bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Until he Receive the Equivalent in Land and Rent’:1 the Use of Annuities as Endowment Patronage in the Reign of Edward III
Authors: Bothwell James 
Published: March 2003

Abstract
This article investigates Edward III's use of annuities for endowing a number of men promoted, or to be promoted, to the parliamentary peerage. It examines the two types of annuity Edward used–those paid through the exchequer and those paid direct from royal revenue sources–and the way he used them. Exchequer annuities are shown to have been somewhat more reliable–though, for a number of reasons, most of Edward's ‘new men’ seem to have preferred the source‐based variety. More importantly, it argues that Edward's use of annuities was directed primarily not at bettering permanently the position of many of these men and their families, but rather towards increasing royal control–dependent, as annuitants were, upon the king's continuing favour. Through this programme Edward III was able to influence the composition and behaviour of the parliamentary peerage to a point where his rule has become a byword for good royal/noble relations in the later middle ages.
The Rise and Fall of Thatcherism*
Authors: Clarke Peter 
Published: March 2003

Abstract
The ‘battle of the books’ conducted in memoirs of the Thatcher government can yield valuable historical insights. ‘Doctrinal Thatcherism’ is examined, especially the proclaimed filiation of the Medium Term Financial Strategy from Friedmanite monetarism. This is shown to be somewhat uncertain either in theory or in practice. Yet the ability of Thatcherism to withstand such frailties proved it ideologically robust in both objectives and methods. If its appeal was crucially dependent on the personality of Thatcher herself, her fall was likewise irreducibly personal, as illustrated in her handling of the poll tax and of her relations with key colleagues.
A Comparison of Parent and Therapist Ratings of Outcome in a Child Mental Health Clinic
Authors: Garcia Ruth , Joseph Terry , Turk Jeremy , Basu Robin 
Published: March 2003

Aim: The study's aim was to ascertain how much parents and therapists agree about therapy outcome.Method: We contacted 50 recently helped families using postal questionnaires including a 7‐item outcome scale derived from MAISY data system. We used a weighted kappa test to compare parents and therapists views.Results: Response rate was 63.8%. Observed agreement was 73%, and expected agreement 54%, producing a kappa of 0.42 consistent with moderate parent‐therapist agreement.Discussion: Results are consistent with parents and therapists having similar perceptions of therapy outcome. It is important to monitor parental and professional views and the extent to which they coincide.
The survival of organic matter in bone: a review
Authors: Collins M. J. , Nielsen–Marsh C. M. , Hiller J. , Smith C. I. , Roberts J. P. , Prigodich R. V. , Wess T. J. , Csapò J. , Millard A. R. , Turner–Walker G. 
Published: March 2003

If bone is considered as a composite of collagen (protein) and bioapatite (mineral), then three pathways of diagenesis are identified: (1) chemical deterioration of the organic phase; (2) chemical deterioration of the mineral phase; and (3) (micro) biological attack of the composite. The first of these three pathways is relatively unusual and will only occur in environments that are geochemically stable for bone mineral. However, because rates of biomolecular deterioration in the burial environment are slow, such bones would yield useful biomolecular information. In most environments, bones are not in thermodynamic equilibrium with the soil solution, and undergo chemical deterioration (path 2). Dissolution of the mineral exposes collagen to biodeterioration, and in most cases the initial phase of dissolution will be followed by microbial attack (path 3). Biological attack (3) also proceeds by initial demineralization; therefore paths 2 and 3 are functionally equivalent. However,in a bone that follows path 3 the damage is more localized than in path 2, and regions equivalent to path 1 may therefore exist outside these zones of destruction.Other biomolecules, such as blood proteins, cellular lipids and DNA, exist within the physiological spaces within bone.For these biomolecules, death history may be particularly important for their survival.
Is Managed Care Leading to Consolidation in Health‐care Markets?
Authors: David Dranove , Simon Carol J. , White William D. 
Published: March 2003

