bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of buspirone with diazepam and fluvoxamine on aversive classical conditioning in humans
Authors: Hellewell J. S. E. , Guimaraes F. S. , Wang M. , Deakin J. F. W.
Published: April 2009

The effects of buspirone, fluvoxamine and diazepam were investigated, using healthy volunteers, in an aversive conditioning paradigm, a putative model for conditioned anxiety. The main prediction was that buspirone, an anxiolytic agent which reduces activity in serotonin (5-hydroxytryptophan, 5-HT) neurones, would attenuate aversively conditioned skin conductance responses. Skin conductance responses were recorded to 10 neutral tones (habituation phase). Tone 11 was immediately followed by a 1-s 90-dB aversive white noise (unconditioned stimulus). The conditioning trial reinstated responding to a second presentation of the tones (extinction phase). Skin conductance response amplitude, inter-response level and spontaneous fluctuations were recorded. There were five treatment groups comprising five men and five women. One control group took placebo, another control group received nothing; there was no effect of placebo on any measure. Diazepam (2 mg, p.o.), a positive comparator, markedly reduced the amplitude of skin conductance responses at all phases of the experiment, but only in women. Buspirone (5 mg, p.o.) had the predicted effect of accelerating extinction but also of unexpectedly accelerated habituation of skin conductance responses. There was a trend to reduce spontaneous fluctuations and no effect on skin conductance level. The effects of buspirone were thus specific to responses to stimuli. Fluvoxamine (25 mg, p.o.) had similar effects to buspirone and diazepam in women. An action common to buspirone, fluvoxamine and diazepam, which may account for their shared effect on conditioned autonomic responses, is the suppression of neural activity in the dorsal raphe nucleus. It is argued that enhanced habituation must involve a different mechanism, such as enhanced 5-HTIA function in the terminal fields of the median raphe nucleus.
The use of dexamethasone in elderly patients with antidepressantresistant depressive illness
Authors: Bodani Mayur , Sheehan Bartley , Philpot Michael
Published: April 2009

Many depressed patients do not respond to first-line antidepressant treatment. Dexamethasone is a synthetic steroid which may have antidepressant properties. Its use in two elderly patients with resistant depression is reported. Both patients appeared to benefit from the treatment. The possible modes of action of this treatment, and its potential benefits to the elderly, are discussed.
Effects of amphetamine on saccadic eye movements in man: possible relevance to schizophrenia?
Authors: Dursun S. M. , Wright N. , Reveley M. A.
Published: April 2009

The antisaccade task can be used to test the voluntary control of saccadic eye movements (SEMs). In many disorders with postulated hyperdopaminergic neurotransmission, there are reports of abnormalities in SEMs. To further investigate this, the role of dopamine in SEMs, performance on an antisaccade task was examined in subjects with a history of amphetamine use (a dopamine releaser and reuptake inhibitor). A prospective design was employed in a teaching hospital setting. Six subjects (five males) with a history of amphetamine use were compared to 24 normal controls. None of the subjects were using any other substances, except alcohol and nicotine, as determined by urine screening, which we believe limited the sample size. For subjects who used amphetamine before the task, the presence of amphetamine was confrmed by urinalysis. All subjects completed the antisaccade task. Both error rates and latency rates during the antisaccade task were compared between the amphetamine users and controls. The amphetamine users had signifcantly increased error rates and latencies. These results may suggest that increased error rates and latencies during antisaccade tasks may be due to increased dopamine transmission, which is similar to the fndings in schizophrenia.
Amisulpride in medium-term treatment of dysthymia: a six-month, double-blind safety study versus amitriptyline
Authors: Ravizza L.
Published: April 2009

Two hundred and fifty patients participated in a 6-month, double-blind study to evaluate safety and e¤cacy of a medium-term treatment with amisulpride 50 mg/day versus amitriptyline 2575 mg/day in dysthymia. Patients in treatment groups (165 amisulpride; 85 amitriptyline) were well balanced for demographic and baseline characteristics. A total of 139 patients (93 amisulpride, 46 amitriptyline) completed the study with no statistically signifcant di¡erences in reasons for premature termination between the two groups. A tendency towards a higher incidence of treatment-emergent adverse events with amitriptyline was observed (73% versus 64% amisulpride). In the amitriptyline group, a statistically signifcantly higher incidence of central nervous system (41% versus 24%, p=0.004) and autonomic nervous system disorders (45% versus 16%, p50.0001) was reported. Conversely, endocrine disorders were more frequent with amisulpride (18% versus 7%, p=0.023). E¤cacy was a secondary end-point. Results of the symptom rating scales indicate that both drugs were equally e¡ective: 60% and 62% of patients under amisulpride and amitriptyline, respectively, achieved a reduction 550% of the Montgomery and Asberg Rating Scale total score at end-point. On the item `global improvement' of the Clinical Global Impression, 67% of amisulpride and 68% of amitriptyline patients were rated as `very much' or `much' improved. Results of the present study in a large patient population further confrm the safe use of amisulpride in dysthymia and support its administration upon a medium-term treatment period.
Evidence-based psychopharmacology 1. Appraising a single therapeutic trial: what is the evidence for treating earlyAlzheimer's disease with donepezil?
Authors: Warner James P.
Published: April 2009

