bluuebunny/crossref_metadata_2025 huggingface dataset:
Decision Maker 3.0
Authors: Lau Joseph , Kassirer Jerome P. , Pauker Stephen G.
Published: March 2007

DECISION MAKER°, a microcomputer program for performing clinical decision analyses, has been extensively revised, allowing the analyst to perform far more complex analyses. A newly developed control structure permits the specification of both recursive decision trees and structural sensitivity analyses. The new program extends classical decision analysis and provides a language and representation for complex clinical problems. (Med Decis Making 3:39-43, 1983)
A Mathematical Model for Timing Repeated Medical Tests
Authors: Eddy David M.
Published: March 2007

This paper presents a mathematical model that can be used to estimate the clinical and economic outcomes of monitoring patients with periodic examinations. The model can compare the consequences of monitoring for different disorders, with different tests, at different frequencies. The paper describes formulas that incorporate information about the incidence and natural history of disorders, the effectiveness of tests, the effectiveness of treatment, and the order and frequency of monitoring, to calculate the probability of detecting a disorder, the method and timing of detection, the earliness (e.g., stage) with which a disorder is detected, and the clinical and economic outcomes. The application of the model is described through a hypothetical example. The model has been used to analyze several cancer screening problems involving multiple disorders and multiple tests. (Med Decis Making 3:45-62, 1983).
Premature Conclusions in the Diagnosis of Iron-deficiency Anemia
Authors: Dubeau Catherine E. , Voytovich Anthony E. , Rippey Robert M.
Published: March 2007

Case records of patients with iron-deficiency anemia were audited using a computer-based algorithm. In 24 of 35 cases, the diagnostic conclusion seemed unjustified and characteristic of premature closure, one of four recurring errors in diagnostic reasoning described previ ously. Premature closure appeared to originate from subjects at all levels of training, to be easily and unquestioningly accepted by other physicians, and to inappropriately condition diagnostic and therapeutic decisions. Heuristics and biases described by Tversky and Kahne man are considered as contributory factors and patient care and teaching implications are discussed.
Hydra
Authors: Miller Perry L. , Blumenfrucht Steven J. , Rose John R. , Rothschild Michael , Swett Henry A. , Weltin Gregory , Mars Nicolaas J.I.
Published: March 2007

HYDRA is a computer-based knowledge acquisition tool under development to assist in the creation of expert systems which critique medical workup. To use HYDRA, a domain expert first outlines the recommended approaches to the workup of a chosen medical problem, using the Augmented Transition Network formalism. From this model, HYDRA produces a list of the various conditions for which critiquing comments may be required to react to all possible approaches that might be proposed by the user of the critiquing system. Domain- specific constraints can be used to restrict the number of conditions suggested. In this way, HYDRA assists the domain expert by providing a model for structuring the problem, and by breaking down the domain expert's work into a set of small, easily understood tasks. Key words: artificial intelligence in medicine; expert systems; knowledge acquisition; medical workup. (Med Decis Making 7:12-21, 1987)
How Much Quality Control is Enough?
Authors: Channing Rodgers R.P.
Published: March 2007

Quality assurance testing represents a substantial proportion of the clinical laboratory budget, but current guidelines are based on criteria that pertain to analytic error rather than to optimization of the cost-effectiveness of patient care. A general Bayesian mathematical model for the cost-effectiveness of assay quality control has been developed, and is demonstrated using previously published data. The cost-effectiveness of quality assurance as defined here depends upon the prevalence of disease, the shapes of the distributions of test results observed in the non-diseased and diseased populations, the decision limit selected for labeling results positive or negative, the costs and benefits associated with each of the possible therapeutic outcomes, the magnitude of random and systematic analytical errors, the statistical power of the quality control test in use, the costs associated with delays due to re-assay, and the proportion of total test cost attributable to quality control procedures. Given current clinical laboratory practice, much of this information will not be routinely avail able. The model combines these factors into a simple equation with three terms: one for the cost of the original and any required repeat laboratory analyses, one for the cost of delay entailed by the rejection of an assay batch, and one for the change in total costs consequent to rejection of erroneous assay results.
Is There a Role for Surgery in the Acute Management of Infectiue Endocarditis?
Authors: Abrams Howard B. , Detsky Allan S. , Roos Leslie L. , Wajda Andre
Published: March 2007

