bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case of Ophthalmoplegic Migraine With Ipsilateral CT‐Documented Hypodense Lesions
Authors: Moretti Giacomo , Scoditti Umberto , Rustichelli Paolo , Manzoni Gian Camillo , Parma Mario
Published: June 2005

SYNOPSIS

The case of a young woman whose clinical picture was suggestive of ophthalmoplegic migraine is reported. In light of an unprecedented finding of two CT documented transient hypodense lesions in the hemisphere ipsilateral to the oculomotor paralysis, the prevalent theories about the pathogenesis of ophthalmoplegia in this type of migraine are reviewed.
Unusual Transient High and Low Density CT Lesion in Migraine: A Case Report
Authors: Jain S. , Ahuja G.K.
Published: June 2005

SYNOPSIS

In a patient suffering from classical migraine, an unenhanced CT scan done a few hours after a recentepisode of headache revealed a low‐density area in the right occipital region. On contrast enhancement, apeculiar high‐density lesion surrounded by a large low‐density area was seen in the same region. This CTscan abnormality totally disappeared spontaneously within two months. Such lesions have been seen inpatients suffering from epilepsy. The possible pathogenetic mechanism is a localized disruption in theblood‐brain barrier during the phase of vasoconstriction. Such a CT scan abnormality in patients sufferingfrom migraine has not been reported earlier.
The Validity of the Vascular "Cold Patch" in the Diagnosis of Chronic Headache
Authors: Swerdlow Bernard , Dieter John Nathan
Published: June 2005

SYNOPSIS

“Cold patches” in the external carotid territory previously have been described to have been associatedwith vascular‐related headaches. This study utilizes electronic thermography to examine the relationship.A sample of 275 patients diagnosed as having: vascular, scalp muscle contraction, cluster, post‐traumaticor psychogenic headaches, as well as 45 headache‐free individuals, served as subjects. Each subject wasadministered electronic thermography to determine if “cold patches” were present in the external carotidterritory. A “cold patch” was defined as a region more than 0.5°C cooler than the surrounding area.Chi Square analysis determined that vascular headache patients displayed a significantly greater number(p<.001) of “cold patches” than did normal individuals, or patients having scalp muscle contraction,psychogenic, or post‐traumatic type I headaches. Mixed headaches involving a vascular component alsodisplayed a significantly greater number (p< .001) of “cold patches,” as did cluster disorders (p<.001), andpost‐traumatic type III headaches (p<.001).This evidence supports a valid relationship between "cold patches" and vascular‐related headaches. It issuggested that the vascular “cold patch” be included as part of the criteria in assessing headaches.
Headaches and Heart Disease: The Lack of a Positive Association
Authors: Featherstone Harvey J.
Published: June 2005

SYNOPSIS

In order to investigate the relationship between headaches and cardiovascular disease, 200 individuals with recurrentidiopathic headaches were compared with age‐ and sex‐matched controls for the prevalence of cardiovasculardiagnoses and electrocardiographic (ECG) abnormalities. Only hypertension was diagnosed more frequently in theheadache group; ischemic heart disease and valvular lesions were diagnosed equally in some cases and controls, aswere rhythm disturbances. Matched ECG's were available in 161 pairs. Ischemic ECG changes were more frequent inthe controls than the headache cases. There were no other differences in ECG findings. This study fails to show apredilection for cardiovascular diseases, other than hypertension, in individuals with headaches. Ischemic heart diseasemay, by ECG analysis, be less common in headache cases than nonheadache controls.
A New Immunological Aspect of Cluster Headache: The Increase of Monocyte and NK Cell Populations
Authors: Giacovazzo M. , Martelletti R , Valeri M. , Piazza A. , Casciani C.U.
Published: June 2005

SYNOPSIS

Our recent work focused on some immunological aspects of CH patients. We found a decrease in the expression of HLA‐B14 antigen on lymphocytes of these patients. In previous studies, we showed that testosterone plasma levels are low in these patients during the crises. It is possible to postulate a correlation between the variation of some hormonal parameter and changes of circulating leukocytes subsets (as in pregnancy and in the pre‐eclamptic syndrome).

The following lymphocyte and monocyte subsets were studied using the monoclonal antibodies of Becton Dickinson series: Leu1 +, Leu2+, Leu3a+, Leu7+, Leu10+, ratio helper/ suppressor, LeuM3 +. We compared, using the ANOVA test, the values obtained during a phase of headache crisis versus those obtained out of crisis. A significant increase in lymphocyte subset Leu7+ (20.9±2.5 vs. 13.8±1.1, p<0.05) and in monocyte subset LeuM3 + (26.3 ± 1.4 vs. 20.8 ± 1.2, p<0.05) was observed during the phase of crisis.
Acephalgic Migraine
Authors: Kunkel Robert S.
Published: June 2005

SYNOPSIS

Acephalgic migraine is a term used interchangeably with the term migraine equivalents. These terms by definition refer to any migrainous phenomena that may occur in the absence of a migraine headache.1 Perhaps 20% of migraineurs may experience acephalgic attacks of migraine at one time or another. The idea that various symptoms can occur in the absence of any headache has been noted for hundreds of years, but very little has been written about this condition recently. Some people do not believe the symptoms that are often classified as migraine equivalents are in actuality part of the migraine syndrome. Because there is as yet no specific test for migraine, there is no proof that these various symptoms are due to the same neurovascular dysfunction we know as migraine. The diagnosis of migraine is based only on the patient's history and the exclusion of other diagnoses. It is not unusual for a headache patient to see several headache “specialists” and be given different diagnoses.