Expertise in setting appropriate, answerable clinical questions, undertaking an accurate search of databases, and appraising the evidence found are all key elements to practising evidence-based medicine. Using the published evidence of the utility of donepezil in Alzheimer's disease as an example, I have attempted to illustrate the process of critical appraisal of a therapeutic intervention. The study appraised was well conducted and the results indicate that donepezil may benefit some patients with Alzheimer's disease.
Postoperative delirium indicating an adverse drug interaction involving the selective serotonin reuptake inhibitor, paroxetine?
Authors: Stanford B. J. , Stanford S. C.
Published: April 2009

We report a postoperative delirium expressed by a 49-year-old female patient during recovery from anaesthesia. Prominent features of the delirium, which lasted for nearly 2 days, included agitation, confusion, uncontrolled limb movements, abnormal ocular function, hypertension, pyrexia, brisk reflexes, ankle clonus and raised creatine kinase. The delirium did not respond to naloxone, diazepam or flumazenil. The patient had not been prescribed neuroleptics but, before surgery, she had been taking the selective serotonin reuptake inhibitor, paroxetine, to relieve her depression. During surgery, she was given morphine, which increases release of the neurotransmitter, serotonin, and ondansetron, which blunts neuronal release of dopamine. Although there is no clear explanation for the delirium, it had many features in common with problems associated with paroxetine withdrawal, the serotonin syndrome and the malignant neuroleptic syndrome. We offer several alternative explanations for this event, all of which rest on disruption of serotonergic and/or dopaminergic transmission and which could also involve inhibition by paroxetine of the P450 enzyme, CYP2D6, which metabolizes ondansetron.
Imaging studies on the role of dopamine in cocaine reinforcement and addiction in humans
Authors: Volkow Nora D. , Fowler Joanna S. , Wang Gene-Jack
Published: April 2009

We summarize our studies with positron emission tomography investigating the role of dopamine (DA) in the reinforcing effects of cocaine and methylphenidate in humans and its involvement in cocaine addiction. These studies have shown that the rate at which cocaine and methylphenidate enter the brain and block the dopamine transporters (DAT) is the variable associated with the `high', rather than the presence per se of the drug in the brain. Our studies also show that, while the level of DAT blockade is important in predicting the intensity of the `high' induced by these drugs (DAT blockade 450% is required for these drugs to induce a `high'), the rate at which DAT are blocked determines whether the `high' is perceived or not. Thus, oral methylphenidate, which leads to slow DAT blockade, does not induce a `high', even at doses which block DAT more than 60%. In cocaine abusers, we have shown significant reductions in DA D2receptors that are associated with decreased metabolism in cingulate gyrus and in orbitofrontal cortex. We suggest that this is one of the mechanisms by which DA disruption leads to compulsive drug administration in cocaine addiction. Cocaine abusers also show significant decreases in DA release, which coupled with the reduction in D2receptors may result in decreased activation of reward circuits by physiological reinforcers and may perpetuate cocaine use as a means to compensate for this deficit. Thus, strategies to enhance DA brain function in ways that mimic physiological DA activity may be of help in overcoming cocaine addiction.
Effects of CCK-4 infusion on the acoustic eye-blink startle and psychophysiological measures in healthy volunteers
Authors: Shlik Jakov , Zhou Yueping , Koszycki Diana , Vaccarino Franco J. , Bradwejn Jacques
Published: April 2009

The acoustic startle response (ASR) and a range of psychophysiological parameters were evaluated during a continuous intravenous administration of cholecystokinin-tetrapeptide (CCK-4) in healthy volunteers. Subjects (n=28) were randomly assigned to double-blind infusion of either CCK-4 (0.5 mg/60 min) or placebo. The ASR sessions were performed prior to infusion and at 20 min and 50 min after the onset of infusion by recording eye-blink response to a series of acoustic stimuli (110 dB, 40 ms). An effect of CCK-4 on the eye-blink startle was observed in the first half of infusion. CCK-4 produced an increase of eye-blink startle amplitude from baseline values in contrast to the decrease observed at this time point with placebo. A mild increase in anxiety and heart rate followed by fatigue was reported with CCK-4. Administration of CCK-4 produced increases in plasma concentrations of adrenocorticotropic hormone, cortisol, prolactin and growth hormone. The results of this study show that a prolonged intravenous administration of CCK-4 may be a useful challenge method for further studies on the role of CCK system in the modulation of human anxiety and stress response.
An Off-the-Shelf Help List
Authors: Bell Chaim M. , Chapman Richard H. , Stone Patricia W. , Sandberg Eileen A. , Neumann Peter J.
Published: April 2009