Objective. To determine the extent to which managed care has led to consolidation among hospitals and physicians.Data Sources. We use data from the American Hospital Association, American Medical Association, and government censuses.Study Design. Two stage least squares regression analysis examines how cross‐section variation in managed care penetration affects provider consolidation, while controlling for the endogeneity of managed‐care penetration. Specifically, we examine inpatient hospital markets and physician practice size in large metropolitan areas.Data Collection Methods. All data are from secondary sources, merged at the level of the Primary Metropolitan Statistical Area.Principal Findings. We find that higher levels of local managed‐care penetration are associated with substantial increases in consolidation in hospital and physician markets. In the average market (managed‐care penetration equaled 34 percent in 1994), managed care was associated with an increase in the Herfindahl of .054 between 1981 and 1994, moving from .096 in 1981 to .154. This is equivalent to moving from 10.4 equal‐size hospitals to 6.5 equal‐sized hospitals. In the physician market place, we estimate that at the mean, managed care resulted in a 14 percentage point decrease of physicians in solo practice between 1986 and 1995. This implies a decrease in the percentage of doctors in solo practice from 38 percent in 1986 to 24 percent by 1995.
The Relationship of Post‐acute Home Care Use to Medicaid Utilization and Expenditures
Authors: Payne Susan M. C. , DiGiuseppe David L. , Tilahun Negussie 
Published: March 2003

Research Objectives:To describe the use of post‐acute home care (PAHC) and total Medicaid expenditures among hospitalized nonelderly adult Medicaid eligibles and to test whether health services utilization rates or total Medicaid expenditures were lower among Medicaid eligibles who used PAHC compared to those who did not.Study Population:5,299 Medicaid patients aged 18–64 discharged in 1992–1996 from 29 hospitals in the Cleveland Health Quality Choice (CHQC) project.Data Sources:Linked Ohio Medicaid claims and CHQC medical record abstract data.Data Extraction:One stay per patient was randomly selected.Design:Observational study. To control for treatment selection bias, we developed a model predicting the probability (propensity) a patient would be referred to PAHC, as a proxy for the patient's need for PAHC. We matched 430 patients who used Medicaid‐covered PAHC (“USE'') to patients who did not (“NO USE'') by their propensity scores. Study outcomes were inpatient re‐admission rates and days of stay (DOS), nursing home admission rates and DOS, and mean total Medicaid expenditures 90 and 180 days after discharge.Principal Findings:Of 3,788 medical patients, 12.1 percent were referred to PAHC; 64 percent of those referred used PAHC. Of 1,511 surgical patients, 10.9 percent were referred; 99 percent of those referred used PAHC. In 430 pairs of patients matched by propensity score, mean total Medicaid expenditures within 90 days after discharge were $7,649 in the USE group and $5,761 in the NO USE group. Total Medicaid expenditures were significantly higher in the USE group compared to the NO USE group for medical patients after 180 days (p<.05) and surgical patients after 90 and 180 days (p<.001). There were no significant differences for any other outcome. Sensitivity analysis indicates the results may be influenced by unmeasured variables, most likely functional status and/or care‐giver support.Conclusions:Thirty‐six percent of the medical patients referred to PAHC did not receive Medicaid‐covered services. This suggests potential underuse among medical patients. The high post‐discharge expenditures suggest opportunities for reducing costs through coordinating utilization or diverting it to lower‐cost settings. Controlling for patients' need for services, PAHC utilization was not associated with lower utilization rates or lower total Medicaid expenditures. Medicaid programs are advised to proceed cautiously before expanding PAHC utilization and to monitor its use carefully. Further study, incorporating non‐economic outcomes and additional factors influencing PAHC use, is warranted.
Medicare Contracting Risk/Medicare Risk Contracting: A Life‐Cycle View from Twelve Markets
Authors: Hurley Robert E. , Grossman Joy M. , Strunk Bradley C. 
Published: March 2003