Some prefer the term “migraine accompaniments” for neurological or visual symptoms occurring with or without a headache.2 The aura of the classic migraine attack may linger into the painful phase and thus “accompany” rather than just precede the headache. At times, symptoms typical of the aura may occur and may not be followed by a headache (acephalgic migraine). The term “complicated migraine”should probably be reserved for those neural and/or visual symptoms that outlast the headache by at least 24 hours and should not be used when referring to symptoms of shorter duration which may accompany the headache or which occur in the absence of migraine headache. Although non‐visual migraine equivalents are not nearly as common as visual symptoms, it is important to recognize the fact that migraine may account for almost any recurrent, transient, episodic organ dysfunction.
A Combination Drug Treatment for Acute Common Migraine
Authors: Uzogara Eugene , Sheehan David V. , Manschreck Theo C. , Jones Kenneth J.
Published: June 2005

SYNOPSIS

Thirty subjects were admitted to a double blind study comparing Migraleve with placebo for the relief of acute common migraine attacks. A flexible dose cross over design was used. Twenty four subjects completed the six month study. The results suggest that Migraleve may reduce the duration and possibly the severity of an acute common migraine attack. Although the study was not designed to test for prophylactic effects since the drug was taken only for acute attacks, the results suggest possible long term prophylactic effects. These findings merit further investigation. While depressed patients had a greater number of common migraine attacks of all kinds, depression did not influence the effect of the drug. No serious side effects were noted in the patients during treatment, and the trial drug had an acceptably low incidence of other side effects. Of the 15 patients who expressed a drug preference in comparing the two 3 month study periods blindly, 14 expressed a preference for the Migraleve over the placebo. Further systematic study of these findings is necessary.
The Effect of Postural Variation on the Electromyographic Evaluation of Tension Headache and Nonheadache Control Participants
Authors: Ahles Tim A. , Sikora Thomas L. , Sturgis Ellie T. , Schaefer Carol A.
Published: June 2005

SYNOPSIS

Twelve tension headache patients and 12 nonheadache controls participated in an electromyographic (EMG) evaluation in which measurements were obtained from horizontal frontalis and bilateral trapezius placements. The evaluation was conducted while the participants were in reclining, sitting and standing positions. The results demonstrated higher frontalis EMG levels for the headache participants. However, contrary to prediction, the headache participants showed no greater EMG elevations in the trapezius musculature while sitting or standing as compared to the nonheadache controls.
Locus of Control, Assertiveness, and Anxiety as Personality Variables in Stress‐Related Headaches
Authors: Jones Colin , Page Stewart
Published: June 2005

SYNOPSIS

The purpose of this study was to investigate the relationship between locus of control, assertiveness, and anxiety, on one side and headache frequency and severity, on the other. The data were obtained by questionnaires (Rotter Locus of Control Scale, Rathus Assertiveness Schedule, The Sixteen Personality Factor Questionnaire, and a Headache Questionnaire), completed by 222 undergraduate psychology students. A significant correlation was found between anxiety and headache but it was weaker than might be expected considering that headache is commonly viewed as a physiological sign of anxiety. None of the permutations of the personality variables (e.g. internal, more assertive, and less anxious) was useful in predicting or discriminating between the frequency or severity of headache. Perceived internal locus of control and assertiveness were shown to suppress reported anxiety, but only to a minor extent. Unassertiveness was shown to be significantly related to headache severity, only for those subjects with weekly headaches. The discrepancy between reported anxiety and physiological anxiety was discussed and the utility of current self‐report measures in headache research was questioned. Future research should concentrate on investigating the hypothesis that denial is an important component in many self‐report personality measures.
Medication Compliance Among Headache Patients
Authors: Packard Russell C. , O'Connell Pat
Published: June 2005

SYNOPSIS

Medication is a major, often primary treatment modality used in the management of headache. However,even the most thorough and well designed therapeutic regimen with appropriate medication will failwithout patient compliance. This study was designed to evaluate compliance among headache patientsbeing treated with prescribed medication. One hundred consecutive new outpatients presenting to aheadache clinic were interviewed extensively in regard to their use of prescribed medication.Fifty‐two patients (52%) were initially determined to be non‐compliant with their medication. Ten patientswho were initially considered compliant were noted to be non‐compliant during a three month follow‐upperiod. Significant in this number were three medication abusers and two alcoholics. Reasons fornon‐compliance varied widely. Age, sex, educational level and headache diagnosis were not predictive foreither compliance or non‐compliance.Discussion centers on the importance of a detailed history of medication use in headache patients,reasons for non‐compliance, and recommendations to assist compliance among headache patients.
A Quantitative Assessment of Photophobia in Migraine and Tension Headache
Authors: Drummond Peter D.
Published: June 2005