Purpose. The Panel on Cost-Effectiveness in Health and Medicine recommends an organized collection of preference measure values for health states that can be used in cost-utility analyses (CUAs). The authors sought to construct a catalog of preference scores from published CUAs, organize the catalog by clinical categories, and identify methods of preference score assessment. Method. The authors systematically searched Medline and other databases to identify original CUAs published through 1997. Information was abstracted on the health state descriptions, corresponding preference scores, method of preference score elicitation, and the source of the estimate. Results. Two hundred twenty-eight CUAs were appraised. The authors found 949 health states and corresponding preference scores. Most frequently, health states pertained to the circulatory system (21.7%), health states were valued by experts (35.8%), and values were derived through community-based preference scores (23.5%). Conclusion. A catalog of preference scores for health states can be constructed. The catalog (http://www.hsph.harvard.edu/organizations/hcra/cuadatabase/intro.html) may provide a useful reference tool for producers and consumers of CUAs but also underscores the methodologic variation and inconsistencies present in the field.
Understanding Birthing Mode Decision Making Using Artificial Neural Networks
Authors: MacDowell Martin , Somoza Eugene , Rothe Kenneth , Fry Richard , Brady Kim , Bocklet Albert
Published: April 2009

Background. This study examined obstetricians’ decisions to perform or not to perform cesarean sections. The aim was to determine whether an artificial neural network could be constructed to accurately and reliably predict the birthing mode decisions of expert clinicians and to elucidate which factors were most important in deciding the birth mode. Methods. Mothers with singleton, live births who were privately insured, nonclinic, non-Medicaid patients at a major tertiary care private hospital were included in the study (N =1508). These mothers were patients of 2 physician groups: a 7-obstetrician multispecialty group practice and a physician group of 79 independently practicing obstetricians affiliated with the same hospital. A feedforward, multilayer artificial neural network (ANN) was developed and trained. It was then tested and optimized until the most parsimonious network was identified that retained a similar level of predictive power and classification accuracy. The performance of this network was further optimized using the methods of receiver operating characteristic (ROC) analysis and information theory to find the cutoff that maximized the information gain. The performance of the final ANN at this cutoff was measured using sensitivity, specificity, classification accuracy, area under the ROC curve, and maximum information gain. Results. The final neural network had excellent predictive accuracy for the birthing mode (classification accuracy = 83.5%; area under the ROC curve = 0.924; maximum information = 40.4% of a perfect diagnostic test). Conclusion. This study demonstrated that a properly optimized ANN is able to accurately predict the birthing mode decisions of expert clinicians. In addition to previously identified clinical factors (cephalopelvic disproportion, maternal medical condition necessitating a cesarean section, arrest of labor, malpresentation of the baby, fetal distress, and failed induction), nonclinical factors such as the mothers’ views on birthing mode were also found to be important in determining the birthing mode.
What White Blood Cell Count Should Prompt Antibiotic Treatment in a Febrile Child? Tutorial on the Importance of Disease Likelihood to the Interpretation of Diagnostic Tests
Authors: Kohn Michael A. , Newman Thomas B.
Published: April 2009

Most diagnostic tests are not dichotomous (negative or positive) but, rather, have a range of possible results (very negative to very positive). If the pretest probability of disease is high, the test result that prompts treatment should be any value that is even mildly positive. If the pretest probability of disease is low, the test result needed to justify treatment should be very positive. Simple decision rules that fix the cutpoint separating positive from negative test results do not take into account the individual patient’s pretest probability of disease. Allowing the cutpoint to change with the pretest probability of disease increases the value of the test. This is primarily an issue when the pretest probability of disease varies widely between patients and depends on characteristics that are not measured by the test. It remains an issue for decision rules based on multiple test results if these rules fail to account for important determinants of patient-specific risk. This tutorial demonstrates how the value of a diagnostic test depends on the ability to vary the cutpoint, using as an example the white blood cell count in febrile children at risk for bacteremia.
Physicians’ Attitudes toward Health Care Rationing
Authors: Perneger Thomas V. , Martin Diane P. , Bovier Patrick A.
Published: April 2009

