interest in most of the institutions we see that are now serving poorer customers. We will suggest that the future of microfinance is unlikely to follow a single path. The recent clash between supporters of profit-driven Banco Compartamos and of the Grameen Bank with its “social business” model offers us a false choice. Commercial investment is necessary to fund the continued expansion of microfinance, but institutions with strong social missions, many taking advantage of subsidies, remain best placed to reach and serve the poorest customers, and some are doing so at a massive scale. The market is a powerful force, but it cannot fill all gaps.
The Economics of Structured Finance
Authors: Coval Joshua , Jurek Jakub , Stafford Erik
Published: February 2009

This paper investigates the spectacular rise and fall of structured finance. The essence of structured finance activities is the pooling of economic assets like loans, bonds, and mortgages, and the subsequent issuance of a prioritized capital structure of claims, known as tranches, against these collateral pools. As a result of the prioritization scheme used in structuring claims, many of the manufactured tranches are far safer than the average asset in the underlying pool. This ability of structured finance to repackage risks and to create “safe” assets from otherwise risky collateral led to a dramatic expansion in the issuance of structured securities, most of which were viewed by investors to be virtually risk-free and certified as such by the rating agencies. At the core of the recent financial market crisis has been the discovery that these securities are actually far riskier than originally advertised. We examine how the process of securitization allowed trillions of dollars of risky assets to be transformed into securities that were widely considered to be safe. We highlight two features of structured finance products—the extreme fragility of their ratings to modest imprecision in evaluating underlying risks, and their exposure to systematic risks—that go a long way in explaining the spectacular rise and fall of structured finance. We conclude with an assessment of what went wrong and the relative importance of rating agency errors, investor credulity, and perverse incentives and suspect behavior on the part of issuers, rating agencies, and borrowers.
Uncovering the Requirements of Cognitive Work
Authors: Roth Emilie M.
Published: February 2009

Objective: In this article, the author provides an overview of cognitive analysis methods and how they can be used to inform system analysis and design. Background: Human factors has seen a shift toward modeling and support of cognitively intensive work (e.g., military command and control, medical planning and decision making, supervisory control of automated systems). Cognitive task analysis and cognitive work analysis methods extend traditional task analysis techniques to uncover the knowledge and thought processes that underlie performance in cognitively complex settings. Methods: The author reviews the multidisciplinary roots of cognitive analysis and the variety of cognitive task analysis and cognitive work analysis methods that have emerged. Results: Cognitive analysis methods have been used successfully to guide system design, as well as development of function allocation, team structure, and training, so as to enhance performance and reduce the potential for error. Conclusions: A comprehensive characterization of cognitive work requires two mutually informing analyses: (a) examination of domain characteristics and constraints that define cognitive requirements and challenges and (b) examination of practitioner knowledge and strategies that underlie both expert and error-vulnerable performance. A variety of specific methods can be adapted to achieve these aims within the pragmatic constraints of particular projects. Application: Cognitive analysis methods can be used effectively to anticipate cognitive performance problems and specify ways to improve individual and team cognitive performance (be it through new forms of training, user interfaces, or decision aids).
Untersuchungen zu einem lokalen optischen PositionierungssystemInvestigations for a Local Optical Positioning System
Authors: Fuhrland Matthias
Published: February 2009

Der Artikel beschreibt ein Prinzip zur 3D-Positionsbestimmung durch Pseudostreckenmessung mit Hilfe ultrakurzer Laserpulse. Ziel der Entwicklung ist ein lokales optisches Positionierungssystem (LOPS). Laserpulse werden hochdivergent ausgesandt zu vier Detektoren mit jeweils bekannter Position. Es gilt, die 3D-Position der Laserquelle zu bestimmen. Ein TCSPC-System (time-correlated single photon counting) wird verwendet, um die differenzielle Laufzeit des Laserpulses zwischen den vier Detektoren zu bestimmen. Die untersuchten Problemstellungen betreffen die notwendige Pulsleistung, die Pulsbreite und die Strahlformung. Es werden vergleichende Untersuchungen verschiedener ps-Laserpulser, Detektortypen und TCSPC-Systeme sowie die Entwicklung einer elastischen Optik gezeigt.
Alcohol effects on family relations: a case study
Authors: Reinaldo Amanda Márcia dos Santos , Pillon Sandra Cristina
Published: February 2009

