bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Administrative Performance in Malaysia: The More Difficult Next Steps in Reform
Authors: Lim Hong-Hai
Published: October 2008

Despite past reforms, the Malaysian bureaucracy has lagged behind rising expectations. This paper reviews past reforms and suggests changes in reform strategy and measures for improving both the capacity and the will of public officials needed to raise administrative performance to meet domestic and global pressures. Combining technological and political perspectives, it argues that improving the will of public officials is both more important and more difficult than improving their capacity. Improving the will to perform promises significant gains in performance, but it requires reforms, mainly strengthening public control and making the bureaucracy more representative, that entail significant sacrifice of the interests of entrenched elites and groups. Malaysia has reached a juncture where she has to confront politically more difficult choices in administrative reform than in the past.
Reforming the Centralised State: Assessing Decentralisation Paradigms in the Drinking Water Sector in the Philippines
Authors: Singh Satyajit
Published: October 2008

Institutional reforms in the drinking water sector in the Philippines have taken the shape of “privatisation” and “decentralisation”. This paper reviews the working of these new institutions in the form of water utility, association and cooperatives in the province of Oriental Negros in the Philippines. While highlighting the important role that the provision of safe drinking water can play in poverty alleviation, this paper questions the ability of these reforms in addressing pressing concerns of poverty and access to water services. The case studies also point to the inability of this model to address wider concerns related to the public goods nature of water. Yet, decentralisation is not synonymous with privatisation and this paper points to the different paradigms of decentralisation (with varying degrees of private and public elements) in the water sector. The paper argues that the decentralisation vision enacted in Local Government Code of 1991 provides an opportunity for the state to deprivatise the drinking water sector and affirm the pivotal role of the local government in the provision of public goods.
Problems, Policies and Ethics in Health Care
Authors: Rogers Wendy A
Published: October 2008

There are three factors necessary for the successful implementation of a policy. First, a problem has to be identified in a way that invites action. Second, there must be a policy that fits the problem in question. And third, there must be the political will to tackle the problem with the policy. Each of these factors is necessary but not sufficient for policy development; implementation requires a happy conjunction of all three. To date there has been little overt ethical analysis in relation to policy development by those identifying as ethicists. This paper describes three potential roles for ethics analysis in the problem-policy-politics nexus, arguing that ethicists have a role to play in the identification of problems and in the substantive and procedural evaluation of policies. In addition, wherever ethics language is used overtly, ethicists have a duty to investigate and offer critiques of the notions in question, both on their own merits and against accepted usage and normative frameworks.
Policy as Ethics: Sterilisation of Girls with Intellectual Disability
Authors: Jewell Paul
Published: October 2008

Any public policy could be seen as an ethical issue, but only some are represented as such and debated using ethical terms. If a policy is generally accepted by the community, then it will not be seen as a controversy meriting debate. If a policy is contentious, protagonists may call upon a variety of paradigms to advance their positions or seek resolution, using, for example, legal arguments, or medical justifications. If there is no such agreed paradigm, the controversy may be framed as an ethical issue.

An illustrative example is the debate concerning the sterilisation of young women who have intellectual disabilities. Are there any circumstances in which it is justifiable for parents to arrange for the sterilisation of their daughter who has an intellectual disability such that she is unable to make such a decision for herself ? There is a debate about the role and responsibilities of the family in deciding whether or not to seek sterilisation, and, in contrast, the role of the state in demanding that such decisions be monitored and authorised. The issue is fundamentally ethical, but attempts to resolve it have been medical and legal. The debate has been conducted through the procedures of guardianship boards and courts, through academic articles, and in mass media. The problem is seen by some as a private matter, by others as a medical one, by some as an example of prudence and care and by others as an example of eugenics.

This paper offers an explanation of why some issues are deemed by the community to be ethical in nature. It provides an ethical analysis of the sterilisation debate, reveals an over-emphasis on rights at the expense of other ethical strategies and concludes that informed ethical commentary can further resolution where medically informed legal approaches have been unsatisfactory.
Contesting Representations of Poverty: Ethics and Evaluation
Authors: Bletsas Angelique
Published: October 2008

This paper starts from the proposition that poverty is a contested concept and that debates about poverty are about more than questions of measurement and technical definition. Debates about poverty, I argue, are ultimately debates about the appropriate role of governments in the alleviation of poverty, and hence are about governance. On these grounds I claim that evaluations of competing conceptions of poverty should be interrogated not merely for their technical or epistemological soundness, but also on ethical grounds.