Background. Optimal allocation of health care resources under a limited budget is controversial. Particularly important questions are whether rationing decisions should be based on efficiency considerations alone or in combination with equity considerations, and who should be in charge of such decisions. In this study, the authors sought to understand the position of Swiss physicians toward rationing using a previously developed rationing scenario. Methods. The authors examined the acceptability of various scenarios implementing health care rationing in a mail survey of 1184 physicians practicing in Geneva, Switzerland. Respondents were asked to choose between providing a suboptimal cancer screening test A to the whole population, which would save 1000 lives, or selecting half of the population to receive a better but more expensive test B, which would save 1100 lives. Physicians were randomly assigned to 3 versions of the scenario: Beneficiaries of test B could be chosen by lottery, on a first-come-first-served basis, or by medical associations. Results. Only 26% of physicians chose the more effective selective rationing option; this proportion was lowest when test beneficiaries were selected by lottery (14%), intermediate for the first-come-first-served scenario (26%), and highest when selection was left to medical associations (39%; P < 0.001). Hospital-based physicians and general practitioners were less likely to endorse selective rationing than community-based physicians and specialists. Conclusion. Swiss physicians appear to be more concerned about equal allocation of health services than about maximizing health in society, and they prefer physicians to be in charge of rationing decisions.
Peripheral Arterial Occlusive Disease: Prognostic Value of Signs, Symptoms, and the Ankle-Brachial Pressure Index
Authors: Hooi Jurenne D. , Stoffers Henri E.J.H. , Kester Arnold D. M. , van Ree Jan W. , Knottnerus J. André
Published: April 2009

Objectives. To determine whether different levels of the ankle-brachial pressure index (ABPI) are associated with an increased risk for progressive limbischemia, nonfatal and fatal cardiovascular events. To investigate the prognostic value of signs and symptoms associated with peripheral arterial occlusive disease (PAOD). Design. Prospective follow-up study. Setting. Eighteen general practice centers in the Netherlands. Participants. Three thousand six hundred forty-nine participants (53% female) with a mean age of 59 years (range: 40-78 years). Main outcome measures. Progressive limbischemia, cardiovascular morbidity and mortality. Results. At baseline, 458 participants had PAOD, defined as an ABPI < 0.95. Among these, 148 (32.2%) had an ABPI < 0.70. Cox proportional hazards models showed that after a mean follow-up period of 7.2 years, PAOD patients with an ABPI < 0.70 were at higher risk for cardiovascular death, compared with participants with a moderately reduced ABPI (< 0.95 - 0.70): HR 2.3 versus 1.2. Older age, complaints of intermittent claudication, abnormal pedal pulses, elevated blood pressure, and coexisting cardiovascular disease at baseline were also significant independent prognostic factors for one or more of the adverse outcome events in these patients. Conclusion. The ABPI is inversely associated with cardiovascular mortality in PAOD patients. A low ABPI is an independent predictor for cardiovascular mortality in PAOD patients.
Bayesian Extensions of the Tobit Model for Analyzing Measures of Health Status
Authors: Austin Peter C.
Published: April 2009

Self-reported health status is often measured using utility indices that provide a score intended to summarize an individual’s health. Measurements of health status can be subject to a ceiling effect. Frequently, researchers want to examine relationships between determinants of health and measures of health status. In this article, Bayesian extensions of the classical Tobit model are used to study the relationship between health status and predictors of health. The author examined models where the conditional distribution of health status was either normal or lognormal, and allowed for both homoscedasticity and heteroscedasticity. Bayes factors were then used to compare the evidence for a given model against that for a competing model. The author found very strong evidence that the distribution of the Health Utilities Index, conditional on age, gender, income adequacy, and number of chronic conditions, was normal with nonuniform variance, compared to the competing models.
Patient Decision Making: Use of and Adherence to Telephone-Based Nurse Triage Recommendations
Authors: O’Connell Joan M. , Towles Winfield , Yin Ming , Malakar C. Lucy
Published: April 2009

Objective. Health plans, employer groups, and medical providers offer telephone-based nurse triage services to provide ready access to medical advice and information to assist patients in making decisions about their medical needs. The purpose of this study is to assess patient adherence to nurse triage recommendations. Patients and Methods. The study includes data for members of an HMO located in a large metropolitan area who used the triage service during 1997 (n = 22,998). The nurse triage call data are linked with medical claims and encounter data to assess patient medical service utilization following a call to the triage service to assess triage adherence. The authors consider no use of medical services following a triage call with the recommendation to use self-care advice at home an indicator of adherence to this recommendation. Results. The percentage of callers who adhered to triage recommendations to use hospital emergency services, physician office services, or self-care advice was 79.2%, 57.4%, and 65.8%, respectively. Adherence varies somewhat by age. Conclusion. The reported adherence levels are lower than those obtained from self-reported data reported elsewhere. Given the inherent limitations of both types of data, actual telephone-based nurse triage adherence may lie between the 2 levels.
The Management and Production of Risk in Romantic Relationships: A Postmodern Paradox
Authors: Bulcroft Richard , Bulcroft Kris , Bradley Karen , Simpson Carl
Published: April 2009

