bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective Evaluation of a Clinical and Exercise-test Model for the Prediction of left Main Coronary Artery Disease
Authors: Lee Thomas H. , Cook E. Francis , Goldman Lee
Published: March 2007

In a multivariate logistic regression analysis of data from 508 patients, only two clinical factors, age and typicality of pain, were independently significant predictors of left main coronary artery disease. The resulting multivariate equation was prospectively applied to another 370 patients to derive pre-exercise-test (ETT) probabilities of left main coronary artery disease, and these pre-ETT probabilities were combined with literature-derived like lihood ratios for various ETT findings to derive post-ETT probabilities. This model, which can be displayed in simple graphic form, accurately predicted the probability of left main coronary artery disease when prospectively evaluated in this independent validation set of patients. The likelihood of left main coronary artery disease was 16% when the ETT increased the probability, and 4% when it decreased the probability (p <0.001 ). While 48% of patients had mid-range (5-15%) probabilities of left main coronary artery disease before the ETT, only 24% fell into this range of probabilities after the ETT (p <0.0001 ), as ETT results moved patients into higher and lower probability ranges. Thus, probability of left main coronary artery disease can be calculated from clinical and ETT data with this model. These estimated pre- and post-ETT probabilities of left main coronary artery disease may aid in the selection of patients for noninvasive testing or for cardiac catheterization.
The Workup of the Asymptomatic Patient with a Positive Fecal Occult Blood Test
Authors: Brandeau Margaret L. , Eddy David M.
Published: March 2007

Twenty-two protocols for working up an asymptomatic patient who has a positive fecal occult blood test were evaluated using existing information on the prevalences of cancers, aden omas and other conditions in such patients; the natural history of colorectal cancer; the effectiveness of screening tests; risks; and costs. The authors estimate the impacts of the 22 workup strategies on outcomes such as the chance of finding an existing cancer or adenoma, risks (bleeding and perforation), and financial costs of different strategies involving rigid sigmoidoscopy, flexible sigmoidoscopy, barium enema, and colonoscopy. Two protocols were particularly effective. The first involves performing a barium enema study and following it with colonoscopy; if colonoscopy is negative, the barium enema study should be repeated. The second is to perform colonoscopy and if it is negative, follow it with a barium enema study. Key words: colorectal cancer diagnosis; colorectal cancer screening; colorectal cancer workup; fecal occult blood test. (Med Decis Making 7:32-46, 1987)
Evaluating Rapid Tests for Streptococcal Pharyngitis
Authors: Deneef Peter
Published: March 2007

The evaluation of new rapid antigen detection tests for streptococcal pharyngitis is compli cated by the presence of errors in the standard of comparison. Even "gold standard" throat cultures are not perfectly accurate. This article is an analysis of how errors in the comparison cultures affect the apparent accuracy of new tests for streptococcal pharyngitis. One of the questions addressed is whether throat cultures performed in a physician's office are accurate enough to use as a standard in a clinical trial of a new rapid test. While the accuracy of office cultures is accepted by many to be adequate for diagnostic purposes, this analysis shows that when evaluating a new test stricter conditions must be placed on the accuracy of the cultures used for comparison. Key words: test accuracy; laboratory diagnosis; strep tococcal pharyngitis. (Med Decis Making 7:92-96, 1987)
Risk Preference and Laboratory Use
Authors: Nightingale Stephen D.
Published: March 2007

One hundred thirty-seven physicians were asked to choose between a certain loss of five years of life expectancy and a 50/50 gamble of losing either ten years or zero years of life expectancy. These choices were presented as hypothetical options for a patient with cancer. The 46 who chose the certain loss ordered 23% fewer laboratory tests/patient visit in our General Medicine Clinic over an eight-week period than those who chose the gamble (p <0.05). This risk preference was further stratified by sequentially offering five, four, three, two, and one years of certain loss against the same 50/50 gamble of ten or zero years of loss; greater preference for the gamble correlated with greater laboratory use (p <0.002). To exclude physician knowledge or case mix as a cause of this result, this risk preference was correlated with total score, and with the cost of tests ordered in patient management problems, of 49 physicians on the American Board of Internal Medicine Certifying Examination. Cost of tests ordered was 23% less for the 17 who chose the certain loss (p <0.001 ); total score did not vary with risk preferences. There was no association between risk preference in the face of gain and laboratory use, and none between an individual's risk preferences in the face of gain and in the face of loss. The cognitive processes that determine risk preference in the face of loss, whatever they may be, appear to have a substantial influence on physician test-ordering behavior.
Multiple Classification and Receiver Operating Characteristic (ROC) Analysis
Authors: Steinbach Walter R. , Richter Karlheinz
Published: March 2007