SYNOPSIS

Intensity of photophobia in dull and bright light was assessed in 39 migrainous patients and 15tension headache sufferers during headache, and in 20 nonheadache control subjects. In 24 patients,measurements were repeated during the headache‐free interval. Subjective estimates of glare andlight‐induced pain were greatest in patients with migraine at the time of examination, but ratings bytension headache sufferers also exceeded control ratings at most levels of illumination. In 19 of 25patients with unilateral headache, light‐induced pain was greater on the symptomatic side. During theheadache‐free interval, glare ratings in dull and bright light, and pain ratings in bright light, weregreater in headache‐prone patients than in nonheadache controls. Sensitivity to glare could thusform part of a general hyperexcitability of the special senses, while bright light appears to exacerbatepain resulting from activation of trigeminal pain pathways during headache.
Piribedil Test in Migraine: Neruoendocrinological Aspects
Authors: Bussone G. , Frediani F. , Lamperti E. , LaMantia L. , Vescovi A. , Peccarisi C. , Boiardi A.
Published: June 2005

SYNOPSIS

Piribedil is a direct central dopamine receptor agonist drug, clinically useful in the diagnosis of migraine. It mayalso be used in the study of migraine pathogenesis, through evaluating dopaminergic “tone”.The observed effects of Piribedil on GH and PRL release, in this study, indicate the existence of dopaminereceptor hypersensitivity in migraine patients. Furthermore our data suggest also the involvement ofnoradrenergic systems in migraine pathogenesis. Estrogen levels do not influence these neuroendocrinologicalresponses to Piribedil, even though the Piribedil test in these female migraine patients was clinically positive (andtherefore diagnostically useful) only during the perimenstrual phase.
Paresthesia of the Second Division of the Trigeminal Nerve Secondary to Endodontic Manipulation with N2
Authors: Orr Daniel L.
Published: June 2005

SYNOPSIS

A woman developed intractable facial pain following the use of N2 paste for endodontic filling. Radiographsrevealed a radiopaque body adjacent to the site of the nerve supplying the painful area, but removal of thisaccumulation of N2 paste failed to relieve the pain, presumably because of leaching of the components of the N2paste into the tissues. Ultimately, nerve avulsion had to be performed to relieve the pain.
Effervescent ASA Versus Solid ASA in the Treatment of Tension Headache. A Double‐Blind, Placebo Controlled Study
Authors: Langemark Michael , Olesen Jes
Published: June 2005

SYNOPSIS

This study aimed at comparing the time courses of pain relief in tension headache after taking 648 mg solid ASA and after taking 648 mg effervescent ASA (acetyl salicylic acid). A modified double dummy technique with both solid and effervescent placebo was used. 47 patients entered, and 33 patients took all four trial drugs. No statistically significant difference between solid and effervescent ASA could be demonstrated. ASA was significantly better than placebo although the median rating of ASA in this study was unexpectedly poor ‐ as was the placebo response. This fact might have reflected the severely afflicted nature of a headache clinic's population.

Different pain rating scales are compared, and it is concluded that the overall (GLOBAL) rating is sensitive, but should not be used alone, since it may sometimes reflect less relevant factors. The power of the trial was good, but reflects the comparatively poor responsiveness to ASA (low variance) in this particular patient population. An advantage of the effervescent preparation in more ASA‐responsive patients cannot be ruled out. It is advised for future studies to recruit patients from general practice rather than from a headache‐clinic population.
Management of Chronic Head and Neck Pain: Effectiveness of Altering Factors Perpetuating Myofascial Pain
Authors: Graff‐Radford Steven B. , Reeves John L. , Jaeger Bernadette
Published: June 2005

SYNOPSIS

The response of 25 chronic myofascial head and neck pain patients to a systematic musculoskeletal rehabilitation program was examined. The program emphasized the acquisition of self‐management skills through a highly structured interdisciplinary format. Physical and cognitive behavioral therapies were aimed at reducing factors which perpetuate myofascial pain. Results immediately following treatment, and at three, six and twelvemonths post‐treatment when compared to pretreatment scores, showed highly reliable reductions in self‐reports of pain and medication intake.
Plasma and Platelet Methionine‐Enkephalin Levels in Chronic Cluster Patients During an Acute Headache Episode
Authors: Mosnaim Aron D. , Diamond Seymour , Freitag Frederick , Chevesich Jorge , Wolf Marion E. , Solomon Glen
Published: June 2005

SYNOPSIS

The different phases of an acute headache episode in chronic cluster patients were generally (6 out of 8 subjects) accompanied by rapid, significant changes in platelet‐rich plasma (PRP) methionine‐enkephalin (MET) levels. In contrast to these findings, platelet MET levels remained fairly unchanged in individual subjects and the observed intergroup variations well within the range of experimental error of the analytical technique used. With each patient serving as its own control we observed that “precluster” plasma peptide levels were substantially higher than their corresponding “during crisis” values, which in turn were higher than the “postcluster” MET concentration. When considered as a group, we showed statistically significant differences between the “pre” and “during cluster” and “pre” and “postcluster” headache phases, but not between the “during” and “postcluster” group of values. Each of these six patients had “precluster” PRP peptide concentration (range 198–318 pg MET/ml) above the range of normal controls (n=19, 54–126 pg MET/ml) and dramatically higher than their own levels when analyzed approximately six months later; at this time none of the subjects were in a “pro” or “during cluster” headache phase. In the other two patients PRP MET levels were fairly unchanged during the acute headache episode, at levels falling below the x ± 1 S.D. of normal controls.

