bluuebunny/crossref_metadata_2025 huggingface dataset:
When the State Kills: Capital Punishment and the American Condition. By Austin Sarat. Princeton, NJ: Princeton University Press, 2001. 314p. $29.95.
Authors: Norris Andrew
Published: May 2008

As the United States begins fighting a war devoted not to the overthrow or liberation of a particular government but, rather, as Mr. Bush put it, to rid the world of “evildoers,” it is easy to forget that our state is also busy at home killing people in the service of a similar oversimplified moralism. Austin Sarat's most recent book is, then, an important reminder. Since the Supreme Court reinstated capital punishment in 1976 the country's appetite for it has steadily increased: More than 3,600 people now sit on death row, and their numbers continue to swell. While there have been some welcome signs of a slackening in the nation's tolerance for the killing of the mentally retarded and the innocent, the Rehnquist court has been streamlining the appeal process in an attempt, in the Chief Justice's words, to “get on with it.” Sarat rightly protests against the ensuing compromises of the rights of those caught up in the system, a disproportionate number of whom are, as everyone knows, poor and black. He argues that routine killing by the state is not just illiberal in its corrosive effect upon the Bill of Rights but in conflict with the institutions and spirit of our democracy. Where democracy calls for a willingness to seek reconciliation and the improvement of institutions through dialogue, and hence a willingness to admit that one's own perspective is limited and one's own judgment fallible, capital punishment requires that we assume the mantle of infallibility, and it is sustained by a spirit of rage that it in turn nurtures. One of the strongest features of Sarat's book is its insistence that none of this is accidental: “State killing…is part of a strategy of governance that makes us fearful and dependent on the illusion of state protection, that divides rather than unites, that promises simple solutions to complex problems” (p. 247). It is easier and less anxiety-producing to tell ourselves familiar comic book stories about the battle of good and evil than to get down to “the difficult, often frustrating work of understanding what in our society breeds such heinous acts of violence” (p. 14). And if we believe the stories we tell, it is hard to imagine living without the protection of a powerful and threatening state that can match the violent forces arrayed against us. For those who profit politically or financially from the present forms of that society, that is all to the better. Protego ergo obligo.
Is the Fetus a Person? A Comparison of Policies Across the Fifty States. By Jean Reith Schroedel. Ithaca, NY: Cornell University Press, 2000. 256p. $29.95.
Authors: Doan Alesha E.
Published: May 2008

The conceptual—and legal—division between a woman and a fetus is most recently rooted in the Supreme Court's 1973 Roe v. Wade decision, which established the trimester framework designed to balance a woman's right to privacy with the state's interest in protecting potential life. Prior to Roe, a woman and her fetus were legally viewed as having identical interests because of their biological tie. The trimester framework, however, established a precedent for viewing the maternal-fetal relationship as an adversarial one, where a woman and her fetus have conflicting interests. Indeed, as states demonstrate their willingness to protect fetal health—via restrictions on access to abortion—the fetus is increasingly being viewed as a separate entity that is entitled to protection and recognition as a person. The questions of when and under what conditions a fetus is a person have policy implications beyond the scope of the abortion debate.
Trading Blows: Party Competition and U.S. Trade Policy in a Globalizing Era. By James Shoch. Chapel Hill: University of North Carolina Press, 2001. 388p. $59.95 cloth, $19.95 paper.
Authors: Mayer Frederick
Published: May 2008

In this history of American trade politics, James Shoch argues for the centrality of political parties in the making of trade policy. His thesis, simply stated, is that parties matter, and matter a good deal more than the literature generally acknowledges. As he depicts it, the historical record is something like a heavyweight prizefight, in which the Democratic and Republican Parties, driven by constituency pressures, ideological differences, and, especially, the quest for political advantage, spar ceaselessly over trade issues.
Congressional Enactments of Race–Gender: Toward a Theory of Raced–Gendered Institutions
Authors: HAWKESWORTH MARY
Published: May 2008

Investigating reports of marginalization from Congresswomen of color, I examine legislative practices in the 103rd and 104th Congresses to illuminate dynamics that structure hierarchies on the basis of race and gender. I advance an account of racing–gendering as a political process that silences, stereotypes, enforces invisibility, excludes, and challenges the epistemic authority of Congresswomen of color. Racing–gendering constitutes a form of interested bias operating in Congress, which has important implications for understandings of the internal operations of political institutions, the policy priorities of Congresswomen of color, the substantive representation of historically underrepresented groups, and the practice of democracy in the United States.
Useful Fiction or Miracle Maker: The Competing Epistemological Foundations of Rational Choice Theory
Authors: MacDONALD PAUL K.
Published: May 2008

