bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of symptomatic simple renal cysts by percutaneous aspiration and ethanol sclerotherapy
Authors: Mohsen Tarek , Gomha Mohamed A.
Published: November 2005

OBJECTIVE

To report our experience with the use of 95% ethanol as sclerotherapy for symptomatic simple renal cysts.

PATIENTS AND METHODS

Sixty patients with 64 symptomatic simple renal cysts were treated by ultrasonography (US)‐guided percutaneous aspiration and injection of 95% ethanol (31 men and 29 women, mean age 46 years, sd 22). The main presentation was renal pain in 34 patients, renal mass in nine, hypertension in 11 and haematuria in six; 24 cysts were on the right, 32 on the left and four bilateral. Patients were evaluated after 1 month and then every 6 months by clinical assessment, US and intravenous urography. Success was defined as complete when there was total ablation of the cyst and partial when there was a recurrence of less than half the original cyst volume with the resolution of symptoms. Failure was defined as the recurrence of more than half of cyst volume and/or persistent symptoms.

RESULTS

After aspiration and ethanol sclerotherapy, there was microscopic haematuria in two patients and low‐grade fever (<38.3°C) in two, but no major complications. During a mean (range) follow‐up of 19 (14–40) months there was complete cyst ablation in 54 cysts and partial resolution in 10. Pain disappeared or was much improved in all patients. After cyst ablation hypertension was well controlled with no medication in all 11 hypertensive patients and haematuria disappeared in all six affected patients.

CONCLUSIONS

Ethanol sclerotherapy for symptomatic simple renal cysts is simple, minimally invasive and highly effective. We recommend it as the first therapeutic option in these patients.
Persistent and occasional nocturnal enuresis in orthotopic urinary diversion: is there a urodynamic difference?
Authors: El‐Bahnasawy Magdy S. , Osman Yasser , Gomha Mohamed A. , Shaaban Atallah A.
Published: November 2005

Authors from Mansoura attempted to determine the urodynamic criteria differentiating patients who have an ileal neobladder and who are either persistently enuretic or are occasionally enuretic. They found that all enuretic patients had significantly higher residual urine volumes than continent patients, and that there were differences in the two groups of enuretics, suggesting areas that can be targeted therapeutically.

OBJECTIVE

To establish urodynamic criteria differentiating between men with a radical cystoprostatectomy and ileal neobladder who are persistently enuretic and those who are occasionally enuretic.

PATIENTS AND METHODS

Fifty enuretic men at least 1 year after a radical cystoprostatectomy and ileal neobladder (hemi‐Kock or ‘W’ neobladders) were divided into two groups according to the persistence of their complaint; 17 men were persistently enuretic (nightly) and 33 were occasionally enuretic (<3 episodes/week). Both groups were compared with 50 fully continent men with similar reservoirs. Uroflowmetry, enterocystometry and urethral pressure profilometry were carried out according to International Continence Society standards and terminology.

RESULTS

Both enuretic groups had significantly higher residual urine volumes, pressure at mid‐capacity and at maximum enterocystometric capacity, amplitude of uninhibited contractions, and lower compliance than continent men. Men with occasional enuresis also had a significantly higher frequency and duration of uninhibited contractions than continent men. Men with persistent enuresis had significantly lower average and maximum urinary flow rates than continent men, and significantly lower functional urethral length and maximum urethral pressure. Uroflowmetric and urethral pressure differences were dissimilar between men with occasional enuresis and controls.

CONCLUSION

Enuretic men had significantly higher residual urine volumes and enterocystometric pressure variables than continent men. Men with persistent enuresis had significantly lower flow rates and less urethral resistance. Pharmacological inhibition of reservoir contraction and/or management of residual urine by clean intermittent catheterization before sleep might cure occasional enuresis.
Influence of weather on New Zealand financial securities
Authors: Keef Stephen P. , Roush Melvin L.
Published: November 2005

The present study examines the influence of four independent facets of the local weather in the two major cities of New Zealand on the interest rates of bank bills and government bonds and the returns of stock indices. Factor analysis of the local weather variables generates four independent facets measuring temperature, sunshine, wind in Auckland and wind in Wellington. The analysis is based on a repeated measures design. Two results, which are consistent within a given financial security, are observed. The prices of bank bills are positively influenced by the level of the sunshine factor. The prices of stock indices are negatively influenced by the level of the Wellington wind factor. The influence of the level of sunshine on the returns of stock indices is susceptible to two interpretations.
Exchange rate exposure among European firms: evidence from France, Germany and the UK
Authors: Rees William , Unni Sanjay
Published: November 2005

We investigate the pre‐Euro exposure to exchange rate changes of large firms in the UK, France and Germany. We find that the exchange rate sensitivity is considerably stronger than previously thought. In all three countries, firms typically gain value when their local currency depreciates against the US dollar, yet most UK firms lose value when sterling depreciates against the European currency unit. We also document the existence of an intriguing intervalling effect in the measurement of exchange rate exposure, which suggests that share prices might exhibit a delayed response to information, and prevents us from making robust generalizations concerning other exchange rate sensitivities.
Emotions and Interpersonal Relationships: Toward a Person‐Centered Conceptualization of Emotions and Coping
Authors: Lazarus Richard S.
Published: November 2005