These results show that, similarly to what has been reported for acute migraine headaches, the “precluster” phase of an acute cluster headache episode is accompanied by significant increases in plasma MET levels. However, and in contrast to migraine, peptide levels decrease rapidly to normal control values (“during cluster” phase), falling even further in the “postcluster” period. These results indicate that cluster patients lack the ability observed in migraineurs to keep a long lasting, sustained increase in plasma peptide concentration, a difference which could prove important for a better understanding of the possible different mechanisms involved in the modulation of the pain response between migraine and cluster headaches, as well as to differentiate biochemically both groups of patients.
Oculomotor Ophthalmoplegic Migraine in an Infant
Authors: Amit R. , Benezra D.
Published: June 2005

SYNOPSIS

Ophthalmoplegia is a rare presentation of migraine. Ophthalmoplegic migraine is frequently encountered in children, but has rarely been observed in infancy. We report a case of an infant with paroxysmal episodes of vomiting followed by a few weeks long periods of oculomotor nerve palsy. The first episode occurred at 14 months of age and the second at two years. In both episodes full recovery of the ophthalmoplegia occurred without treatment. The differential diagnosis of painful ophthalmoplegia and the variety of therapeutic regimens are discussed.
Platelet Fibrinogen Receptors in Migraine Patients
Authors: Kozubski Wojciech , Walkowiak Bogdan , Cierniewski Czeslaw S. , Prusinski Antoni
Published: June 2005

SYNOPSIS

In order to determine the platelet characteristics responsible for aggregation, the number and apparent dissociation constant (K D aPP ) of fibrinogen receptors were determined in 12 women with common migraine. The studies were performed by the use of 125 ‐fibrinogen. The patients were assessed in headache‐fee intervals. The mean number of platelet fibrinogen receptors exposed in migraine patients was significantly higher than those obtained in healthy controls (p<0.05). The (K D aPP ) in migraineurs was about three times lower than in the controls (p<0.02). The results indicate that both the number and affinity of fibrinogen receptors or platelets are increased in migraine patients. The authors conclude that this phenomenon may be responsible for the increased number of circulating platelet aggregates in migraine patients and for the prevalence of various kinds of strokes during migraine attacks.
Pentazocine in Migraine: Subjective and Pupillary Abnormal Effects
Authors: Boccuni M. , Cangi F. , Fusco B.M. , Curradi C. , Sicuteri F.
Published: June 2005

SYNOPSIS

Migraine has been hypothesized to be the clinical expression of a deficiency in pain modulating mechanisms. Abnormalities in opiate receptor responsiveness may be an aspect of this dysfunction.

In migraine patients, i.v. administration of pentazocine (15 mg), a kappa and sigma opiate receptor agonist, provoked: (1) disturbances in visual and/or body image perception in 9 of the 24 treated patients, different from controls where these phenomena were never observed; (2) other symptoms which were also reported by controls; (3) miosis, without differences from controls. No differences between common and classical migraine sufferers were found.

In patients complaining of perceptive disorders from pentazocine the other symptoms were longer lasting and miosis less intense than in the remaining patients, who responded to the drug as controls did. Two subgroups of patients could be defined, with and without pentazocine‐induced perceptive disturbances, the former abnormally, the latter normally reacting to the drug.

Pretreatment with naloxone (0.4 mg): (a) prevented pentazocine‐induced perceptive disturbances, (b) shortened duration of the other symptoms in both patients and controls, (c) antagonized pentazocine‐induced miosis in controls but not in patients.

It was discussed whether reduced miosis in patients with pentazocine‐induced perceptive disorders depends on a hyporesponsiveness of kappa receptors, or may be attributed to the sigma opiate receptor hyperreactivity upon which the perceptive disturbances seem to depend.
The Thermographically Observed Effects of Hyperoxia on Vascular Headache Patients and Non‐Headache Individuals
Authors: Swerdlow Bernard , Dieter John Nathan
Published: June 2005

SYNOPSIS

This study utilizes electronic thermography to investigate the response of 30 headache patients (migraine and mixed) and 20 non‐headache individuals to inhaling 100% oxygen at 10 liters per minute for 5 minutes. Observations were made prior to, immediately following, and at 3, 6 and 10 minutes post‐inhalation.

Thermograms were inspected to determine the influence of hyperoxia on facial pattern temperatures across time. Chi‐square analysis determined that there was a significant difference (P<.01) in response between the control group and headache patients immediately following inhalation. While the temperature of each control subject decreased, 14 (46.67%) patients displayed a 0.5 to 1.0°C paradoxical rise. There was no significant difference in response between the types of headache. Statistically significant difference in response continued during the post‐inhalation phase; at 10 minutes, 6 (20.00%) patients continued to display temperatures above baseline, The response to hyperoxia did not differ if the patient was experiencing a headache, nor did oxygen significantly reduce pain. No difference in response was noted in those patients who were prescribed beta or calcium channel block‐ere. Hyperoxia increased migraine “cold patch” size. Regardless of temperature fluctuations, facial patterns remained stable across conditions. A blind calling of pre‐ and post‐inhalation thermograms was 93% accurate.