Objective To examine the evolution of the Medicare HMO program from 1996 to 2001 in 12 nationally representative urban markets by exploring how the separate and confluent influences of government policy initiatives and health plans' strategic aims and operational experience affected the availability of HMOs to Medicare beneficiaries.Data Source Qualitative data gathered from 12 nationally representative urban communities with more than 200,000 residents each, in tandem with quantitative information from the Centers for Medicare and Medicaid Services and other sources.Study Design Detailed interview protocols, developed as part of the multiyear, multimethod Community Tracking Study of the Center for Studying Health System Change, were used to conduct three rounds of interviews (1996, 1998, and 2000–2001) with health plans and providers in 12 nationally representative urban communities. A special focus during the third round of interviews was on gathering information related to Medicare HMOs' experience in the previous four years. This information was used to build on previous research to develop a longitudinal perspective on health plans' experience in Medicare's HMO program.Principal Findings From 1996 to 2001, the activities and expectations of health plans in local markets underwent a rapid and dramatic transition from enthusiasm for the Medicare HMO product, to abrupt reconsideration of interest corresponding to changes in the Balanced Budget Act of 1997, on to significant retrenchment and disillusionment. Policy developments were important in their own right, but they also interacted with shifts in the strategic aims and operational experiences of health plans that reflect responses to insurance underwriting cycle pressures and pushback from providers.Conclusion The Medicare HMO program went through a substantial reversal of fortune during the study period, raising doubts about whether its downward course can be altered. Market‐level analysis reveals that virtually all momentum for the program has been lost and that enrollment is shrinking back to the levels and locations found in the mid‐1990s.
Quantifying Components of Drug Expenditure Inflation: The British Columbia Seniors' Drug Benefit Plan
Authors: Morgan Steven G 
Published: March 2003

Objective. To quantify the relative and absolute importance of different factors contributing to increases in per capita prescription drug costs for a population of Canadian seniors.Data Sources/Study Setting. Data consist of every prescription claim from 1985 to 1999 for the British Columbia Pharmacare Plan A, a tax‐financed public drug plan covering all community‐dwelling British Columbians aged 65 and older.Study Design. Changes in per capita prescription drug expenditures are attributed to changes to four components of expenditure inflation: (1) the pattern of exposure to drugs across therapeutic categories; (2) the mix of drugs used within therapeutic categories; (3) the rate of generic drug product selection; and (4) the prices of unchanged products.Data Collection/Extraction Methods. Data were extracted from administrative claims files housed at the UBC Centre for Health Services and Policy Research.Principal Findings. Changes in drug prices, the pattern of exposure to drugs across therapeutic categories, and the mix of drugs used within therapeutic categories all caused spending per capita to increase. Incentives for generic substitution and therapeutic reference pricing policies temporarily slowed the cost‐increasing influence of changes in product selection by encouraging the use of generic drug products and/or cost‐effective brand‐name products within therapeutic categories.Conclusions. The results suggest that drug plans (and patients) would benefit from more concerted efforts to evaluate the relative cost‐effectiveness of competing products within therapeutic categories of drugs.
Health Insurance and Mammography: Would a Medicare Buy‐In Take Us to Universal Screening?
Authors: Taylor Donald H , Scoyoc Lynn Van , Hawley Sarah Tropman 
Published: March 2003

Objective. To determine whether health insurance expansions via a Medicare buy‐in might plausibly increase mammography screening rates among women aged 50–64.Data Sources. Two waves of the Health and Retirement Study (HRS) (1994, 1996).Study Design. A longitudinal study with most explanatory variables measured at the second wave of HRS (1994); receipt of mammography, number of physician visits, and breast self exam (BSE) were measured at the third wave (1996).Data Extraction. Our sample included women aged 50–62 in 1994 who answered the second and third HRS interview (n=4,583).Principal Findings. From 1994 to 1996, 72.7 percent of women received a mammogram. Being insured increased mammography in both unadjusted and adjusted analyses. A simulation of universal insurance coverage in this age group increased mammography rates only to 75–79 percent from the observed 72.7 percent. When we accounted for potential endogeneity of physician visits and BSE to mammography, physician visits remained a strong predictor of mammography but BSE did not.Conclusion. Even in the presence of universal coverage and very optimistic scenarios regarding the effect of insurance on mammography for newly insured women, mammography rates would only increase a small amount and gaps in screening would remain. Thus, a Medicare buy‐in could be expected to have a small impact on mammography screening rates.
Usual Source of Care in Preventive Service Use: A Regular Doctor versus a Regular Site
Authors: Xu K. Tom 
Published: March 2003

