bluuebunny/crossref_metadata_2025_split huggingface dataset:
It's kuloo tu: recent
developments in Kenya's Englishes
Authors: Meierkord Christiane 
Published: March 2009

ABSTRACTIn most areas where English is spoken today, it is part of a multilingual
context. English is one component of the sociolinguistic profile of many
nations. In nations where English is a mother tongue or first language for the
majority of the population, other speech communities contribute further
languages to the linguistic environment. And in contexts where the majority
speak a language other than English, it may serve as a language of
administration or as a medium of instruction in the educational domain. Over
the past few decades, speech communities have also increasingly been influenced
by languages usually spoken outside the community. A particular case is the
spread of English via music and films through the radio, television, and the
internet. As a result, English is part of the linguistic repertoire of many
nations and the individuals living in them. These multilingual contexts have in
common the fact that individuals can draw on the various languages to meet their
diverse communicative needs and to construct their identities. This article
describes how this may result in changes to the English language and even in the
emergence of new linguistic forms, with particular reference to the
post-colonial nation of Kenya.
Assessing the status of lesser-known varieties of English
Authors: Schreier Daniel 
Published: March 2009

ABSTRACTThe study of lesser-known varieties of English is opening up new research. Over the last twenty years or so, the role(s) and function(s) of English around the world have received a great deal of interest from linguists concerned with research on topics as diverse as sociolinguistics, variation and change, contact linguistics, language typology, genetic linguistics, etc. Kachru's work (The Inner Circle, the Outer Circle, and the Expanding Circle) inspired others and alternative models were put forward by McArthur (1987) and Görlach (1990). Though they differ on how the varieties should be classified (varying in criteria such as geographic distribution, usage and function, development history, etc.), they share the idea that varieties of English can be grouped in first- (or native-), second- and foreign-speaker groups.
World Englishes, English as a Lingua Franca, and the case of Hong Kong English
Authors: Sewell Andrew 
Published: March 2009

ABSTRACTPerspectives from both World Englishes (WE) and English as a Lingua Franca (ELF) can assist in the description of Hong Kong English phonology. Mario Saraceni's article (English Today 94) provides some useful insights into the current debates about English as a Lingua Franca (ELF). His discussion of the background to this debate identifies three viewpoints: a traditional ENL view with its adherence to native-speaker models; the WE (World Englishes) paradigm with its ‘pluralised and pluricentric view of English in the world’; and the emerging ELF position, with its rejection of native-speaker norms in favour of ‘endonormative realisations of lingua franca varieties’ (Alessa Cogo, English Today 95). However, Cogo believes that the second and third positions are not separate paradigms, and that ELF sits ‘comfortably within a WE framework’, as claimed by Jenkins (2007:17). In this article, I would like to show how the two positions can work together to inform pedagogy by exploring the possible options for English pronunciation models in Hong Kong.
English in China: some thoughts after the Beijing Olympics
Authors: Fong Emily Tsz Yan 
Published: March 2009

ABSTRACTInstitutional and learners' discourses about English and the implications for ‘China English’. China's politics and international relations with Western powers have historically determined the role and status of the English language in China (Adamson, 2004). Following the country's Open Door Policy in the 1970s, the entry into the World Trade Organization (WTO) and the Beijing Olympics, English, once considered a barbaric language, has been enjoying unprecedented popularity. The seven years leading up to the 2008 Beijing Olympics saw a series of foreign language campaigns in different sectors of Chinese society. The Beijing Olympics provided China with an opportunity to improve its world position and to ‘reclaim’ – and show the world – its glorious past. Since 2001, when China won the bid to host the Olympics in 2008, English learning campaigns have promoted both so-called ‘standard’ and ‘authentic’ English. The purpose of these campaigns was not only to ensure a successful Olympics, but also to equip the people with a tool essential for modernising and integrating China into the global community.
Diffusion of Western Medical Technology in China Since the Economic Reform
Authors: Hu Teh-wei 
Published: March 2009

