bluuebunny/crossref_metadata_2025_split huggingface dataset:
Power and Powerlessness: Brecht’s Poems to Carola Neher
Authors: Crick Joyce 
Published: March 2003

This essay is a study of Brecht’s poems to Carola Neher: the two versions of ’Rat an die Schauspielerin C.N.’ (?1930, ?1956) and ’Das Waschen’ (1937). Their dating and textual authority in the three main editions of Brecht’s works are a matter of some uncertainty, but the essay suggests a sequence for them that makes sense in the overall pattern of Brecht’s life and poetry. They are analysed with two leading questions, particularly acute in the 1930s, in view: what is the nature of the poet’s authority; what is the relation of poetry to action?The ’original version’ (Elisabeth Hauptmann’s term) of the two poems of advice is read as the product of Brecht and Neher’s shared success with Die Dreigroschenoper:the poet is in command; the situation is intimate, but the mood is imperative, the gesture as invasive as it is tender; the director is instructing his leading lady how to perform ‐ exemplarily. ’Das Waschen’, written from Brecht’s exile in Dennmark to Neher in prison in Moscow, is read as the gesture of one powerless to help, but writing into the dark, as a reminder of a ‐ Brecht’s word is ’menschenwürdigere’ ‐ situation: subdued though it is, the poem carries a charge of memory and muted encouragement. The third porm, a variant of the first, is read as a retreat, lacking the purposeful authority of the first and the paradoxical power in powerlessness of the second. The poems move from celebration to reminder to wish‐fulfilment ‐ which is both less and more than Brecht sert out to require of poetry.
The Nature of Violence in the Middle Ages: an Alternative Perspective
Authors: Finch A. J. 
Published: March 2003

Abstract
An alternative perspective on the nature of violence in the middle ages is provided by the register of the ecclesiastical jurisdiction of Cerisy‐la‐Forêt in Normandy. Of particular interest are the detailed descriptions of assaults and brawls. Although numerous, these were mainly petty and unpremeditated and, as such, they serve to highlight the exceptional and often accidental nature of homicide, and the absence of ingrained habits of violence in the form of the feud. This contrasts with those studies which have taken such extreme forms of violence to be the norms and which, as a result, may have overlooked the mundane, everyday reality of violence.
Attitudes To and Knowledge of CAMHS: Differences Between Pakistani and White British Mothers
Authors: Stein Samuel M. , Christie Deborah , Shah Razmin , Dabney Jackie , Wolpert Miranda 
Published: March 2003

Background: Research suggests that there are differences in the problems that are referred to Child and Adolescent Mental Health Services (CAMHS) by White British and Asian families as well as differences in how these services are accessed. There is a need for more information about how different ethnic communities perceive and access CAMH services.Method: White British or Pakistani mothers of children between 0–20 years at an urban health centre were invited to complete a study‐specific questionnaire written in English (with verbal translation provided when needed). Data were collected on awareness and experience of, and willingness to use CAMH services; severity of problems before referral is considered and additional factors that influence service use.Results: In comparison to White British mothers, Pakistani mothers were found to be less likely to consider a referral for problems judged as mild or moderate. There was no difference for severe problems. Qualitative factors that would enhance the use of CAMH services by Pakistani mothers include the availability of culture and gender matched therapists, and better access to translation facilities.Conclusions: The study highlights service needs and expectations of mothers of Pakistani origin, and emphasises the need for relevant, inclusive and culturally sensitive services.
Can High Quality Overcome Consumer Resistance to Restricted Provider Access? Evidence from a Health Plan Choice Experiment
Authors: Harris Katherine M. 
Published: March 2003

Objective. To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access.Data Sources and Setting. A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance.Study Design. An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access.Principal Findings. The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents “extremely satisfied with results of care'' had the greatest impact on plan choice while the proportion of network doctors “affiliated with university medical centers'' had the least. Other consumer and expert assessed measures had more comparable effects.Conclusions. Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high quality. However, the results of this study suggest that in many cases, the level of quality required for consumers to accept access restrictions may be so high as to be unattainable. The results provide empirical support for the current focus of decision support efforts on consumer assessed quality measures. At the same time, however, the results suggest that consumers would also value quality measures based on expert assessments. This finding is relevant given the lack of comparative quality information based on expert judgment and research suggesting that consumers have apprehensions about their ability to meaningfully interpret performance‐based quality measures.
Is Exposure to Income Inequality a Public Health Concern? Lagged Effects of Income Inequality on Individual and Population Health
Authors: Mellor Jennifer M. , Milyo Jeffrey 
Published: March 2003