Rational choice theorists have not clearly articulated their epistemological positions, and for this reason, their arguments in favor of rational choice theory are inconsistent, contradictory, and unpersuasive. To remedy this problem, I describe how two of the main positions in the philosophy of science, instrumentalist-empiricism and scientific-realism, act as competing epistemological foundations for rational choice theory. I illustrate how these philosophical perspectives help political scientists (1) understand what is at stake in the theoretical debates surrounding the rationality assumption, self-interest, and methodological individualism, (2) identify inconsistencies in the epistemological positions adopted by rational choice theorists, and (3) assess the feasibility and desirability of a universal theory based on the rationality assumption.
Enhancing the Validity and Cross-Cultural Comparability of Measurement in Survey Research
Authors: KING GARY , MURRAY CHRISTOPHER J. L. , SALOMON JOSHUA A. , TANDON AJAY
Published: May 2008

We address two long-standing survey research problems: measuring complicated concepts, such as political freedom and efficacy, that researchers define best with reference to examples; and what to do when respondents interpret identical questions in different ways. Scholars have long addressed these problems with approaches to reduce incomparability, such as writing more concrete questions—with uneven success. Our alternative is to measure directly response category incomparability and to correct for it. We measure incomparability via respondents' assessments, on the same scale as the self-assessments to be corrected, of hypothetical individuals described in short vignettes. Because the actual (but not necessarily reported) levels of the vignettes are invariant over respondents, variability in vignette answers reveals incomparability. Our corrections require either simple recodes or a statistical model designed to save survey administration costs. With analysis, simulations, and cross-national surveys, we show how response incomparability can drastically mislead survey researchers and how our approach can alleviate this problem.
Putting Race in Context: Identifying the Environmental Determinants of Black Racial Attitudes
Authors: GAY CLAUDINE
Published: May 2008

Prior research on the contextual determinants of black racial attitudes has focused on the effects of residential segregation while overlooking differences in the socioeconomic character of neighborhoods. I posit that socioeconomic environments, in particular, the quality and socioeconomic composition of neighborhoods, may affect whether blacks view race as a defining interest in their lives. I test these propositions with a multilevel dataset that merges the 1992–1994 Multi-City Survey of Urban Inequality with block-group–level demographic statistics from the 1990 Census. The results indicate that neighborhood quality and neighborhood socioeconomic composition work at cross-purposes in affecting black racial attitudes. The salience of race recedes with improvements in neighborhood quality yet advances with greater exposure to the race-oriented predispositions of high-status blacks. In closing, I discuss the implications of shifting residential patterns for the future of political consensus and group-based mobilization among African Americans.
A Theory of Endogenous Institutional Change
Authors: GREIF AVNER , LAITIN DAVID D.
Published: May 2008

This paper asks (a) why and how institutions change, (b) how an institution persists in a changing environment, and (c) how processes that it unleashes lead to its own demise. The paper shows that the game-theoretic notion of self-enforcing equilibrium and the historical institutionalist focus on process are both inadequate to answer these questions. Building on a game-theoretic foundation, but responding to the critique of it by historical institutionalists, the paper introduces the concepts of quasi-parameters and self reinforcement. With these concepts, and building on repeated game theory, a dynamic approach to institutions is offered, one that can account for endogenous change (and stability) of institutions. Contextual accounts of formal governing institutions in early modern Europe and the informal institution of cleavage structure in the contemporary world provide illustrations of the approach.
The Reputations Legislators Build: With Whom Should Representatives Collaborate?
Authors: CRISP BRIAN F. , KANTHAK KRISTIN , LEIJONHUFVUD JENNY
Published: May 2008

How do legislators build the reputations they use in bids for reelection? Do they use their personal reputations or associate with other legislators? And how do parties, coalitions, and institutions affect these decisions? Research on how electoral systems affect parties in legislatures frequently focuses on the extent to which electoral rules make legislators more or less ideologically convergent with respect to other members of the chamber—copartisan and not. However, finding equilibrium strategies is often possible only under restrictive institutional and spatial assumptions. Instead of viewing ideology spatially, we conceive of ideological reputations as currencies, used to purchase electoral support in transactions we liken to auctions. In our test of the model, we use bill cosponsorship patterns as an indicator of the reputations incumbents use to purchase electoral support. We show that under relatively common institutional conditions, legislators may have strong incentives to cultivate reputations they must share with their toughest electoral competitors.
Laura Wright (ed.), The development of Standard English,
1300–1800. Cambridge: Cambridge University Press,
2000. Pp. xi + 236. $59.95.
Authors: Bailey Richard W.
Published: May 2008

This important book – hereafter
DSE – demonstrates for all linguists how an
insightful observation by a young scholar can question basic
assumptions and fondly held beliefs. In 1996, Laura Wright
published an essay in a Festschrift for Eric Stanley in which
she pointed to the fragility of the received wisdom that the
modern prestige dialect of Britain emerged from a medieval
“Central Midland” progenitor brought to London from
the north and promulgated through the scribes in the Court of
Chancery. In 1997, a conference was held in Cambridge to pursue
the questions she had raised; then, in 1999, further discussion
at the University of London led to this volume.
Oral narrative skills of late talkers at ages 8 and 9
Authors: MANHARDT JOAN , RESCORLA LESLIE
Published: May 2008