AbstractThis article reviews the diffusion of western medical technology in China since 1978. The author demonstrates how medical organization and financing at both the national and hospital levels have contributed to a relatively rapid diffusion. The example of the CT scanner is used to evaluate the financing, distribution, and utilization of medical technology in China. The author concludes with an examination of the policy implications and practical impact of current trends.
Distributing and Transferring Medical Technology
Authors: Peña-Mohr Jorge 
Published: March 2009

AbstractGreat variation exists in the health care delivery systems throughout Latin America and the Caribbean. In general, medical technology is concentrated in large cities at private hospitals that serve a small, elite segment of the population. What is missing in most of these countries is a clearly defined social policy guaranteeing distribution of medical technology to all segments of society. While data is scarce, it appears that political and economic concerns, rather than medical concerns, determine what and how much technology will be available to all segments of the society. Products are sometimes imported that compete with domestically produced ones. Moreover, transfers of technology often fail to include the necessary knowledge to make imported technology truly useful. However, current economic crises throughout the region are forcing changes in policies; as a result, there is a new emphasis on domestic production of technology over imports and the evaluation of medical technology for its appropriate use in Latin America and the Caribbean.
Technology Assessment Using Insurance Claims: Example of Prostatectomy
Authors: Fisher Elliott S. , Malenka David J. , Wennberg John E. , Roos Noralou P. 
Published: March 2009

AbstractThis article describes the findings of an ongoing assessment of prostatectomy that relied on the use of administrative data bases. Examples of the use of claims data for monitoring outcomes and treatment comparisons are provided, as well as a discussion of the strengths and limitations of administrative data for technology assessment.
Problems in the Use of Large Data Sets to Assess Effectiveness
Authors: Temple Robert 
Published: March 2009

AbstractLarge data sets are an attractive source of information for outcome assessment, but their use involves certain problems and risks. Data base evaluations are retrospective and unblinded; they often represent the result of multiple analyses of multiple endpoints, and it is difficult to identify the procedures used and analytic choices made because critical details are often omitted. While data bases can suggest problems and offer answers, they cannot prove them; data base analyses must be followed by trials.
Use of Insurance Claims Data in Measuring Quality of Care
Authors: Lohr Kathleen N. 
Published: March 2009

AbstractThis article discusses data that might be used for measuring quality of care, for health care administrative purposes, and for tracking the use of technologies. The advantages and limitations of administrative data banks for research purposes and some process-of-care and outcome analysis are noted. Three important obstacles to their use—reliability of diagnosis and service information, unique patient identifiers, and provider identifiers—are discussed briefly.
Impact of Claims Data Research on Clinical Practice
Authors: Steinberg Earl P. , Whittle Jeffrey , Anderson Gerard F. 
Published: March 2009

AbstractDespite their potential utility, clinicians are skeptical about claims data as a substrate for clinical research. Clinicians' concerns are centered on two issues—the quality of the data and the fairness of comparisons that are made. To increase the impact of claims data research on clinical practice, several strategies should be pursued.
Creonization of Health Care
Authors: Bulger Roger J. 
Published: March 2009

AbstractAs prefigured in the Greek tragedy Antigone, one of the primary conflicts in contemporary health care is that between humane concern for the individual and concern for society at large and administrative rules. The computerization of the health care system and development of large data bases will create new forms of this conflict that will challenge the self-definition of health care and health care professionals.
Long-Term Assessment of Periodontal Surgery Versus Curettage or Scaling and Root Planing
Authors: Ramfjord Sigurd P. 
Published: March 2009

AbstractThe various treatments for periodontal disease must be assessed in light of the recently articulated goals of periodontal therapy to preserve teeth for a lifetime and to enhance esthetics and comfort as well as oral health. This article examines the long-term comparisons of periodontal surgery, curettage, and scaling and root planing in improving attachment levels instead of the more traditional pocket depth.
Rationale for the Use of Antimicrobial Agents in Periodontal Disease
Authors: Loesche Walter J. 
Published: March 2009