ABSTRACTThis essay describes my theory of emotions. I make a case for studying discrete emotions in the context of four processes that represent the central features of my theoretical system: appraising, coping, flow of actions and reactions, and relational meaning. I explain why coping is a key feature of the emotion process, and I discuss issues related to the measurement of coping and the importance of understanding coping processes in the context of personality and situational demands. I make the argument that emotions are best studied as narratives, and I offer one such narrative in the form of a case study to demonstrate how emotions can best be understood in the context of an interpersonal relationship and by considering individual differences, interpersonal transactions, and relational meaning. I conclude this essay with a caution that field specialization may interfere with our understanding of emotions and other psychological phenomena, and I underscore the virtues of ipsative‐normative research designs as a way to move closer to a person‐centered personality psychology.
Interest Group Strategies: Navigating between Privileged Access and Strategies of Pressure
Authors: Binderkrantz Anne
Published: November 2005

The literature often contrasts interest groups possessing insider status and outsider groups forced to seek influence through more indirect means. Drawing on data from a survey of all national Danish interest groups, this article demonstrates that most groups have an action repertoire including both direct contacts to bureaucrats and parliamentarians and indirect activities such as media campaigns and mobilizations of members. Different strategies of influence are correlated positively, hence, there is no contradiction between pursuing strategies associated with insider access to decision-making and strategies where pressure is put on decision makers through media contacts and mobilizations. An analysis of four distinct strategies – an administrative, a parliamentary, a media and a mobilization strategy – finds interesting variations in the factors that affect the pursuance of the various strategies of influence. Groups with a privileged position vis-à-vis decision makers have high levels of activities targeting these decision makers, but the lack of a privileged position does not lead groups to pursue indirect strategies. Indirect strategies are most intensively pursued by cause groups and groups who find themselves in a competitive situation with regard to attracting members.
Social Democrats and NEO-Liberalism: A Case Study of the Australian Labor Party
Authors: Lavelle Ashley
Published: November 2005

Social democratic parties have been agents in the neo-liberal transformation of public policy in recent decades. There has been debate about the reasons why social democrats have embraced market policies, with particular emphasis given to ideological trends, globalisation and electoral factors. This paper aims to shed further light on this debate by examining the case of the Australian Labor Party (ALP), which was a prominent social democratic exponent of neo-liberalism during its time in office in the 1980s and 1990s. In Labor's case, the primary cause of the shift from pledging social reform and interventionist government to neo-liberalism was the lower levels of economic growth that followed the end of the post-war boom in the 1970s. Social democrats rely on strong economic growth to fund redistributive policies. Thus when recession occurred in the 1970s it eroded the economic base to Labor's programme. While this paper focuses on the story of the ALP, it may provide some answers as to why social democrats elsewhere have adopted neo-liberalism.
The Reform of Public Administration in Northern Ireland: From Principles to Practice
Authors: Carmichael Paul , Knox Colin
Published: November 2005

The system of public administration in Northern Ireland has, perhaps inevitably, been of secondary concern during 30 years of inter-communal sectarian strife. Faced with combating terrorism, successive United Kingdom governments would not consider reform of the province's local public administration, pending a resolution of the wider constitutional imbroglio. Consequently, much of the system atrophied, becoming progressively more cumbersome and ill-equipped to deal with the requirements of modern government. Moreover, to help minimise charges of sectarian discrimination, quangos provided many public services, compounding the ‘democratic deficit’ of Direct Rule. In 1998, the Belfast Agreement (also known as the Good Friday Agreement), offered a breakthrough in the search for a durable settlement that could command cross-community support. As part of subsequent devolved executive's Programme for Government, a Review of Public Administration (RPA) was launched to consider sub-regional governance arrangements with a view to enhancing democratic accountability and improving efficiency through streamlining the current arrangements. To that end, the RPA has been committed to adhering to clear principles on which any credible reform should be based. While devolution itself has proved fitful, the work of the RPA has continued apace. Although embarking on reforms within functioning devolution is ministers' preferred option, there is a determination to continue the reform process irrespective of the present impasse. This paper outlines the issues, values and concepts that might shape the principles for conducting a review before considering the particular context within Northern Ireland. It also considers the impediments to overhauling the present arrangements and speculates on the likely outcome.
Polish Democracy in Transition?
Authors: Puchalska Bogusia
Published: November 2005

The roots of the current weaknesses in Poland's democratic process reach back not only to the era of socialism, but also to the first years of systemic reforms. The policy choices and the style of governance at such time of unprecedented revival of social activity were bound to have a long-term impact on the development of the political process, including the democratisation of society and of the political system. In the light of this, I argue that the authoritarian, exclusive and undemocratic style of politics of the first years of reforms squandered social trust and undermined the potential which this democratic revival represented, and that it damaged the prospects for building sound democratic foundations for the Polish political order in the nearer future.
THE HISTORY AND THEORY OF EMPIRES
Authors: POMPER PHILIP
Published: November 2005