To develop this argument, I explore representations of poverty in government policy. I look briefly at the Commonwealth Government’s understanding of poverty and more comprehensively at the South Australian Government’s Social Inclusion Unit. I find that, in both examples, poverty is represented to be an outcome of the poor choices of individuals, and proceed to reflect upon the inadequate ethical and governmental commitments that I find this particular representation of poverty entails.
Design Principles for Policy Mixes: Cohesion and Coherence in ‘New Governance Arrangements’
Authors: Howlett Michael , Rayner Jeremy
Published: October 2008

New Governance Arrangements (NGAs) have emerged as a lively topic in comparative policy studies and are often proposed as solutions to complex policy problems like environmental or health protection. However, assessing the merits and demerits of particular arrangements or instrument mixes is difficult. The paper proposes a variety of tools to tackle the often-overlooked problem of identifying and inventorying the instruments found in instrument mixes and assessing their likelihood to produce optimal results. A framework is developed for evaluating the likelihood of successful implementation of NGA's that exploits the fact that new policy development is almost always constrained by previous policy choices which have become institutionalized. The degree to which this institutionalization has occurred is seen as variable and the implementation to depend on a number of well-understood processes such as increasing returns and other kinds of positive feedback; sunk costs; and incremental policy learning. The applicability of the framework is demonstrated in the context of NGAs found in the forestry sector.
Modern Regulatory Policy – Ideals and Practice
Authors: Christensen Tom , Laegreid Per
Published: October 2008

In this article we examine the preconditions for fulfilling the aims of regulatory reform, exemplified through the case of Norway. We cover both the process of regulatory reorganization and decision-making within established regulatory structures. We argue that regulatory agencies operate in a complex political-administrative context and that we must combine instrumental and institutional perspectives to understand how they work in practice. This is done by applying a transformative approach that embraces organizational-structural elements, interests, cultural components and features from the institutional environment. We describe how a new regulatory reform policy has been introduced in Norway and focus on agency reform processes in two policy areas and on regulatory practice in two regulatory agencies. The main picture is that there is a loose coupling between the OECD regulatory policy ideal and a) general Norwegian regulatory policy; b) the reorganization of regulatory agencies in specific policy areas; and c) regulatory practice in individual cases.
The Divided Profession: The interplay of research, policy, and practice
Authors: Laws David
Published: October 2008

The integration of knowledge and action is often discussed in terms of dyadic relationships between knowledge and policy or knowledge and practice. Experience with these relationships is reviewed and a research-policy-practice triad is proposed as an alternative that better captures the dynamics that are evident in experience. The model of a divided profession is suggested as a way to capture and address that tensions that characterize relationships in the triad and undermine efforts to relate knowledge and action.
Establishing a Constitutional Court? An alternative political culture approach – the Israeli case
Authors: Doron Gideon , Meydani Assaf
Published: October 2008

In the beginning of January 2002, the Israeli parliament (The Knesset) rejected a proposal that had been filed two years earlier advocating the establishment of a constitutional court of law. This article explains the legislative process in Israel and places it within the framework of the political-public dialogue about establishing a special constitutional court of law, outside the legal system, which would function solely as a critic of constitutional issues.

The central claim we shall present stresses the role of the major divisions that exist in Israeli society, and the existence of an alternative political culture. These two factors, combined with the existing institutional structure, make it hard for the political system to cope with issues that require a change in public policy. Due to this phenomenon, the public has taken pro-active steps involving increased petitions to the high court that may help in the process of public decision-making or force the politicians to alter the existing institutional structure.
Transesophageal Echocardiography and Laryngeal Mask Airway for Placement of Permanent Central Venous Catheter in Cancer Patients with Radiographically Unidentifiable SVC‐RA Junction: Effectiveness and Safety
Authors: Hsu Jong‐Hau , Wang Chien‐Kuo , Hung Chueh‐Wen , Wang Shie‐Shan , Cheng Kuang‐I , Wu Jiunn‐Ren
Published: October 2008

In patients who require a permanent central venous catheter (PCVC), the usual aim is to put the catheter tip at the superior vena cava and right atrium (SVC‐RA) junction. However, there is no study regarding how to guide the positioning of the catheter tip when the SVC‐RA junction cannot be identified on chest radiograph. The objectives of this prospective study were: (1) to investigate the incidence and etiologies of radiographically undetermined SVC‐RA junctions in cancer patients undergoing PCVC implantation; and (2) to evaluate the feasibility, effectiveness and safety of combined transesophageal echocardiography (TEE) and laryngeal mask airway (LMA) to guide the positioning of catheters during implantations in patients without this radiographic landmark. Over a 1‐year study period, 83 consecutive patients with oncologic diseases who required implantation of a PCVC in a tertiary center were screened. Their preoperative chest radiographs were examined by radiologists to identify the presence of the SVC‐RA junction. Patients without a radiographically identifiable SVC‐RA junction were classified as cancer‐related or cancer‐unrelated in terms of etiology. For patients without this landmark, we used TEE with a pediatric biplane transducer and a LMA under intravenous general anesthesia during PCVC implantation to guide the positioning of the catheter tip at the SVC‐RA junction. We found that in 16% (13/83) of patients, the SVC‐RA junction could not be identified on radiograph. Among the 13 patients, only three (23%) had cancer‐related etiologies. In all of the 13 patients, the LMA was successfully placed after the TEE transducer was inserted. No episode of air leak from the LMA was found during surgery. All had the catheter tip positioned in the anatomic SVC‐RA junction under TEE guidance. In conclusion, 16% of cancer patients requiring PCVC implantation had no identifiable SVC‐RA junction on chest radiograph and most causes were cancer‐unrelated. In patients without a radiographically identifiable SVC‐RA junction, guidance by TEE under LMA general anesthesia is a feasible, safe and effective management to position a PCVC at the SVC‐RA junction.
Diffusion‐weighted Magnetic Resonance Imaging of the Liver in Hepatitis B Patients with Child‐Pugh A Cirrhosis
Authors: Hsu Feng‐O , Chiou Yen‐Yu , Chen Chiao‐Yun , Liu Gin‐Chung , Chu Hui‐Chen , Liu Hui‐Cheng , Chu Hui‐Min , Hsu Jui‐Sheng
Published: October 2008