AbstractThe traditional approach to treating dental decay and periodontal disease has often focused on caries, neglecting periodontal infection. The past 15 years have seen significant advances in the treatment of periodontal disease with antimicrobial therapy, both with and without moretraditional debridement or surgery. This article presents an overview of the use of antimicrobials, including an examination of treatment philosophies and the diagnosis of periodontal infection.
Format and Conduct of Consensus Development Conferences
Authors: McGlynn Elizabeth A. , Kosecoff Jacqueline , Brook Robert H. 
Published: March 2009

AbstractThe consensus development conference method developed by the National Institutes of Health in the United States has been adopted and modified by a number of countries. Based on published articles and communication with representatives from each country, we examined whether the organization and conduct of these conferences in nine countries (United States, Canada, Denmark, Finland, the Netherlands, Norway, Sweden, Switzerland, and the United Kingdom) enhanced or detracted from achieving the stated conference goals and objectives. We conclude that improvements in the process by which consensus conferences are conducted may be warranted. More scientific methods for synthesizing literature, such as meta-analysis, should be used in developing inputs for the conference panel. Formalizing the decision-making processes through polling or other methods that allow for structured disagreement with parts of a consensus statement would potentially expand the range and type of issues that can be addressed in such conferences. Finally, countries should consider having the consensus statement written over a longer period of time than the traditional overnight session, which seems unlikely to promote clear thinking.
Two Strategies For Prophylaxis of Fatal Postoperative Pulmonary Embolism
Authors: Hilson Steven D. , Rich Eugene C. 
Published: March 2009

AbstractWhile subcutaneous heparin is a standard prophylaxis for death from pulmonary embolism following general surgery, it has been suggested that adding the vasoconstricting drug dihydroergotamine would improve survival compared to heparin alone. Dihydroergotamine may be associated with rare but life-threatening side effects; thus, reduced mortality from pulmonary embolism could be offset by increased mortality from other causes. Because a clinical trial to examine this possibility would be impractical, we performed a cost-effectiveness analysis to evaluate the effects of prophylactic dihydroergotamine on mortality. Based on published data, despite its favorable effects on the prevention of deep vein thrombosis, the addition of dihydroergotamine did not appear to save lives when added to heparin as prophylaxis. Probabilistic sensitivity analysis demonstrated that even if published risk estimates are in error, substantial changes would still not support the conclusion that dihydroergotamine is lifesaving. In the absence of clear potential for improved survival, the increased costs associated with dihydroergotamine provide reason to question its routine prophylactic use in general surgery.
Assessing Technology for Rehabilitation
Authors: Finkelstein Stan N. , Hutton John , Persson Jan 
Published: March 2009

AbstractThe rehabilitation field has not always been regarded as the most glamorous or commercially promising section of medical care. But changing attitudes and demographics in many industrial countries have led to increased recognition of opportunity to provide services for individuals with disabilities and those in need of chronic care. As hospitals are under increasing pressure to offer rehabilitation services, this article focuses on three different technologies developed in three different countries, Sweden, the United Kingdom, and the United States.
Epilogue
Authors: Grossman Jerome H. 
Published: March 2009

“From a distant vantage the [Mandelbrot] set resembles a squat wart-covered figure eight lying on its side. The inside of the figure is ominously black. Surrounding it is a halo colored electric white, which gives way to deep blues and blacks in the outer reaches of the plane.Approaching the Mandelbrot set, one finds that each wart is a tiny figure shaped much like the parent set. Zooming in for a close look at one of the tiny figures, however, opens up an entirely different pattern: a riot of organic-looking tendrils and curlicues sweeps out in whorls and rows. Magnifying a curlicue reveals yet another scene: it is made up of pairs of whorls joined by bridges of filigree…, and in the center of these curlicues another version of the Mandelbrot set is found.The magnified version is not quite the same Mandelbrot set. As the zoom continues, such objects seem to reappear, but a closer look always turns up differences. Things go on this way forever, infinitely various and frighteningly lovely.” (4)
Commentary on Guyatt and Drummond
Authors: Wulff Henrik R. 
Published: March 2009