Contemporary histories and theories of empire generally remain within boundaries inspired by varieties of liberalism, and by Marxian theory and its hybrids, in which changing modes of production determine the forms of power, including empire. Liberal theorists and historians of empire generally trace a complex process in which expanding imperial power systems led ultimately to nation‐states, democracy, and market economies. For Marxists and postmodern theorists, the formal aspects of empire remain unimportant compared to the broader workings of modes of production and particularly, the global power of capitalism. Michael Hardt and Antonio Negri use the word “empire” to describe the workings of contemporary capitalism and its myriad forms of power.

Whether they rely upon the formal definitions of empire or the Marxian‐postmodern one, theories of empire often descend from modern utopian visions: perhaps the Kantian variety emphasizing a peaceful union of states and collective learning, or the Marxian one, although now taking into account changes in the mode of production and victims unattended to by Marx and Engels. New technologies and communications networks impress all contemporary theorists. Some proclaim the end of modern power systems and empire; others find empire in a new, postmodern form. Nonetheless, there are stubborn continuities with the modern in the very persistence of modern utopias, the dominance of nation‐states, the pursuit of democracy, and the durability of capitalism. Theorists of power and empire have to explain these and other continuities, alongside the disappearance of the more than 400‐year‐old balance‐of‐power system in which imperial powers in the European core finally delivered vast power to the United States and the Soviet Union, and created new technologies that strengthen human connection as well as threaten vast destruction. The question of the power of the United States and its imperial status commands the center of attention.
MOVING BEYOND BIOPOWER: HARDT AND NEGRI'S POST‐FOUCAULDIAN SPECULATIVE PHILOSOPHY OF HISTORY
Authors: FILLION RÉAL
Published: November 2005

I argue in this paper that the attempt by Michael Hardt and Antonio Negri in Empire and Multitude to “theorize empire” should be read both against the backdrop of speculative philosophy of history and as a development of the conception of a “principle of intelligibility” as this is discussed in Michel Foucault's recently published courses at the Collège de France. I also argue that Foucault's work in these courses (and elsewhere) can be read as implicitly providing what I call “prolegomena to any future speculative philosophy of history.” I define the latter as concerned with the intelligibility of the historical process considered as a whole. I further suggest, through a brief discussion of the classical figures of Kant, Hegel, and Marx, that the basic features of speculative philosophy of history concern the articulation of both the telos and dynamics of history. My claim is that Hardt and Negri provide an account of the telos and dynamics of history that respects the strictures imposed on speculative philosophy of history by Foucault's work, and thus can be considered as providing a post‐Foucauldian speculative philosophy of history. In doing so, they provide a challenge to other “theoretical” attempts to account for our changing world.
Access to Care and Children's Primary Care Experiences: Results from a Prospective Cohort Study
Authors: Seid Michael , Stevens Gregory D.
Published: November 2005

Objective.To examine whether and how different kinds of access to care (financial, potential, and realized) predict parent‐report child primary care experiences in an urban community sample.

Data Sources/Study Setting.A prospective cohort study was performed. Baseline survey data were collected (67 percent response rate) from 3,406 parents of kindergarten through sixth grade students in a large urban school district in California during the 1999–2000 school year. A 1‐year survey (80.4 percent response rate) resulted in a final sample of 2,738.

Study Design.Data were analyzed using multiple regression models with robust estimation. The dependent variable was Time 2 parent reports of primary care experiences, assessed via the Parents' Perceptions of Primary Care (P3C) measure. The independent variables were financial access (insurance status), potential access (presence of a regular source of care), and realized access (foregone care), controlling for child and family characteristics (race/ethnicity, parent's language, mother's education level, and child chronic health condition status) and baseline P3C scores.

Data Collection.Data were collected by mail, telephone, and in person in English, Spanish, Vietnamese, and Tagalog.

Principal Findings.Controlling for baseline P3C scores and child and family characteristics, having no health insurance at both baseline and Time 2 was associated with a 6.2‐point lower Time 2 P3C score, relative to having had health insurance at both time points. Having a regular provider at Time 2 (either always having had one or gaining one during the year) was associated with, on average, a 10‐point higher Time 2 P3C score, compared to children without a regular provider (either never having had one or losing one during the year). Episodes of foregone care during the year were associated with 10.7 points lower Time 2 P3C scores, relative to children whose parents did not report foregone care. Similar relationships were found between all three measures of access to care and each of the sub‐domain measures of primary care experience.