The receiver operating characteristic (ROC) curve was applied to observer performances in a multiple-alternative decision task. It was shown that the probability of correct classification, a performance criterion often maximized in multiple-classification procedures, corresponds to the area under an appropriately constructed ROC curve. Degrees of confidence in the observer's judgment of 0, 1, ... , 10 were used for both classification and ROC rating. To demonstrate the validity of the method, 1,190 photofluorograms were examined by experi enced staff radiologists to identify four cardiovascular conditions distinguishable on the basis of images of structural elements of the contours of the heart and great vessels. The clas sification matrices for three radiologists who achieved high, medium, and low performance ratings in this experiment are reported. The ROC curves are symmetric, with their points located around the off-diagonal. Differences between the overall probability of correct clas sification and the ROC curve index calculated from the same evaluator's data were very small, 0.004 to 0.011. Key words: receiver operating characteristic (ROC) curve; multiple classification; medical decision making; cardiovascular diagnostics; thorax, radiography. (Med Decis Making 7:234-237, 1987)
Whose Utilities for Decision Analysis?
Authors: Boyd Norman F. , Sutherland Heather J. , Heasman Karen Z. , Tritchler David L. , Cummings Bernard J.
Published: March 2007

The goal of this study was to examine sources of variation in the utilities assigned to health states. The authors selected a common clinical problem, carcinoma of the rectum, and examined the utilities assigned to colostomy, a common outcome of treatment for that disease. After preparing and validating a description of colostomy and its effects on patients' lives, utilities for the state were obtained from five groups of individuals. These comprised two groups of patients who received treatment for rectal cancer, a group of physicians and surgeons specializing in the treatment of this disease, and two groups of healthy subjects, none of whom were health professionals. Of the patients who had been treated for rectal cancer, one group had been treated surgically with the formation of colostomies and the other had been treated with radiotherapy and none had a colostomy. Utilities for colostomy were elicited using the standard gamble, category rating, and a treatment choice question naire. The groups differed substantially in the utilities assigned to colostomy. In general, patients with colostomies and physicians assigned significantly higher utilities than did pa tients who did not themselves have a colostomy. The clinical significance of these differences was examined in a simplified clinical decision problem that compared surgery (with colostomy) and radiotherapy (without colostomy) as primary treatment. The expected clinical value of these treatment alternatives was substantially influenced by the differences observed in utilities for colostomy. These results emphasize the importance of patient utilities in clinical decision making and the need to gain greater understanding of the factors that influence the utilities that patients assign to health states. Key words: utilities; decision analysis; oncology. (Med Decis Making 1990;10:58-67)
Decision-making Studies in Patient Management
Authors: Beck J. Robert
Published: March 2007

This article surveys the contribution of decision analysis to diagnosis and treatment in med icine, beginning with a review of Dr. Lee B. Lusted's 1971 paper, "Decision-making studies in patient management." From this beginning methods of decision analysis were developed that were particularly appropriate to medical problems. The author reviews the effects of Dr. Lusted's interests in the field on subsequent research and publications, and critiques proph etic statements found in the early paper.
Eualuation of Medical Technologies
Authors: Sainfort François
Published: March 2007

The author describes a new methodology to solve medical decision problems involving a choice between alternatives under conditions of risk and uncertainty when imperfect empirical information from diagnostic technologies is available. The main new concept is the gener alized ROC (GROC) curve, which extends considerably the scope of analysis of the traditional ROC curve as well as the threshold approach to medical decision making. Both techniques become special cases of the new general approach. The author shows how to apply the technique and derive comprehensive clinical guidelines to solve the medical decision problem involving one patient in the most general situation. The larger problem of evaluating the performances of diagnostic technologies for a population of patients with varying prior prob abilities of disease is then addressed. A new measure of performance is proposed that goes beyond the well-accepted area under the ROC curve index. This measure is used to compare different technologies for a population of patients, and a new methodology is proposed to carry out such comparisons. Key words: technology assessment; decision theory; diagnostic information; ROC analysis. (Med Decis Making 1991;11:208-220)
Stochastic Trees
Authors: Hazen Gordon B.
Published: March 2007

This paper introduces stochastic trees, a new modeling approach for the class of medical decision problems in which risks of mortality and morbidity may extend over time. A stochastic tree may be regarded as a continuous-time version of a Markov-cycle tree, or alternately, as a multi-state DEALE model. Optimal decisions in stochastic trees can be determined by rollback, much in the same fashion as decision trees. The author discusses how age- dependent mortality rates and declining incidence rates may be modeled using stochastic trees. Concepts are illustrated using examples from the medical literature. It is argued that stochastic trees possess important advantages over Markov-cycle trees for medical decision modeling. Key words: stochastic trees; DEALE models; decision analysis; Markov cycle trees. (Med Decis Making 1992;12:163-178)
Development of an Index of Maternal Transport
Authors: Strobino Donna M. , Frank Richard , Oberdorf Mary Ann , Shachtman Richard , Kim Young J. , Callan Nancy , Nagey David
Published: March 2007