The purpose of this study was to test the hypothesis that cirrhotic change of liver in hepatitis B patients observed in Child‐Pugh classification based on clinical assessment would be reflected in the apparent diffusion coefficient (ADC) values calculated from diffusion‐weighted magnetic resonance (MR) imaging. Twenty‐seven patients with hepatitis B Child‐Pugh class A cirrhosis and 10 control subjects were referred for measurement values of the liver on a 3.0‐T MR unit. The results revealed that ADCs were significantly lower in hepatitis B patients with Child‐Pugh class A compared with control subjects (p<0.01). In conclusion, our preliminary study showed that hepatitis B patients with Child‐Pugh class A had reduced ADC values in liver vis‐a‐vis normal subjects.
Effects of Zinc Compound on Body Weight and Recovery of Bone Marrow in Mice Treated with Total Body Irradiation
Authors: Huang Ming‐Yii , Lian Shi‐Long , Wu Hsin‐Lung , Chai Chee‐Yin , Chang Shun‐Jen , Huang Chih‐Jen , Tang Jen‐Yang
Published: October 2008

This study aimed to investigate if zinc compound would have effects on body weight loss and bone marrow suppression induced by total body irradiation (TBI). ICR mice were divided randomly into two groups and treated with test or control compounds. The test compound contained zinc (amino acid chelated with bovine prostate extract), and the control was reverse osmosis pure water (RO water). One week after receiving the treatment, mice were unirradiated, or irradiated with 6 or 3 Gy by 6MV photon beams to the total body. Body weight changes were examined at regular intervals. Three and 5 weeks after the radiation, animals were sacrificed to examine the histologic changes in the bone marrow. Lower body weight in the period of 1‐5 weeks after radiation and poor survival rate were found after the 6 Gy TBI, as compared with the 3 Gy groups. The median survival time after 6 Gy and 3 Gy TBI for mice given the test compound were 26 and 76 days, respectively, and the corresponding figures were 14 and 70 days, respectively, for mice given the control compound (p < 0.00001). With zinc supplement, the mean body weight in mice which received the same dose of radiation was 7‐8 g heavier than in the water‐supplement groups during the second and third weeks (p < 0.05). Hence, there was no statistically significant difference in survival rate between zinc and water supplement in mice given the same dose of irradiation. Histopathologically there was less recovery of bone marrow cells in the 6Gy groups compared with the 3Gy groups. In the 3 Gy water‐supplement group, the nucleated cells and megakaryocytes were recovered in the fifth week when recovery was still not seen in the 6Gy group. With zinc supplement, these cells were recovered in the third week. In this study, we found that zinc is beneficial to body weight in mice treated with TBI. Histologic examination of bone marrow showed better recovery of bone marrow cells in groups of mice fed with zinc. This study suggests that zinc can be used as supplements in cancer patients receiving radiotherapy to reduce radiation‐induced complications.
Biloma Following Transcatheter Arterial Chemoembolization with Microspheres: A Case Report
Authors: Huang Chao‐Kuan , Chen Shinn‐Cherng , Ming‐Chen Shih Paul , Chuang Wan‐Long
Published: October 2008

We report a case of inrrahepatic biloma following transcatheter arterial chemoembolization (TACE) with microspheres in a 44‐year‐old male patient. He was diagnosed with hepatocellular carcinoma with satellite nodules and inrrahepatic duct invasion in August 2004. TACE was performed with a mixture of lipiodol, epirubicin hydrochloride, and mitomycin followed by microspheres as devas‐cularizing material. Local external irradiation was performed on the area of intrahepatic duct invasion after the first TACE. Owing to local rumor progression and growth of new rumor nodules, a series of TACEs were performed. However, fever and diarrhea developed 2 weeks after the third TACE. Biloma with infection was diagnosed and was then treated successfully with percutaneous drainage and antibiotics. Embolization using microspheres at the proximal right hepatic artery was considered to have been the jeopardizing etiologic factor of biloma formation.
Renal Cell Carcinoma Presenting with Skull Metastasis: A Case Report and Literature Review
Authors: Yeh Hsin‐Chih , Yang Sheau‐Fang , Ke Hung‐Lung , Lee Kung‐Shing , Huang Chun‐Hsiung , Wu Wen‐Jeng
Published: October 2008