Conclusions.Financial, potential, and realized access to care are associated prospectively with the full range of primary care experiences—comprehensiveness, communication, coordination, and contextual knowledge—beyond continuity and accessibility. Access to a regular source of care and to needed care are each associated with larger effects on primary care experiences than is the presence of health insurance. Gaining insurance or a regular source of care results in primary care experiences similar to always having had these, while losing a regular source of care has a more immediate effect than losing insurance on primary care experiences.
Developing a Quality Measure for Clinical Inertia in Diabetes Care
Authors: Berlowitz Dan R. , Ash Arlene S. , Glickman Mark , Friedman Robert H. , Pogach Leonard M. , Nelson Audrey L. , Wong Ashley T.
Published: November 2005

Objective. To develop a valid quality measure that captures clinical inertia, the failure to initiate or intensify therapy in response to medical need, in diabetes care and to link this process measure with outcomes of glycemic control.

Data Sources. Existing databases from 13 Department of Veterans Affairs hospitals between 1997 and 1999.

Study Design. Laboratory results, medications, and diagnoses were collected on 23,291 patients with diabetes. We modeled the decision to increase antiglycemic medications at individual visits. We then aggregated all visits for individual patients and calculated a treatment intensity score by comparing the observed number of increases to that expected based on our model. The association between treatment intensity and two measures of glycemic control, change in HbA1c during the observation period, and whether the outcome glycosylated hemoglobin (HbA1c) was greater than 8 percent, was then examined.

Principal Findings. Increases in antiglycemic medications occured at only 9.8percent of visits despite 39percent of patients having an initial HbA1c level greater than 8 percent. A clinically credible model predicting increase in therapy was developed with the principal predictor being a recent HbA1c greater than 8 percent. There were considerable differences in the intensity of therapy received by patients. Those patients receiving more intensive therapy had greater improvements in control (p<.001).

Conclusions. Clinical inertia can be measured in diabetes care and this process measure is linked to patient outcomes of glycemic control. This measure may be useful in efforts to improve clinicians management of patients with diabetes.
Assessing Quality of Diabetes Care by Measuring Longitudinal Changes in Hemoglobin A1c in the Veterans Health Administration
Authors: Thompson Wes , Wang Hongwei , Xie Minge , Kolassa John , Rajan Mangala , Tseng Chin‐Lin , Crystal Stephen , Zhang Quanwu , Vardi Yehuda , Pogach Leonard , Safford Monika M.
Published: November 2005

Context. A1c levels are widely used to assess quality of diabetes care provided by health care systems. Currently, cross‐sectional measures are commonly used for such assessments.

Objective. To study within‐patient longitudinal changes in A1c levels at Veterans Health Administration (VHA) facilities as an alternative to cross‐sectional measures of quality of diabetes care.

Design. Longitudinal study using institutional data on individual patient A1c level over time (October 1, 1998–September 30, 2000) with time variant and invariant covariates.

Setting. One hundred and twenty‐five VHA facilities nationwide, October 1, 1998–September 30, 2000.

Patients. Diabetic veteran users with A1c measurement performed using National Glycosylated Hemoglobin Standardization Project certified A1c lab assay methods.

Exposures. Characteristics unlikely to reflect quality of care, but known to influence A1c levels, demographics, and baseline illness severity.

Main Outcome Measure. Monthly change in A1c for average patient cared for at each facility.

Results. The preponderance of facilities showed monthly declines in within‐patient A1c over the study period (mean change of −0.0148 A1c units per month, range −0.074 to 0.042). Individual facilities varied in their monthly change, with 105 facilities showing monthly declines (70 significant at .05 level) and 20 showing monthly increases (5 significant at .05 level). Case‐mix adjustment resulted in modest changes (mean change of −0.0131 case‐mix adjusted A1c units per month, range −0.079 to 0.043). Facilities were ranked from worst to best, with attached 90 percent confidence intervals. Among the bottom 10 ranked facilities, four remained within the bottom decile with 90 percent confidence.

Conclusions. There is substantial variation in facility‐level longitudinal changes in A1c levels. We propose that evaluation of change in A1c levels over time can be used as a new measure to reflect quality of care provided to populations of individuals with chronic disease.
Improved Estimates of the Benefits of Breastfeeding Using Sibling Comparisons to Reduce Selection Bias
Authors: Evenhouse Eirik , Reilly Siobhan
Published: November 2005

Objective. Better measurement of the health and cognitive benefits of breastfeeding by using sibling comparisons to reduce sample selection bias.

Data. We use data on the breastfeeding history, physical and emotional health, academic performance, cognitive ability, and demographic characteristics of 16,903 adolescents from the first (1994) wave of the National Longitudinal Study of Adolescent Health. The sample includes 2,734 sibling pairs.

Study Design. We examine the relationship between breastfeeding history and 15 indicators of physical health, emotional health, and cognitive ability, using ordinary least squares and logit regression. For each indicator, we estimate, in addition to the usual between‐family model, a within‐family model to see whether differences in siblings' outcomes are associated with differences in the siblings' breastfeeding histories.

