bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosing Aspergers syndrome in the elderly: a series of case presentations
Authors: James Ian Andrew , Mukaetova‐Ladinska Elizabeta , Reichelt F. Katharina , Briel Ruth , Scully Ann 
Published: August 2006

AbstractBackgroundThere are over 200 000 people in the UK diagnosed with Aspergers Syndrome (AS). Most of these are children and young adults, owing to the fact the disorder was established relatively recently. It can be argued, therefore, that there are many older adults who may have met the criteria for AS as children, but never received such a diagnosis due to the fact it had yet to be established. What happended to these people as they aged?MethodThis paper examines this issue in detail and presents five case studies of elderly individuals who the authors believe meet the criteria of AS.ResultsThe work illustrates AS presentation in old age, the assessment problems and tools required to assess older people, and the implications of such formulations for clinical practice.ConclusionOlder patients with undiagnosed AS may currently be receiving inappropriate treatments. Greater awareness of AS in the older population would enable better management of such patients. Copyright © 2006 John Wiley & Sons, Ltd.
Cholinesterase inhibitors for Alzheimer's disease: variations in clinical practice in the north‐west of England
Authors: Purandare Nitin , Swarbrick Caroline , Fischer Alastair , Burns Alistair 
Published: August 2006

AbstractBackgroundIn the UK, the National Institute for Health and Clinical Excellence (NICE) is currently reviewing cost‐effectiveness of cholinesterase inhibitors (ChEIs) for Alzheimer's disease (AD) in the NHS. The implementation of the original NICE (2001) guidance that made these drugs available in the UK was not examined in this review process, and was the objective of this study.MethodTen hospitals in and around Manchester participated in the audit. Case records of all patients who were started on ChEIs between January 2002 and the date of the audit (November 2003 to December 2004) were examined to assess adherence to the NICE (2001) guidance. Information about available resources was gathered from lead clinicians of each hospital.ResultsA total of 1092 case records were examined. The treatment of AD with ChEIs varied considerably with regard to pre‐treatment investigations, waiting period for treatment, scales used to assess efficacy, adherence to the NICE (2001) guidance, and available resources. The actual number of patients with mild to moderate AD receiving ChEIs was much lower than that expected from known prevalence rates. Non‐uniformity of clinical practice and missing data were the main limitations of the audit.ConclusionThere is a need to harmonise the use and monitoring of ChEIs for AD in the NHS so that the data from routine clinical practice could feed into future clinical and cost‐effectiveness analyses. Copyright © 2006 John Wiley & Sons, Ltd.
Elevation of plasma concentration of adhesion molecules in late‐life depression
Authors: Dimopoulos Nikolaos , Piperi Christina , Salonicioti Aristea , Mitsonis Charalampos , Liappas Ioannis , Lea Robert W. , Kalofoutis Anastasios 
Published: August 2006

AbstractObjectivesLate‐life depression may be associated with vascular disease. The purpose of the study was to investigate this association by determining the levels of soluble adhesion molecules (sICAM‐1 and sVCAM‐1) which represent markers of ischemia‐induced inflammation in elderly individuals with depression.MethodsBlood samples were obtained from 33 subjects with depression selected from a community‐dwelling population after screening with the Geriatric Depression Scale, and 33 matched controls. Serum concentrations of sICAM‐1 (ng/mL) and sVCAM‐1 (ng/mL) were measured in both groups.ResultsDepressed patients (Group A) possessed significantly higher sICAM‐1 levels compared to healthy controls (Group B) (674.94 ± 166.90 ng/ml vs 467.05 ± 231.26 ng/ml, respectively, p < 0.01). Similarly the same groups demonstrated elevated sVCAM‐1 levels compared to controls (572.14 ± 182.20 ng/ml vs 449.04 ± 285.27 ng/ml, p < 0.05); a difference that in both cases remained significant after adjustment for potential confounders (gender, smoking, presence of metabolic syndrome).ConclusionThese findings indicate an association between high serum levels of VCAM‐1, and ICAM‐1 and depression in the elderly and further support the vascular depression hypothesis, which has important implications for the understanding and management of late‐life depression. Copyright © 2006 John Wiley & Sons, Ltd.
Testing effective connectivity changes with structural equation modeling: What does a bad model tell us?
Authors: Protzner Andrea B. , McIntosh Anthony R. 
Published: August 2006