This study compared the oral narrative skills of 31 school-aged children diagnosed at 24 to 31 months with expressive language delay (late talkers) with those of 23 typically developing peers. Based upon an extensively studied picture-book task, Frog, Where are You?, narratives were elicited from all participants both at age 8 and age 9. At age 9, children were asked to tell the story again and to increase their references to evaluative information (characters' emotions, character speech, and causal explanations of events; “supported” telling condition). Groups were compared on Syntax, Story Grammar, Cohesion, and Evaluative Information factor scores derived from the narrative measures. Children with histories of early language delay obtained lower Syntax, Story Grammar, and Evaluative Information factor scores than typically developing peers for each of their three narrative productions. The late talkers scored in the average range at age 8 on the Clinical Evaluation of Language Fundamentals–Revised (CELF-R), but their scores were significantly lower than those of the comparison peers. When the group differences on the Story Grammar factor were reanalyzed with the CELF-R score as a covariate, the late talkers demonstrated weaknesses in story grammar skills independent of the variance accounted for by their weaker general language skills. This suggests that the use of narrative structure may be a specific area of underachievement for late talkers, in addition to their continuing weakness in syntactic and lexical abilities, relative to typically developing peers from the same SES background.
Morphology in incipient bilingual Spanish-speaking preschool children with specific language impairment
Authors: JACOBSON PEGGY F. , SCHWARTZ RICHARD G.
Published: May 2008

This study examined the use of clitic pronouns by incipient bilingual Spanish-speaking 4- and 5-year-old children with and without language impairments. Incipient bilingualism refers to the initial stages of contact between two languages, when an individual still has only passive knowledge of a second language. The participants included 10 children with typical language development and 10 children with specific language impairment (SLI). The experimental task elicited clitic pronouns serving as direct objects with finite verbs (lo, la, los, and las). The children who had SLI used clitic pronouns less frequently than their age-matched peers and were less accurate in their use of gender agreement for clitics. No group differences were found for third person singular and plural verb inflections in the preterite tense. These results were compared to previous studies of Spanish- and Italian-speaking children with SLI.
Effects of general processing capacity and sustained selective attention on temporal processing performance of children with specific language impairment
Authors: HANSON REBECCA A. , MONTGOMERY JAMES W.
Published: May 2008

This study investigated the potential influences of general processing capacity and sustained selective attention on the temporal processing of a group of children with specific language impairment (SLI) and a group of age-matched (CA) controls. Children completed a sustained selective auditory attention task and two speech processing tasks, the Speech Identification Task, representing a cognitively more complex task, and a standard speech discrimination task, representing a cognitively less complex task. The speech stimuli included two-formant, 40-ms transition [ba] and [da] consonant–vowel (CV) syllables and the nonstop CV syllable [sa]. We hypothesized, in accordance with Tallal's temporal processing deficit view, that if SLI children have a fundamental deficit in temporal processing, they should demonstrate poor performance on both speech processing tasks relative to CA children. By contrast, if the temporal processing problem of SLI children relates to a limitation in general processing capacity, the SLI children should show better performance on the discrimination task compared to the identification task. Alternatively, if poor sustained selective attention mediates SLI children's poor temporal processing, the SLI children should show poor performance on an independent measure of auditory attention, which in turn should account for a portion of the variance in any observed group differences in temporal processing. Results showed no group difference in sustained selective auditory attention. On the identification task, group, stimulus-type, and interaction effects emerged. SLI children performed more poorly than CA children, and stop CV syllables were identified less frequently than the nonstop CV syllable. On the discrimination task, there were no main effects or interactions for accuracy (Á score). For the reaction time analysis, only a stimulus-type effect was found, with children responding faster to the /sa/ syllable. Results were interpreted to suggest that these SLI children did not evidence a basic temporal processing deficit. Rather, the SLI children's poor identification task performance was interpreted to reflect an interaction between these children's more limited general processing capacity and the nature of the task.
A similarity in word-recognition procedures among second language readers with different first language backgrounds
Authors: AKAMATSU NOBUHIKO
Published: May 2008

This study investigated word recognition among fluent readers of English as a second language (ESL). Specifically, the study examined whether ESL readers' first language (L1) affects the procedures underlying second language word recognition, with respect to the effects of word frequency and regularity on word recognition. The results revealed a similarity in word-recognition procedures between fluent ESL readers with various L1 backgrounds (i.e., Chinese, Japanese, and Persian). In processing high-frequency words, all the ESL groups recognized exception words as quickly as regular words; low-frequency exception words, on the contrary, took longer to recognize than low-frequency regular words.
The generative study of second language acquisition. S. Flynn, G. Martohardjono, and W. O'Neil (Eds.). Mahwah, NJ: Erlbaum, 1998. Pp. 366.
Authors: Bolotin Naomi
Published: May 2008