Principal Findings. Nearly all of the correlations found in the between‐family model become statistically insignificant in the within‐family model. The notable exception is a persistent positive correlation between breastfeeding and cognitive ability. These findings hold whether breastfeeding is measured in terms of duration or as a Yes/No variable.

Conclusions. This study provides persuasive evidence of a causal connection between breastfeeding and intelligence. However, it also suggests that nonexperimental studies of breastfeeding overstate some of its other long‐term benefits, even if controls are included for race, ethnicity, income, and education.
What Do Consumers Want to Know about the Quality of Care in Hospitals?
Authors: Sofaer Shoshanna , Crofton Christine , Goldstein Elizabeth , Hoy Elizabeth , Crabb Jenny
Published: November 2005

Objective. To guide the development of the Consumer Assessments of Healthcare Providers and Systems (CAHPS®) Hospital Survey by identifying which domains of hospital quality included in a survey of recent hospital patients, and which survey items within those domains, would be of greatest interest to consumers and patients.

Data Sources/Study Setting. Primary data were collected in four cities (Baltimore, Los Angeles, Phoenix, and Orlando), from a demographically varied mix of people of whom most, but not all, had recently been hospitalized or had a close loved one hospitalized.

Study Design/Data Collection Method. A total of 16 focus groups were held in these four cities. Groups were structured to be homogeneous with respect to type of health care coverage (Medicare, non‐Medicare), and type of recent hospital experience (urgent admission, elective admission, maternity admission, no admission). They were heterogeneous with respect to race/ethnicity, gender, and educational attainment. In addition to moderated discussions, focus group participants completed a pregroup questionnaire and various paper and pencil exercises during the groups.

Principal Findings. A wide range of features were identified by participants as being relevant to hospital quality. Many were consonant with domains and items in the CAHPS Hospital Survey; however, some addressed structural features of hospitals and hospital outcomes that are not best derived from a patient experience survey. When shown the domains and items being considered for inclusion in the CAHPS Hospital Survey, participants were most interested in items relating to doctor communication with patients, nurse and hospital staff communication with patients, responsiveness to patient needs, and cleanliness of the hospital room and bathroom. Findings were quite consistent across groups regardless of location and participant characteristics.

Conclusions. Consumers and patients have a high degree of interest in hospital quality and found a very high proportion of the items being considered for the CAHPS Hospital Survey to be so important they would consider changing hospitals in response to information about them. Hospital choice may well be constrained for patients, but publicly reported information from a patient perspective can also be used to support patient discussions with facilities and physicians about how to ensure patients have the best hospital experience possible.
Review of the Literature on Survey Instruments Used to Collect Data on Hospital Patients' Perceptions of Care
Authors: Castle Nicholas G. , Brown Julie , Hepner Kimberly A. , Hays Ron D.
Published: November 2005

Objective. To review the existing literature (1980–2003) on survey instruments used to collect data on patients' perceptions of hospital care.

Study Design. Eight literature databases were searched (PubMED, MEDLINE Pro, MEDSCAPE, MEDLINEplus, MDX Health, CINAHL, ERIC, and JSTOR). We undertook 51 searches with each of the eight databases, for a total of 408 searches. The abstracts for each of the identified publications were examined to determine their applicability for review.

Methods of Analysis. For each instrument used to collect information on patient perceptions of hospital care we provide descriptive information, instrument content, implementation characteristics, and psychometric performance characteristics.

Principal Findings. The number of institutional settings and patients used in evaluating patient perceptions of hospital care varied greatly. The majority of survey instruments were administered by mail. Response rates varied widely from very low to relatively high. Most studies provided limited information on the psychometric properties of the instruments.

Conclusions. Our review reveals a diversity of survey instruments used in assessing patient perceptions of hospital care. We conclude that it would be beneficial to use a standardized survey instrument, along with standardization of the sampling, administration protocol, and mode of administration.
Equivalence of Mail and Telephone Responses to the CAHPS® Hospital Survey
Authors: de Vries Han , Elliott Marc N. , Hepner Kimberly A. , Keller San D. , Hays Ron D.
Published: November 2005

Objective. To estimate the effect of survey mode (mail versus telephone) on reports and ratings of hospital care.

Data Sources/Study Setting. The total sample included 20,826 patients discharged from a group of 24 distinct hospitals in three states (Arizona, Maryland, New York). We collected CAHPS® data in 2003 by mail and telephone from 9,504 patients, of whom 39 percent responded by telephone and 61 percent by mail.

Study Design. We estimated mode effects in an observational design, using both propensity score blocking and (ordered) logistic regression on covariates. We used variables derived from administrative data (either included as covariates in the regression function or used in estimating the propensity score) grouped in three categories: individual characteristics, characteristics of the stay and hospital, and survey administration variables.

Data Collection/Extraction Methods. We mailed a 66‐item questionnaire to everyone in the sample and followed up by telephone with those who did not respond.