In the absence of good clinical evidence from a randomized trial, the authors performed a decision analysis to determine the potential value of early elective surgery (OPNOW) for patients with left-sided Staphylococcus aureus infective endocarditis. Initial impressions (before per formance of decision analysis) and initial runs at the formal models using probability estimates derived from clinicians suggested that OPNOW (i.e., within a few days of starting antibiotics) offered no advantage over attempted medical cure (WAIT) (life expectancy: WAIT = 325 weeks; OPNOW = 255 weeks). Extensive sensitivity analyses identified critical variables that needed further empirical estimation. The Manitoba Health Services Commission database identified 127 incident cases of endocarditis between April 1, 1979, and March 31, 1985, enabling estimation of values for these critical variables. With these estimates, the early surgery strategy appeared much better than the previous analyses had suggested (life expectancy: WAIT = 208 weeks, OPNOW = 256 weeks). The authors believe that this approach of com bining decision analysis with medical claims databases is useful as an alternative or precursor to randomized trials, especially where the resource requirements and logistic difficulties of performing randomized trials are great. Key words: infective endocarditis; valve replacement; therapy; databases. (Med Decis Making 8:165-174, 1988)
Toward an Applied Technology for Quality Measurement in Health Care
Authors: Berwick Donald M.
Published: March 2007

Cost containment, financial incentives to conserve resources, the growth of for-profit hos pitals, an aggressive malpractice environment, and demands from purchasers are among the forces today increasing the need for improved methods that measure quality in health care. At the same time, increasingly sophisticated databases and the existence of managed care systems yield new opportunities to observe and correct quality problems. Research on targets of measurement (structure, process, and outcome) and methods of measurement (implicit, explicit, and sentinel methods) has not yet produced managerially useful applied technology for quality measurement in real-world settings. Such an applied technology would have to be cheaper, faster, more flexible, better reported, and more multidimensional than the majority of current research on quality assurance. In developing a new applied technology for the measurement of health care quality, quantitative disciplines have much to offer, such as decision support systems, criteria based on rigorous decision analyses, utility theory, tools for functional status measurement, and advances in operations research. Key words: quality assurance; measurement; quantification. (Med Decis Making 8:253-258, 1988)
Focusing Technology Assessment Using Medical Decision Theory
Authors: Phelps Charles E. , Mushlin Alvin I.
Published: March 2007

Combining medical decision theory and epidemiologic information, the authors have devel oped a strategy to assess diagnostic technologies. For any patient, patient utilities with new diagnostic information are compared with the preferred fallback action absent that diagnostic information. After determination of whether the expected value of diagnostic information (EVDI) justifies its cost, the method adds across the eligible population to determine whether the global EVDI justifies the technology's deployment, employing a screen (Hurdle 1) that assumes that the diagnostic device has perfect accuracy. This preliminary evaluation relies on published data on treatment efficacy, population probabilities of illness, etc., but not on new clinical trials. If the technology is not sufficiently cost-effective, even with this optimistic assumption, the strategy recommends against its use. Otherwise, the next step is Hurdle II, in which the critical clinical studies, identified by the decision-theory model, are undertaken. These commonly include measuring the actual diagnostic accuracy of a device, with which the cost-effectiveness is recalculated. These studies in general do not require randomized controlled trials. Key words: technology assessment; decision theory; diagnostic information. (Med Decis Making 8:279-289, 1988)
Effects of 0utcome Framing on Treatment Decisions in the Real World
Authors: Siminoff Laura A. , Fetting John H.
Published: March 2007

This study was an in-depth examination of how 100 patients and physicians made treatment decisions about adjuvant therapy for breast cancer. Specifically, the authors examined how outcome framing was associated with these decisions. Based on other studies, it was hy pothesized that patients would choose more aggressive, nonstandard treatment regimens when outcomes were framed negatively, rather than positively. Contrary to these expecta tions, no significant associations were found between the framing of treatment outcomes and type of treatment chosen, or the acceptance or rejection of the physicians' treatment recommendations. Physicians practiced routinized communication patterns. Physicians tended to frame treatment outcomes similarly for all patients, regardless of severity of disease. It is concluded that the impact of outcome framing in real clinical situations is attenuated by verbal presentation of information and other factors more important to the decision process. Key words: outcome framing; decision making; adjuvant therapy; breast cancer. (Med Decis Making 1989;9:262-271)
A Descriptive Analysis of National Library of Medicine-funded Medical Informatics Training Programs and the Career Choices of Their Graduates
Authors: Braude Robert M.
Published: March 2007

The initial 13 National Library of Medicine-supported medical informatics training programs and their graduates were studied to determine the program objectives, trainee selection factors, and curriculum components of the programs and the backgrounds and career choices of the trainees. All 13 programs and over 60% of the available population of trainees were studied. The analysis indicated that 1 ) the major objective was to train individuals in the applications of computer and information science to medicine; 2) the most frequent selection factor was the MD degree; 3) course work in computer science and a research project were the most common curriculum components; 4) 52% of the graduates selected academic careers; and 5) personal reasons most frequently influenced career choices. There is now a baseline of data that can be used in future studies. Key words: medical informatics; computers; National Library of Medicine; career choices. (Med Decis Making 1991;11:33- 37)
Do Physicans Have a Bias toward Action?
Authors: Ayanian John Z. , Berwick Donald M.
Published: March 2007