The occurrence of metastasis to the head and neck region in renal cell carcinoma is extremely rare. An 80‐year‐old man presented with a soft nodule in the left parietal calvarium and was admitted to our hospital. Biopsy of the nodule showed nests of clear tumor cells, suggesting metastatic renal cell carcinoma. Computed tomography of the abdomen revealed a well‐defined hypervas‐cular tumor, measuring around 7×7×8 cm, exophytic from the lower pole of the right kidney. Since there were no other systemic metastases, right nephrectomy and complete resection of the skull lesion were performed. No adjunctive therapy was given postoperatively After 22 months of follow‐up, the patient was well and without evidence of disease.
Branchial Cleft Cyst as the Initial Impression of a Metastatic Thyroid Papillary Carcinoma: Two Case Reports
Authors: Chi Hung‐Sheng , Wang Ling‐Feng , Chiang Feng‐Yu , Kuo Wen‐Rei , Lee Ka‐Wo
Published: October 2008

Branchial cleft cysts are the most common lesions in lateral neck cysts, predominantly occurring in the fourth decade of life and without sexual propensity. Rare branchial cleft cysts are associated with malignant tumors metastatic from the oral cavity, nasal cavity, pharynx or thyroid gland. Occult thyroid papillary carcinomas often present as a solid mass in the lateral neck, with only a few cases revealing a branchial cleft cyst as the initial manifestation. Herein, we report two cases of metastatic thyroid papillary carcinoma that presented as lateral neck cysts, with preoperative diagnosis of branchial cleft cyst. Finally, after complete surgical resection and histopathologic examination, one case was diagnosed as cystic change of metastatic lymph node from thyroid papillary carcinoma, and the other was determined to be a branchial cleft cyst with concurrent lymph node metastasis from thyroid papillary carcinoma. When a branchial cleft cyst is diagnosed by clinical or histopathologic examination, a metastatic thyroid papillary carcinoma should be considered as part of the differential diagnosis.
Developing the “Why” Facet of Medical Professionalism
Authors: Nomura Hideki
Published: October 2008

Numerous articles have been published that discuss medical professionalism from the perspective of “what‐to‐be” and “what‐to‐do”. In this paradigm, for doctors to effectively execute the “right” attitudes and behaviors, they must incorporate a “know‐how” attitude or “reflective practice” into their professional lives. However, definitions of “what” change over time in an evolving social context. For physicians to be able to continue incorporating the right new attitudes and behaviors, they must also develop a “know‐why” perspective. The health care market follows the criteria of a “market for lemons”. The high degree of information asymmetry seen in health care is a strong risk factor for adverse selection, producing an excess of defective articles of commerce in the market. In this case, the processes of signaling and screening, two known solutions for adverse selection in general, cannot bridge the information gap between patients and doctors, since patients must put their lives and their privacy into doctors' hands. Professionalism, therefore, is used by doctors to win the trust of patients, their caregivers and society at large. This is the “why”‐level intellect, in which the physician sets developing public trust as a goal for his own self‐actualization and develops it in conjunction with altruism. This is a key to success for the physician as a doctor and as a person.
Intra‐ and Extra‐abdominal Actinomycosis Mimicking Urachal Tumor in an Intrauterine Device Carrier: A Case Report
Authors: Hsiao Hsi‐Lin , Shen Jung‐Tsung , Yeh Hsin‐Chih , Wu Wen‐Jeng , Wang Chii‐Jye , Huang Chun‐Hsiung
Published: October 2008

Actinomycosis is a rare, chronic suppurative infection caused by the Gram‐positive anaerobic filamentous bacterium, Actinomyces Israeli. In most cases, the diagnosis is made postoperatively because of its unusual clinical presentation. Abdominal actinomycosis is the second most common site of the disease and may mimic abdominal cancer, inflammatory bowel disease or diverticulitis. The abdominal‐pelvic form of this disease mostly results from the prolonged use of an intrauterine device. We report a rare case of combined intra‐ and extra‐abdominal actinomycosis mimicking urachal tumor that was diagnosed by computed tomography, which presented as two tender abdominal palpable masses following long‐term intrauterine device use. The disease was confirmed by postoperative histopathologic examination, which revealed sulfur granules microscopically, and was successfully treated by complete surgical resection following a period of appropriate antibiotic treatment.
Infection After Surgical Reconstruction of a Clavicle Fracture Using a Reconstruction Plate: A Report of Seven Cases
Authors: Liu Ping‐Cheng , Hsieh Chih‐Hsin , Chen Jian‐Chih , Lu Cheng‐Chang , Chuo Chin‐Yi , Chien Song‐Hsiung
Published: October 2008