The authors used a decision-analytic approach to develop a Maternal Transport Index (MTI) from ACOG guidelines for maternal transport. Data were obtained from three questionnaires administered to five perinatologists, practicing in facilities with various casemixes. Each questionnaire was based on a given level of hospital and contained scenarios describing indications for maternal transport. The MTls, ratios of the logs of the proportions with given outcomes in Level III hospitals relative to Level I (or II) hospitals, ranged from 1.0 to 26.3 for newborn outcomes. They were greater for Level I hospitals (than Level II) and when newborn outcomes included severe disability as well as death. Within gestational age cat egories, the MTI was generally greatest for active preterm labor and, within complication categories, for 24-26 or 27-31 weeks' gestation. It was large for maternal outcomes only for two rare acute medical conditions. The MTI has potential use in setting priorities for maternal transport. Key words: Maternal Transport Index; obstetrics; outcomes; newborns. (Med Decis Making 1993;13:64-73)
A Multiattribute-utility-function Approach to Weighing the Risks and Benefits of Pharmaceutical Agents
Authors: Eriksen Stuart , Keller L. Robin
Published: March 2007

Both the selection of doses of pharmaceutical agents and comparisons between pharma ceutical agents have long been based on the nonquantified concept of the risk-benefit ratio. Though useful, this concept implies a data comparison that is difficult to make: the toxicity versus the efficacy of a drug compound. This research demonstrates an approach for weigh ing risks and benefits by combining utility functions for human efficacy and toxicity with animal and laboratory toxicity information to develop an overall multiattribute utility function for an ophthalmic pharmaceutical agent, I-bunolol, intended for the treatment of glaucoma. With this multiattribute function and a small portion of the published data available for this drug, the expected utilities for six doses (including a control) could be compared and the value of this approach in drug-dosage selection demonstrated. Key words: decision analysis; expected utility; dosage selection; compound comparison; pharmaceutical decision; mul tiattribute utility; risk-benefit ratio. (Med Decis Making 1993;13:118-125)
Using Treatment-tradeoff Preferences to Select Diagnostic Strategies
Authors: Deneef Peter , Kent Daniel L.
Published: March 2007

Selection of optimal diagnostic strategies depends on the accuracy of diagnostic tests, the prevalence of disease, and the relative benefits and harms resulting from test/treatment choices. One can characterize diagnostic strategies according to their net benefit-to-harm ratios. Within the framework of expected-utility theory, the benefit-to-harm ratio is equivalent to the marginal tradeoff between erroneous and correct treatment choices. Consequently, a physician can identify his or her preferred strategy by asking the question: "How many additional treatment errors am I willing to make in order to treat one additional person correctly?" Family physicians were asked to indicate their lowest and highest acceptable tradeoff ratios in a survey about streptococcal pharyngitis. All 53 respondents indicated uncertainty about their preferred treatment-tradeoff ratios. For 58% of respondents, the midpoints of the acceptable range of tradeoff ratios corresponded to generally accepted diagnostic strategies: 1) test all or 2) treat if classic, test all others. In contrast, previously published patient utilities yield a treatment-tradeoff ratio that corresponds to the strategy of treating all cases. The analysis illustrates the linkage between the optimal operating point on a receiver operating characteristic (ROC) curve and the selection of a preferred diagnostic strategy based on treatment thresholds derived from benefit-to-harm ratios. The survey results indicate that physicians can respond directly to questions assessing their preferences for such treatment thresholds. Differences between patients and physicians have significant impacts on choices of test and treatment strategies. Key words: decision making; utility assessment; ROC curve; laboratory diagnosis; streptococcal pharyngitis. (Med Decis Mak ing 1993;13:126-132)
Hypothesis Generation and the Coordination of Theory and Evidence in Novice Diagnostic Reasoning
Authors: Arocha José F. , Patel Vimla L. , Patel Yogesh C.
Published: March 2007

This study investigates hypothesis generation and evaluation in clinical problem solving by medical trainees. The study focuses on 1) directionality of reasoning and 2) use of confir mation and disconfirmation strategies in generating and evaluating hypotheses. Two clinical problems were divided into segments of information containing presenting complaint, past history, and physical examination. The initial information indicated a typical myocardial infarct but subsequent information contradicted it. The results showed that the participating students predominantly used forward reasoning and confirmation strategies. When faced with con tradictory evidence: 1) second-year students ignored cues in the problem or reinterpreted them to fit the hypothesis; 2) third-year students generated concurrent hypotheses to account for different sets of data; and 3) fourth-year students generated several initial hypotheses and subsequently narrowed the hypothesis space by generating a single coherent diagnostic explanation. The results are discussed in terms of coordination of clinical evidence and its relationship to scientific reasoning. Key words: hypothesis generation; diagnostic reasoning; novice strategies; medical problem solving. (Med Decis Making 1993;13:198-211)
Adjusting the Number Needed to Treat
Authors: Riegelman Richard , Schroth W. Scott
Published: March 2007