The response of the medial canthi did not significantly differ between conditions. Hyperoxia generally increased size, temperature and symmetry. During the post‐inhalation phase original patterns generally returned.

This study supports previous headache/thermography findings and points to vascular dissimilarities between headache and non‐headache individuals.
Greater Occipital Neuralgia: An Unusual Presenting Feature of Neurosyphilis
Authors: Smith David L , Lucas Linda M. , Kumar Kusum L.
Published: June 2005

SYNOPSIS

The syndrome of greater occipital neuralgia (GON) is a cause of chronic unilateral or bilateral headaches. It occurs when the greater occipital nerve is compressed, irritated or inflamed. We describe a case of neurosyphilis in which GON was the presenting manifestation. We discuss this previously unreported early presenting feature of neurosyphilis and its implication.
Urinary Excretion of Taurine in Migraine
Authors: Rao Anjali , Rao Suryanarayana
Published: June 2005

SYNOPSIS

The level of urinary taurine was estimated in 25 cases of common migraine. These levels were then compared with those of normal, healthy subjects. The urinary taurine levels were significantly lower in migraine. Therefore, we propose that taurine may be involved in the pathogenesis of migraine.
Classic Migraine and Intercalated Seizures in a Young Woman: Efficacy of Flunarizine
Authors: Narbone Maria Carola , D'Amico Domenico , Di Perri Raoul
Published: June 2005

SYNOPSIS

A case of a young woman suffering from both migraine and epilepsy is reported. Since the age of 28, she complained of classic migraine attacks and of generalized or partial seizures. The seizures often intercalated themselves between the visual prodrome and the painful phase of her attacks. She came to our observation at the age of 31. Neurological examination, laboratory work and CT‐scan were normal. The EEG showed an asymmetry of the background activity between the two hemispheres and medium‐voltage sharp waves, not blocking upon eye opening, in the left parieto‐temporel leads. Flunarizine was added to her anti‐convulsant therapy. It remarkably reduced the migraine attacks and controlled the intercalated seizures. After one year, flunarizine was discontinued and two intercalated seizures occurred four months later. The efficacy of flunarizine and its hypothetical mechanism of action in such a clinical condition is discussed.
Onset of Action of Ibuprofen in the Treatment of Muscle‐Contraction Headache
Authors: Schachtel Bernard P. , Thoden William R.
Published: June 2005

SYNOPSIS

A double‐blind, randomized, placebo‐controlled trial was conducted to determine the onset of action of ibuprofen 400 mg in the treatment of muscle‐contraction headache. Because this represents a non‐prescription dosage of this analgesic, we evaluated subjects with a history of recurrent muscle‐con‐traction headaches that were amenable to over‐the‐counter analgesic therapy. Headache pain intensity was evaluated on a visual analog scale, and pain relief was measured on a categorical scale 15, 30, 45, 60, 90, and 120 minutes after a single 400‐mg dose of ibuprofen or placebo. Efficacy was detected within 15 minutes on the pain intensity rating scale (P<0.05) and within 30 minutes and at all subsequent time points on both the pain intensity and pain relief rating scales (P<0.001). These results indicate an early onset of action of ibuprofen 400 mg in the treatment of muscle‐contraction headache.
Regional Cerebral Blood Flow in the Different Clinical Types of Migraine
Authors: Juge Olivier
Published: June 2005

SYNOPSIS

Modifications of regional cerebral blood flow (rCBF) were measured during different phases of different types of migrainous headache in a population of 180 migraineurs, using the 133Xenon inhalation technique. Mean hemispheric and regional distribution of flow were compared to normal values obtained in age‐matched normal controls. Generalized, and particularly fronto‐temporal, increase of the fast flow (F1) component was found during the acute phase of common migraine ( + 37%) with a progressive decrease during the days following. Comparable changes were observed for the slow component of blood flow (F2). During the interictal period, the only difference between normals and migraineurs was an enhanced fronto‐temporal predominance of the fast flow values (F1). In the accompanied forms of migraine, the major finding was the presence of two subgroups of patients: in the first group, reduced flow was correlated with the neurological deficit, while in the second, high flows were measured in the presence of neurological deficits. A review of the personal history of each patient revealed that the two subgroups differed in age, sex, time course of the headache and past history of migraine. The high flow group was more characteristic of migraine while the oligemic group raised the questions of either another pathophysiological mechanism {vasospasm) or of another degree of severity of the same disease. The two hypotheses are discussed in the light of review of the literature.
SAFETY‐RELATED DEFECTS IN MOTOR VEHICLES AND THE EVALUATION OF SELF‐REGULATION*
Authors: Tobin Richard J.
Published: June 2005