In an attempt to replicate the findings of a classic study of medical decision making, the authors studied decision making in modern pediatrics practice. They prepared case scenarios and surveyed pediatricians for three common clinical decisions: tympanostomy tube place ment, radiography orders, and emergency room referrals. Initial reviewers rated the cases according to the likelihoods that they would take the clinical actions mentioned. Subsequently, other physicians presented with a subset of scenarios in which the initial reviewers were least likely to act tended to be more active in the tympanostomy (p = 0.004) and radiography (p = 0.076) decisions. In these cases the physicians appeared to have a bias toward action. For a subset of scenarios in which the initial reviewers were most likely to act, subsequent reviewers were neither more nor less likely to act than the initial reviewers. (Med Decis Making 1991 ;11 :154-158)
Availability, Wishful Thinking, and Physicians' Diagnostic Judgments for Patients with Suspected Bacteremia
Authors: Poses Roy M. , Anthony Michele
Published: March 2007

A prospective cohort study was done to assess the effects of value bias and the inappropriate use of the availability heuristic on physicians' judgments of the probability of bacteremia. Subjects of the study were 227 medical inpatients in a university hospital who had blood cultures done. Estimates of the probabilities that individual patients would have positive blood cultures were collected from the house officers who ordered the cultures. Clinical data and culture results were also obtained. Based on the data the authors calculated "value varia bles," reflecting doctors' assessments of the risks that individual patients would die in the hospital if they were to have bacteremia. "Recalled experience variables" reflected the doctors' recollections of recent experiences with patients with bacteremia. The physicians significantly overestimated the likelihood of bacteremia for most of their patients. Their ROC curve for this diagnosis showed moderate discriminating ability (area = 0.687, SE = 0.073). Two recalled experience variables were significantly associated with the physicians' prob ability estimates. The value variables were significantly inversely associated with them. These relationships were independent of several clinical variables and measures of disease severity. The physicians' intuitive diagnostic judgments were thus influenced by the availability heu ristic and by wishful thinking, a form of the value bias. The availability heuristic may mislead physicians by causing them to believe that random variations in the prevalence of a non- epidemic disease represent real trends. Wishful thinking may lead physicians to underes timate the likelihood of a disease for patients most at risk for its consequences. Teaching physicians to develop better judgmental strategies may improve the quality of their judgments and hence their patient care. Key words: diagnosis; probability; septicemia; availability heu ristic ; value bias. (Med Decis Making 1991;11:159-168)
Statistical Methods That Distinguish between Attributes of Assessment
Authors: Loewy John W. , Kapadia Asha S. , Hsi Bart , Davis Barry R.
Published: March 2007

The authors propose a method to generate information relevant to the decision tree that adds addibonal perspective to the characterization of health quality during survival. Their approach uses survival data to distinguish two attributes of utility. prolongation of life and quality of life (QOL) Health-state transition probabilities correspond to the prolongation of life and are modeled in a discrete-time transient semi-Markov process. Quality-of-life-state transition probabilities are derived from the assumptions of a simple recurrent Markov proc ess They reflect events within the health-state sojourn time that differentiate perceptions of pain and suffering over a short fixed time period. Outcomes for these two dimensions of utility are highly relevant to the assessment of medical technology that might prolong life at the cost of increased pain and suffering, implying a reduced QOL The methods are dem onstrated on a subset of follow-up data from the Beta-Blocker Heart Attack Trial (BHAT). Key words: occupancy statistics, quality of life, transient semi-Markov process, two- dimensional outcome, waiting-time probabilities (Med Decis Making 1992;12:83-92)
Time Preference in Medical Decision Making and Cost - Effectiveness Analysis
Authors: Redelmeier Donald A. , Heller Daniel N.
Published: March 2007

Cost-effectiveness analyses usually quantify peoples' attitudes towards delayed outcomes using the exponential discount model. The authors examined three assumptions of this model by assessing the time preferences of individuals towards hypothetical health states and calculating implicit annual discount rates. Of a random sample of medical students, house officers, and attending physicians, 121 participated, reflecting a response rate of 81%. The participants considered three temporary events (colostomy, blindness, depression) that were destined to occur at five sequentially distant times in the future (one day, six months, one year, five years, and ten years). The utility of each prospect was measured using two elicitation techniques (standard gamble and categorical scaling), and 1,394 implicit discount rates were calculated. Of all the discount rates, 62.1 % equalled zero, 10.0% were less than 0.00, and 15.7% were greater than 0.10. Mean discount rates for relatively proximal time intervals tended to be larger than those for relatively more distant intervals (0.041 vs. 0.025, p < 0.01). Mean discount rates for blindness tended to be smaller than those for colostomy or depression (0.023 vs 0.039 vs 0.037, respectively, p < 0.005). Hence, peoples' implicit discount rates are not always small positive numbers that are constant over time and the same for all settings. The authors suggest that the conventional exponential discount model may not fully characterize the time preferences held by individuals. Key words: cost-effec tiveness; time preferences; exponential discount model. (Med Decis Making 1993;13:212- 217)
Hemodynamic Assessment in Managing the Critically III
Authors: Dawson Neal V. , Connors Alfred F. , Speroff Theodore , Kemka Ashish , Shaw Patricia , Arkes Hal R.
Published: March 2007