Objective. To examine the health consequences of exposure to income inequality.Data Sources. Secondary analysis employing data from several publicly available sources. Measures of individual health status and other individual characteristics are obtained from the March Current Population Survey (CPS). State‐level income inequality is measured by the Gini coefficient based on family income, as reported by the U.S. Census Bureau and Al‐Samarrie and Miller (1967). State‐level mortality rates are from the Vital Statistics of the United States; other state‐level characteristics are from U.S. census data as reported in the Statistical Abstract of the United States.Study Design. We examine the effects of state‐level income inequality lagged from 5 to 29 years on individual health by estimating probit models of poor/fair health status for samples of adults aged 25–74 in the 1995 through 1999 March CPS. We control for several individual characteristics, including educational attainment and household income, as well as regional fixed effects. We use multivariate regression to estimate the effects of income inequality lagged 10 and 20 years on state‐level mortality rates for 1990, 1980, 1970, and 1960.Principal Findings. Lagged income inequality is not significantly associated with individual health status after controlling for regional fixed effects. Lagged income inequality is not associated with all cause mortality, but associated with reduced mortality from cardiovascular disease and malignant neoplasms, after controlling for state fixed‐effects.Conclusions. In contrast to previous studies that fail to control for regional variations in health outcomes, we find little support for the contention that exposure to income inequality is detrimental to either individual or population health.
Hospitals' Negotiating Leverage with Health Plans: How and Why Has It Changed?
Authors: Devers Kelly J. , Casalino Lawrence P. , Rudell Liza S. , Stoddard Jeffrey J. , Brewster Linda R. , Lake Timothy K. 
Published: March 2003

Objective To describe how hospitals' negotiating leverage with managed care plans changed from 1996 to 2001 and to identify factors that explain any changes.Data Sources Primary semistructured interviews, and secondary qualitative (e.g., newspaper articles) and quantitative (i.e., InterStudy, American Hospital Association) data.Study Design The Community Tracking Study site visits to a nationally representative sample of 12 communities with more than 200,000 people. These 12 markets have been studied since 1996 using a variety of primary and secondary data sources.Data Collection Methods Semistructured interviews were conducted with a purposive sample of individuals from hospitals, health plans, and knowledgeable market observers. Secondary quantitative data on the 12 markets was also obtained.Principal Findings Our findings suggest that many hospitals' negotiating leverage significantly increased after years of decline. Today, many hospitals are viewed as having the greatest leverage in local markets. Changes in three areas—the policy and purchasing context, managed care plan market, and hospital market—appear to explain why hospitals' leverage increased, particularly over the last two years (2000–2001).Conclusions Hospitals' increased negotiating leverage contributed to higher payment rates, which in turn are likely to increase managed care plan premiums. This trend raises challenging issues for policymakers, purchasers, plans, and consumers.
The Effects of Primary Care Depression Treatment on Patients' Clinical Status and Employment
Authors: Schoenbaum Michael , Unützer Jürgen , McCaffrey Daniel , Duan Naihua , Sherbourne Cathy , Wells Kenneth B 
Published: March 2003

Objective. To evaluate the effects of depression treatment in primary care on patients' clinical status and employment, over six months.Data Sources/Study Setting. Data are from a randomized controlled trial of quality improvement for depression that included 938 adults with depressive disorder in 46 managed primary care clinics in five states.Study Design. Observational analysis of the effects of evidence‐based depression care over six months on health outcomes and employment. Selection into treatment is accounted for using instrumental variables techniques, with randomized assignment to the quality improvement intervention as the identifying instrument.Data Collection/Extraction Methods. Patient‐reported clinical status, employment, health care use, and personal characteristics; health care use and costs from claims data.Principal Findings. At six months, patients with appropriate care, compared to those without it, had lower rates of depressive disorder (24 percent versus 70 percent), better mental health‐related quality of life, and higher rates of employment (72 percent versus 53 percent), each p<.05.Conclusions. Appropriate treatment for depression provided in community‐based primary care substantially improves clinical and quality of life outcomes and employment.
Measuring What People Value: A Comparison of “Attitude” and “Preference” Surveys
Authors: Phillips Kathryn A , Johnson F. Reed , Maddala Tara 
Published: March 2003