Tobin reviews the National Highway Traffic Safety Administration's (NHTSA) self‐regulating program including recall of vehicles, the ever‐changing definition of defects, frequency of defect reports, and the notification of vehicle owners. He concludes that self‐regulation–while minimizing government's cost and involvement in the private sector–has serious defects of its own. It gives manufacturers too much latitude in determining the existence of a defect and makes government overly dependent on the manufacturers for information. Under self‐regulation the definition of what constitutes a defect changes from year‐to‐year; and under it manufacturer's recalcitrance in acknowledging a defect has kept the NHTSA from ordering recalls.
THE ECONOMIC REVITALIZATION OF AMERICA: AN OVERVIEW OF THE ISSUES
Authors: Buss Terry F. , Redburn F. Stevens , Ledebur Larry C.
Published: June 2005

This paper presents an overview of the economic issues facing the American economy. Crisis and transformation scenarios are presented and supply‐side versus demand‐side economic policies are considered as approaches to revitalizing the economy. Issues such as the extent to which centralization is needed, the kinds of trade‐offs that will be required, and the various constraints that exist for policy making are discussed.
RURAL POLICY PROBLEMS: AN ILL‐ATTENDED FIELD
Authors: Browne William P. , Hadwiger Don F.
Published: June 2005

The editors call for rural research and policy attention. Past research efforts, while laudatory, have been fragmented and have not directed broad attention to rural problems. Public policies have lacked both support and continuity. Present conditions, in terms of population trends and economics, mean an increasing need to focus on the national importance of rural areas.
GENERATING “SPARKS” IN URBAN RESEARCH
Authors: Mounts Richard
Published: June 2005

Paul E. Peterson, City Limits
A TYPOLOGY OF IMPLEMENTATION BEHAVIORS OF STREET‐LEVEL BUREAUCRATS
Authors: Sorg James D.
Published: June 2005

The role of the individual implementer in the process of policy implementation deserves more attention. This paper focuses on the behaviors of individual implementers at the street‐level. A typology of fourteen compliant and non‐compliant behaviors is introduced and i t s application in studies of micro‐implementation is discussed.
INNOVATION POLICY IN THE UNITED STATES: AN OVERVIEW OF THE ISSUES*
Authors: ROESSNER J. DAVID
Published: June 2005

This article introduces the symposium on innovation policy. It identifies a number of relatively unexplored issues concerning the relationships among government policies and industrial innovation in the United States. While the effects of specitic government policies on innovation have been researched, relatively little is known about the ways U.S. policymaking processes and political institutions condition efforts to improve innovation policies. Methods of evaluating innovation programs that would yield results persuasive to innovation policymakers have proven elusive.
THE EVALUATION OF INNOVATION*
Authors: de LEON PETER
Published: June 2005

This essay examines the difficulties of evaluating procedural and technological innovations while they are still being developed or the interim evaluation of ongoing innovation. The major recommendations warn against a premature reliance on a yet‐undeveloped theory. Careful attention could be directed to delineate a series of relatively discrete steps in the innovation processes, defining and collecting pertinent data, and developing an innovation typology. All of these have direct policy relevance.
ON BECOMING MORE OF A POLICY SCIENTIST
Authors: Dror Ythezkel
Published: June 2005

This essay presents some subjective thoughts on becoming more of a policy scientist, based on nearly thirty years of intense interest in policymaking and its improvement. Written as a token of gratitude for the privilege of receiving the first Harold Lasswell Award from the Policy Studies Organization, the essay takes the form of advice to striving policy scientists in nine desiderata followed by five operational recommendations. Some readings for exploring the suggestions presented in this paper are included in the reference section.
SCATTERED THOUGHTS ON A DEMOCRATIC DILEMMA
Authors: Henry Nicholas
Published: June 2005

Americans, particularly American intellectuals, have a deeply held tradition that ineffectual, limited government is in the public interest. The author questions this premise and suggests that when government is ineffectual, democracy itself suffers.
MAKING ENDS MEET: CITIES, FISCAL STRESS, AND EQUILIBRIUM
Authors: Boles Janet K.
Published: June 2005

Books reviewed in this article

Terry Nichols Clark and Lorna Crowley Ferguson, City Money: Political Processes, Fiscal Strain, and Retrenchment

Richard Rose and Edward Page (Eds.), Fiscal Stress in Cities

Irene S. Rubin, Running in the Red: The Political Dynamics of Urban Fiscal Stress
THE BIOTECHNOLOGY OF SEX PRESELECTION: SOCIAL ISSUES IN A PUBLIC POLICY CONTEXT
Authors: Wiegle Thomas C.
Published: June 2005

Sex preselection is the ability to select the sex of one's offspring prior to conception. After a discussion of the potential methods of sex preselection, this paper explores the possible diffusion of sex preselection biotechnologies within sociopolitical systems. Ethical aspects are discussed w i t h i n the context of broad social issues, family considerations, social class effects, crime, religion, and medical services. The article concludes with an examination of the public policy choices that might confront decision makers should sex preselection become a reality.
PRODUCTIVITY MEASUREMENT AND THE PUBLIC ORGANIZATION
Authors: Dalton Thomas C. , Fitzpatrick Linda C.
Published: June 2005