Prior to right-heart catheterization of 846 patients, 198 study physicians estimated values of pulmonary capillary wedge pressure (WP), cardiac index (CI), and systemic vascular resis tance index (VRI). The physicians also expressed their confidence in these estimates. Actual values of WP, CI, and VRI as determined by catheterization enabled the authors to evaluate the quality of the physicians' judgments. The discrimination of the judgments was modest; areas under the ROC curves for WP, CI, and VRI were 0.724, 0.681, and 0.656, respectively. Calculated using clinically relevant cutoff values, sensitivities were 64%, 50%, and 64%, and specificities were 71%, 75%, and 63%, respectively. Calibration of the estimates of WP, CI, and VRI was also modest; physicians tended to overestimate low values and underestimate high values. Physicians were generally confident of their estimates, but there was no relation between confidence and accuracy. Experienced physicians were no more accurate than less experienced ones, although they were significantly more confident. The authors conclude that physicians should not use their levels of confidence in their subjective estimates of cardiac function in deciding whether to base therapy on these estimates. Key words: con fidence; accuracy; discrimination; hemodynamic status; cardiac function; physicians. (Med Decis Making 1993;13:258-266)
Markov Models in Medical Decision Making
Authors: Sonnenberg Frank A. , Beck J. Robert
Published: March 2007

Markov models are useful when a decision problem involves risk that is continuous over time, when the timing of events is important, and when important events may happen more than once. Representing such clinical settings with conventional decision trees is difficult and may require unrealistic simplifying assumptions. Markov models assume that a patient is always in one of a finite number of discrete health states, called Markov states. All events are represented as transitions from one state to another. A Markov model may be evaluated by matrix algebra, as a cohort simulation, or as a Monte Carlo simulation. A newer repre sentation of Markov models, the Markov-cycle tree, uses a tree representation of clinical events and may be evaluated either as a cohort simulation or as a Monte Carlo simulation. The ability of the Markov model to represent repetitive events and the time dependence of both probabilities and utilities allows for more accurate representation of clinical settings that involve these issues. Key words: Markov models; Markov-cycle decision tree; decision mak ing. (Med Decis Making 1993;13:322-338)
Patency Results of Percutaneous and Surgical Revascularization for Femoropopliteal Arterial Disease
Authors: Hunink Maria G.M. , Wong John B. , Donaldson Magruder C. , Meyerovitz Michael F. , Harrington Donald P.
Published: March 2007

To estimate the patency results of percutaneous transluminal angioplasty and bypass surgery in the treatment of femoropopliteal arterial disease, a Medlars search of the English-language medical literature was performed. Inclusion required that studies 1) report original data, 2) report patency with a life table or Kaplan-Meier analysis with the number at risk or standard errors, 3) define patency as hemodynamic improvement, 4) report the distribution of co variates, and 5) not duplicate other published material. Using a method based on the pro portional-hazards model and the actuarial life-table approach, the results were adjusted for differences in case-mix of the study populations and patency was predicted for subgroups at various levels of risk for failure. The unadjusted pooled life tables yielded five-year pa tencies of 45% (± 2%) for angioplasty, 73% (± 2%) for bypass surgery using a vein graft, and 49% ( ± 3%) for bypass surgery using a polytetrafluoroethylene graft. Adjusted five- year primary patencies after angioplasty varied from 12% to 68%, the best results being for patients with claudication and stenotic lesions. Adjusted five-year primary patencies after surgery varied from 33% to 80%, the best results being for saphenous vein bypass performed for claudication. The authors conclude that pooling life-table data without adjustment for covariates can be misleading. Indication, lesion type, vein graft availability, and site of the distal graft anastomosis need to be considered in predicting patency results of revascular ization for femoropopliteal arterial disease. Key words: arteries, femoral; arteries, popliteal; arteries, transluminal angioplasty; arteries, surgery; review; meta-analysis. (Med Decis Mak ing 1994;14:71-81)
Judgment Processes for Medication Acceptance
Authors: Wills Celia E. , Moore Colleen F.
Published: March 2007

In the present study college students (N = 186) made judgments of the likelihood of accepting a medication for treatment of a hypothetically experienced clinical depression. Three types of information were manipulated: effectiveness of the medication for alleviating the symptoms of depression, potential side effects of the medication, and severity of depression hypo thetically being experienced. The functional-measurement approach was used to examine whether self-reports are related to judgments and whether there is configurality in judging likelihood of medication acceptance. The results showed that subjects who reported different variables to be most important had predictably different effects of the variables in their judgments. There was also evidence for configural combination of information, and the nature of the configurality differed between subjects who reported Depression versus Side Effects as the most important type of information, respectively. The results show how the same information can be used differently by different individuals in making judgments, and that self-reports may reveal some important aspects of how information is used. The implications of the individual differences for health care consumer decision making and health care professionals' assessments and interventions are discussed. Key words: judgment and decision making processes; configurality; self-reports; mental health treatment; information use. (Med Decis Making 1994;14:137-145)
An Influence Diagram for Assessing GVHD Prophylaxis after Bone Marrow Transplantation in Children
Authors: Quaglini Silvana , Bellazzi Riccardo , Locatelli Franco , Stefanelli Mario , Salvaneschi Cristina
Published: March 2007