The number needed to treat is a unique and cognitively useful summary measurement for the description of medical treatments. However, the original concept lacks the means to account for multiple benefits and harms or differences in the utilities or timings of patient outcomes. The authors describe an "adjusted" number needed to treat that allows for the inclusion of multiple harms and benefits, and also adjustments for the utilities and timings of these outcomes. This expanded version offers a richer description of medical outcomes, and may be utilized as an adjunct to traditional risk-benefit, cost-effectiveness, and de cision-analytic techniques. Key words: medical decision making; cost-effectiveness anal ysis ; decision analysis; risk-benefit analysis. (Med Decis Making 1993;13:247-252)
A Meta-analytic Method for Summarizing Diagnostic Test Performances
Authors: Midgette Andre S. , Stukel Therese A. , Littenberg Benjamin
Published: March 2007

The authors have devised a meta-analytic method to summarize diagnostic test perfor mances, which they describe along with a clinical example wherein they analyze the perfor mances of real-time ultrasonography in eight studies of the detection of proximal deep venous thrombosis of the lower extremity, selected on the basis of specific inclusion criteria. To evaluate the evidence for fitting a summary receiver operating characteristic (ROC) curve, a test of correlation between the estimates of true-positive rate (TPR) and false-positive rate (FPR) is performed. A high positive correlation argues for summarizing the studies with an ROC curve. In the absence of such correlation, a test of homogeneity is applied separately to the estimates of sensitivity (TPR) and specificity (TNR) to evaluate whether differences among studies are due to chance alone. If the estimates are homogeneous, a summary point estimate and confidence intervals (Cls) are calculated. As a final step, subgroup anal yses can be performed to assess alternative explanations of variability in TPR and FPR. Within groups defined by the presence or absence of symptoms of venous thrombosis, a negative correlation between TPR and FPR and homogeneity among studies were found. For symptomatic patients, the summary TPR was 0.97 with a 95% CI of (0.94, 0.99) and the summary TNR was 0.97 (0.95, 0.99). For asymptomatic patients, the summary TPR was 0.66 (0.50, 0.81), and the summary TNR was 0.96 (0.90, 0.99). The difference in TPR between symptomatic and asymptomatic patients was statistically significant. There was no evidence that test referral bias or lack of independent interpretation of test results influenced these findings. It is concluded that this meta-analytic method represents a quantitative ap proach to summarizing the performances of diagnostic tests. It provides criteria for deciding among the approaches of fitting a summary ROC curve, calculating a summary point esti mate, or reporting ranges of TPRs and TNRs. A summary point estimate is introduced for use when TPR and FPR are not positively correlated but index test characteristics are homogeneous among studies. This method also allows examination of alternative expla nations of differences in test performance characteristics such as differences among sub groups of patients or biases in study design. Key words: meta-analysis; technology as sessment; diagnostic test accuracy. (Med Decis Making 1993;13:253-257)
Risk Attitude in Gambles with Years of Life
Authors: Verhoef Lia C.G. , De Haan Anton F.J. , Van Daal Willem A.J.
Published: March 2007

According to prospect theory, risk attitude changes depending on whether a prospect is perceived as a gain or a loss relative to a reference or aspiration level. To investigate risk attitude with respect to years of life, the authors elicited utilities at two occasions by the certainty equivalent method from 30 women from the general population. The respondents gave certainty equivalents to gambles with years of life. The gambles were two-outcome gambles with equal probabilities to experience each outcome. A shift from a risk-seeking towards a risk-averse attitude was observed with increasing expected value of the gambles. For each individual, the averaged responses over the two replications were fitted with an s- shaped logistic curve that showed an excellent fit (r2 ≥ 0.97) for all respondents. The aspiration level of survival can be derived from this function and was negatively correlated with age (r = -0.43, p < 0.025). The data are consistent with prospect theory and may explain why patients opt for risky treatments, since most of the respondents were risk-seeking in the short term. Key words: utility assessment; medical decision making; prospect theory; risk attitude; certainty equivalent gambles; aspiration level. (Med Decis Making 1994;14:194- 200)
Improving Clinical Guidelines with Logic and Decision-table Techniques
Authors: Shiffman Richard N. , Greenes Robert A.
Published: March 2007

Clinical practice guidelines can be clarified, verified, and simplified by the use of logical analysis and the application of decision-table techniques. This methodology is applied to a CDC guideline for the prevention of perinatal transmission of hepatitis B by immunization. Relevant clinical variables are identified and possible values for each variable are defined. An exhaustive enumeration of value combinations is generated. Logically impossible com binations are identified and eliminated. The guideline's recommendations are next translated into a set of rules and compared with the remaining value combinations. Variable combi nations that are not covered by guideline recommendations represent incomplete guideline specifications. Inconsistency can be identified by finding identical condition sets in two or more rules. The procedure demonstrates that the hepatitis guideline is incomplete. Logical analysis can improve the quality of clinical practice guidelines by assuring comprehensive- ness and consistency. Key words: clinical guidelines; decision table; logic, verification; hep atitis B; immunization. (Med Decis Making 1994;14:245-254)
Prototype Decision Support System for a Differential Diagnosis of Psychotic, Mood, and Organic Mental Disorders
Authors: Plant Robert T. , Murrell Stephen , Moreno Henry R.
Published: March 2007