Expanding on the work of Ulrich Beck and other social theorists, the central thesis of this article is that individuals in contemporary North American society are increasingly motivated by the need to alleviate expanding levels of perceived risks associated with interpersonal love relationships and mate selection. In response to these perceived risks, men and women today are altering their relationship patterns in such a way that the process of relationship formation and assessment has become increasingly rationalized. As a result, a paradox has been created between the rational management of interpersonal risk associated with romance and the production of risk. This article is primarily a theoretical treatment of the issues, augmented with data on the social history of adolescence, courtship, and marriage and a review of the literature on mate selection processes in contemporary society.
Dysfunctional Domesticity: Female Insanity and Family Relationships among the West Riding Poor in the Mid-Nineteenth Century
Authors: Levine-Clark Marjorie
Published: April 2009

“Dysfunctional Domesticity” contributes to the growing reevaluation of the importance of the history of the family to understanding the history of insanity. Using patient case histories from the West Riding Pauper Lunatic Asylum, this article examines representations of family life among the poor in England in the 1830s and 1840s. Among the so-called moral causes of insanity, family relationships held a prominent place. Female patients more than male patients had their mental illnesses attributed to their domestic circumstances: the poverty of their home lives, grief over the death of friends and family, love and marital relationships gone wrong, and violence in their homes. The case histories reveal that poor women experienced many pressures in the domestic sphere, and insanity may have been one way to escape dysfunctional domesticity.
Accounting for Affection: Battles Between Aristocratic Mothers and Sons in Eighteenth-Century Rome
Authors: Castiglione Caroline
Published: April 2009

A rich historiography has explored how European nobles successfully confronted financial difficulties during the early modern period. Less well known is the impact that economic crisis had on the dynamics between family members. This article uses a microhistorical approach to examine how a Roman aristocratic mother and her son conceptualized the crisis facing their family at the turn of the eighteenth century. Through a comparative reading of two histories of the Barberini family, this article uncovers significant differences in the way each imagined the place of authority, affection, and accounting in the governing of an aristocratic family.
Home and Away: Patterns of Residence, Schooling, and Work among Children and Never Married Young Adults, Canada, 1871 and 1901
Authors: Darroch Gordon
Published: April 2009

Microdata samples of the 1871 and 1901 censuses of Canada document a significant shift in which residence with parents increased substantially among young children, while leaving home was increasingly likely among those in their late teens and in their twenties. There were striking rural-urban and regional differences in these patterns. Surprisingly large numbers of children and young adults living away attended school; others worked. Both were especially common in the still partially settled regions of the west. Religious and ethnic differences were muted. Multivariate analysis confirms the significance of schooling and working for living away from home. The normalization of familial child nurturing did not rapidly undermine informal practices of child fostering.
Late-Life Historical Reflections of Philippe Ariès on the Family in Contemporary Culture
Authors: Hutton Patrick H.
Published: April 2009

Philippe Ariès is renowned among social historians for Centuries of Childhood (1960), his pioneering study that set the course for research on the rise of the modern family as a newfield for historical inquiry. Also significant but less well known are his late-life writings (late 1970s, early 1980s) on the family in the present age. In this article, the author analyzes Arièss reconsideration of his original thesis in light of his inquiry into three issues: the crisis of the contemporary family, with particular attention to the problem of adolescence; the changing cultural understanding of the relationship between love and marriage; and the historical emergence of the distinction between public and private life as a context for understanding long-range changes in the dynamics of family life.
A Company of Women and Men: Men's Recollections of Childbirth in Medieval England
Authors: Lee Becky R.
Published: April 2009

The events that took place in medieval English birthing chambers were witnessed and assisted by a company of women. Although these events may have been isolated, they did not exist in isolation. Rather, they interacted in complex ways with the lives and activities of the men in the manor hall. This article examines those interactions as they are evidenced in proof-of-age inquests, legal documents that record the recollections of husbands, fathers, and male relatives and neighbors regarding the events surrounding the birth of an heir to crown land. It concludes that even though men rarely entered the birthing chamber, their dynastic interests and social politics routinely penetrated its walls, blurring the boundary between private and public spheres, female and male space.
History Telling at the Kitchen Table: Private Joseph Shields, World War II, and Mother-Centered Memory in the Late Twentieth Century
Authors: Jefferson Robert F. , Reyes Angelita
Published: April 2009

This essay adds to the discourses of African American history, military history, and autobiography that focus on the process of collective memory telling in black families in the latter half of the twentieth century. By exploring an African American family's postwar recollection of the homicide of a black soldier during the SecondWorldWar, this essay examines the relationship between memory and history. It reconstructs how the parameters ofWorldWar II shaped the wartime experiences of African American servicemen and their families'memory of the “Good War” in a period of national forgetting. By exploring the episodes of memory telling among black family members of those who stood in the ranks of America's armed forces during World War II, the importance of investigating aspects of the tension between memory and history in African American culture in the twentieth century can be discerned.
“Nobody Would Tell You Anything”: The War and Foreign Offices and British Prisoner of War Families During World War II
Authors: Hately-Broad Barbara
Published: April 2009