This article applies a broad theoretical framework identifying factors which provide an understanding of the relationship between electoral politics, organizational reform and institutional change. In focusing upon product i v i t y reforms undertaken in the 1970's and early 1980's. the authors find that political conflicts over measures of public performance may contribute to a life cycle in which organizational structures are reconstituted and subjects of regulation o r services redefined in ways that are potentially inconsistent with the demand for public accountability. The conjunction of such factors may contribute to a crisis of legitimacy resulting in the redefinition of the boundaries between public and private realms of responsibility, as expressed in the electoral process. Today liberal reformers are confronted by a dilemma of productivity and legitimacy involved in the cycle of reform and retrenchment in which the goal of public accountability is undermined by erosion of the rights of the subject. The attempt to break this bind requires, in part, an explicitness on the part of liberals about the presuppositions regarding the subject underpining the measures and strategies by which organizational reforms are undertaken.
A NEW DEFENSE POLICY FOR COSTA RICA: CONSTRUCTING REALITY AND THE POLICY AGENDA
Authors: Lincoln Jennie K. , Lauderdale Pat
Published: June 2005

This paper examine5 the policymaking progress in Costa Rica, specifically the creation of a new item for the governmental agenda. This new agenda challenges the traditional Itno army” policy of Costa Kica. Following a brief historical overview of the traditional policy, the paper considers the role of specific factors that promote structural conduciveness for the new “defense” policy and the attendant transformation of political symbols and definitions. The impact of the definitional and organizational changes on the implementation stage of policy is explored. This article suggests the importance of studying the role of hegemony in the construction and transformation of political and cultural definitions, an explication of deci‐ sionmaking as well as nondecisionmaking processes, and the influence of external and internal threats on nation‐state dependency.
LONG TERM CARE REGULATION IN THE STATES: A SYSTEMIC PERSPECTIVE
Authors: Myrtle Robert C. , Lammers William W. , Klingman David
Published: June 2005

In recent years there has been growing interest in differing state roles in the regulation of the health care industry. Most of this attention has stressed the impact of regulatory policy with only superficial attention directed towards understanding the extent to which states can be counted on to act effectively in the area of health care regulation. Using the regulation of nursing homes as a focus, this study evaluates a variety of sociocultural, political, and economic conditions for their impact on the development of various regulatory policies. The findings suggest that the development of certificate of need legislation and reimbursement controls were not related to significant changes ir, states' budgets for Medicaid services or in bed/population ratios. Instead, regulatory efforts were more closely linked to the sociopolitical environments surrounding the policy arena. While these factors provide some indication of the potential for strong state action in the regulatory arena, ultimately the use of state regulatory policies will depend quite centrally on the innovative tendencies of the state, its organizational capacity for addressing policy issues, and the nature and extent of interest group politics.
Institutional Capacity And The Resolution Of A Commons Dilemma
Authors: Blomquist William , Ostrom Elinor
Published: June 2005

This article concerns the dynamic process of resolving a commons dilemma without an externally imposed solution. We focus on two approaches: a model by Lewis and Cowens (1983) that yields a cooperative private arranghent that incorporates voluntarily chosen public institutions as instruments facilitating a resolution of the commons dilemma. The conditions necessary to Lewis and Cowen's result–a Itresolution without institutions–are contrasted with Ilinstitutional capacity” conditions treated as variables that may take on values enhancing the possibility of resolution. This latter approach yields certain advantages: less extreme assumptions, greater descriptive relevance, and the possibility of a variety of actual resolutions. A description of the case of West Basin in Southern California offers an example of the interaction of institutional capacity with participants' actions to produce a successful resolution of a commons dilemma.
Water Pollution Control In Democratic Societies: A Cross‐National Analysis Of Sources Of Public Beliefs In In Japan And The United States
Authors: Lovrich Nicholas P. , Pierce John C. , Tsurutani Taketsugu , Abe Takematsu
Published: June 2005

Postindustrial society seems to bring with it an inevitable heightening of official and public concern with environmental pollution. In light of this fact it becomes important to understand the dynamics by which public opinion is formulated in this area of public policy. What factors are associated with citizens placing concern for environmental pollution above other public policy concerns? What individual characteristics are associ‐ ated with the development of the view that government ought to take direct action to prevent or deal with environmental pollution? Are such factors common to postindustrial democratic societies generally? The study reported here identifies the similarities and differences in the patterns and correlates of pollution relevant beliefs and behavior in Japan (in the cities of Llishima, Fuji and Numazu in Shizuoka Prefecture] and the United States (Spokane City and County, Washington State). A comparative study of pollution policy can be especially instructive inasmuch as unique cultural, economic, historical and social patterns may generate distinctive citizen conceptions of desired policy outcomes and means to achieve them.
POLICY EVALUATION. DEMOCRATIC THEORY. AND THE DIVISION OF SCHOLARLY LABOR
Authors: Hofferbert Richard I.
Published: June 2005