AbstractStructural equation modeling (SEM) is a statistical method that can assess changes in effective connectivity across tasks or between groups. In its initial application to neuroimaging data, anatomical connectivity provided the constraints to decompose interregional covariances to estimate effective connections. There have been concerns expressed, however, with the validity of interpreting effective connections for a model that does not adequately fit the data. We sought to address this concern by creating two population networks with different patterns of effective connectivity, extracting three samples sizes (N = 100, 60, 20), and then assessing whether the ability to detect effective connectivity differences depended on absolute model fit. Four scenarios were assessed: (1) elimination of a region showing no task differences; (2) elimination of connections with no task differences; (3) elimination of connections that carried task differences, but could be expressed through alternative indirect routes; (4) elimination of connections that carried task differences, and could not be expressed through indirect routes. We were able to detect task differences in all four cases, despite poor absolute model fit. In scenario 3, total effects captured the overall task differences even though the direct effect was no longer present. In scenario 4, task differences that were included in the model remained, but the missing effect was not expressed. In conclusion, it seems that when independent information (e.g., anatomical connectivity) is used to define the causal structure in SEM, inferences about task‐ or group‐dependent changes are valid regardless of absolute model fit. Hum Brain Mapp, 2006. © 2006 Wiley‐Liss, Inc.
The economic value of fatal and non‐fatal occupational risks in Mexico City using actuarial‐ and perceived‐risk estimates
Authors: Hammitt James K. , Ibarrarán María Eugenia 
Published: August 2006

AbstractCompensating wage differentials are used to estimate marginal rates of substitution between income and both fatal and non‐fatal occupational‐injury risks in the Mexico City metropolitan area. Data are obtained by in‐person survey of almost 600 workers and include workers' perceived risks of fatal and non‐fatal occupational injury supplemented by actuarial‐risk estimates from government statistics. Results using both actuarial‐ and perceived‐risk estimates are reasonably consistent. Estimates of the value per statistical life are between US$235 000 and US$325 000 and estimates of the value per statistical non‐fatal injury are between US$3500 and US$11 000 (2002 US dollars). These values are much smaller than corresponding estimates for higher‐income countries but are compatible with the small number of prior estimates for lower‐income countries. Copyright © 2006 John Wiley & Sons, Ltd.
Behavioral differences between public and private not‐for‐profit hospitals in the Italian national health service
Authors: Barbetta Gian Paolo , Turati Gilberto , Zago Angelo M. 
Published: August 2006

AbstractIn this paper we attempt to identify behavioral differences between public and private not‐for‐profit hospitals, by exploiting the introduction of the DRG‐based payment system in the Italian NHS during the second half of the 1990s. We estimate the technical efficiency of a sample of hospitals for the period 1995–2000 considering an output distance function, and adopting both parametric (COLS and SF) and nonparametric (DEA) approaches. Our results show a convergence of mean efficiency scores between not‐for‐profit and public hospitals, and seem to suggest that differences in economic performances between competing ownership forms are more the result of the institutional settings in which they operate than the effect of the incentive structures embedded in the different proprietary forms. We also observe a decline in technical efficiency, probably due to policies aimed at reducing hospitalization rates. Copyright © 2006 John Wiley & Sons, Ltd.
Progressive segmented health insurance: Colombian health reform and access to health services
Authors: Ruiz Fernando , Amaya Liliana , Venegas Stella 
Published: August 2006