This paper presents a prototype parallel-processing decision support system, based on the ALICE graph reduction machine, for the differential diagnosis of psychotic, mood, and organic mental disorders in accordance with the American Psychiatric Association's revised third edition of the Diagnostic and Statistical Manual of Mental Disorders. The paper extends the authors' earlier work where the same domain was implemented on an expert-system shell using a rule-based representation. Key words: mental disorders; decision support system; parallel processing, artificial intelligence. (Med Decis Making 1994;14:273-288)
An Economic Analysis of Strategies for the Use of Contrast Media for Diagnostic Cardiac Catheterization
Authors: Barrett Brendan J. , Parfrey Patrick S. , Foley Robert N. , Detsky Allan S.
Published: March 2007

A decision tree model was used to estimate the incremental cost per quality-adjusted life year (QALY) of low- as opposed to high-osmolality contrast media for cardiac angiography. Analyses were done from the viewpoints of a third-party payer and society using data from a randomized trial and the literature. Assuming low-osmolality media reduce the risk of myocardial infarction and stroke, the incremental cost per QALY gained with these media is $17,264 in high-risk or $47,874 in low-risk patients for a third-party payer. From a societal viewpoint, the corresponding costs are $649 and $35,509. These estimates are sensitive to the cost and volume of the contrast medium employed and to the estimate of reduction in severe adverse events with low-osmolality media. The authors conclude that, in the context of restricted budgets, limiting the use of low-osmolality media to high-risk patients is justifiable, as the incremental cost per QALY in high-risk patients may be reasonable and it is not certain that low-osmolality media prevent severe or fatal events. A considerable reduction in the cost per QALY gained is possible by minimizing the volume of contrast medium used. Key words: contrast media; low-osmolality; high-osmolality; cardiac angiography; cost-utility; cost-benefit; cost-effectiveness; economic analysis. (Med Decis Making 1994;14:325- 335)
The International Marketing Field-Study Course: a Unique Variation On an Existing Theme
Authors: Dovel Thomas D. , Miaoulis George
Published: March 2007

This paper discusses the educational value to be gained by both faculty and student from a unique classroom format that involves a multi-national marketing course which culminates in a field-study tour of a foreign business center. Special attention is given to the essential rudiments of study-tour initiation, promotion, conduct and evaluation. Throughout, the reader is given the complete details necessary to develop a similar course that will provide maximum educational value to the student.
Optimal Geometric Structures of Force/Torque Sensors
Authors: Svinin M.M. , Uchiyama M.
Published: March 2007

In controlling manipulators interacting with the external en vironment, an important role is played by the force/torque sensors. In recent years, a number of constructs for such sen sors have been proposed, and some criteria for their evaluation have been introduced. This article presents a systematic analy sis of force sensors at the design stage, which has not been undertaken in the literature. A generalized model of the sensors is developed on the basis of static and kinematic equations, and a block form of the resulting strain compliance matrix of the sensor is obtained. The model developed is then applied to the analysis of two- and three-dimensional sensor schemes cor responding to regular polygons and polyhedrons, respectively. The condition number of the normalized strain compliance matrix of the sensor is used as a performance index. The im possibility of reaching the optimal values of this criterion is stated for the regular polygon form-based sensors. Partial solutions of the optimization problem are found out for the reg ular polyhedron form—based sensors. The presentation of the material is illustrated by analytical examples.
A Fading Aztec Sun
Authors: McDonald James H.
Published: March 2007

■ This article examines the changing nature of contemporary political discourse in Mexico. The traditional nationalist political discourse centered on issues of sovereignty and social justice, carefully cultivated and controlled by the Insititutional Revolutionary Party (PRI) to legitimize its dominant position in a one-party corporate state. Using the 1994 presidential elections as my entry point, I argue that the PRI has undergone a semiotic metamorphosis, shedding nationalist rhetoric and image in favor of global ones. Its discourse has evolved as the domestic socio-economic situation has devolved. Central to this project is the redefinition of national identity. As Chatterjee (1993: 21) observes, 'nation- ness is virtually inseparable from political consciousness'. The PRI is establishing new sets of institutional myths about the relationship between prosperity, the free market and globalization. Complementing its symbolic rebirth is a redefin ition of danger in a stark survivalist narrative - the politics of everyday fear. Presi dent Carlos Salinas's (1988-94) message emphasized that traditional nationalist economic policies were dangerous, and that Mexico could only survive through economic globalism. Over the course of his term, he was able to disarm the nationalist symbolism of the leftist opposition candidate, Cuauhtémoc Cárdenas, with an equally powerful integrationist utopian discourse that promised pros perity, especially to the middle class. I conclude by noting that there is a pro nounced disjuncture between material conditions and the historically imagined identity of Mexicans that signifies a break between the nation and the state. Out of the detritus of economic reform, a critical project facing Mexicans is to reimagine what it means to be Mexican and carry forward a sense of social justice in the new global economic order.
The Flexible Woman
Authors: Susser Ida
Published: March 2007