Mid‐shaft clavicle fractures have traditionally been treated conservatively, although this has been associated with non‐union and unsatisfactory shoulder function. The preferred approach is plate fixation, with a reconstruction plate for open reduction and internal fixation. Infection is a potential complication after such surgery, with rates of 0.4‐7.8% reported in the literature. In our cases, an infection rate of 4.9% (7 of 142 patients) was noted; five of the seven patients suffered from acute postoperative infection within 1 month of surgery. The average time to presentation with an infection was 28 (23‐32) days, with signs and symptoms of wound dehiscence in one patient and sinus discharge in four patients. Two patients suffered from subacute infections, with durations of 72 and 103 days, presenting with local heat and radiographic findings of screw loosening. Six of the cases healed with primary bony union after intensive debridement and early removal of the implants.
Socrates, Problem‐based Learning and Critical Thinking—A Philosophic Point of View
Authors: Wang Shin‐Yun , Tsai Jer‐Chia , Chiang Horn‐Che , Lai Chung‐Sheng , Lin Hui‐Ju
Published: October 2008

Problem‐based learning (PBL) is a learner‐centered educational method based on the principles of heuristics and collaboration. It has been considered an effective learning method in general and in professional education, especially in medical education. This article analyzes the thinking structure and philosophical background of PBL through the educational ideas of Socrates and the truth conception of Karl Popper. In the different phases of the PBL process, various truth conceptions will help to formulate the thinking framework of PBL—from Socrates' truth of openness toward the truth of scientific accuracy of our modern age. Meanwhile, Popper's scientific theory of falsifiability further leads us to discuss the relationship between PBL and critical thinking.
An Educational Approach to Problem‐based Learning
Authors: Chen Nan‐Chieh
Published: October 2008

This paper provides an analysis of the educational framework of problem‐based learning (PBL). As known and used, PBL finds its root in the Structuralism and Pragmatism schools of philosophy. In this paper, the three main requirements of PBL, namely learning by doing, learning in context, and focusing on the student, are discussed within the context of these two schools of thought. Given these attributes, PBL also seems ideally suited for use in learning bioethics.
Using Problem‐based Learning for Pandemic Preparedness
Authors: Marshall Carrie S. , Yamada Seiji , Inada Megan K.
Published: October 2008

To test the hypothesis that PBL is an effective method for preparing multidisciplinary learner groups at community health centers (CHCs) for pandemics, quantitative and qualitative methods were utilized to evaluate the conduct of a PBL case of a hypothetical outbreak of severe acute respiratory syndrome (SARS) at two CHCs in Hawaii, with multidisciplinary health professional and student participants. It was found that: (1) there was an overall increase in knowledge of bioevent preparedness; (2) participants gave high ratings for the effectiveness of the PBL process; (3) participants found value in the multidisciplinary group process; and (4) participants strongly agreed that they preferred the PBL process to the traditional lecture format for learning about bioevent preparedness. The PBL approach is useful in educating community‐based health professionals from different disciplines about issues related to pandemic preparedness.
The good life: living for health and a life without risks? On a prominent script of nutrigenomics
Authors: Komduur Rixt H. , Korthals Michiel , Molder Hedwig te
Published: October 2008

Like all scientific innovations, nutrigenomics develops through a constant interplay with society. Normative assumptions, embedded in the way researchers formulate strands of nutrigenomics research, affect this interplay. These assumptions may influence norms and values on food and health in our society. To discuss the possible pros and cons of a society with nutrigenomics, we need to reflect ethically on assumptions rooted in nutrigenomics research. To begin with, we analysed a set of scientific journal articles and explicated three normative assumptions embedded in the present nutrigenomics research. First, values regarding food are exclusively explained in terms of disease prevention. Health is therefore a state preceding a sum of possible diseases. Second, it is assumed that health should be explained as an interaction between food and genes. Health is minimised to quantifiable health risks and disease prevention through food–gene interactions. The third assumption is that disease prevention by minimisation of risks is in the hands of the individual and that personal risks, revealed either through tests or belonging to a risk group, will play a large role in disease prevention. Together, these assumptions suggest that the good life (a life worth living, with the means to flourish and thrive) is equated with a healthy life. Our thesis is that these three normative assumptions of nutrigenomics may strengthen the concerns related to healthism, health anxiety, time frames and individual responsibilities for health. We reflect on these ethical issues by confronting them in a thought experiment with alternative, philosophical, views of the good life.
The Scope of IMF Conditionality
Authors: Stone Randall W.
Published: October 2008

International organizations are governed by two parallel sets of rules: formal rules, which embody consensual procedures, and informal rules, which allow exceptional access for powerful countries. A new data set drawn from the IMF's records of conditionality provides an opportunity to study the bargaining process within an important international organization and answer questions about the institution's autonomy. I find evidence of U.S. influence, which operates to constrain conditionality, but only in important countries that are vulnerable enough to be willing to draw on their influence with the United States. In ordinary countries under ordinary circumstances, broad authority is delegated to the IMF, which adjusts conditionality to accommodate local circumstances and domestic political opposition. The IMF has refrained from exploiting the vulnerability of particular countries to maximize the scope of conditionality.
Sticks and Stones: Naming and Shaming the Human Rights Enforcement Problem
Authors: Hafner-Burton Emilie M.
Published: October 2008