AbstractEqual access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow‐up health service utilization and out‐of‐pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non‐insured. Other social health insurance schemes preserved high utilization with variable out‐of‐pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out‐of‐pocket expenses. Projected utilization rates and a simulation favor a dual policy for two‐stage income segmented insurance to progress towards the universal insurance goal. Copyright © 2006 John Wiley & Sons, Ltd.
A dynamic analysis of GP visiting in Ireland: 1995–2001
Authors: Nolan Anne 
Published: August 2006

AbstractThis paper examines the determinants of GP visiting in Ireland, using panel data from the Living in Ireland Survey from 1995–2001. While cross‐sectional studies provide important information on GP visiting patterns at a certain point in time, with panel data we can also control for unobserved individual heterogeneity, as well as identify whether it is the same individuals who consistently visit their GP year on year, or whether there is more mobility in visiting. We therefore estimate dynamic models of GP utilisation, and attempt to decompose the observed variation in GP visiting into components attributable to observed individual characteristics, unobserved individual heterogeneity and state dependence. Copyright © 2006 John Wiley & Sons, Ltd.
Do personal and societal preferences differ by socio‐demographic group?
Authors: Franks Peter , Lubetkin Erica I. , Melnikow Joy 
Published: August 2006

AbstractFor equity, preferences used in cost‐effectiveness analyses (CEAs) should yield similar values for different groups with similar health states. We used data from the US 2000 Medical Expenditure Panel Survey, including socio‐demographics, EQ‐5D Index and EQ Visual Analog Scale (EQ VAS) scores, to examine whether EQ‐5D Index (representing community preferences) and EQ VAS (representing personal preferences) scores differed systematically by socio‐demographic group. Differences between EQ‐5D Index and EQ VAS scores by socio‐demographic group were small and mostly not statistically significant. These preliminary findings suggest that using the EQ‐5D Index in CEAs may not contribute to socio‐demographic inequities. Copyright © 2006 John Wiley & Sons, Ltd.
Do targets matter? A comparison of English and Welsh National Health priorities
Authors: Hauck Katharina , Street Andrew 
Published: August 2006

AbstractNational priorities and performance management regimes in the National Health Services of England and Wales diverged following devolution, most notably with respect to the use of waiting time targets, which have been progressively strengthened in England but were abandoned in Wales in the immediate post‐devolution period. We analyse routine data collected over a six‐year period from three English and one Welsh hospital trust close to the English–Welsh border to ascertain whether: (a) there is evidence of differential performance over time that relates to the country where the hospital is located; (b) within each hospital, there is evidence that English and Welsh patients faced different waiting times. Over the period the English hospitals recorded increased levels of activity, undertook proportionately more day case activity, and mortality rates fell. Activity levels remained constant in Wales, the proportion of day case activity fell, proportionately more non‐elective patients were admitted, and mortality rates rose. There is partial evidence that English patients faced lower waiting times than their Welsh counterparts and were more likely to be admitted within a target waiting period. The stronger performance management regime operating in England appears to have contributed to higher levels of performance in the English hospitals over the period. Copyright © 2006 John Wiley & Sons, Ltd.
The relationship between reliability and size of willingness‐to‐pay values: a qualitative insight
Authors: Smith Richard D. 
Published: August 2006

AbstractIn a previous paper, the reliability of willingness‐to‐pay (WTP) values was found to be an increasing function of the size of WTP expressed. Here, the results of a qualitative exercise conducted alongside this quantitative study are presented. The results of this exercise suggest that higher WTP values may require more thought from the respondent which, in turn, gives them greater stability. At low levels of WTP, values appear to be taken from a ‘discretionary account’, where expenditure is more volatile. Caveats to this result, and suggestions for future research, are considered in the discussion. Copyright © 2006 John Wiley & Sons, Ltd.
Does a slump really make you thinner? Finnish micro‐level evidence 1978–2002
Authors: Böckerman Petri , Johansson Edvard , Helakorpi Satu , Prättälä Ritva , Vartiainen Erkki , Uutela Antti 
Published: August 2006