In the US, as more poor women must work to support their house holds, and state support for women/caregivers is consistently reduced, we find an increase in violence and domestic conflict and the abandonment and neglect of children. The 1996 welfare laws exacerbate this situation as they force more poor women into the low-paid or unpaid labor force, to the further cost of poor children. These new laws reflect and reinforce a shift in what was viewed by the welfare state as legitimate dependence for mothers and children. It is no longer sufficient, if it ever was, to talk of male or female domination or subordination among poor people in the United States. In the 1990s, arenas of power for men are contradicted by other arenas of power or access to resources from the state for women. Thus in spite of the utility of analyses that dealt with the experiences of men and women separately, only an analysis that portrays the integral inter dependencies of the two interlocking/conflicting gender hierarchies in terms of class, poverty and state regulations can elucidate the parameters of the new poverty and the violence it generates.
Three Mazatec Wise Ones and their Books
Authors: Feinberg Benjamin
Published: March 2007

■ Most accounts of psychedelic mushroom use in Mexico's Sierra Maza teca describe the practice as a prehispanic survival degraded by tourism. This article explores how - through chants, self-descriptions and life stories - Mazatec curers who deal with 'outsiders' use the discourse surrounding mushrooms to construct a mimetic model of power and the relationship between inside and outside that highlights the importance of the border and the position of the mediator. The themes of shamanic travel and the book make both sense and power out of magical mushroom mediation and involve the outsider as an essential component of Mazatec identity.
Man, Soil, Garden: Basic Plot in Genesis 2-3 Reconsidered
Authors: Stordalen Terje
Published: March 2007

Oriental and Hebrew material confirms that Gen. 2.5 is to be read as a narrative 'program' for the basic plot of the subsequent story (Gen. 2-3). Careful reading indicates that the narrative nucleus in Gen. 2-3 is the account of how (wild and culti vated) vegetation appeared in the land, by provision of irrigation and a tilling man. Analysing the story according to a Greimasian actant scheme, it appears that YHWH himself only 'accidentally' and even 'unwillingly' supported that plot. His concern was with the garden, not with the land. The aims of the basic plot were not fulfilled until YHWH was forced to expel the human couple and issue curses upon the ground.
The Copyright System in Japan
Authors: Moriyama Takane
Published: March 2007

The following articles continues the series of articles on copyright issues of interest to IFLA members. Articles on copyright of audiovisual materials and electronic materials will appear in a forthcoming issue of IFLA Journal. The IFLA Copyright Committee invites IFLA members to comment on these articles, to offer advice on activities it should undertake, and to share their experiences, interests or questions on this important professional aspect of our work.
One Person, One Country: Participation at IFLA Conferences
Authors: Carroll Frances Laverne
Published: March 2007

Frances Laverne Carroll received her Ph.D. from the University of Oklahoma in General Education with fields in Higher Education, International Education and Media. Much of her library career was at the University of Oklahoma, where she was Professor from 1975 until 1985, and then Professor Emeritus from 1986 onwards. She was employed as the Head of Department of Library Studies and Senior Lecturer at Western Australian Secondary Teachers College in Perth, Australia, from 1977 until 1981, and is currently working at Kingswood College at the University of Western Australia until September 1999. She is the author of numerous publications including Guidelines for the Planning and Organization of School Library Media Centers, co-authored with Pat Bielke under an IFLA/UNESCO contract in 1978 and revised by Ms Carroll for UNESCO in 1990. She has authored many titles for IFLA including Guidelines for School Libraries, 1990, and is currently working on International Librarianship: Cross-border Idea and Information Flow among Libraries and Information Centers to be completed in the year 2000. Ms Carroll has carried out an extensive series of interviews with IFLA Presidents, published in many international journals. During her IFLA career she served as the first Chair of the (then) sub-Section of School Libraries in 1973 and continued until the Section was formally established in 1977. Ms Carroll may be contacted at Kingswood College, University of Western Australia, Hampton Road, Crowley 6009, Western Australia (e- mail : admin@kingswood.uwa.edu.au) until September 1999, or via the University of Oklahoma, 201 East Lindsay Street, #102, Norman, Oklahoma 73019-0380, USA (flcarroll@slis.lib.ou.edu).
Role Transitions and their Timing in the Peasant Life Course During the Late Tokugawa Period, 1825-1869
Authors: Masoaka Kanji
Published: March 2007

Using data on peasant family roles in the Tokugawa period, this article examines patterns in the assumption of and withdrawal from family roles and analyzes the interactional characteristics of these dynamics in the course of the family life. A critical methodological issue is the synchronization of the transitions of all family members and the understanding of the transitions in the collective family cycle.
Sisters Together: Women without Men in Seventeenth-Century French Village Culture
Authors: Cashmere John
Published: March 2007