This article surveys the ways in which official information was communicated through the Foreign and War Office to the relatives and dependants of British prisoners of war during World War II and how, driven by apparently more successful “unofficial” channels, an imperative developed as the war proceeded to improve systems of communication with prisoners' relatives and dependants. A detailed examination of the methods used by state agency highlights both the exasperation experienced by many ordinary civilians in their attempts to obtain official information and the problems faced by the state in creating and maintaining reliable channels of communication with both the Axis powers and the Japanese. The article demonstrates how dissatisfaction with official channels led to an increased role for the charitable agencies such as the Red Cross and the Soldiers, Sailors and Air Force Families Association, together with the formation of local prisoner of war committees.
Sentiment and Survival: Family and Friends in Late Medieval English Towns
Authors: Kermode Jenny
Published: April 2009

Most studies of medieval English urban society analyze the demographic characteristics of households or reconstruct the life of a single family. This study focuses instead on perceptions of family and household among merchants, using the testamentary evidence of three sizable northern towns. What emerges is a surprising variety of family forms, the consequence of second and third marriages; extensive kin recognition; and an acceptance of wider responsibilities for dependents in and beyond the household. Intermarriage, acting as guardians and executors for fellow merchants, and the creation of networks of affines and in-laws signal early stages of class formation. Comparisons are made with studies of medieval and early Tudor London.
Crimes of Reason, Crimes of Passion: Suicide and the Adulterous Woman in Nineteenth-Century France
Authors: Lieberman Lisa
Published: April 2009

The anxieties that determined the nineteenth-century French obsession with female behavior found symbolic expression in the adulterous and suicidal woman. We see this clearly in novels where both adultery and suicide feature prominently, but the anxiety these themes provoked was not limited to works of fiction. A striking number of moral essays and medical studies were devoted to the subject of feminine nature during this period, and it is here especially that the dangerous tendencies of independent and sexually active women were revealed. By analyzing the literary representation of the suicidal and adulterous woman in the works of male and female writers alongside the theories of physicians, critics, and moral reformers, the author demonstrates how this image came to symbolize much more than the violation of ethical standards. In literature as in life, unconventional women needed to be severely punished lest their defiant attitudes inspire further acts of rebellion.
Paternity Tests: Fatherhood on Trial in Mexico's Revolution of the Family
Authors: Bliss Katherine
Published: April 2009

This article analyzes the politicization of fatherhood in revolutionary Mexico City's process of social reform and institution building between 1910 and 1940. Based on evidence culled from juvenile court case histories, criminal trial transcripts, and letter-writing campaigns, it concludes that reformist and popular ideas about fatherhood were highly contested in this era of social change, legal reform, and state formation. By examining the competing visions of fatherhood that reformers, women, and fathers themselves promoted, it shows that ideas about appropriate parental roles in Mexico were linked to revolutionary conceptualizations of progress, social mobility, and political participation.
Anatomical Reconstruction of the Medial Collateral Ligament and Posteromedial Corner of the Knee in Patients With Chronic Medial Collateral Ligament Instability
Authors: Lind Martin , Jakobsen Bent Wulff , Lund Bent , Hansen Mogens Strange , Abdallah Ossama , Christiansen Svend Erik
Published: April 2009

Background

In cases of multiple ligament injury or severe medial collateral ligament (MCL) lesion, nonoperative treatment of the MCL lesion may lead to chronic valgus instability or rotatory instability.

Hypothesis

In a retrospective case series after isolated and combined MCL reconstructions using a novel MCL reconstruction technique that addresses both the MCL and the posteromedial corner, an acceptable clinical outcome is expected 2 years after MCL reconstruction.

Study Design

Case series; Level of evidence, 4.

Methods

From July 2002 to December 2005, 61 patients with grade 3 or 4 medial instability were treated with MCL reconstruction. Median age was 33 years (range, 14–62). Thirteen underwent isolated MCL reconstructions, 34 had combined MCL and anterior cruciate ligament (ACL) reconstruction, and 14 had multiple ligament reconstructions. All patients had reconstruction of the medial collateral and the posteromedial complex using ipsilateral semitendinosus autografts. Fifty patients were available for follow-up more than 24 months postoperatively and were examined by an independent observer using objective International Knee Documentation Committee (IKDC) measures and subjective Knee Injury and Osteoarthritis Outcome Score (KOOS).

Results

At follow-up, medial stability according to the IKDC score showed 98% normal or nearly normal (grade A or B), and for overall IKDC score, patients improved from 5% with grade A or B preoperatively to 74% with grade A or B at follow-up. There were 91% who were satisfied or very satisfied with the result; 88% would go through surgery again. The KOOS improved primarily for sports and quality of life subscales with approximately 10-point improvements.