AbstractThis paper explores the relationship between height‐adjusted weight and economic conditions in Finland, using individual microdata for the period 1978–2002. If anything, the results reveal that an improvement in regional economic conditions measured by the employment rate produces a decrease in BMI, other things being equal. The Finnish evidence presented does not support the conclusions reported for the USA, according to which temporary economic slowdowns are good for health. In contrast, at least BMI seems to increase during slumps. Copyright © 2006 John Wiley & Sons, Ltd.
The effects of Taiwan's National Health Insurance on access and health status of the elderly
Authors: Chen Likwang , Yip Winnie , Chang Ming‐Cheng , Lin Hui‐Sheng , Lee Shyh‐Dye , Chiu Ya‐Ling , Lin Yu‐Hsuan 
Published: August 2006

AbstractThe primary objective of this paper is to evaluate the impact of Taiwan's National Health Insurance program (NHI), established in 1995, on improving elderly access to care and health status. Further, we estimate the extent to which NHI reduces gaps in access and health across income groups. Using data from a longitudinal survey, we adopt a difference‐in‐difference methodology to estimate the causal effect of Taiwan's NHI. Our results show that Taiwan's NHI has significantly increased utilization of both outpatient and inpatient care among the elderly, and such effects were more salient for people in the low‐ or middle‐income groups. Our findings also reveal that although Taiwan's NHI greatly increased the utilization of both outpatient and inpatient services, this increased utilization of health services did not reduce mortality or lead to better self‐perceived general health status for Taiwanese elderly. Measures more sensitive than mortality and self‐perceived general health may be necessary for discerning the health effects of NHI. Alternatively, the lack of NHI effects on health may reflect other quality and efficiency problems inherent in the system not yet addressed by NHI. Copyright © 2006 John Wiley & Sons, Ltd.
Modelling the chloride signal at Plynlimon, Wales, using a modified dynamic TOPMODEL incorporating conservative chemical mixing (with uncertainty)
Authors: Page T. , Beven K. J. , Freer Jim , Neal Colin 
Published: August 2006

AbstractThe application of a modified version of dynamic TOPMODEL for two subcatchments at Plynlimon, Wales is described. Conservative chemical mixing within mobile and immobile stores has been added to the hydrological model in an attempt to simulate observed stream chloride concentrations. The model was not fully able to simulate the observed behaviour, in particular the short‐ to medium‐term dynamics. One of the primary problems highlighted by the study was the representation of dry deposition and cloud‐droplet‐deposited chloride, which formed a significant part of the long‐term chloride mass budget. Equifinality of parameter sets inhibited the ability to determine the effective catchment mixing volumes and coefficients or the most likely partition between occult mass inputs and chloride mass inputs determined by catchment immobile‐store antecedent conditions. Some success was achieved, in as much as some aspects of the dynamic behaviour of the signal were satisfactorily simulated, although spectral analysis showed that the model could not fully reproduce the 1/f power spectra of observed stream chloride concentrations with its implications of a wide distribution of residence times for water in the catchment. Copyright © 2006 John Wiley & Sons, Ltd.
Determination of Forchheimer equation coefficients a and b
Authors: Sidiropoulou Melina G. , Moutsopoulos Konstadinos N. , Tsihrintzis Vassilios A. 
Published: August 2006

AbstractThis study focuses on the determination of the Forchheimer equation coefficients a and b for non‐Darcian flow in porous media. Original theoretical equations are evaluated and empirical relations are proposed based on an investigation of available data in the literature. The validity of these equations is checked using existing experimental data, and their accuracy versus existing approaches is studied. On the basis of this analysis, some insight into the physical background of the phenomenon is also provided. The dependence of the coefficients a and b on the Reynolds number is also detected, and potential future research areas, e.g. investigation of inertial effects for consolidated porous media, are pointed out. Copyright © 2006 John Wiley & Sons, Ltd.
The River Arno catchment, northern Tuscany: chemistry of waters and sediments from the River Elsa and River Era sub‐basins, and sulphur and oxygen isotopes of aqueous sulphate
Authors: Cortecci Gianni , Dinelli Enrico , Boschetti Tiziano 
Published: August 2006