Graft-versus-host disease (GVHD) represents one of the major complications of allogeneic bone marrow transplantation (BMT). Nevertheless, the occurrence of mild GVHD could be desirable in high-risk leukemic patients, due to a relapse-preventing effect known as the graft-versus-leukemia (GVL) effect. Given that different prophylactic interventions are avail able to prevent GVHD development, the decision problem consists in assessing both type and dosage of the drugs in order to avoid or induce GVHD, according to the specific patient's condition. The decision problem can be represented and solved by using an influence dia gram. The choice of this formalism allows using new available methods for building and updating the model of the decision problem. The qualitative structure of the model and the conditional probabilities were first derived by combining literature results with a medical expert's judgement. More specifically, probabilities were initially assigned as ranges rather than as point values. Then, conditional probabilities were updated, by using a learning algorithm, as new cases became available. The authors analyzed 50 cases of pediatric patients affected by either malignant or nonmalignant diseases, undergoing BMT and re ceiving GVHD prophylaxis. They used the first 25 cases to adjust the initially assigned conditional probabilities, then checked the model obtained on the remaining patients. The overall performance for GVHD prediction was about 80%. Key words: Bayesian belief net works; influence diagrams; therapy planning; graft-versus-host-disease. (Med Decis Making 1994;14:223-235)
Using Markov Processes to Describe the Prognosis of HIV-1 Infection
Authors: Ying Lu  , Stitt Frank W.
Published: March 2007

In 1989, Turner and colleagues proposed a new method for automated classification and prediction of outcomes for hospitalized patients with AIDS, based on severity of illness. The authors have confirmed this system, which includes three main stages and 20 substages, in a cohort of HIV-1-infected symptomatic patients admitted to the Miami Veteran's Affairs Medical Center (VAMC) since 1988. They propose a new model of Markov illness-and-death processes and use it to describe the disease progression of the patient cohort. The new Markov model also measures transitions between stages, including risk factors associated with the speed of transitions. Significant differences in survival experiences were found from the different disease stages. The estimated mean (median) survival times were: from stage 1, 21.0 (17.8) months; from stage 2, 10.5 (8.4) months; and from stage 3, 6.7 (4.7) months. In addition, age at HIV-1 diagnosis and homosexual behavior were significant prognostic factors for disease progression and survival. The results indicate that the combination of a severity-of-illness clinical staging system with Markov illness-and-death process modeling is particularly useful for the evaluation of prognostic factors influencing the course of HIV-1 disease progression. Key words: acquired immunodeficiency syndrome (AIDS); Markov illness-and-death processes; HIV-1 prognostic factors and stages. (Med Decis Making 1994;14:266-272)
The Nonprofit/Service Organization as a Marketing Research Problem: Issues and Examples
Authors: Stiff Ronald
Published: March 2007

A minority of schools offer one or more courses in nonprofit or service marketing. Several possible reasons for limited nonprofit/service offerings are proposed, including the integration of nonprofit/service marketing concepts into existing courses such as marketing research, which can be taught effectively by using a nonprofit or service organization's research problems as a course project. Benefits of this approach are discussed and three examples of nonprofit/service projects are described.
The Kinematics and Dynamics of Space Manipulators: The Virtual Manipulator Approach
Authors: Vafa Z. , Dubowsky S.
Published: March 2007

Future robotic manipulator systems will be required to per form complex tasks in space such as satellite repair. These robotic manipulators will encounter a number of kinematic, dynamic, and control problems caused by the dynamic coup ling between the manipulators and its spacecraft. This dy namic coupling also makes it difficult to analyze these sys tems. This paper introduces a new analytical modeling method for space manipulators called the Virtual Manipula tor (VM), which has a fixed base in inertial space at a point called a Virtual Ground. The kinematics and dynamics of the manipulator, spacecraft, and payload can be described relatively easily in terms of the VM. With its fixed base, the Virtual Manipulator is shown to have the potential to be an effective aid for the analysis, design, and development of future space manipulator systems.
In Defence of Realism and Truth
Authors: Morris Brian
Published: March 2007

■ This article offers a critique of postmodernism, and the rather nihilis tic ethos that some of its advocates suggest. It thus seeks to affirm the salience of a realist metaphysic, and argues for the crucial importance of such conceptions as truth as representation, human agency and empirical science. It suggests the continuing need in anthropology to combine empirical science (naturalism) and hermeneutics (humanism), thus avoiding both positivism, which repudiates hermeneutics and tends towards a reductive materialism, and textualism, which repudiates empirical social science entirely.
Manufacturing Ethnicity
Authors: Kwong Peter
Published: March 2007