It is often assumed that the institution of the family and all that implied in terms of patriarchal power, settlement patterns, and inheritance customs restricted women within village communities. This article sets out to explore the possibility that there were female-centered households in seventeenth-century France, based on sibling relationships, that these households did not require male suzerainty, and that they may have survived in village communities with the support offemale networks operating through the evening spinning bees. The article focuses on texts that represent a legal dispute over a village fire in Normandy toward the end of the seventeenth century and on the complex ways in which male voices in these texts constituted the lives of the female villagers involved.
Hapless Innocence and Precocious Perversity in the Courtroom Melodrama: Representations of the Child Criminal in a Paris Legal Journal, 1830-1848
Authors: Nilan Cat
Published: March 2007

An analysis of the reports on the trials of child criminals that appeared in the French legal journal, La Gazette des Tribunaux, in the years between 1830 and 1848 reveals the emergence of a distinctive construction of childhood marked both by an insistence on the natural innocence of "true" children and by consternation in the face of the "precociously perverse" juvenile delinquent. After two genera tions of revolution and war, French journalists shared with other cultural arbiters a common commitment to the reestablishment of a stable moral order through the reification of a stark opposition between good and evil—a project Peter Brooks has linked to the "melodramatic imagination" of early-nineteenth-century Ro manticism. In this context, the innocent child served as a symbolic guarantor of good in a world threatened by evil, whereas the perverse child appeared as an anomaly whose very existence threatened to disrupt the social order.
Semantics and Neurology: Neuronal Man and Linguistics
Authors: Mounin Georges
Published: March 2007

Jean-Pierre Changeux's Neuronal Man attempts to define mental activity, that is thought, with respect to the neurophysiology of the brain.*

Since antiquity, the historical account of these problems has undergone the examination of classical notions: what is a mental image, a concept, a representation? Changeux, who accepts these traditional points of departure, as well as the notion of signification, aims to clarify the physical, neurophysiological counterparts of these notions, in order to arrive at less simplistic terms: image de memoire “memory image,” later - objet mental “mental object,” and still later - objet de mémoire “memory object.” Behind these terms lies transition to neurophysiology, with the notion of engram, and finally with the notion of trace, a notion which is precise but very general, since the substantive reality of these traces, their anatomy and physiology in the brain has yet to be determined.
The Microeconomics of Conflict and Hierarchy in Capitalist Production
Authors: Reich Michael , Devine James
Published: March 2007

This paper develops a formal model of worker-employer relations within capitalist firms. The results illuminate the effects of property rela tions on the organization of work, the monitoring of workers, the extent of wage hierarchies and incentives and inefficiencies in such firms. A comparison model of a workers' cooperative demonstrates that the nature of the political-economic system, not just technology or information and transaction costs, affects produc tion conditions.
Markets, Industrial Processes and Class Struggle: The Evolution of the Labor Process in the U.K. Engineering Industry
Authors: Walker J.
Published: March 2007

This paper employs H.Braverman's theoretical framework to ana lyze the development of the labor process in the industrial equipment, or "engin eering" industry in the U.K. Though Braverman's distinction between labor and labor-power clearly provides many essential insights, it is nevertheless funda mentally defective inasmuch as it ignores what are seen to be important aspects in the historical evolution in the industry. Most centrally, Braverman's analysis oversimplifies the complex nature of the class struggle, specifically the extent and effectiveness of workers' and employers' organizations and divisions within them. Secondly, insufficient attention is paid to the constraint imposed by the structure and conditions of the market. In the concrete history discussed here, both the nature and intensity of the class struggle as well as competition in the product market are seen to be fundamental determinants of the development of the labor process.
Capital, Constant Capital and the Social Division of Labor
Authors: Perelman Michael
Published: March 2007

This paper builds upon the analysis of constant capital as a social relation. It begins by developing the relationship between constant capital and the social divi sion of labor. Next, it investigates the manner in which Marx has treated this subject. To do so, it discusses the alternative perspectives of commodity production as a se quence of processes and as a composite of parallel pro cesses. Based on this discussion, it attempts to reconstruct Marx's use of these two approaches. Then it discusses why the category of constant capital cannot be aggregated and why the theory of the deterministic falling rate of profit must be rejected. The following section introduces Marx's theory of the devalorization of capital in order to show its relationship with the theory of the falling rate of profit. Finally, the paper discusses the relationship between cons tant capital and primitive accumulation.
Emergency Response Systems: An Overview
Authors: Hizer David D. , Hamilton A.
Published: March 2007

Emergency response systems have been demonstrated to be useful as aids in indepen dent living for the elderly. This article provides information on the development, background, and use of in-home emergency response systems. Two different types of systems are delineated, and three different model applications of emergency response systems are discussed. Results from two of these models, which have been in use for three or more years, are reviewed. Possible criteria for selection of emergency response systems are also presented, along with limitations that should be considered in the use of such systems.
Stroke: The Perspective of Family Caregivers
Authors: Silliman Rebecca A. , Earp JoAnne L. , Fletcher Robert H. , Wagner Edward H.
Published: March 2007