AbstractWithin the hydrologic balance of the River Arno catchment (northern Tuscany), the Rivers Elsa and Era are important tributaries entering the main river from the left bank in the lower part of the watershed. Waters and bed sediments were sampled in June 2000 during low discharges in the Rivers Elsa and Era, as well as in major tributary streams. Water samples were analysed for major chemistry and sulphur isotope composition of sulphate, and sediment samples were analysed for major composition and selected trace elements of environmental concern (Zn, Cu, Pb, Cr and Ni).The main results for the waters are: (1) Na and Cl in solution show consistent downstream positive trends in the main rivers, thus supporting progressive contributions of anthropogenic salts; the highest concentration values are observed in tributaries; (2) as shown by sulphur isotopes, sulphate in solution is mainly controlled by dissolution of evaporites (Elsa basin) or oxidation of reduced organic/biogenic sulphur (Era basin), with anthropogenic contributions in most streams not higher than 10% in both the basins. A δ34S signature in the range −2 to +3‰ is estimated for pollutant sulphate in the basins studied. The main results for the sediments are: (1) major chemistry is essentially controlled by the lithotypes drained by the waters; (2) pollution by heavy metals does not reach high levels; (3) compared with local fine‐grained rocks, copper is more frequently anomalous, whereas lead and zinc show only occasional anomalies; (4) local high concentrations of chromium and nickel can be attributed to upstream occurrences of ophiolites. Copyright © 2006 John Wiley & Sons, Ltd.
Parameter identification for leaky aquifers using global optimization methods
Authors: Yeh Hund‐Der , Lin Yu‐Chung , Huang Yen‐Chen 
Published: August 2006

AbstractIn the past, graphical or computer methods were usually employed to determine the aquifer parameters of the observed data obtained from field pumping tests. Since we employed the computer methods to determine the aquifer parameters, an analytical aquifer model was required to estimate the predicted drawdown. Following this, the gradient‐type approach was used to solve the nonlinear least‐squares equations to obtain the aquifer parameters. This paper proposes a novel approach based on a drawdown model and a global optimization method of simulated annealing (SA) or a genetic algorithm (GA) to determine the best‐fit aquifer parameters for leaky aquifer systems. The aquifer parameters obtained from SA and the GA almost agree with those obtained from the extended Kalman filter and gradient‐type method. Moreover, all results indicate that the SA and GA are robust and yield consistent results when dealing with the parameter identification problems. Copyright © 2006 John Wiley & Sons, Ltd.
A recurrent support vector regression model in rainfall forecasting
Authors: Pai Ping‐Feng , Hong Wei‐Chiang 
Published: August 2006

AbstractTo minimize potential loss of life and property caused by rainfall during typhoon seasons, precise rainfall forecasts have been one of the key subjects in hydrological research. However, rainfall forecast is made difficult by some very complicated and unforeseen physical factors associated with rainfall. Recently, support vector regression (SVR) models and recurrent SVR (RSVR) models have been successfully employed to solve time‐series problems in some fields. Nevertheless, the use of RSVR models in rainfall forecasting has not been investigated widely. This study attempts to improve the forecasting accuracy of rainfall by taking advantage of the unique strength of the SVR model, genetic algorithms, and the recurrent network architecture. The performance of genetic algorithms with different mutation rates and crossover rates in SVR parameter selection is examined. Simulation results identify the RSVR with genetic algorithms model as being an effective means of forecasting rainfall amount. Copyright © 2006 John Wiley & Sons, Ltd.