■ Immigrants often depend on ethnic mutual assistance to make a start in this country. But the concept of ethnic solidarity can also be manipulated by employers to gain better control over their co-ethnic employees. In studying the predicament of Chinese immigrant workers in New York's Chinatown, and especially the Chinese illegals, this article shows that Chinese employers often invoke ethnic symbols to project an image that only co-ethnics can be trusted, thus blocking the new immigrants' attempts to seek better opportunities outside of their ethnic environment. Ultimately, this article questions the validity of the ethnic enclave thesis.
The Morality of Modernity and the Travails of Tradition
Authors: Nugent David
Published: March 2007

■ This paper examines the process by which the Peruvian nation-state consolidated control in Chachapoyas, a peripheral section of the national space in the northern sierra. The focus is on a key period of state expansion, circa 1930, when subaltern groups coalesced into a broad political movement that seized power from the local elite. This movement: (1) eliminated racial designations from pubic discourse; (2) subsumed them within a national order of moral classification based on notions of citizenship and nationhood; and (3) embraced the cultural values of modernity and the institutions of the nation-state. Sub altern groups embraced modernity and nationhood as powerful forces of emancipation due to historical peculiarities of post-colonial Peru. Prior to 1930 local elite groups strongly wedded to notions of aristocratic sovereignty and inherent racial difference used the local apparatus of state to reproduce privi lege and inequality. Subaltern groups responded by making common cause among racial groups denigrated within the cultural logic of aristocratic sover eignty, by combining all into a single non-racial category (el pueblo, or 'the people') derived from the rhetoric of popular sovereignty, and by appealing to the central state to establish the strong institutional presence necessary to safe guard the constitutional rights and protections of el pueblo.
Sex and Familial Crimes in the D Code: a Witness to Mores in Transition
Authors: Stulman Louis
Published: March 2007

This essay examines D's treatments of sex and familial crimes carrying the threat of death ( môt statements). The findings suggest that D is in the process of limiting the fringe powers vested in the paterfamilias and consolidating those powers in regional tribunals under community/state authority. This witness to mores in transition had perhaps the most profound effect on women, since it involved the limitation of pater nal authority in family and sex matters. Consequently, D reflects a benevolent attitude towards women, but not primarily as a result of a 'humanistic orientation' (Weinfeld); rather, D's concern for women is the result of the transition in mores from familial to communal authority—a transition engendered by social pressures and a social world marked by Internal anxiety, vulnerability and danger.
The Provision of Legal and Economic Information to the Public in some European Community Countries
Authors: Villanueva Eduardo
Published: March 2007

Mr Villanueva, a lecturer at the library school of the Pontificia Universidad Catolica in Lima (Peru), was awarded the last Martinus Nijhoff Study Grant in 1991. This grant, administered by IFLA Headquarters, enabled Mr Villanueva to undertake a study tour in the Netherlands, the UK, France and Spain during November— December 1991. As required under the terms of the Grant, a full report has been filed at IFLA HQ and submitted to Martinus Nijhoff International. In the short report which follows, Mr Villanueva gives some personal and professional impressions of the services which formed the main subject of the study.
The Social Demography of Hungarian Villages in the Eighteenth and Nineteenth Centuries (With Special Attention To Sárpilis, 1792-1804)
Authors: Andorka Rudolf , Balazs-Kovács Sandor
Published: March 2007

Nine family reconstitution studies of Hungarian villages in the late eighteenth and early nineteenth centuries indicate the appearance of fertility control linked to low age at first marriage. Studies of household structure suggest considerable variance and a higher percentage of complex households than existed in northwestern Europe, as well as the growth of this percentage. These results are scrutinized in detail in the sources of the southern Transdanubian village of Sárpilis, where there was a clear tendency of households to become complicated and for birth control to appear in relatively poorer complex households. It is hypothesized that both growing household complexity and birth control were responses to the growing scarcity of arable land.
Modernization and the Family in Japan
Authors: Kumagai Fumie
Published: March 2007

Analysis of external and internal aspects of the Japanese family today reveal that it is not modern or traditional but an harmonious blending of both modernity and tradition. For example, the external or demographic characteristics of today's Japanese family all demonstrate its modern nature. Yet the internal or struc tural nature of the Japanese family and household also exemplifies the persistence of tradition. These findings suggest that the uniqueness of the Japanesefamily exists in the very fact that it is externally modern but internally traditional. This harmonious traditional-modern blend in a certain sense parallels the history of Japan as a modern society, in that Western industrial technology was enthusiastically adopted but at the same time traditional Japanese culture was retained.
Kinship and Sociability: Urban Shopkeepers in Nineteenth-Century Sweden
Authors: Ericsson Tom
Published: March 2007