Objective. To compare and contrast methods and findings from two approaches to valuation used in the same survey: measurement of “attitudes” using simple rankings and ratings versus measurement of “preferences” using conjoint analysis. Conjoint analysis, a stated preference method, involves comparing scenarios composed of attribute descriptions by ranking, rating, or choosing scenarios. We explore possible explanations for our findings using focus groups conducted after the quantitative survey.Methods. A self‐administered survey, measuring attitudes and preferences for HIV tests, was conducted at HIV testing sites in San Francisco in 1999–2000 (n=365, response rate=96 percent). Attitudes were measured and analyzed using standard approaches. Conjoint analysis scenarios were developed using a fractional factorial design and results analyzed using random effects probit models. We examined how the results using the two approaches were both similar and different.Results. We found that “attitudes” and “preferences” were generally consistent, but there were some important differences. Although rankings based on the attitude and conjoint analysis surveys were similar, closer examination revealed important differences in how respondents valued price and attributes with “halo” effects, variation in how attribute levels were valued, and apparent differences in decision‐making processes.Conclusions. To our knowledge, this is the first study to compare attitude surveys and conjoint analysis surveys and to explore the meaning of the results using post‐hoc focus groups. Although the overall findings for attitudes and preferences were similar, the two approaches resulted in some different conclusions. Health researchers should consider the advantages and limitations of both methods when determining how to measure what people value.
Strategies for Reporting Health Plan Performance Information to Consumers: Evidence from Controlled Studies
Authors: Hibbard Judith H. , Slovic Paul , Peters Ellen , Finucane Melissa L. 
Published: March 2003

Objective. To assess whether presentation approaches designed to be more meaningful result in greater weighting of quality information in decisions. An emerging body of research indicates that the way information is presented affects how it is interpreted and how it is weighted in decisions. Comparative health plan performance reports are not being used by consumers possibly because the information presented is difficult to use. The next generation of these reports should be designed to support decision making.Design and Study Participants. The study uses a controlled experimental design. Participants (n=162) were randomly assigned to different conditions and asked to complete tasks related to using quality information and making health plan selections. Dependent variables included the amount of weight given to quality information in choices and decision accuracy.Results. Some presentation approaches make it easier for users to process and integrate quality data into their choices. However, other presentation formats influence consumers' decisions in ways that undermine their self‐interest.Conclusions. Findings indicate that presenting quality data in a more evaluable format increases the weight it carries in consumer decisions. Every change made in the presentation of comparative data has the potential to influence decisions. Those who disseminate information have a responsibility to be aware of how they use that influence and to direct it in productive and defensible ways. The alternative is to manipulate people in ways that are unknown, are not thought out, or are not defensible, but are no less manipulative.
Managing Indigent Care: A Case Study of a Safety‐Net Emergency Department
Authors: Dohan Daniel 
Published: March 2003

Objective. To examine how one safety‐net emergency department (ED) managed problems associated with the provision of indigent care in everyday life.Data Sources/Study Setting. Interview and observational data collected in County Hospital ED, a public teaching hospital in a California city, during 6 months of 1999.Study Design. The study used ethnographic methods to document and understand day‐to‐day routines and practices for providing indigent care in a safety‐net facility.Data Collection/Extraction Methods. One‐ to 2‐hour semistructured interviews with a snowball sample of eight ED physicians were tape recorded, and fieldnotes were recorded in situ during 10–30 hours of participant observation per week in all areas of the ED. Data were coded to highlight themes of interest and to identify recurrent patterns of behavior.Principal Findings. In everyday life, providers at County ED relied on graduate medical education (GME) to manage two everyday problems, social use and tenuous financing, associated with the provision of indigent care. GME helped manage problematic social visits to the ED by defining them as interesting cases. GME helped with tenuous finances by creating a work culture that encouraged the provision of uncompensated work.Conclusions. Safety‐net facilities often face problems similar to those in County ED. Future research should assess the extent to which the everyday management of these problems in County ED resembles that in other safety‐net facilities.
Comparing Oral Health Care Utilization Estimates in the United States Across Three Nationally Representative Surveys
Authors: Macek Mark D. , Manski Richard J. , Vargas Clemencia M. , Moeller John 
Published: March 2003

