Software export from developing nations

It is shown that software export is an attainable goal for developing nations, especially when government policies are favorable, and that the industrialized nations dominating the worldwide market can expect some serious competition. Examples of the efforts of developing nations to export software to North America and Europe are cited     

Relationship of provider characteristics to outcomes, process, and costs of care for community-acquired pneumonia

OBJECTIVES: The authors describe the relation of provider characteristics to processes, costs, and outcomes of medical care for elderly patients hospitalized for community-acquired pneumonia. METHODS: Using Medicare claims data, Medicare beneficiaries discharged from Pennsylvania hospitals during 1990 with community-acquired pneumonia were identified. Claims data were used to ascertain mortality, readmissions, use of procedures and physician consultations, and the costs of care. The relationship of these measures to provider characteristics was analyzed using regression techniques to adjust for patient characteristics, including comorbidity and microbial etiology. RESULTS: Among 22,294 pneumonia episodes studied, 30-day mortality was 17.0%. After adjusting for patient characteristics, 30-day mortality and readmission rates were unrelated to hospital teaching status or urban location or to physician specialty. Use of procedures and physician consultations was more common and costs were 11% higher among patients discharged from teaching hospitals compared with nonteaching hospitals. Similarly, costs were 15% higher at urban hospitals compared with rural hospitals. General internists and medical subspecialists used more procedures and had higher costs than family practitioners. CONCLUSIONS: Processes and costs of care for community-acquired pneumonia varied by provider characteristics, but neither mortality nor readmission rates did. These differences cannot be explained by clinical variables in the database. Further studies should determine whether less costly patterns of care for pneumonia, and perhaps other conditions, could replace more costly ones without compromising patient outcomes.     

Some physico-chemical properties of ellagic acid

Examples of formation of troublesome deposits containing ellagic acid in the wood pulping process are mentioned. The deposit from one such process in the U.K. has been examined in detail. This paper is mainly devoted to the determination of some physico-chemical properties of ellagic acid, which are relevant to the study of minimising the formation of the deposit in the wood digester. A specially built apparatus was used for the determination of these properties at 170° (the normal digestion temperature). The ultra-violet and visible absorption spectra measured at different pH values and temperatures were used to determine a dissociation constant of the acid at 20° which was found to be 11·0. The solubility of the acid was determined at 20°, 90° and 170°. From the changes in absorbance at 250 nm the decomposition was found to consist of two consecutive firstorder reactions, the rate constant of the first reaction being inversely proportional to a fractional power of hydrogen ion concentration. The activation energy was estimated to be 5·5 kcal and was independent of pH value.     

Composition and formation of the sleeve enveloping a central venous catheter

PURPOSE: After catheterization, 42% to 100% of central venous catheters are surrounded by a "fibrin sleeve." This sleeve has been considered the cause of catheter-related infections, withdrawal occlusion, and pulmonary embolism. The reactions between the vein wall and the catheter were studied. METHODS: A silicone catheter was placed in the anterior caval vein of 123 rats. After in situ fixation at scheduled intervals, the pathologic changes were studied on semi-serial histologic sections by means of light microscopy, transmission electron microscopy, and scanning electron microscopy (SEM). In 36 rats, the catheter was withdrawn immediately; in 72 rats, it was left in situ up to 6 months; and in 15 rats, the study was performed up to 10 months after withdrawal of a catheter that had remained in situ for 6 months. RESULTS: In the group in which the catheter was withdrawn immediately, mural thrombi disappeared by day 7. In the group in which the catheter remained in situ, thrombi remained around the proximal portion of the catheter. This pericatheter thrombosis (PCT) was invaded by migrating and proliferating smooth muscle cells (SMCs), originating from an injured vein wall, and transformed from day 7 into a tissue composed predominantly of SMCs and collagen and covered by endothelial cells. Later, the number of cells decreased, and the relative amount of collagen increased. Up to 10 months after withdrawal of the catheter, the collapsed sleeve was still present within the vein. CONCLUSION: The sleeve around a central venous catheter is not a fibrin sleeve, but a stable cellular-collagen tissue covered by endothelium. It is mainly formed by smooth muscle cells migrating from the injured vein wall into the early pericatheter thrombus.     

Violence classifications and their impact on observed relationships with key factors in young offenders.

The understanding of violent criminal behavior is hindered by definitional problems in both the legal and research communities. Different definitions of violent criminal behavior and different classifications of the severity of violence are fundamental problems that need to be resolved in order to develop better conceptual models of the precursors to criminal violence that can inform management and treatment of violent young offenders. This study evaluated 6 classifications of violent juvenile offenses derived from the legal system and published research. The authors compare frequencies from different classifications and examine the influence of classifications on observed associations with expected predictor variables. Differences in frequencies and perceived associations between classifications highlight the need to adopt a consistent method of coding violent offenses for research purposes in order to obtain valid results that are capable of informing policy, the judiciary, and the development of effective interventions. The final classification system offers a method of systematic coding based on the type, frequency, and outcome of the violent behavior that distinguishes between levels of violence severity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)