Recent studies in the history of the European petty bourgeoisie, that is, shop keepers, master artisans, and other small tradesmen, have shown the close social relations that existed between the petty bourgeoisie and the working class. Because the two classes occupied the same geographical space, historians have concluded that they were also socially close. In this study an examination of the social structure of witnesses appearing at baptisms of urban shop keepers in four Swedish towns it is possible to see that Swedish shopkeepers mingled within their own stratum and above themselves, while social relations to other classes hardly existed at all.
"The Fruit That Hangs Highest": Courtship and Chaperonage in New York High Society, 1880-1920
Authors: Montgomery Maureen E.
Published: March 2007

Strict rules of chaperonage were introduced into U.S. society in the 1880s. They were considered to have taken a firm hold by 1900, but by the 1920s, not even chaperonage of engaged couples was deemed necessary. Focusing on New York's high society, this study looks at how the representation of chaperonage in etiquette discourse intersected with the shaping of gender and class relations and with the construction of a national identity. More specifically, it considers how chaperons were conceptualized as protective shields designed to police the sexuality ofyoung, unmarried women while, at the same time, chaperonage contributed to the modernizing forces that brought about its own abandonment.
Gilded Palace, Gilded Playpen: Louis Xv's Use of Palatial Space To Control His Rebellious Children and Their Politics 1
Authors: Justus Kevin L.
Published: March 2007

Behind the splendor and glitter of eighteenth-century Versailles existed a contentious and dangerous hotbed of royal family politics. Throughout the second half of his reign, Louis XV experienced opposition and intrigue from his children, particularly from his son, Louis the dauphin, and his eldest surviving daughter, Adélaïde. Fortunately for the king, this intrigue of family politics took place within the environs of Versailles, an environment that was his to control. Louis XV was able to use this palatial space to oversee and counter his children's politics and intrigues. I suggest that in the final analysis, Louis XV communicated his satis faction and displeasure within the transformations he made at Versailles.
The New World, 1492-1992 An Endless Debate?
Authors: León-Portilla Miguel
Published: March 2007

On our planet only the American continent has had the privilege, or the unhappiness perhaps, of being subjected to a sort of accounting of “anniversaries” or, let us say, “centennials.” But this does not mean, for all that, that these anniversaries serve to commemorate its birth. Geologists tell us the continents were formed hundreds of millions of years ago, making the commemoration of the American continent relatively recent. Moreover, the origins of this custom are foreign to it and are imbued, it must be said, with perspectives that are by all evidence “Eurocentric.” Curiously, no one took any notice of the first or the second centennial of the American continent.
Continuum and Discontinuity
Authors: Martinet André
Published: March 2007

There inevitably comes a time when even the best informed minds are tempted to yield to the lure of binarism: when we are no longer concerned with the details of a system, but rather with our vision of the relationship between man and the world. Without going any further it can already be said that the problem of existence is presented to us in terms of a man/world duality, as though we were unable to exceed our subjective vision of things so as to assess their intrinsic reality.

When linguists discovered that they could isolate discrete units called phonemes, they were tempted to oppose the discontinuity of these phonemes – reflecting the underlying discontinuity of the signifiers – to a continuum of prelinguistic experience, a continuum that is not arranged as discrete elements except with reference to any significant units of the language selected for the purpose of communicating this experience to others. At the outset we have nothing but a nebulous mass where only the application of a linguistic grid allows us to discern identifiable units. Even if, in the final analysis, it will prove necessary to doubt the universal validity of this vision of things, we must recognize its usefulness in concretizing a concept of linguistic facts – a concept that has for some time played a beneficent role in research. At least for some of us, this vision should reflect the manner in which the world is gradually organized in our minds each time a perceptible reality is isolated from its context at the instant it receives a name. Allow me to introduce an illustration from personal experience. It was the last day of July in 1914. In our little village in the Savoy the international tension – which would eventually end in general mobilization – was very perceptible; our classes were idle, and teachers and pupils had settled down in a field near the school. I was six. Sitting on the grass, my attention was attracted by a plant with large flat leaves. At that moment someone said the word plantain “plantain.” The plant had not been heretofore exactly unknown to me; it didn't strike me, at that moment, as a discovery; but it acquired a distinct existence only at that instant in the green carpet of the field when a signifier had definitively isolated it. It was most assuredly the gravity of the hour that engraved this incident in my memory.
The Rule of Art: On Kant with Wittgenstein
Authors: Méchoulan Éric
Published: March 2007

I do not propose to compare the esthetics of Kant and Wittgenstein or to show the sometimes very Kantian basis of some of Wittgenstein's reflections. I do not intend to take up the history of philosophy here (I will not, therefore, attempt to expound upon the relationship in Kant of the esthetic to the teleological or the moral, for example, or the relationship of art to ordinary language in Wittgenstein). That would not be without interest; quite the contrary, but I would prefer to compare the remarks of the one to those of the other in order to respond to a specific question: why is it said that there can be no rules for art, or more precisely, that the only rule is that there must be no rules? What authorizes art to play with the rules?
A Comment on John Roemer's Theory of Differentially Exploited Labor
Authors: England Richard , Greene Michael
Published: March 2007