Magnetic resonance (MR) undoubtedly constitutes a major technological advance, but as yet we do not know whether this invention also represents a breakthrough from the clinician's point of view.Guyatt and Drummond suggest that the clinical value of MR is tested by means of a randomized clinical trial (RCT) in a well-defined and limited clinical area, and I fully agree with the authors that the use of such trials should not be confined to the testing of new treatments. In this particular field, however, I miss a discussion of alternative options. With few exceptions, new drugs can only be tested satisfactorily by means of an RCT, but the superiority of one imaging technique over another can sometimes be proved in other ways. Imagine, for instance, that the CT-scan is normal but that MR reveals a space-occupying lesion, the presence of which is confirmed by surgical operation or an autopsy. In that case the diagnostic superiority of MR has been proved in that particular patient. If such cases are seen frequently, and if it is known from controlled therapeutic trials that they are susceptible to treatment, then the value of MR has been proved without doing an RCT.
Creating the Costliest Orphan:The Orphan Drug Act in the Development of Ceredase™
Authors: Goldman Dana P. , Clarke Ann E. , Garber Alan M. 
Published: March 2009

AbstractThe FDA recently approved Ceredase™, a new treatment for Gaucher's disease, under the provisions of the Orphan Drug Act. Ceredase™ is unusually expensive, but there are no satisfactory alternative therapies. It appears likely that Ceredase™would not have become available without the protection of the Orphan Drug Act, but its expense and the lack of information about its long-term effects on health raise questions about whether the ODA provides appropriate incentives to develop cost-effective technologies.
Recombinant Erythropoietin:Orphan Product with a Silver Spoon
Authors: Coster John M. 
Published: March 2009

AbstractThe U.S. Food and Drug Administration's (FDA) approval of the orphan biological product recombinant erythropoietin (rEPO) in June 1989 resulted both in a breakthrough treatment for the chronic anemia of people who suffer from chronic renal failure and a powerful argument for change in the legislation that spawned its development: the Orphan Drug Act of 1983. At a cost of over $6,000 per patient per year, Congress could not understand how a product that no manufacturer wanted to produce was suddenly costing the federal government hundreds of millions of dollars each year. Congress attempted to change the act in 1990 to preclude a manufacturer from using its provisions to secure lucrative monopolies in certain drug markets. In early 1991, the FDA finally issued regulations to implement the act that addressed some of the very concerns that were caused by rEPO.
Evaluation of Orphan Products by the U.S. Food and Drug Administration
Authors: Haffner Marlene E. , Kelsey John V. 
Published: March 2009

AbstractOrphan drug products generally are used in treating or preventing rare diseases. The small number of patients available for study may create special problems in the evaluation of these products. This paper examines some of the special problems that are associated with the design and implementation of studies to evaluate the safety and efficacy of orphan drugs. The U.S. Food and Drug Administration (FDA) has not established special criteria for evaluating orphan drugs per se, but the FDA has been flexible in evaluating drug products that present special problems, especially when these products are for treatment of serious of life-threatening illnesses. The FDA and other U.S. governmental agencies also have taken steps to promote the development and availability of drugs for rare diseases, including making these products available to patients who are in need, even before the drugs have full FDA marketing approval.
Contraceptives: On Their Own
Authors: Kaeser Lisa , Darroch Forrest Jacqueline , Rosenfield Allan 
Published: March 2009