The implicit priorities of political science have been inhospitable to policy evaluation as a scholarly endeavor. Political science, at least as practiced in the West, draws from a philosophic tradition that views political life, and especially democratic political life, as a public objective, not principally as instrumental for other social ends. Comparative policy analysis deviated from that tradition by treating political conditions as independent variables. Policy evaluation, which assesses the social consequences of governmental actions, deviated even further, adopting an explicitly and totally instrumental approach. The argument ofthis essay is that the tactics of policy evaluation should be adopted for assessing the impact of policy patterns on democratic institutions and citizenship. This recommendation flows from a diagnosis of the division of labor in policy evaluation and an identification of the optimum entry points for political science.
RESEARCH, EVALUATION, AND POLICY ANALYSIS: HEURISTICS FOR DISCIPLINED INQUIRY
Authors: Lincoln Yvonna S. , Guba Egon E.
Published: June 2005

Terminology like “evaluation research” and “policy analysis research” poses a fundamental conflict in talking about what constitutes legitimate inquiry activities. Using the two‐part definition of disciplined inquiry developed by Cronbach and Suppes (1969). it is possible to characterize research, evaluation and policy analysis as three separate and distinct forms of disciplined inquiry. As distinct forms, each has its own unique definition, purpose(s), products, intended outcomes or effects, and audiences. Further, under the definitions proposed, emergent inquiry paradigms have as much utility as older, conventional models.
OVERSIGHT AND COMPETITION IN PROFIT VS NONPROFIT CONTRACTS FOR HOME CARE
Authors: Hill Bette S. , Blaser C. Jean , Balmer Pamela W.
Published: June 2005

The paper reports the experience of the State of Illinois using proprietary and nonproprietary vendors to provide in‐home services to the elderly. The analysis suggests proprietary vendors were associated with a significant increase in service costs when vendors were allowed to determine service needs of clients. However, such differences disappeared as the state implemented effortso increase political oversight and competition.
THE CASE OF COMPARABLE WORTH IN WASHINGTON STATE
Authors: Remick Helen
Published: June 2005

Twelve years after its precedent‐setting comparable worth study, Washington State has approved an agreement guaranteeing implementation of its comparable worth system by 1993. A history is presented of state actions on comparable worth. The causes for the slow course of policy formation and implementation are seen to lie with the following: being the first to conduct a study, taking too long to act, the changes in persons in key positions, the state economy, attitudes towards state workers, lack of focus of responsibility, and denial that sex‐based differences in wages are the bases for Comparable worth adjustments.
CREATING NEW TECHNOLOGY‐BASED ORGANIZATIONS: A SYSTEM DYNAMICS MODEL
Authors: Hart Stuart L. , Denison Daniel R.
Published: June 2005

While the study of mature organizations and bureaucracies is well established, there has been comparatively little examination of the creation and development of new organizations. What work has been done is highly fragmented, primarily by discipline, and concentrates on different facets of a complex phenomenon. Following a literature review and classification this article attempts a conceptual integration; it proposes a system dynamics model for the creation and development of one particular organizational type: new, technology based organizations. Drawing upon concepts from ecology, the central concept of the model is that new venture creation takes place within, and is thus dependent upon, a larger context of “ecosystem” consisting of environmental resources (technical expertise, capital, services) and existing inhabitants (individuals, firms, and institutions). Intraorganizational factors are also discussed including a set of proposed measures for new venture success. The article closes with some suggestions for the direction of future research and describes a research project the authors have recently begun.
THE POLITICS OF LEGISLATIVE CURTAILMENT OF ADMINISTRATIVE RULEMAKING: OBSTACLES TO POLICE‐PATROL OVERSIGHT
Authors: Miller Cheryl M.
Published: June 2005

State Administrative Procedure Acts (APAs), like their federal counterpart, attempt to even the odds that citizens’rights will be protected as administrative agencies exercise quasi‐legislative and quasi‐judicial functions. North Carolina is one of several states which has recently attempted to constrain agency power in rulemaking and complaint adjudication. This is a case study of policy outcomes attained by the North Carolina General Assembly in its 1985 revision of the state's APA. Why did some state legislators’efforts to assume stricter oversight over administrative rulemaking fall far short of the kind of control and accountability they aimed for? We explore three types of obstacles to APA reform encountered in North Carolina. Each is relevant to other states. First, direct surveillance or “police‐patrol” techniques of legislative oversight impose undesirable political costs on legislators. Second, there is an absence of (or categorical precedence is against) the adoption of such techniques. Third, executive‐legislative branch conflict and complex separation of powers issues arise when state legislatures attempt to curtail administrative rulemaking in significantly new and restrictive ways.
A COMPARATIVE ANALYSIS OF RULEMAKING PROVISIONS IN STATE ADMINISTRATIVE PROCEDURE ACTS
Authors: Renfrew Patty D. , Houston David J.
Published: June 2005

As the primary source of procedures that state agencies must follow, state Administrative Procedure Acts (APAs) structure administrative discretion in the promulgation of rules and regulations. While the federal APA has been studied extensively, much less has been written about state procedural statutes. This article describes the major rulemaking provisions in state APAs and provides a broad, comparative, and systematic understanding of these provisions. Our analysis yields three major findings. First, state procedural statutes vary considerably in the extent to which they structure administrative discretion in rulemaking. Second, adoption of these rulemaking provisions tends to vary in a systematic way, as states first incorporate due process provisions, and then adopt responsiveness and rationality provisions. Third, in the area of procedural regulatory reform, states have made considerable strides in reforming regulatory administration.