Objective. To compare estimates of dental visits among adults using three national surveys.Data Sources/Study Design. Cross‐sectional data from the National Health Interview Survey (NHIS), National Health and Nutrition Examination Survey (NHANES), and National Health Expenditure surveys (NMCES, NMES, MEPS).Study Design. This secondary data analysis assessed whether overall estimates and stratum‐specific trends are different across surveys.Data Collection. Dental visit data are age standardized via the direct method to the 1990 population of the United States. Point estimates, standard errors, and test statistics are generated using SUDAAN.Principal Findings. Sociodemographic, stratum‐specific trends are generally consistent across surveys; however, overall estimates differ (NHANES III [364‐day estimate] versus 1993 NHIS: –17.5 percent difference, Z=7.27, p value < 0.001; NHANES III [365‐day estimate] vs. 1993 NHIS: 5.4 percent difference, Z=–2.50, p value=0.006; MEPS vs. 1993 NHIS: –29.8 percent difference, Z=16.71, p value < 0.001). MEPS is the least susceptible to intrusion, telescoping, and social desirability.Conclusions. Possible explanations for discrepancies include different reference periods, lead‐in statements, question format, and social desirability of responses. Choice of survey should depend on the hypothesis. If trends are necessary, choice of survey should not matter; however, if health status or expenditure associations are necessary, then surveys that contain these variables should be used, and if accurate overall estimates are necessary, then MEPS should be used. A validation study should be conducted to establish ``true'' utilization estimates.
Identifying a policymaker’s target: an application to the Bank of Canada
Authors: Rowe Nicholas , Yetman James 
Published: March 2003

We develop a new way to test hypotheses about policymakers’ targets and implement that test for Canadian monetary policy. For example, if the Bank of Canada is targeting a 2 per cent inflation rate, and if the Bank’s instrument takes eight quarters to affect inflation, then deviations of inflation from 2 per cent should be uncorrelated with the Bank’s information set lagged eight quarters. We show that there was a major change in the Bank’s objectives near the time when formal inflation targets were announced and that the Bank has indeed been targeting inflation since then. JEL Code: E52, E61 Identifier une cible du définisseur de politique: une application à la Banque du Canada. Les auteurs développent une nouvelle manière de tester des hypothèses quant aux cibles des définisseurs de politiques, et utilisent ce protocole pour analyser la politique monétaire canadienne. Par exemple, si la Banque du Canada s’est donnée pour cible un taux d’inflation de 2 pour‐cent, et si l’instrument utilisé par la Banque du Canada met huit trimestres à avoir son effet sur le taux d’inflation, alors les déviations de l’inflation autour de 2 pour‐cent ne devraient pas être co‐reliées à l’information disponible aux autorités monétaires quand elle a agi. On montre que il y a eu changement dans les objectifs de la Banque aux environs du moment où les cibles formelles d’inflation ont été annoncées, et que la Banque a de fait ciblé le taux d’inflation depuis.
Can cross–border pollution reduce pollution?
Authors: Hatzipanayotou Panos , Lahiri Sajal , Michael Michael S. 
Published: March 2003

We develop a two–country model of foreign aid and cross–border pollution resulting from production activities in the recipient country. There is both private and public abatement of pollution, the latter being financed through emissions tax revenue and foreign aid. We characterize a Nash equilibrium in which the donor country chooses the amount of aid and the recipient chooses the fraction of aid allocated to pollution abatement and the emission tax rate. At this equilibrium, an increase in the donor’s perceived rate of cross–border pollution reduces emission levels. JEL Classification: Q28, F35, H41 Est–ce que la pollution trans–frontière peut réduire le niveau de pollution? Les auteurs développent un modèle à deux pays d’aide à l’étranger et de pollution trans–frontière résultant d’activités de production dans le pays qui reçoit l’aide. Il existe des efforts privés et publics pour réduire la pollution, ces derniers étant financés par les rentrées fiscales d’une taxe sur la pollution et par l’aide étrangère. On définit un équilibre à la Nash pour lequel le pays donateur choisit le montant de l’aide, et le pays récipiendaire choisit la fraction de l’aide étrangère qu’il allouera à la lutte à la pollution ainsi que le taux de taxation sur la pollution. A cet équilibre, un accroissement dans le taux de pollution trans–frontière perçu par le donataire réduit le taux de pollution.
Map kinase signaling pathways and hematologic malignancies
Authors: Platanias Leonidas C. 
Published: March 2003

AbstractMitogen-activated protein (Map) kinases are widely expressed serine-threonine kinases that mediate important regulatory signals in the cell. Three major groups of Map kinases exist: the p38 Map kinase family, the extracellular signal-regulated kinase (Erk) family, and the c-Jun NH2-terminal kinase (JNK) family. The members of the different Map kinase groups participate in the generation of various cellular responses, including gene transcription, induction of cell death or maintenance of cell survival, malignant transformation, and regulation of cell-cycle progression. Depending on the specific family isoform involved and the cellular context, Map kinase pathways can mediate signals that either promote or suppress the growth of malignant hematopoietic cells. Over the last few years, extensive work by several groups has established that Map kinase pathways play critical roles in the pathogenesis of various hematologic malignancies, providing new molecular targets for future therapeutic approaches. In this review, the involvement of various Map kinase pathways in the pathophysiology of hematologic malignances is summarized and the clinical implications of the recent advances in the field are discussed.