We studied the family caregivers of elderly stroke patients, focusing on perceptions of the positive and negative aspects of caregiving and the resources used by caregivers to meet its demands. Most caregivers were women and either spouses of daughters. The majority were satisfied with their roles as caregivers and would do it again if faced with that decision. They relied on family and friends for help with caregiving, but not on formal services. Greater understanding of the determinants of caregivers' heterogeneous responses to the demands of caregiving is needed.
Health Status and Quality of Life Among Elderly Public Housing Residents
Authors: Hiner Sharon L. , Weinberger Morris , Darnell Jeffrey C.
Published: March 2007

We compared the quality of life and health status of elderly public housing residents living alone to that of residents living with another person. Those living alone were predominantly women and had significantly better scores on time-use and social interaction domains. On measures of physical health, they were at least as healthy as those living with another person. We conclude that living alone did not place these low-income aged persons at additional risk for worse health outcomes or a diminished quality of life.
Selected Social Gerontology Theories and Older Adult Leisure Involvement: A Review of the Literature
Authors: Howe Christine Z.
Published: March 2007

Selected studies conducted by leisure researchers about the leisure involvement of older adults are reviewed and implications are drawn for readers concerned with aging and leisure. To set the tone, the activity and disengagement theories of aging are discussed within the overall conceptual framework ofrole theory. The range of contributions found in recent leisure literature related to aging and activity involvement, from testimonials to atheoretical works to empirical studies, is then discussed. Shortcomings of the state of the art lead to the consideration of continuity theory as a fruitful avenue for leisure research within the role theory framework. Finally, some implications for further research and professional practice are highlighted.
A Quick Language Screening Test for Young Children: The Token Test
Authors: Cole Kevin N. , Fewell Rebecca R.
Published: March 2007

The usefulness of a modified version of the Token Test as a quick language screening test is demon strated by comparison of Token Test Scores with Preschool Language Scale (PLS) Scores. Subjects were 90 children ages 31 months to 103 months with a mean age of 66.4 months. High correlations were found between the Token Test and the PLS overall Language Age raw scores (r = .78, p < .01), between the Token Test and PLS Auditory Comprehension raw score (r = .74, p < .01) and between the Token Test and the PLS Verbal Ability raw score (r = .76, p < .01). The Token Test also demonstrated strong agreement with the PLS in identifying children as either normal or language delayed.

These findings indicate that the modified version of the Token Test is a quick, sensitive, and reliable predictor of both receptive and expressive language abilities.
Use of a Behavior Rating Scale to Aid in the Identification of Developmentally and Culturally Different Gifted Children
Authors: Elliott Stephen N. , Argulewicz Ed N.
Published: March 2007

This investigation was designed to determine whether there were similarities in the behavioral ratings of developmentally and culturally different gifted children, and whether norms could be developed for the Scales for Rating the Behavioral Characteristics of Superior Students (SRBCSS). The SRBCSS was used by teachers to rate gifted students' learning, motivational, creative, and leadership characteristics. The effects of ethnicity, grade, sex, and SES were examined and found to influence teachers' behavior ratings of gifted students significantly. It was concluded SRBCSS norms, local or national, when constructed should consider these variables.
Simultaneous-Successive Interpretation of the WISC-R: Making the Most of Indeterminacy
Authors: Matheson David W.
Published: March 2007

The validity of factor-analyzing a select set of WISC-R subtests to support a simultaneous-successive processing interpretation of the subtests is evaluated. The Similarities subtest has been identified in previous research as a test requiring simultaneous processing as a result of its large loading with several Performance Scale subtests. The subtest intercorrelation matrix for the 2,200 children in the standardization sample was reanalyzed to determine the degree to which the above result is artifactual. The present research demonstrates that any Verbal Comprehension subtest may be identified as a Simultaneous test by isolating it in a factor analysis with subtests from the Perceptual Organization and Distractibility factors. Difficulties associated with inferring cognitive processes from the factor analysis of this limited set of variables are discussed.
Self-Concept and Locus of Control as Related to Achievement of Junior High Students
Authors: Diesterhaft Kay , Gerken Kathryn
Published: March 2007

The purpose of this study was to determine the relationship between self-concept and locus of control, and the relationship of each variable to ability, achievement, and degree of over-or underachievement in a group of seventh graders in an urban junior high school. Support was found for the association between students' attitudes concerning self-concept and locus of control and their academic achievement, between attitudes and ability, and between attitudes and over-or underachievement. These relationships were stronger for the female group than the male group. Self-concept and locus of control were closely related variables for both sexes and merit further study in order to integrate the two constructs in educational theory. Ability test scores proved to be the best predictors for achievement test scores, a finding that must be kept in mind an any instructional program.