This volume contains all 14 papers and three commentaries from the Recent Advances in the Generative Study of Second Language Acquisition Conference that was held in 1993 at MIT. Eleven of the papers address the acquisition of syntax. Of these, four focus on functional categories in second language (L2) acquisition. Vainikka and Young-Scholten propose that, although lexical categories or content phrases (NP, VP, AP, PP) transfer from the first language to the second, along with the headedness of those categories, functional categories or grammatical phrases (DP, IP, CP) do not. Using longitudinal data from Korean, Turkish, Italian, and Spanish learners of German, they suggest that learners begin by adopting a VP structure for the sentences in the L2 and then subsequently expand this into an underspecified finite phrase (FP), then an agreement phrase (AgrP), and finally a complementizer phrase (CP).
Second language acquisition processes in the classroom: Learning Japanese. Amy Snyder Ohta. Mahwah, NJ: Erlbaum, 2001. Pp. 316.
Authors: Minami Masahiko
Published: May 2008

In traditional foreign-language classrooms, students are explicitly taught grammar and vocabulary. Language learners' difficulties in conveying their messages in the target language, however, may relate to the development of interactional competence, which is achieved through interactions with peers and teachers within the classroom setting. Unfortunately, the importance of such pragmatic development is not always emphasized in traditional classrooms. To address this inadequacy, Amy Synder Ohta's new book provides an introduction to the complex process of learning a second or foreign language (L2) in a classroom setting.
Spelling performance of Chinese children using English as a second language: Lexical and visual–orthographic processes
Authors: WANG MIN , GEVA ESTHER
Published: May 2008

The present study compared lexical and visual–orthographic processing in the spelling performance of 30 Cantonese Chinese children who are English as a second language (ESL) learners to that of 33 native English-speaking (L1) children. Chinese ESL children showed poorer performance in spelling to dictation of pseudowords than L1 children. The difference between real word and pseudoword spelling performances for ESL children was significantly greater than that for L1 children. Moreover, Chinese ESL children outperformed their L1 counterparts in a confrontation spelling task of orthographically legitimate and illegitimate letter strings. In line with their advantage in spelling visually presented materials, the difference between spelling performance on legitimate and illegitimate letter strings for the Chinese children was significantly smaller than that for the L1 children. These findings are discussed in terms of early transfer of L1 literacy skills in second language literacy acquisition and support for a multiroute reading model.
Auditory recognition of idioms by native and nonnative speakers of English: It takes one to know one
Authors: VANLANCKER–SIDTIS DIANA
Published: May 2008

The abilities of second language speakers to discriminate the prosodic contrasts between idiomatic and literal meanings of ambiguous sentences were investigated using utterances previously shown to be reliably identified by acoustic cues. Four listener groups of varying proficiency, native speakers of American English, native speakers of non-American English, fluent nonnative speakers of English, and advanced students of English as a second language (ESL), judged whether single and paired, tape-recorded, literal and idiomatic utterances were spoken with intended idiomatic or literal meanings. Both native speaker groups performed significantly better than fluent nonnatives, while ESL students performed at chance. These results lend support to the hypothesis that abilities to discriminate subtle prosodic contrasts are learned later than other components of speech and language.
A multivariate model of early reading acquisition
Authors: KONOLD TIMOTHY R. , JUEL CONNIE , MCKINNON MARLIE , DEFFES REBECCA
Published: May 2008

How similar are the cognitive and linguistic profiles of those children who easily learn to read? How similar are the profiles of those children who have difficulty learning to read? Do the profiles of successful and less successful readers vary among children 5–10 years of age? These were the questions that guided this study. Six core profiles were identified on four fluid reasoning to comprehension knowledge constructs previously found to be both theoretically and empirically linked to children's reading acquisition: auditory processing, crystallized ability, processing speed, and short-term memory. Cluster analysis was used to develop this taxonomy and the six-cluster solution was supported through cross-validation. The internal and external validity of the resulting profiles was favorable, suggesting homogeneous within-cluster membership and clear separation among the six core profiles. A summary of the defining characteristics for each profile is provided. The performance of children comprising different profiles was investigated on four external reading outcomes. These comparisons were conducted for each of the six age groups comprising the sample (i.e., 5–10 years) to assess whether the importance of certain score configurations varied as a function of the reading tasks required of children learning to read and those who are already readers. Results indicated that certain profiles were associated with greater success on external measures of reading achievement than other profiles. Trends across ages and differences among age groups are described.
Perceptual restoration in children versus adults
Authors: NEWMAN ROCHELLE S.
Published: May 2008

Children often listen to speech in noisy environments, where they must use prior knowledge to help them interpret the intended signal. The present experiment compares school-aged children's and adults' use of one such form of prior knowledge, as demonstrated in the perceptual restoration effect. Children, like adults, perform better when speech is intermittently replaced with noise than when it is replaced with silence, suggesting that children are able to make use of prior knowledge to help them restore interrupted signals. Despite this fact, children appear to be more affected by acoustic signal disruptions than are adult listeners, suggesting they will experience greater difficulty in noisy environments.
The impact of phonemic and lexical distance on the phonological analysis of words and pseudowords in a diglossic context
Authors: SAIEGH–HADDAD ELINOR
Published: May 2008