Problems related to alcohol abuse have been associated to different factors, regardless of the causes attributed to this phenomenon. Alcohol consumption and dependence is considered a public health problem and deserve attention because of the social, work, family, physical, legal and violence-related risks it represents. This study aimed to identify the effects of alcoholism on family relations and, by means of case management, to encourage the recovery of these relationships. The results show that the problems caused by alcohol abuse impose profound suffering to family members, which contributes to high levels of interpersonal conflict, domestic violence, parental inadequacy, child abuse and negligence, financial and legal difficulties, in addition to clinical problems associated to it.
Undergraduate students' motivations for the consumption of legal drugs
Authors: Hernández Rodríguez Verónica Margarita , Scherer Zeyne Alves Pires
Published: February 2009

This qualitative research aimed at identifying conceptions held by undergraduate students regarding the term motivation, and motives leading them to the consumption of legal drugs. Data were collected through a questionnaire with four open questions, applied to 15 students of a public university in the central region of Mexico. In order to perform the data analysis, answers were classified in two categories: a) Undergraduate students' conceptions regarding the term motivation and b) Undergraduate students' conceptions regarding the motives for consumption. Such analysis indicated that students identify two types of motivations: external and internal. The external motivation includes family, mass media and friends; whereas internal motivation includes personal characteristics, need of belonging, curiosity, pleasure and idleness.
Nursing students' premature pregnancy and consumption of alcohol
Authors: Alvarez Martha Lucio
Published: February 2009

This qualitative descriptive research aimed to analyze pregnancy dynamics, experienced by a group of women who, at the time, were at most 19 years old, and identify the role attributed to the consumption of alcohol in such dynamics. The research was developed with a group of 20 students from the Colombia National University. Six of them were selected for in dept investigation through interviews, which were analyzed by content analysis. Based on the literature and the subjects' life history, the study examines the following categories: pregnancy, making love, maternity, being a woman, and drinking. Through these categories, was possible to identify the dynamics experienced by these women during pregnancy.
Persistent organochlorine pollutants and toxaphene congener profiles in bottlenose dolphins (Tursiops truncatus) frequenting the Turtle/Brunswick River Estuary, Georgia, USA
Authors: Pulster Erin L. , Smalling Kelly L. , Zolman Eric , Schwacke Lori , Maruya Keith A.
Published: February 2009

Although the Turtle/Brunswick River Estuary (TBRE) in coastal Georgia (USA) is severely contaminated by persistent organochlorine pollutants (POPs), little information regarding POPs in higher-trophic-level biota in this system is available. In the present study, polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs; including DDTs, chlordanes, and mirex), and chlorinated monoterpenes (toxaphene) were measured using gas chromatography with electron-capture detection and gas chromatography with electron-capture negative ion mass spectrometry (GC-ECNI-MS) in blubber of free-ranging and stranded bottlenose dolphins (Tursiops truncatus). Mean total PCBs (78.6 ± 32.4 μg/g lipid) and toxaphene (11.7 ± 9.3 μg/g lipid) were significantly higher in dolphins sampled in the TBRE than in dolphins stranded near Savannah (GA, USA) 80 to 100 km to the north. Levels of OCPs were several-fold lower than levels of PCBs; moreover, PCBs comprised 81 and 67% of the total POP burden in TBRE and non-TBRE dolphins, respectively. Analyses with GC-ECNI-MS revealed that 2,2,5-endo,6-exo,8,8,9,10-octachlorobornane (P-42a), a major component in technical toxaphene and a major residue congener in local estuarine fish species, was the most abundant chlorobornane in both sets of blubber samples. Mean total POP concentrations (sum of PCBs, OCPs, and toxaphene) approached 100 μg/g lipid for the TBRE animals, well above published total PCB thresholds at which immunosuppresion and/or reproductive anomalies are thought to occur. These results indicate extended utilization of the highly contaminated TBRE as habitat for a group of coastal estuarine dolphins, and they further suggest that these animals may be at risk because of elevated POP concentrations.
Ontogeny of FOXP3+ Regulatory T Cells in the Postnatal Human Small Intestinal and Large Intestinal Lamina Propria
Authors: Weitkamp Jörn-Hendrik , Rudzinski Erin , Koyama Tatsuki , Correa Hernan , Matta Pranathi , Alberty Brannon , Polk D-Brent
Published: February 2009