Principal Findings. We found significant (p<.01) mode effects for 13 of the 21 questions examined in this study. The maximum magnitude of the survey mode effect was an 11 percentage‐point difference in the probability of a “yes” response to one of the survey questions. Telephone respondents were more likely to rate care positively and health status negatively, compared with mail respondents. Standard regression‐based case‐mix adjustment captured much of the mode effects detected by propensity score techniques in this application.

Conclusions. Telephone mode increases the propensity for more favorable evaluations of care for more than half of the items examined. This suggests that mode of administration should be standardized or carefully adjusted for. Alternatively, further item development may minimize the sensitivity of items to mode of data collection.
Effect of Social Security Payments on Substance Abuse in a Homeless Mentally Ill Cohort
Authors: Rosen Marc I. , McMahon Thomas J. , Lin HaiQun , Rosenheck Robert A.
Published: November 2005

Objectives. To determine whether receipt of social supplemental security income (SSI) or Social Security disability income (SSDI) disability payments is associated with increased drug and alcohol use.

Data Sources/Study Setting. Secondary analysis of data from 6,199 participants in the Access to Community Care and Effective Social Supports and Services demonstration for the homeless mentally ill.

Design. Observational, 12‐month, cohort study completed over 4 years. Substance abuse and other outcomes were compared between the participants who did not receive SSI or SSDI during the 12‐month study, those newly awarded benefits, and those without benefits throughout the 12 months.

Data Collection Methods. Social Security administrative records were used to corroborate Social Security benefit status. Drug and alcohol use were measured by self‐report and clinician ratings.

Principal Findings. Participants who did not receive benefits significantly reduced their substance use over time. In generalized estimating equations models that adjusted for potentially confounding covariates, participants who newly received Social Security benefits showed no greater drug use than those without benefits but had significantly more days housed and fewer days employed. Participants whose benefits antedated the demonstration and continued during the 12 months had more clinician‐rated drug use over time than those without benefits.

Conclusions. In this vulnerable population, participants with newly awarded benefits did not have any different drug use changes than those without benefits, and had relatively more days housed. The hypothesis that Social Security benefits facilitate drug use was not supported by longitudinal data in this high‐risk population.
Diet‐associated hepatic failure and immune‐mediated hemolytic anemia in a Weimaraner
Authors: Smith Ashley J. , Stenske Katherine A. , Bartges Joseph W. , Kirk Claudia A.
Published: November 2005

Objective: To describe the medical and nutritional management of a 4‐year‐old Weimaraner with acute hepatic failure and immune‐mediated hemolytic anemia (IMHA) associated with consuming a commercial dog food.

Case summary: A 4‐year‐old male castrated Weimaraner developed signs of IMHA, hepatic failure, disseminated intravascular coagulopathy, and malnutrition after consuming a commercial dog food. During the course of hospitalization, medical management included immunosuppressive therapy and supportive care. Nutritional support consisted of both enteral and parenteral nutrition. The dog was discharged after 19 days of hospitalization and fully recovered by 6 months. An investigation by the Food and Drug Administration was not able to determine the exact cause of the acute hepatic failure and IMHA.

New information provided: This is the first case report documenting the medical and nutritional management of a critically ill animal associated with ingestion of this commercial dog food.
Use of a Chemical Probe to Increase Safety for Human Volunteers in Toxicokinetic Studies
Authors: Brochot Céline , Bois Frédéric Y.
Published: November 2005

To avoid interspecies extrapolation in toxicokinetics and drug development, it is convenient to directly develop human data. In that case, exposure dose should pose null or negligible risk to the exposed individual, but still be sufficiently high to allow quantification. We propose to reduce the dose received by human volunteers during exposure, and to compensate for loss of information by exposing the same volunteers to a nontoxic agent. This method was applied to develop 1,3‐butadiene (BD) exposure protocols for humans. To study the potential of such a procedure, we worked with simulated data. Three exposure times (20, 10, and 5 minutes) and four exposure concentrations (2, 1, 0.8, and 0.5 ppm) were used to define 12 inhalation exposure scenarios for BD. Isoflurane was used as a probe, with simulated exposure of 20 subjects to 20 ppm isoflurane during 15 minutes. Isoflurane or BD‐exhaled air concentrations were supposed to be measured 10 times. A three‐compartment physiological toxicokinetic model was used to jointly describe BD and isoflurane data. For each subject, BD data were analyzed, in a Bayesian framework, either alone or together with the isoflurane data. The precision of BD metabolic rate constant or fraction metabolized was increased, and bias reduced, when BD and probe data were considered jointly. An exposure to 10 ppm × min BD and 300 ppm × min isoflurane gave equivalent precision and bias as a unique exposure to 40 ppm × min BD. The BD dose received by volunteers could therefore be at least quartered if BD exposure was supplemented with that of a probe.
Dietary and Inhalation Intake of Lead and Estimation of Blood Lead Levels in Adults and Children in Kanpur, India
Authors: Sharma Mukesh , Maheshwari Mayank , Morisawa S.
Published: November 2005