The study examined the impact of the phonemic and lexical distance between Modern Standard Arabic (MSA) and a spoken Arabic vernacular (SAV) on phonological analysis among kindergarten (N=24) and first grade (N=42) native Arabic-speaking children. We tested the effect of the lexical status of the word (SAV, MSA, and pseudoword), as well as the linguistic affiliation of the target phoneme (SAV vs. MSA), on initial and final phoneme isolation. Results showed that, when words were composed of SAV phonemes only, the lexical status of the word did not affect phoneme isolation. However, when MSA and pseudowords encoded both SAV and MSA phonemes, kindergarteners found MSA words significantly more difficult to analyze. Comparing children's ability to isolate SAV versus MSA phonemes revealed that all children found MSA phonemes significantly more difficult to isolate. Kindergarteners found MSA phonemes that were embedded within MSA words even more difficult to isolate. Results underscore the role of the lexical status of the stimulus word, as well as the linguistic affiliation of the target phoneme in phonological analysis in a diglossic context.
The effects of discourse processing with regard to syntactic and semantic cues: A competition model study
Authors: SU I-RU
Published: May 2008

Based on Bates and MacWhinney's competition model, the present study aims to examine the effects of discourse context on sentence interpretation. In my previous study it was found that both Chinese and English monolinguals paid less attention to context than to intrasentential cues that have been identified as the determinants for Chinese and English sentence processing. The conclusions obtained in that study have to be considered tentative because the contextual sentences were short and might not have been sufficiently biasing toward the intended interpretation. Hence, the present study was undertaken to further examine the context effects by elaborating the contents of the contextual sentences. The results show that English native speakers rely on discourse context in interpreting their native language to a greater extent than the previous research has suggested and that Chinese native speakers make use of context information to a greater degree than do their English counterparts.
Generation and confinement of high energy electrons generated by irradiation of ultra-intense short laser pulses onto cone targets
Authors: Nakamura T. , Mima K. , Sakagami H. , Johzaki T. , Nagatomo H.
Published: May 2008

Interactions of cone targets with different shapes with laser pulses are studied numerically. Two important parameters which characterize the laser-cone interaction in 2006 are introduced, which are cone angle and ratio of laser spot and cone tip. By changing these two parameters, energy coupling from laser to electrons is controlled. Some fraction of high energy electrons generated at side wall and cone tip are not freely propagating out from the target, but confined around the cone tip due to the disturbed electric field.
Hotter electrons and ions from nano-structured surfaces
Authors: Bagchi S. , Prem Kiran P. , Bhuyan M.K. , Bose S. , Ayyub P. , Krishnamurthy M. , Ravindra Kumar G.
Published: May 2008

The impact of nano-structured surfaces on particle generation from ultrashort intense laser produced plasmas is presented over an intensity range of 1015–1017 Wcm−2. The nano-structured surface evidently produces hotter plasma but does not lead to the generation of hotter ions, a counterintuitive result based on present understanding of plasma expansion mechanism. Although the total ion flux and energy is more in the case of structured surfaces, the average energy of the projectiles is found to be lower than that from polished surfaces. The nano-structured surface shows preferential enhancement of lower energy ions and an intensity dependent divergence of the ejected particles.
PID control of robot manipulators equipped with brushless DC motors
Authors: Hernández-Guzmán V. M. , Santibáñez V. , Campa R.
Published: May 2008

This paper is concerned with PID control of rigid robots equipped with brushless DC (BLDC) motors when the electric dynamics of these actuators is taken into account. We show that an adaptive PID controller yields global stability and global convergence to the desired link positions. Moreover, we also show that virtually the PID part of the controller suffices to achieve the reported global results. We present a theoretical justification for the torque control strategy, commonly used in practice to control BLDC motors. Our controller does not require the exact knowledge of neither robot nor actuator parameters.
HEALTH TECHNOLOGY ASSESSMENT
Authors: Schubert Francois
Published: May 2008

Increasingly, health technology assessment (HTA) is used to aid decisions on the reimbursement of pharmaceuticals or recommendations for their use. The pharmaceutical industry seeks to work in partnership with HTA agencies; however, this presents a number of challenges. Clinical trials will need to include appropriate measures that capture economic and patient benefits as well as relevant clinical endpoints, and the industry will want to seek international harmonization of the many guidelines for economic evaluation. The problem of demonstrating cost-effectiveness of a product before it is available for use must be addressed, possibly by conditional reimbursement to allow collection of real world evidence. It is also important that reimbursement decision makers minimize bias, play fair, and adhere to the written rules they issue. If the industry fairly demonstrates the value of a product using the best available evidence, HTA agencies should be transparent in the rationale for their recommendations.
CHALLENGES, CHOICES, AND CANADA
Authors: Sanders Jill M.
Published: May 2008