Objective. To compare the effects of having a regular doctor and having a regular site on five preventive services, controlling for the endogeneity of having a usual source of care.Data Source. The Medical Expenditure Panel Survey 1996 conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics.Study Design. Mammograms, pap smears, blood pressure checkups, cholesterol level checkups, and flu shots were examined. A modified behavioral model framework was presented, which controlled for the endogeneity of having a usual source of care. Based on this framework, a two‐equation empirical model was established to predict the probabilities of having a regular doctor and having a regular site, and use of each type of preventive service.Principal Findings. Having a regular doctor was found to have a greater impact than having a regular site on discretional preventive services, such as blood pressure and cholesterol level checkups. No statistically significant differences were found between the effects a having a regular doctor and having a regular site on the use of flu shots, pap smears, and mammograms. Among the five preventive services, having a usual source of care had the greatest impact on cholesterol level checkups and pap smears.Conclusions. Promoting a stable physician–patient relationship can improve patients’ timely receipt of clinical prevention. For certain preventive services, having a regular doctor is more effective than having a regular site.
Japan's ‘Un-Westminster’ System: Impediments to Reform in a Crisis Economy
Authors: Mulgan Aurelia George 
Published: March 2003

AbstractJapan's Prime Minister Koizumi is attempting a bold program of ‘structural reform’ in order to revive a moribund economy. However, his actual achievements after more than a year in office have fallen far short of his original goals. Such lack of progress for a prime minister bent on reform can only be understood in the context of Japan's ‘Un-Westminster’ system in which the cabinet is not an authoritative decisionmaking body for government policy. Although modelled along Westminster lines, Japan does not have strong cabinet government; it has party-bureaucratic government. In practice this means that Koizumi's push for reform faces the de facto veto power of bureaucrats and his own ruling party.
Pharmacokinetics of alemtuzumab used for in vivo and in vitro T-cell depletion in allogeneic transplantations: relevance for early adoptive immunotherapy and infectious complications
Authors: Morris Emma C. , Rebello Peppy , Thomson Kirsty J. , Peggs Karl S. , Kyriakou Charalampia , Goldstone Anthony H. , Mackinnon Stephen , Hale Geoff 
Published: March 2003

Abstract
Persistence of alemtuzumab at lympholytic concentrations after reduced-intensity conditioning allogeneic stem cell transplantations (RITs) could impair immune reconstitution and reduce donor T-cell–mediated graft-versus-leukemia/lymphoma (GVL) effects, derived from the graft or subsequent adoptive immunotherapy. We have studied the pharmacokinetics of alemtuzumab in 2 different groups: RIT (100 mg alemtuzumab in vivo over 5 days) and myeloablative allografts (20 mg alemtuzumab added in vitro to the stem cells prior to return). Alemtuzumab concentrations in RIT patients were in excess of that required to kill infused donor CD52+ cells at the time of transplantation and remained at potentially lympholytic levels (&gt; 0.1 μg/mL) for approximately 56 days after transplantation, 26 days longer than for the myeloablative group. Total lymphocyte counts were significantly lower in the RIT group persisting beyond 6 months after transplantation (P = .005), and median absolute CD4 counts higher than 200 × 106/L were delayed until 9 months after transplantation. (Blood. 2003;102:404-406)
Different pattern of risk factors for atopic and nonatopic asthma among children – report from the Obstructive Lung Disease in Northern Sweden Study
Authors: Rönmark E. , Lundbäck B. , Jönsson E. , Rönmark E , Lundbäck B , Platts‐mills T 
Published: March 2003