Conclusion

Acceptable clinical results with the MCL reconstruction technique were achieved in patients suffering from chronic valgus instability.
The Civil Service Under Clinton
Authors: Thompson James R.
Published: April 2009

With the failed attempt at comprehensive reform of the civil service system in 1995, the Clinton administration encouraged individual agencies to seek their own personnel flexibilities. That strategy met with some success with the granting by Congress of special authorities to units with a total of approximately 200,000 employees. However, the disaggregation of the federal personnel system this approach portends holds profound and potentially adverse consequences for the institution of the civil service, for the values of merit and equity that have been traditionally associated with the civil service, and for the public service ethos that provides the civil service a constitutive role in our system of governance.
Succession Management Strategies in Public Sector Organizations
Authors: Lynn Dahlia Bradshaw
Published: April 2009

This research reviews the development of succession management strategies in public service organizations. The results reinforce the direct link between organizational culture and leadership and the need for new human resource management initiatives to foster the systematic identification, recruitment, development, and selection of high-potential candidates to improve leadership growth in the public sector.
An Inquiry Into the Chilling Effects of Stringent Little Hatch Act Prohibitions
Authors: Snead John David
Published: April 2009

This study examined ways that differences in state political-activity laws affect the political attitudes and reported behavior of state-level public administrators. It included officials employed in Pennsylvania, which has restrictive laws, and New Jersey, which has generally permissive statutes. Compared with New Jersey’s employees, Pennsylvania’s were less knowledgeable about their state laws, less politically active, and less satisfied with their activity. However, the Pennsylvania workers were no less inclined to engage in permissible activities. These findings cast doubt upon the “chilling effects” argument that strict laws prompt government employees to develop apolitical tendencies. Nonetheless, they do raise concerns about the stifling effects of the statutes.
Are Exit Interviews and Surveys Really Worth the Time and Effort?
Authors: Jurkiewicz Carole L. , Knouse Stephen B. , Giacalone Robert A.
Published: April 2009

The value of conducting exit interviews and surveys (EIS) with public sector employees has been well documented and seems intuitively evident. Yet is the value of the information received through this technique worth the considerable investment in time and effort necessary to collect it? As a measure of accountability, this article introduces a method for determining the value of conducting EIS through the concept of return on investment (ROI). The advantages of employing an ROI analysis for EIS are fully explored, and a 7-step model for evaluating EIS through ROI is detailed.
Georgia’s Merit System Reform 1996-2001
Authors: Lasseter Reuben W.
Published: April 2009

This article analyzes Georgia’s merit system reform from a state agency practitioner’s perspective. It provides a short history of personnel practices prior to reform, which established the impetus for the reform effort. It then examines the effects of reform on job classification, employee discipline, operating agency-merit system relationships, recruitment, and employee rights.
Women in Public Service in the Russian Federation
Authors: Antonova Victoria K.
Published: April 2009

Despite great reform, Russia has spent little time, effort, or money on improving and enhancing the role and status of its female public servants. Legislative measures are often discussed but are rarely completed and implemented. To date, few systematic studies of this situation have been undertaken. It can be argued that public service reform and development cannot be attained if they continue to ignore the role of women. Women constitute more than half of Russia’s population and nearly three quarters of its public service. As such, any governmental reform that fails to address gender and the expression of gender power within the public workplace is likely to be incomplete. This study examines the experiences of public servants within different structures of both the federal and regional public service of Russia. The information traces the nature and impact of shifting societal values regarding gender equity in public service employment.
An Economic Model of The East-West Confrontation
Authors: Yunker James A.
Published: April 2009

In this paper, we develop a comprehensive analytical perspective on the contemporary conflict situation between the United States and the Soviet Union, based upon standard concepts and methodologies in contemporary economic thinking. The perspective involves static-model specification, comparative-statics analysis, and a possible extension of the model to dynamic uncertainty circumstances. Applications of the model include results on the determination of socially optimal armaments spending and on the effect of the invention and dissemination of nuclear weapons upon the probability of war. The complexity of the comparative-statics results obtained on the basis of an apparently quite-simple static-model specification reflect the complexity of the contemporary human predicament. Because of this complexity, the model does not necessarily support the widespread contemporary presumption that the invention and dissemination of nuclear weapons has reduced the probability of total war.
Expected Utility and Peace Science: An Assessment of Trade and Conflict
Authors: Sayrs Lois W.
Published: April 2009