The Canadian Coordinating Office for Health Technology Assessment (CCOHTA) was established by the Federal, Provincial, and Territorial Ministers of Health in 1989 for a 3-year trial period. In 1993 CCOHTA was made a permanent organization and in 1999 the Deputy Ministers of Health renewed CCOHTA's mandate and increased its funding. CCOHTA's role is to coordinate health technology assessment (HTA) priorities across jurisdictions, foster and undertake assessment activity, and function as a clearinghouse for technology assessment results while increasing healthcare system stakeholder awareness of HTA findings. The coordinated and collaborated approach adopted by CCOHTA minimizes duplication with other national and provincial organizations and contributes to the ability of the Canadian healthcare system to continue to deliver high-quality health care to its constituents.
EXECUTIVE SUMMARY OF THE ECHTA/ECAHI PROJECT
Authors: Jonsson Egon , David Banta H. , Henshall Chris , Sampietro-Colom Laura
Published: May 2008

Health technology is an indispensable part of any nation's healthcare system. During the past 50 years, all member states that comprise the European Union have increased their technological base for health care, both in terms of knowledge and by investments in equipment, devices, and pharmaceuticals. Generally, this process has gone well. However, several problems have emerged related to the acquisition, diffusion, and use of modern health technology. Concerns have been also raised about the effectiveness and efficiency of already established procedures in health care.
EUROPEAN JOINT ASSESSMENTS AND COORDINATION OF FINDINGS AND RESOURCES
Authors: Sampietro-Colom Laura , Semberg Virpi , Estrada M. Dolors , Asplund Kjell , Barrington Ruth , Faisst Karin , Kahan James P. , Kjonniksen Inge , Mariotto Aldo , Milne Ruaridh , R¨ther Alric , Stilvén Staffan , Xerri Bertrand
Published: May 2008

The aim of Working Group 3 has been to identify possible joint assessments and to coordinate findings and existing resources within the community to support joint assessments.
INTERRUPTED TIME SERIES DESIGNS IN HEALTH TECHNOLOGY ASSESSMENT: LESSONS FROM TWO SYSTEMATIC REVIEWS OF BEHAVIOR CHANGE STRATEGIES
Authors: Ramsay Craig R. , Matowe Lloyd , Grilli Roberto , Grimshaw Jeremy M. , Thomas Ruth E.
Published: May 2008

Objectives:In an interrupted time series (ITS) design, data are collected at multiple instances over time before and after an intervention to detect whether the intervention has an effect significantly greater than the underlying secular trend. We critically reviewed the methodological quality of ITS designs using studies included in two systematic reviews (a review of mass media interventions and a review of guideline dissemination and implementation strategies).

Methods:Quality criteria were developed, and data were abstracted from each study. If the primary study analyzed the ITS design inappropriately, we reanalyzed the results by using time series regression.

Results:Twenty mass media studies and thirty-eight guideline studies were included. A total of 66% of ITS studies did not rule out the threat that another event could have occurred at the point of intervention. Thirty-three studies were reanalyzed, of which eight had significant preintervention trends. All of the studies were considered “effective” in the original report, but approximately half of the reanalyzed studies showed no statistically significant differences.

Conclusions:We demonstrated that ITS designs are often analyzed inappropriately, underpowered, and poorly reported in implementation research. We have illustrated a framework for appraising ITS designs, and more widespread adoption of this framework would strengthen reviews that use ITS designs.
KEEPING CANCER GUIDELINES CURRENT: RESULTS OF A COMPREHENSIVE PROSPECTIVE LITERATURE MONITORING STRATEGY FOR TWENTY CLINICAL PRACTICE GUIDELINES
Authors: Johnston Mary E. , Brouwers Melissa C. , Browman George P.
Published: May 2008

Objectives:To describe a methodology used to keep practice guidelines up to date and to summarize data collected during the first year of implementing this plan with a cancer practice guidelines program.

Methods:The updating strategy includes regular searches of peer-reviewed literature and meeting proceedings, review and interpretation of new evidence, review and revision of clinical recommendations, and notification to practitioners and policy makers about new evidence and its impact on recommendations.

Results:Eighty pieces of new evidence were found relating to seventeen of the twenty guidelines included in this study. On average, four pieces of new evidence were found per guideline, but there was considerable variation across the guidelines. Of the eighty pieces, nineteen contributed to modifications of clinical recommendations in six practice guidelines, whereas the remaining evidence served to support the original recommendations. None of the modifications led to changes that advised against original recommendations. MEDLINE, the Cochrane Library, and meeting proceedings yielded many pieces of evidence, whereas CancerLit and HealthStar did not contribute significantly to the overall yield. Furthermore, key pieces of evidence that led to modifications to the recommendations were often identified by members of the disease site groups before appearing in electronic databases.

Conclusions:The updating process is resource intensive but yields important findings. In response to this evaluation, the updating protocol has been revised such that literature searches are conducted quarterly and the scope of sources searched routinely is restricted to MEDLINE, the Cochrane Library, and meeting proceedings.
EFFECT OF A NATIONWIDE PROGRAM OF EDUCATIONAL OUTREACH VISITS TO IMPROVE THE PROCESSES OF CARE FOR PATIENTS WITH TYPE 2 DIABETES
Authors: Ricordeau Philippe , Durieux Pierre , Weill Alain , Chatellier Gilles , Vallier Nathalie , Bissery Alvine , Fender Pierre , Allemand Hubert
Published: May 2008

Objectives: To improve processes of ambulatory care for patients with type 2 diabetes in a nationwide program.