“Naming and shaming” is a popular strategy to enforce international human rights norms and laws. Nongovernmental organizations, news media, and international organizations publicize countries' violations and urge reform. Evidence that these spotlights are followed by improvements is anecdotal. This article analyzes the relationship between global naming and shaming efforts and governments' human rights practices for 145 countries from 1975 to 2000. The statistics show that governments put in the spotlight for abuses continue or even ramp up some violations afterward, while reducing others. One reason is that governments' capacities for human rights improvements vary across types of violations. Another is that governments are strategically using some violations to offset other improvements they make in response to international pressure to stop violations.
Inviscid axisymmetric absolute instability of swirling jets
Authors: HEALEY J. J.
Published: October 2008

The propagation characteristics of inviscid axisymmetric linearized disturbances to swirling jets are investigated for two families of model velocity profiles. Briggs' method is applied to dispersion relations to determine when the basic swirling jets are absolutely or convectively unstable. The method is also applied to the neutral inertial waves used by Benjamin to characterize the subcritical or supercritical nature of the flow. Although these waves are neutral, Briggs' method nonetheless indicates a qualitative change in behaviour at Benjamin's criticality condition. The first model jet has uniform axial velocity, rigid-body rotation and issues into still fluid. A known difficulty in the application of Briggs' method to the analytical dispersion relation for inviscid waves in this flow is resolved. The difficulty is that the pinch point can cross into the left half of the complex-wavenumber plane, where waves grow exponentially with radius and fail to satisfy homogeneous boundary conditions. In this paper the physical consequences of this behaviour are explained. It is shown that if the still fluid is of infinite extent in the radial direction, then the jet is convectively unstable to axisymmetric waves, but if the jet is confined by an outer cylinder concentric with the jet axis, then it becomes absolutely unstable to axisymmetric waves provided that the swirl (ratio of azimuthal to axial velocity) is large enough. This destabilizing effect of confinement occurs however large the radius of the outer cylinder. A second family of model swirling jets with smooth profiles and a finite thickness shear layer at the jet edge is also studied. The inviscid stability equations are solved numerically in this case. The results from the analytical dispersion relations are reproduced as the shear layer thickness tends to zero. However, increasing this thickness acts to destabilize the absolute instability of axisymmetric waves, apparently due to the centrifugal instability present in the shear layer. It is suggested that the transition from convective to absolute instability could be associated with the onset of an unsteady vortex breakdown. The swirl required to produce this transition can be either greater, or less, than the swirl required to produce the transition from supercritical to subcritical flow, depending on the details of the basic velocity profiles. A codimension-two point in parameter space can exist where the unsteady bifurcation associated with the convective–absolute transition coincides with the steady bifurcation associated with the supercritical–subcritical transition. Such codimension-two points can control a rich variety of nonlinear dynamical behaviour.
Moltmann's dismissal of divine impassibility: Warranted?
Authors: Castelo Daniel
Published: October 2008

A key feature of Jürgen Moltmann's doctrine of God is his dismissal of divine impassibility as a heretical importation of Hellenistic metaphysics. This argument is a broader one assumed among many detractors of this theological tenet that is illegitimate given its rushed historical judgements. By dismissing the important features divine impassibility provided by past articulations, Moltmann offers a doctrine of God that in many ways repeats or avoids problems within the (im)passibility debates. Rather than dismissing divine impassibility from the onset, Moltmann would have benefited from a more careful appraisal of this axiom, one that would have chastened and enlivened his project within the ongoing conversation of God's relationship to suffering.
Directed, ordered and related: The male and female interpersonal relation in Karl Barth's Church Dogmatics
Authors: Stephenson Lisa P.
Published: October 2008

This article examines Karl Barth's conception of the interpersonal relation of male and female and demonstrates that, although Barth superimposes the concept of order within the Trinity onto the specific interpersonal relation of male and female, there is provision within his anthropology concerning interpersonal relations in general (i.e. interpersonal relations which are irrespective of sexual distinctions) to correct this error. I focus on Barth's exegesis of the creation narratives in Church Dogmatics III/1 and his discussion of the interpersonal relation of male and female in Church Dogmatics III/4. Then, because of Barth's principle of analogia relationis, I will briefly examine his doctrine of the Trinity in Church Dogmatics I/1. Whereas the role of christology in Barth's anthropology is frequently highlighted, there is often little regard for the trinitarian grounding of Barth's anthropology, especially with regard to the interpersonal relation of male and female. Finally, I will look at Barth's discussion of interpersonal relations in general in Church Dogmatics III/2 where he delineates a principle of the ‘priority of the other’, which serves to redeem his anthropological statements on the humanity of male and female. I contend that the recognition of the imago Dei in the interpersonal relation of male and female, sustained by the priority of the other, is a better way to achieve the personhood of both sexes than Barth's proposed static relational order.
The emergent church and neo-correlational theology after Tillich, Schleiermacher and Browning
Authors: Keuss Jeff
Published: October 2008