Background: A cross‐sectional study was performed among 7–8‐year‐old schoolchildren during the winter of 1996 in three municipalities in the most northern province of Sweden, Norrbotten. The study was the starting point of a longitudinal study of asthma, rhinitis, eczema, and type‐1 allergy, and provided data on prevalence and risk factors for these conditions. The aim of the present study was to validate the classification of asthma based on a parental questionnaire, and to examine risk factors for atopic and nonatopic asthma. Methods: The ISAAC questionnaire with additional questions was distributed by the schools to the parents. The response rate was 97%, and 3431 completed questionnaires were returned. The children in Kiruna and Luleå were also invited to be skin tested, and 2149 (88%) were tested with 10 common airborne allergens. A structured interview was administered by pediatricians in stratified samples of the children to test the validity of the diagnosis of asthma based on the questionnaire. Results: After the validation study, the prevalence of “ever asthma” was estimated to be 8.0%. The specificity of the question, “Has your child been diagnosed as having asthma by a physician?”, was high, >99%, while the sensitivity was around 70%. The strongest risk factor for “ever asthma” was a positive skin test (OR 3.9). Risk factors for asthma in the asthmatics who were not sensitized were family history of asthma, OR 3.6; breast‐feeding less than 3 months, OR 1.8; past or present dampness at home, OR 1.8; smoking mother, OR 1.7; and male sex, OR 1.6. Among the sensitized asthmatics, only a family history of asthma was a significant risk factor (OR 3.0), while breast‐feeding less than 3 months was not associated with an increased risk (OR 1.0). A synergistic effect between genetic and environmental factors was found especially in the nonatopic asthmatics; the children with a family history of asthma who had a smoking mother and past or present dampness at home had an OR for “ever asthma” of 13. Conclusions: Different risk‐factor patterns were found for asthma and type‐1 allergy. In addition, the risk factors for atopic or allergic asthma diverged from those for nonatopic asthma.
Biologic activity of Dermatophagoides siboney and Blomia tropicalis allergens in exposed and unexposed mite‐allergic individuals. Effect of patient selection on the biologic standardization of mite extracts
Authors: Casas R , Ferrándiz R , Wihl J.‐A , Fernández B , Dreborg S 
Published: March 2003

Background: This study aimed to investigate the influence of patient selection criteria, i.e., mite‐allergic individuals exposed and not exposed to Dermatophagoides siboney and Blomia tropicalis, on the biologic activity of mite extracts. Determination of the potency of mite extracts in vivo requires selection of patients with a clinical history of mite allergy. In Scandinavia, there are some anamnestic criteria for mite allergy, whereas in the tropics, where patients are continuously exposed to high levels of mites, selection of patients with mite allergy by clinical history is difficult. Methods: A total of 210 Cuban asthmatics with continuous symptoms, and 43 Swedes with a clinical history of mite allergy were investigated. Skin prick tests were performed with D. siboney, D. pteronyssinus, D. farinae, B. tropicalis, Acarus siro, Lepidoglyphus destructor, and Tyrophagus putrescentiae extracts. For analysis of the biologic activity of mite extracts, Cuban patients were divided into four groups:1)all patients skin‐test‐positive to mites2)patients positive to mites, but not to other inhalant allergens3)patients reacting most to the mite species analyzed4)patients reactive only to mites and reacting most to the mite species analyzed.The biologic potency was calculated according to the Nordic Guidelines. Results: Due to cross‐reactivity between mites, Swedish mite‐sensitive patients, with a clear clinical history of mite allergy, but not exposed to D. siboney and B. tropicalis, were more skin reactive to these mites than were Cubans. The estimated potency increased gradually to >200% in group 4. In group 1 Cubans, the reactivity to all mites but B. tropicalis was lower than that in mite‐sensitive Swedes. Conclusions: According to the influence of patient selection criteria on the estimation of the potency of mite extracts, the determination of the biologic activity of allergenic extracts in subjects without a clear‐cut clinical history should be replaced by new methods when available.