Methods: Interrupted time-series analysis with audits of practice. To implement selected recommendations of national guidelines, educational outreach visits (office visits or phone discussions) were offered to all French physicians who diagnosed one case of type 2 diabetes during a six-month intervention period. Outcome measures were the number of HBA1c measurements recorded monthly in the medical insurance computer database and the proportion of diabetic patients for whom one test had been reimbursed during the previous six months (HBA1c, fasting blood glucose) or previous twelve months (serum cholesterol, serum creatinine, urine microalbumin, electrocardiogram, ophthalmologic examination).

Results: A total of 15,522 office visits and 9,062 telephone discussions were performed among 22,940 physicians. The increase in the monthly proportion of the number of HBA1c tests to the total number of laboratory tests was higher during the intervention period than during the preintervention (p value<.0001) and postintervention periods (p value<.001). Between the first audit (n=651,574) and the third audit (n=911,871), HBA1c measurements increased from 41.2% to 60.5% and blood glucose measurements performed alone decreased from 38.8% to 18.7%. Urine microalbumin measurements increased from 10.6% before to 15.3% after intervention. Only a slight increase was observed for other tests.

Conclusions: Physician to physician outreach visits can be an effective way to improve the processes of care for diabetes and to routinize nationwide use of practice guidelines.
HOW IMPORTANT IS THE SIZE OF A REPRINT ORDER?
Authors: Hopewell Sally , Clarke Mike
Published: May 2008

Objectives: This study aims to assess the impact of articles with very high reprint orders (“high-reprint articles”) by measuring their citation in the subsequent literature as compared with a control group of articles.

Methods: The twenty-one articles (published in the Lancet in 1998) with reprint orders of over 10,000 were matched with a control set of twenty-one articles with smaller reprint orders. The Science Citation Index was used to obtain the number of citations for each of the forty-two articles.

Results: The twenty-one high-reprint articles were cited 2,548 times; the mean number of citations was 121 (range, 3 to 499 citations per article). Five of the twenty-one high-reprint articles had more than 200 citations, but seven (33%) were cited twenty-five times or fewer. The twenty-one control articles were cited 986 times; the mean number of citations was forty-seven (range, 1 to 165). Fifteen (71%) of the twenty-one control articles were cited twenty-five times or fewer. Thirteen of the high-reprint articles were reports of randomized trials with a mean of 163 citations. In the control articles, six were reports of randomized trials with a mean of eighty-eight citations.

Conclusions: Articles with a high-reprint order were cited more frequently than other articles. However, some high-reprint articles were cited infrequently. If the size of a reprint order is related to the importance of an article, those articles with very high reprint orders may, therefore, be perceived as more important. Further research is needed to explore other aspects of the relative importance and impact of high-reprint articles.
SKIN DISEASES CAUSED BY ULTRAVIOLET RADIATION: THE COST OF ILLNESS
Authors: Nilsson Gunnar H. , Carlsson Lennart , Dal Henrik , Ullén Henrik
Published: May 2008

Objectives:To assess the annual direct and indirect costs of skin diseases caused by ultraviolet radiation.

Methods:A model for cost-of-illness, including costs for hospital care, primary care, pharmaceuticals, mortality, and morbidity, for approximately 1.8 million inhabitants in Stockholm.

Results:The total annual discounted cost-of-illness in Stockholm was approximately 162 million SEK (MSEK; approximate 2002 exchange rate: 1 U.S. dollar=10 SEK). The indirect costs were predominant and constituted approximately 91 MSEK (56% of total costs), mainly due to an estimated cost of mortality for cutaneous malignant melanoma of 84 MSEK. The direct costs of these diseases, approximately 71 MSEK, were predominated by hospital ambulatory care costs of approximately 33 MSEK. The direct costs constituted approximately 0.4% of the overall health-care costs for hospital care and primary health care in the area.

Conclusions:Skin diseases caused by ultraviolet radiation result in moderate economic losses in the community. Therefore, it may not be easy to make successful prevention of these diseases economically beneficial.
Health technology assessment and policy from the economic perspective
Authors: Rutten Frans
Published: May 2008

This article comments on the four country papers in this volume from an economic perspective. Different phases of the decision-making process, which can be supported by Health Technology Assessment (HTA), are considered. For each of these, there is large cross-country variation in the way in which HTA influences policy. Furthermore, economic themes regarding the relevance of HTA evidence for policy making, the position of cost-effectiveness in relation to other criteria vis-à-vis reimbursement decisions, the use of a cost per quality-adjusted life year threshold, and the incorporation of economic considerations in practice guidelines are discussed.
Issues for countries considering introducing the “fourth hurdle”: The case of Hungary
Authors: Gulácsi László , Boncz Imre , Drummond Michael
Published: May 2008

Objectives:This study outlines the needs and current development of the “fourth hurdle” (i.e., requirement of effectiveness and cost-effectiveness data for drug coverage policy decisions) in Hungary, describes the legal background and seeks to address some of the most important questions in this field.