This research was initiated to study lead levels in various food items in the city of Kanpur, India, to assess the dietary intake of lead and to estimate blood lead (PbB) levels, a biomarker of lead toxicity. For this purpose, sampling of food products, laboratory analysis, and computational exercises were undertaken. Specifically, six food groups (leafy vegetables, nonleafy vegetables, fruits, pulses, cereals, and milk), drinking water, and lead air concentration were considered for estimating lead intake. Results indicated highest lead content in leafy vegetables followed by pulses. Fruits showed low lead content and drinking water lead levels were always within tolerable limits. It was estimated that average daily lead intake through diet was about 114 μg/day for adults and 50 μg/day in children; tolerable limit is 250 μg/day for adults and 90 μg/day for children. The estimated lead intakes were translated into the resultant PbB concentrations for children and adults using a physiologically‐based pharmacokinetic (PBPK) model. Monte Carlo simulation of PbB level variations for adults showed that probability of exceeding the tolerable limit of PbB (i.e.,10 μg/dL) was 0.062 for the pre‐unleaded and 0.000328 for the post‐unleaded gasoline period. The probability of exceeding tolerable limits in PbB level was reduced by a factor of 189 in the post‐unleaded scenario. The study also suggested that in spite of the introduction of unleaded gasoline, children continue to be at a high risk (probability of exceeding 10 μg/dL = 0.39) because of a high intake of lead per unit body weight.
Measurement and Pricing of Risk in Insurance Markets
Authors: Tsanakas Andreas , Desli Evangelia
Published: November 2005

The theory and practice of risk measurement provides a point of intersection between risk management, economic theories of choice under risk, financial economics, and actuarial pricing theory. This article provides a review of these interrelationships, from the perspective of an insurance company seeking to price the risks that it underwrites. We examine three distinct approaches to insurance risk pricing, all being contingent on the concept of risk measures. Risk measures can be interpreted as representations of risk orderings, as well as absolute (monetary) quantifiers of risk. The first approach can be called an “axiomatic” one, whereby the price for risks is calculated according to a functional determined by a set of desirable properties. The price of a risk is directly interpreted as a risk measure and may be induced by an economic theory of price under risk. The second approach consists in contextualizing the considerations of the risk bearer by embedding them in the market where risks are traded. Prices are calculated by equilibrium arguments, where each economic agent's optimization problem follows from the minimization of a risk measure. Finally, in the third approach, weaknesses of the equilibrium approach are addressed by invoking alternative valuation techniques, the leading paradigm among which is arbitrage pricing. Such models move the focus from individual decisiontakers to abstract market price systems and are thus more parsimonious in the amount of information that they require. In this context, risk measures, instead of characterizing individual agents, are used for determining the set of price systems that would be viable in a market.
Rapid Climate Change and Society: Assessing Responses and Thresholds
Authors: Niemeyer Simon , Petts Judith , Hobson Kersty
Published: November 2005

Assessing the social risks associated with climate change requires an understanding of how humans will respond because it affects how well societies will adapt. In the case of rapid or dangerous climate change, of particular interest is the potential for these responses to cross thresholds beyond which they become maladaptive. To explore the possibility of such thresholds, a series of climate change scenarios were presented to U.K. participants whose subjective responses were recorded via interviews and surveyed using Q methodology. The results indicate an initially adaptive response to climate warming followed by a shift to maladaptation as the magnitude of change increases. Beyond this threshold, trust in collective action and institutions was diminished, negatively impacting adaptive capacity. Climate cooling invoked a qualitatively different response, although this may be a product of individuals being primed for warming because it has dominated public discourse. The climate change scenarios used in this research are severe by climatological standards. In reality, the observed responses might occur at a lower rate of change. Whatever the case, analysis of subjectivity has revealed potential for maladaptive human responses, constituting a dangerous or rapid climate threshold within the social sphere.
Consortium for Atlantic Regional Assessment: Information Tools for Community Adaptation to Changes in Climate or Land Use
Authors: Dempsey Rachael , Fisher Ann
Published: November 2005

To inform local and regional decisions about protecting short‐term and long‐term quality of life, the Consortium for Atlantic Regional Assessment (CARA) provides data and tools (for the northeastern United States) that can help decisionmakers understand how outcomes of their decisions could be affected by potential changes in both climate and land use. On an interactive, user‐friendly website, CARA has amassed data on climate (historical records and future projections for seven global climate models), land cover, and socioeconomic and environmental variables, along with tools to help decisionmakers tailor the data for their own decision types and locations. CARA Advisory Council stakeholders help identify what information and tools stakeholders would find most useful and how to present these; they also provide in‐depth feedback for subregion case studies. General lessons include: (1) decisionmakers want detailed local projections for periods short enough to account for extreme events, in contrast to the broader spatial and temporal observations and projections that are available or consistent at a regional level; (2) stakeholders will not use such a website unless it is visually appealing and easy to find the information they want; (3) some stakeholders need background while others want to go immediately to data, and some want maps while others want text or tables. This article also compares what has been learned across case studies of Cape May County, New Jersey, Cape Cod, Massachusetts, and Hampton Roads, Virginia, relating specifically to sea‐level rise. Lessons include: (1) groups can be affected differently by physical dangers compared with economic dangers; (2) decisions will differ according to decision makers' preferences about waiting and risk tolerance; (3) future scenarios and maps can help assess the impacts of dangers to emergency evacuation routes, homes, and infrastructure, and the natural environment; (4) residents' and decisionmakers' perceptions are affected by information about potential local impacts from global climate change.
Service Charters: Reshaping Trust in Government—The Case of Spain
Authors: Torres Lourdes
Published: November 2005