FOXP3+ regulatory T cells (Treg) suppress innate and adaptive immune responses and are critical for intestinal immune homeostasis. Our objective was to define the postnatal developmental regulation of Treg in relationship to other T cells in the human intestinal tract. We analyzed 41 small and 18 large intestinal paraffin-embedded tissue samples from preterm and term infants with and without necrotizing enterocolitis (NEC) for the presence of CD3+, CD4+, CD8+, and FOXP3+ cells by immunohistochemistry. We compared labeled cells against age, gestational age (GA), or (corrected) postmenstrual age (PMA). The GA ranged from 23 to 40 weeks, with a mean of 32 (standard deviation, 4.7) weeks. Independent of age, GA, or PMA, the numbers of CD4+ cells were higher in the small intestine compared to the large intestine ( P = 0.046), except in patients with NEC. FOXP3+ cells could be detected as early as 23 weeks in GA in both large and small bowel, and similar quantities were detected at the highest GA examined (40 weeks). We saw no statistically significant effect of GA, age, or PMA on total number of FOXP3+ cells or by comparing FOXP3+ to CD4+ or FOXP3+ to CD8+ ratios, indicating intact ontogeny of Treg in intestinal tissue early in gestation. Human infants exhibit presence of mucosal FOXP3+ cells in the small and large intestinal mucosa at birth and as early as 23 weeks GA. The frequency of FOXP3+ cells and the ratios of FOXP3+ to CD4+ or CD8+ cells do not change with increasing intrauterine development or postnatal age.
Antimicrobial resistance in bacteria
Authors: Bockstael Katrijn , Aerschot Arthur
Published: February 2009

The development of antimicrobial resistance by bacteria is inevitable and is considered as a major problem in the treatment of bacterial infections in the hospital and in the community. Despite efforts to develop new therapeutics that interact with new targets, resistance has been reported even to these agents. In this review, an overview is given of the many therapeutic possibilities that exist for treatment of bacterial infections and how bacteria become resistant to these therapeutics.
The production of reactive oxygen species in peripheral blood neutrophils is modulated by airway mucous
Authors: Babusyte Agne , Jeroch Jolanta , Stakauskas Rimantas , Sakalauskas Raimundas
Published: February 2009

Neutrophils are a major source of reactive oxygen species (ROS). The role of airway mucous on ROS production is unknown. The aim of our study was to investigate the direct influence of bronchoalveolar lavage fluid (BALF) and induced sputum (IS) alone or in combination with chemical/biological stimulus on ROS production in peripheral blood neutrophils during chronic obstructive pulmonary disease (COPD). Neutrophils were isolated from peripheral blood of 47 patients with moderate COPD and 14 healthy individuals (HI). BALF/RPMI (1:1) or IS/RPMI (1:1) from COPD patients were used to stimulate neutrophils alone or in combination with phorbolmyristate- acetate (PMA) (0.1–30 nM) or Staphylococcus aureus bacteria (0.7–500 bact/neutrophil). Relative generation of ROS was measured flow cytometrically. BALF/RPMI and in combination with relatively low PMA or all bacteria concentrations stimulated ROS; while, combination with relatively high PMA concentrations suppressed ROS in of COPD patients and HI. IS/RPMI and its combination with PMA inhibited ROS generation in both groups; whereas, IS stimulated or had a tendency to stimulate ROS production with relatively high bacteria concentrations. In conclusion, BALF and IS directly or in combination with chemical/biological factors modulated ROS production. This effect was stronger in neutrophils from COPD patients and depended on chemical/biological stimulus intensity.
Blood pressure increase detected by ambulatory monitoring correlates with hypoxemia reflecting sleep apnea severity
Authors: Grešová Soňa , Tomori Zoltán , Kurpas Martin , Marossy Alexander , Vrbenská Adela , Kundrík Martin , Donič Viliam
Published: February 2009

Ambulatory blood pressure monitoring and parallel polysomnographic study were performed in 116 adult males divided into 6 groups. Thirty blood-pressure (BP) and polysomnographic variables were measured to test their usefulness for screening for both arterial hypertension and sleep apnea-hypopnea syndrome (SAHS). The development of severe breathing disorders and hypoxemia during sleep was attributed to SAHS, when compared with measurements in healthy controls and in patients with arterial hypertension. Such disorders manifested as an increased apnea-hypopnea index, apnea index, duration of arterial oxygen saturation of less than 85%, and decrease of average arterial oxygen saturation that correlated with nocturnal average diastolic BP (p=0.0049, p=0.0027, p=0.049 and p=0.0457, respectively). These respiratory disorders resulted in various nocturnal, rather than diurnal, and diastolic and systolic BP variables. The acute antihypertensive effect of continuous positive airway pressure therapy for SAHS significantly reduced the episodes of apnea and hypopnea and the secondary component of hypertension caused by excessive sympathetic stimulation. For the SAHS-induced, dose-dependent component of hypertension that responded to continuous positive airway pressure, the following variables, in decreasing significance, were useful: nocturnal average systolic and diastolic BP and 24-hour average systolic and diastolic BP, as well as percent time elevation and mean blood pressure load. The monitoring of these variables could contribute to early diagnostic and prognostic stratification of complications and adequate therapy of the secondary component of hypertension caused by SAHS.