Methods:The study draws on international experiences and discusses five issues that a given jurisdiction needs to consider before introducing the “fourth hurdle” for pharmaceuticals.

Results:The “fourth hurdle” is very relevant in Hungary because many existing drugs are unevaluated and many new, expensive drugs are becoming available. On the other hand, the existing resources for health technology assessment, including economic evaluation, are quite limited. All the five issues are relevant in the Hungarian setting and were helpful in determining exactly how the “fourth hurdle” should be applied.

Conclusions:The most important issue seems to be that the implementation of the “fourth hurdle” needs to be achieved in a way consistent with the limited resources for HTA in Hungary. Specifically this means that, in setting priorities for drugs to evaluate, additional criteria need to be applied. In particular, priority should be given to assessing drugs that have been evaluated in other countries, because this affords the opportunity to adapt existing studies or models to the Hungarian situation.
Modeling utility of second-eye cataract surgery
Authors: Lundström Mats , Wendel Eva
Published: May 2008

Objectives:To study the impact on public health in terms of utility of various proportions of first-eye and second-eye cataract surgery.

Methods:A model was used to study the impact on a population of a fixed cataract surgical rate (9,250 operations/1,000,000 people) with varying proportions of first-eye and second-eye cataract operations. The study population was the County of Blekinge with a known incidence of previous cataract surgery. The prevalence of cataract, the estimated need for cataract surgery, and the utility values were taken from the literature. The population was grouped by disability stage of cataract and previous cataract surgery in accordance with prevalence studies and data from a large national database on cataract surgery and patients' self-assessed visual function. The mortality rate was taken from real data for the study population.

Results:Given a fixed cataract surgical rate over a period of five years, a high percentage of second-eye cataract surgery (42 percent) resulted in a mean utility of 0.82239 in the population forty years of age and older and the corresponding number for a low percentage of second-eye cataract surgery (25 percent) was 0.82253. A high percentage of second-eye surgeries resulted in 421 more individuals who were well compared with a low percentage of second-eye surgeries. On the other hand, a low percentage of second-eye surgeries resulted in 152 fewer individuals with disability and 118 fewer individuals with dependence compared with a high percentage of second-eye surgeries.

Conclusions:A high frequency of first-eye cataract surgeries instead of second-eye surgeries affects more individuals and means an optimized improvement of utility in a population. This should be recommended if the cataract surgical rate is very insufficient. If the cataract surgical rate is high, more second-eye surgeries should be performed to optimize quality of life to as many as possible.
Cost of stroke in Sweden: An incidence estimate
Authors: Ghatnekar Ola , Persson Ulf , Glader Eva-Lotta , Terént Andreas
Published: May 2008

Objectives:To estimate the excess cost of stroke in Sweden and the potential costs that could be avoided by preventing first-ever strokes.

Methods:We adopted the incidence approach for estimating the present value of both direct and indirect costs. Data on mortality, stroke recurrence, and inpatient care were estimated from a national register of patient data with a four-year follow-up period. To estimate costs for social services, we used survey data on living conditions before stroke onset and at three and at twenty-four months. Costs for outpatient visits, rehabilitation, drugs, and production losses due to premature death and early retirement were estimated on the basis of both published and nonpublished sources. Lifetime costs were based on life tables adjusted for excess mortality of stroke, and costs in year 4 were extrapolated to subsequent years.

Results:The present value direct cost for an average stroke patient is SEK513,800 (US$56,024 or Euro60,825). The corresponding indirect cost is SEK125,110 (US$13,640 or Euro14,810). Almost 45 percent of the direct costs were attributable to social services. Women had higher costs than men, and costs for survivors increased with age due to social services.

Conclusions:With an incidence of 213 first-ever strokes per 100,000 individuals, the total excess direct and indirect cost of stroke would be SEK12.3 billion (approximately US$1.3 billion or Euro1.5 billion). Hence, there are large potential cost offsets both in the health-care sector and in the social service sector if the incidence of first-ever stroke could be reduced.
Are clinical practice guidelines impartial?
Authors: Cohen Joshua
Published: May 2008

InA Theory of Justice, John Rawls demands from citizens who decide upon principles of justice and the rules derived from such principles that they abstract from all particularities that constitute their identity as unique individuals. This demand is unrealistic in policy settings where actual policy-makers convene to provide guidance, establish rules regarding public good, and enact legislation. In practice, I argue, policy-makers, legislators, and others involved in developing social rules that pertain to distributive justice formulate such rules as reasonably partial spectators. To illustrate, I show how clinical practice guidelines are established and mediated by a reasonably partial expert panel whose partial action is publicly justifiable, yet whose claims to impartiality are not.