In this paper, I attempt to tease out the implications of expected utility models on conflict resolution and peace science. I also consider the trade-conflict model of Polachek (1980) and its extensions, as one example of expected utility in international relations. I raise three questions concerning the impact of expected utility: (1) when does trade mitigate conflict? (2) can trade provoke conflict? (3) can trade induce cooperation? From a review of empirical findings, I consider the political content of the trade-conflict model in particular, and of expected utility models, in general. Subsequently, I discuss two additional questions: (4) how do exchange norms influence trade and conflict? and (5) what incentives exist to foster cooperation from trade under expected utility? I advance the critique that while expected utility underrepresents political actions and motives, the implicit content of politics in the trade-conflict model is predominantly realist. Given this tendency, expected utility in conflict resolution and peace science will invariably be used to model strategic and geostrategic concerns.
Weak Cycles, Length and Magnitude of War: Duration Dependence in International Conflict
Authors: Conybeare John A. C.
Published: April 2009

Standard statistical tests have provided little evidence for the existence of war cycles. Cycle theorists argue that these tests are inappropriate because such cycles are inherently irregular. Duration analysis provides a means of testing for the presence of somewhat irregular weak cycles, by determining the extent to which measures of war duration cluster around a mean value, a phenomenon known as positive duration dependence or increasing hazard. Tests are performed on a 500-year data set. Turning points in long cycles of war intensity do manifest a weak cycle of 50 years, when the cycle is measured from peak to peak. The length and magnitude of individual wars exhibit no common durations and appear prone to an anti-cyclical process of negative duration dependence, whereby the probability of war termination declines with the time and magnitude duration of the war.
The Economic Effects of Reduced Defense Expenditures: An Applied General Equilibrium Analysis
Authors: Baum Donald N.
Published: April 2009

This paper employs an applied general equilibrium model to simulate the long-run effects of reductions in U.S. defense expenditures. In the long-run these reductions significantly affect only the output of the defense and government industries, and do not significantly affect the distribution of income or the relative price of capital and labor. The structure of the tax or expenditure changes which accompany defense reductions may cause large allocative and distributional effects. Thus, the fiscal decisions which accompany defense expenditure reductions are the key to determining their impact.
Modeling 'Massive Retaliation'
Authors: Zagare Frank C. , Kilgour D. Marc
Published: April 2009

A generic asymmetric two-stage escalation model of incomplete information is used to examine strategic relationships in which one player adopts a defense posture akin to the “Massive Retaliation” policy of the Eisenhower administration that relies only on the threat of escalation to deter aggression. In the model, a challenger must decide whether to contest the status quo and a defender must choose between capitulation and escalation. Each player has probabilistic knowledge of the other's preference between conceding and fighting an all-out war. All perfect Bayesian equilibria of the Incomplete Information Escalation game are identified and interpreted. Unlike two-stage games of complete information, war and escalation may be rational outcomes under incomplete information. At certain times, these outcomes may be inevitable. Challengers preferring conflict to capitulation always initiate conflict, whatever the information state of the game. But when information is incomplete, even challengers with an aversion to all-out war may rationally precipitate a crisis. Similarly, when it is unsure of a challenger's preferences, even a defender preferring not to wage war may rationally choose to escalate a conflict. The conditions associated with a stable status quo, a successful challenge, an escalated conflict, and war are discussed.
An Introduction To Lewis Fry Richardson and His Mathematical Theory of War and Peace
Authors: Hess G. D.
Published: April 2009

Lewis Fry Richardson was a pioneer of peace research. His brilliant, groundbreaking studies, Arms and Insecurity, and Statistics of Deadly Quarrels, showed how mathematical modeling techniques and statistical analysis could be applied to quantitatively investigate questions relating to war and peace. These studies and his database on “deadly quarrels“, that is quarrels in which humans died, have influenced many peace researchers and continue to be a rich source of ideas. In this paper we begin by giving a brief background sketch of Richardson's life. We then proceed to introduce some of the basic ideas of his peace research. Richardson's work indicates a number of areas of difficulty and limits to our understanding, both in regards to theory and to data, and it raises questions that still need to be addressed. It also demonstrates the need for an interdisciplinary approach.
A House Divided Against Itself Cannot Stand: Presidential Address to the Peace Science Society
Authors: Wolfson Murray
Published: April 2009

The ante-bellum history of the United States is modelled as the competing expansion of urban, slave and citizen fanners expanding into a frontier occupied by indigenous Native American and Mexican peoples. The resulting “irrepressible conflict” illustrates a circumstance in which all of the actors can be described as exhibiting democratic political institutions to a significant degree. In this instance, peoples rationalized their opposed interests and implemented them through representative governments. Wars are likely to be particular events to be analyzed as an aspect of a total social conjuncture and are unlikely to be explicable in a uniform fashion across various economic and political circumstances. 'A house divided against itself cannot stand.' I believe this government cannot endure permanently half slave and half free. I do not expect the Union to be dissolved–I do not expect the house to fall–but I do expect it will cease to be divided. It will become all one thing, or all the other. Either the opponents of slavery will arrest the further spread of it, and place it where the public mind shall rest in the belief that it is in the course of ultimate extinction; or its advocates will push it forward till it shall become alike lawful in all the states, old as well as new, North as well as South. Abraham Lincoln (1858)