This comment discusses John Roemer's Marxian theory of dis crimination (RRPE 10:2). On the one hand, Roemer's analysis is a positive accomplishment since he accepts previous historical and statistical research verifying the existence of various forms of discrimination and then tries to situate discrimination in Marx's theory of value and exploitation of labor. In doing so, he generalizes several theorems arrived at previously by Morishima, Okishio, et al. concerning the static relationships between differences in the rate of exploi tation, the real wage and the rate of profit. However, Roemer's analysis suffers from his attempt to make inferences about the dynamics of exploitation, discrim ination and capitalist development based on an essentially static model. Roemer's model is a good first attempt at introducing discrimination into Marx's labor theory of value, but such a line of analysis will ultimately require si tuating discrimination in Marx's theory of reproduction and accumulation, not just in his static theory of exploitation.
Planning as a Factor in the Assessment of Cognitive Processes
Authors: Das J. P. , Heemsbergen D. B.
Published: March 2007

In assessing cognitive processes, one can distinguish between coding and planning functions. Two studies on planful behavior are reported with a view to delineate the nature of planning as a factor within the neuropsychological model of Luria. In the first study, planning emerged as a factor which was orthogonal to two other coding factors consistent with previous research. In the second study, good and poor performers in visual search, a marker task for planning, could be clearly distinguished in a game of strategies, “Master Mind.” It was suggested that assessment of planning can be made by observing how strategies are used in games and in experimental situations.
An Analysis of Teachers' Reasons and Desired Outcomes for Students Referred for Psychoeducational Assessment
Authors: Ysseldyke James E. , Christenson Sandra , Pianta Bob , Algozzine Bob
Published: March 2007

The purpose of this investigation was to describe elementary classroom teachers' specific reasons and desired outcomes for referral. Data were collected from 105 teachers at the point when they referred students for psychoeducational assessment. The primary reasons for referral were learning-related and behavioral; most of the major desired outcomes related to special education consideration and/or intervention. A comparison of students referred primarily for learning versus behavior problems is described. Implications and future research needs for the assessment and decision-making process are discussed.
Normal Children's Performance on the McCarthy Scales, Kaufman Assessment Battery, and Peabody Individual Achievement Test
Authors: Naglieri Jack A.
Published: March 2007

The aim of this study was to examine the relationship between the McCarthy Scale of Children's Abilities and the Kaufman Assessment Battery for Children for a sample of 51 normal children. Results revealed no significant difference between the McCarthy General Cognitive Index and the K-ABC Mental Processing Composite (t = .55, p > .10), and these scores correlated significantly (r = .55, p = .001). The predictive validity of these instruments was examined using the Peabody Individual Achievement Test (administered after a three-month interval). Multiple regression analyses revealed that the K-ABC Achievement scale was the best predictor of PIAT Total scores (R = .75), and none of the remaining K-ABC or McCarthy scales added significantly to the prediction. Implications of these and other findings are discussed.
A Comparison of the WISC-R and WAIS-R Performance Scales in Deaf Adolescents
Authors: Braden Jeffery P. , Paquin Marius M.
Published: March 2007

Scores from the WISC-R and WAIS-R Performance Scales were compared using a sample of 32 deaf adolescents. Performance scores were obtained during routine evaluations (mean interval between tests = 41.6 months). Results show that the two scales produce virtually identical scores. WISC-R and WAIS-R subtest scores and PIQs are correlated (all rs > .470, p < .008). Observed correlations are not significantly different from maximum possible correlations, with the exceptions of the Picture Completion subtest and Performance IQs. Differences between means are nonsignificant, but WISC-R Picture Completion and Block Design variances are significantly larger than their respective WAIS-R variances (p < .008). On the strength of these findings, psychologists are cautioned regarding the equivalence of the Picture Completion subtest in the two scales, although practitioners may directly compare other WISC-R and WAIS-R Performance Scale scores in deaf adolescents.
Discrepancy Score Analysis: A Computer Simulation of Classification Stability
Authors: Macmann Gregg M. , Barnett David W.
Published: March 2007

Although the identification of a severe discrepancy between achievement and intellectual ability has been proposed as a diagnostic indicator of learning disabilities, questions regarding the technical adequacy of severe discrepancy score classification have not been carefully examined. This study simulated the effects of measurement error, instrument selection, and the cutoff standards used to define “severe” underachievement on the stability of severe discrepancy score classification decisions. A statistical software package was used to generate aptitude and achievement data, calculate regression-prediction discrepancy scores, and classify cases of severe underachievement for a hypothetical population of 5,000 cases. The results indicated that the actuarial classification of severe underachievement was disproportionately related to chance and instrument selection. The results are generalizable to any psychometrically-based classification procedure.