What has ‘emerged’ in the ‘emerging church’ movement, through writers such as Brian McLaren, is merely a new form of correlational theology – or what I will term ‘neo-correlational theology’. This ‘emergent’ movement aligns itself with Paul Tillich's systematic presentation of what he termed a ‘theology of culture’ addressed in his 1919 lecture ‘Über die Idee einer Theologie der Kultur’ and is deeply rooted in theological essentialisms aligned with Friedrich Schleiermacher and Don Browning. While many adherents of the Emergent movement have recently attempted to catalogue its theological legacy, this article will address three key emphases which haunt the corners of its discourse yet remain largely unacknowledged. First, the heritage of Schleiermacher's notion of ‘feeling’ as an authentic categorical form of knowledge forged through radical reflexivity which is the proper domain for authenticity in the Emergent movement. Second, as underscored in Tillich's Theology of Culture, the church as ‘emergent’ is profoundly imminent and therefore necessarily social, positivistic and historical. Third, theological anthropology is understood primarily through our freedom over and (at times) against the necessity of redemption. The question this article will address is whether or not such an approach reimagined as ‘neo-correlational theology’ and actualised through the ‘emerging church’ movement tacitly relies upon a more traditional theology which it explicitly rejects.
Critical Postliberalism: Lindbeck's cultural-linguistic system and the socially extrasystemic
Authors: Heather Noel
Published: October 2008

I argue that Lindbeck's notion of religion as a cultural-linguistic system may be profitably considered in the light of contemporary socio-linguistic concerns orientated towards the critical analysis of real-world language usage. Examples drawn from observation are used to show how, by combining Lindbeck's approach with Critical Discourse Analysis (Critical Postliberalism), extrasystemic features of religion and religious language can be perceived which link with a basic (R1–R2) dialectic. The latter can be correlated not only with the observable product of socio-theological grammars in believing communities today, but also with salient features of the gospels. Regional and other culturally related variations appear within limits to be accommodated by the model.
JOHN HARBISON'S ‘MIRABAI SONGS’: RELIGION, RITUAL, LOVE AND EROTICISM
Authors: Bonous-Smit Barbara
Published: October 2008

Captured by the 16th-century Indian poetess Mirabai and her works (transcribed by Robert Bly), John Harbison was especially intrigued with the manner in which she combined religion with ritual and eroticism. He has stated:

Her answers involved the ecstatic, the devotional and the artistic, but her independence and resolve and her dancer's vitality led my setting toward narrative and characterization, unusual territory for a song cycle.
Memes shape brains shape memes
Authors: Blackmore Susan
Published: October 2008

Christiansen & Chater's (C&C's) arguments share with memetics the ideas that language is an evolving organism and that brain capacities shape language by influencing the fitness of memes, although memetics also claims that memes in turn shape brains. Their rejection of meme theory is based on falsely claiming that memes must be consciously selected by sighted watchmakers.
Language as shaped by social interaction
Authors: Enfield N. J.
Published: October 2008

Language is shaped by its environment, which includes not only the brain, but also the public context in which speech acts are effected. To fully account for why language has the shape it has, we need to examine the constraints imposed by language use as a sequentially organized joint activity, and as the very conduit for linguistic diffusion and change.
The origin of language as a product of the evolution of double-scope blending
Authors: Fauconnier Gilles , Turner Mark
Published: October 2008

Meaning construction through language requires advanced mental operations also necessary for other higher-order, specifically human behaviors. Biological evolution slowly improved conceptual mapping capacities until human beings reached the level of double-scope blending, perhaps 50 to 80 thousand years ago, at which point language, along with other higher-order human behaviors, became possible. Languages are optimized to be driven by the principles and powers of double-scope blending.
Why and how the problem of the evolution of Universal Grammar (UG) is hard
Authors: Harnad Stevan
Published: October 2008

Christiansen & Chater (C&C) suggest that language is an organism, like us, and that our brains were not selected for Universal Grammar (UG) capacity; rather, languages were selected for learnability with minimal trial-and-error experience by our brains. This explanation is circular: Where did our brain's selective capacity to learn all and only UG-compliant languages come from?
Emotional responses in mother-infant musical interactions: A developmental perspective
Authors: Longhi Elena
Published: October 2008

With this commentary, I raise two issues relevant to the theoretical framework from a developmental perspective. First, the infants' emotional responses are induced by the music as well as by the multimodal information they perceive in interaction with their mothers, and these responses change with time. Second, contrary to what is suggested in the target article, musical expectancy is already experienced by young infants.
The role of literature in instructed foreign language learning and teaching: An evidence-based survey
Authors: Paran Amos
Published: October 2008

The resurgence in the use of literature in language teaching has been accompanied by an increasing number of research articles in this area. Research (in a number of second languages) has looked at the type of interactions and the type of language that arise from classroom discussions about literature, as well as at the views of teachers and learners. Importantly, the reactions that learners have to incorporating literature in their language lessons are linked to the type of approach and type of task that are used in the classroom. The paper surveys the existing research, as well as evidence from practitioners about approaches that are used and the range of works and authors that are taught.
Shift from first generation antipsychotics to olanzapine may improve health-related quality of life of stable but residually symptomatic schizophrenic outpatients: A prospective, randomized study
Authors: Joffe Grigori , Sintonen Harri , Appelberg Björn
Published: October 2008

Objectives:The aim of this study was to elucidate, whether shift from first generation antipsychotics (FGA) to olanzapine can affect health-related quality of life (HRQoL) of residually symptomatic schizophrenic outpatients.