Service charters are located at the intersection between public administration reforms and governance initiatives for improving citizen trust in governments. Service charters in Spain show the will to shift from a legal tradition to one that meets citizens' needs and makes government more accessible, transparent, and open to the public. The article examines the role and performance of service charters and the contribution of charters to change in Spanish public administration, to the empowerment of citizens in the improvement of service standards, and to citizen participation in the organization of public services. It aims to investigate the factors that drive the introduction of charters and the performance that can be obtained. To test the potential of service charters in Spain, we interviewed public‐sector managers at the central level by applying the Delphi method and statistical techniques.
Contrasting Visions of Global Civil Society for Organization and Policy
Authors: Srinivas Nidhi
Published: November 2005

Books reviewed in this article:

Mary Kaldor, Helmut Anheier, and Marlies Glasius, eds., Global Civil Society Yearbook 2003

John Keane, Global Civil Society?

Lester M. Salamon, Helmut K. Anheier, Regina List, Stefan Toepler, S. Wojcieh Sokolowski, and associates, Global Civil Society: Dimensions of the Nonprofit Sector
An unusual presentation of rhinofacial zygomycosis due to Cunninghamella sp. in an immunocompetent patient: a case report and literature review
Authors: Jayasuriya NSS , Tilakaratne WM , Amaratunga EAPD , Ekanayake MKB
Published: November 2005

Zygomycosis is a rare fungal infection usually found in immunocompromised patients. It is a rapidly progressing infection with a high mortality rate. Our report describes an unusual case of rhinofacial zygomycosis due to Cunninghamella sp. in an immunocompetent patient, who presented with a slowly progressive swelling of the left cheek. An interrupted course of amphotericin B treatment caused regression of the lesion. Drug therapy was abandoned due to impairment of renal function. The patient was clinically and radiologically disease free for 2 years following cessation of therapy.
Measuring the Impact of State Accountability Programs
Authors: Chester Mitchell D.
Published: November 2005

“No Child Left Behind is a law that makes good people bad and bad people worse.”

Declaration of the keynote speaker at the public forum on the No Child Left Behind Act in Columbus, Ohio, on November 17, 2004, sponsored by the Kappa Delta Pi International Honor Society in Education, the National Academy of Education, and the National Society for the Study of Education.
Time-Dependent Rheological Behavior of Fluids For Electronics Packaging
Authors: Chen X. B.
Published: November 2005

In electronics packaging, one of the key processes is dispensing fluid materials, such as adhesive, epoxy, encapsulant, onto substrates or printed circuit boards for the purpose of surface mounting or encapsulation. In order to precisely control the dispensing process, the understanding and characterization of the flow behavior of the fluid being dispensed is very important, as the behavior can have a significant influence on the dispensing process. However, this task has proven to be very challenging due to the fact that the fluids for electronics packaging usually exhibit the time-dependent rheological behavior, which has not been well defined in literature. In the paper a study on the characterization of the time-dependent rheological behavior of the fluids for electronics packaging is presented. In particular, a model is developed based on structural theory and then applied to the characterization of the decay and recovery of fluid behavior, which happen in the dispensing process due to the interruption of process. Experiments are carried out to verify the effectiveness of the model developed.
Isothermal Mechanical Durability of Three Selected PB-Free Solders: Sn3.9Ag0.6Cu, Sn3.5Ag, and Sn0.7Cu
Authors: Zhang Qian , Dasgupta Abhijit , Haswell Peter
Published: November 2005

This study is motivated by the urgent need in the electronics industry for mechanical properties and durability of Pb-free solders because the use of Pb will be banned in the EU by July 1, 2006. The isothermal mechanical durability of three NEMI recommended Pb-free solders, 95.5Sn-3.9Ag-0.6Cu, 96.5Sn-3.5Ag, and 99.3Sn-0.7Cu, is tested on the thermo-mechanical-microscale (TMM) setup under two test conditions: room temperature and relatively high strain rate, and high temperature and low strain rate. The test data are presented in a power law relationship between three selected damage metrics (total strain range, inelastic strain range, and cyclic work density) to 50% load drop. The obtained mechanical durability models of three Pb-free solders are compared with those of the eutectic 63Sn-37Pb solder at the two selected test conditions and at the same homologous temperature of 0.75. The results of this study can be used for virtual qualification of Pb-free electronics during design and development of electronics under mechanical loading.