AbstractDespite the need for more safe and effective contraceptive drugs and devices, enormous barriers to contraceptive research and development have been raised in the United States. The designation of contraceptives as orphan drugs, with concomitant incentives, may be warranted to encourage private manufacturers to reenter the field.
Ambulatory Cardiac Monitoring for the Evaluation of Antiarrhythmic Agents
Authors: Antczak-Bouckoms Alexia , Tulloch J. F. C. , Adams Miriam E. 
Published: March 2009

AbstractThis decision-analysis model assesses ambulatory cardiac monitoring (ACM), ACM followed by exercise testing, and electrophysiologic studies (EPS) in the evaluation and selection of antiarrhythmic agents in postinfarct patients with malignant arrhythmias. With existing data, we find no consistent advantage for one method of drug testing over another, although ACM appears to require fewer resources than does EPS. More patients qualify for EPS, but this fact does not increase the proportion of patients for whom a drug can be identified. These methods may test different aspects of arrhythmia activity and drug response, and sequential use may provide additional benefits. Such benefits must be determined empirically.
Accidental Injuries of Hospitalized Patients: A Prospective Cohort Study
Authors: Groves James E. , Lavori Philip W. , Rosenbaum Jerrold F. 
Published: March 2009

AbstractEight hundred and six medical and surgical patients who were hospitalized via the emergency ward were followed over their entire inpatient stays and rated in anterograde, double-blind fashion for inpatient incidents (falls, medication errors, other). Injuries were minor but affected 2.2% of admissions, a figure which is strikingly similar to studies in other hospitals. There was a statistical trend toward a higher-than-normal risk of hazardous in-hospital incidents for males age 20 to 40 admitted because of injury and for medically ill females over 60 years old.
When Does Information Change Practitioners' Behavior?
Authors: Kanouse David E. , Jacoby Itzhak 
Published: March 2009

AbstractPrograms that disseminate information to health care practitioners often do so partly to encourage appropriate changes in practice. However, merely providing information is seldom enough to accomplish such changes. If information transfer programs are to influence practice, they must be designed to maximize the conditions facilitating change. Reliance on a diffusion model for thinking about how information reaches practitioners has led researchers to over-emphasize the importance of exposure to information and ignore other factors that determine whether change will occur, such as practitioners' motivation to change, the context in which clinical decisions are made, and how information is presented. The fact that successful dissemination will not necessarily produce change also has implications for how information transfer programs should be monitored and evaluated.
Consensus Development Conferences in Sweden: Effects on Health Policy and Administration
Authors: Calltorp Johan 
Published: March 2009

AbstractSeven consensus development conferences have been held in Sweden since 1982. The conferences, sponsored by the Swedish Medical Research Council and Spri, typically examine social, organizational, and economic aspects of technology, and therefore, generate consensus statements of interest not only to physicians but also to politicians and health administrators.The study presented here examines the influence of the first five consensus development conferences on politicians and health administrators. Data was obtained via a mail questionnaire and personal interviews with leading individuals in these groups. More than half of the respondents indicated that they had found the statements from one or more conferences to be of practical value as a basis for discussing specific technologies with medical staffs. In some cases the statements directly influenced political decisions.
Update on Assessment Activities: United States Perspective
Authors: Jacoby Itzhak 
Published: March 2009

AbstractThe purpose of this paper is to present an update on biomedical technology assessment activities from a United States perspective. In 1985, I described in detail (a) a primary vehicle for technology assessment—the Consensus Development Program (CDP) of the National Institutes of Health (NIH)— and also discussed, in a second paper, (b) the transfer of consensus-enhanced scientific information and some of its impact on U.S. medical practice. Here, I focus on what has transpired during the past year: the changes in the climate in which U.S. technology assessment efforts are being conducted, the consequences of these changes, and the challenges that they pose for all concerned with the provision of quality health care. The first part of this paper centers on the broader framework within which technology assessment plays a role ir the United States. Later, it addresses the specific technology assessment and transfer activities in which the NIH is engaged.