Methods:Patients were randomized to either olanzapine or to continuation on their FGA. The 15D-measured HRQoL at baseline and end-point (after 12 weeks) was compared.

Results:Patients (n= 21) randomized to olanzapine achieved better HRQoL than those (n= 21) who continued on their FGA. This difference on the 15D (0.048 on a 0–1 scale;p= .037) was clinically important and comparable to that resulting from common surgical interventions, for example, hip or knee replacement.

Conclusions:HRQoL of stable outpatients with residual symptoms or adverse effects may improve substantially after shift from FGAs to olanzapine.
Reuse of single use medical devices in Canada: Clinical and economic outcomes, legal and ethical issues, and current hospital practice
Authors: Hailey David , Jacobs Philip D. , Ries Nola M. , Polisena Julie
Published: October 2008

Objectives:The aim of this study was to assess the evidence that reuse of medical devices marketed for single use only (SUDs) is safe, effective and cost-effective, and to consider the use and health services impact of this practice in Canada.

Methods:A systematic review was performed of studies that reported clinical or economic outcomes following reuse of SUDs in humans. Direct costs of adverse health events associated with SUD reuse and indications of budget impact were obtained using data for devices for laparoscopic cholecystectomy and coronary angioplasty. Legal and ethical issues were reviewed, drawing on material relevant to Canada. Data on current reuse of SUDs were obtained through a survey of Canadian acute care hospitals.

Results:Studies of variable quality suggested that SUD reuse could be safe and effective, and would give cost savings, if there were no adverse events. Eliminating reuse of SUDs for laparoscopic cholecystectomy and coronary angioplasty would add less than 0.1 percent to costs of the procedures over 1 year. Adverse health events associated with device reuse create liability risks; patients should be informed of any known or foreseeable risks of reuse. Most of the 28 percent (111/398) of acute hospitals that reprocess SUDs do so in-house. Some do not have a written policy or an incident reporting mechanism.

Conclusions:There is insufficient evidence to establish the safety, efficacy and cost-effectiveness of reusing SUDs. Legal and ethical issues require attention to minimize liability and maintain patient safety and trust. Some hospitals that reprocess SUDs do not have adequate documentation. These findings do not support the reuse of SUDs in Canadian hospitals.
Harmonization of evidence requirements for health technology assessment in reimbursement decision making
Authors: Hutton John , Trueman Paul , Facey Karen
Published: October 2008

As more countries use HTA to inform decisions on the reimbursement of health technologies, harmonization of evidence requirements between jurisdictions has been proposed, mainly on the grounds of improved efficiency. Harmonization has the potential to avoid duplication of effort for both manufacturers and HTA bodies involved in preparing and reviewing HTA submissions for innovative technologies. However, it also carries risks of loss of local control over decisions, the application of general data standards which are not universally accepted and slowing the rate of development of innovation in the analytical disciplines supporting HTA. This study reviews the issues associated with harmonization taking into account the perspectives of the multiple stakeholders. This study draws on experiences from recent initiatives intended to promote the harmonization of HTA and experience from related fields, particularly regulatory approval of new medical technologies.
An Adaptive Sensor Fusion Method with Applications in Integrated Navigation
Authors: Jwo Dah-Jing , Weng Tsu-Pin
Published: October 2008

The Kalman filter (KF) is a form of optimal estimator characterized by recursive evaluation, which has been widely applied to the navigation sensor fusion. Utilizing the KF requires that all the plant dynamics and noise processes are completely known, and the noise process is zero mean white noise. If the theoretical behaviour of the filter and its actual behaviour do not agree, divergence problems tend to occur. The adaptive algorithm has been one of the approaches to prevent divergence problems in the Kalman filter when precise knowledge on the system models is not available. Two popular types of adaptive Kalman filter are the innovation-based adaptive estimation (IAE) approach and the adaptive fading Kalman filter (AFKF) approach. In this paper, an approach involving the concept of the two methods is presented. The proposed method is a synergy of the IAE and AFKF approaches. The ratio of the actual innovation covariance based on the sampled sequence to the theoretical innovation covariance will be employed for dynamically tuning two filter parameters – fading factors and measurement noise scaling factors. The method has the merits of good computational efficiency and numerical stability. The matrices in the KF loop are able to remain positive definitive. Navigation sensor fusion using the proposed scheme will be demonstrated. Performance of the proposed scheme on the loosely coupled GPS/INS navigation applications will be discussed.