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Fourth Year (fourth + year)
Selected AbstractsA longitudinal evaluation of medical student knowledge, skills and attitudes to alcohol and drugsADDICTION, Issue 6 2006Gavin Cape ABSTRACT Aim To examine the knowledge, skills and attitudes of medical students to alcohol and drugs as training progresses. Design A longitudinal, prospective, cohort-based design. Setting The four schools of medicine in New Zealand. Participants All second-year medical students (first year of pre-clinical medical health sciences) in New Zealand were administered a questionnaire which was repeated in the fourth (first year of significant clinical exposure) and then sixth years (final year). A response rate of 98% in the second year, 75% in the fourth year and 34% in the sixth year, with a total of 637 respondents (47.8% male) and an overall response rate of 68%. Questionnaire The questionnaire consisted of 43 questions assessing knowledge and skills,a mixture of true/false and scenario stem-based multiple-choice questions and 25 attitudinal questions scored on a Likert scale. Demographic questions included first language, ethnicity and personal consumption of alcohol and tobacco. Findings The competence (knowledge plus skills) correct scores increased from 23.4% at the second year to 53.6% at the fourth year to 71.8% at the sixth year, being better in those students who drank alcohol and whose first language was English (P < 0.002). As training progressed the student's perceptions of their role adequacy regarding the effectiveness of the management of illicit drug users diminished. For example, at second year 21% and at sixth year 51% of students felt least effective in helping patients to reduce illicit drug use. At the sixth year, 15% of sixthyear students regarded the self-prescription of psychoactive drugs as responsible practice. Conclusion Education on alcohol and drugs for students remains a crucial but underprovided part of the undergraduate medical curriculum. This research demonstrated that while positive teaching outcomes were apparent, further changes to medical student curricula need to be considered to address specific knowledge deficits and to increase the therapeutic commitment and professional safety of medical students to alcohol and drugs. [source] Increased growth and recruitment of piscivorous perch, Perca fluviatilis, during a transient phase of expanding submerged vegetation in a shallow lakeFRESHWATER BIOLOGY, Issue 12 2005ANDERS HARGEBY Summary 1. In this study, we examine how a 7-year period of expanding submerged stonewort (Chara spp.) vegetation during a shift from turbid to clear water in a shallow lake influenced individual growth and population size structure of perch (Perca fluviatilis). We expected that a shift from phytoplankton to macrophyte dominance and clear water would improve feeding conditions for perch during a critical benthivorous ontogenetic stage, and enhance the recruitment of piscivorous perch. 2. Growth analysis based on opercula showed that growth during the second year of life was significantly higher in years with abundant vegetation than in years with turbid water and sparse vegetation. Growth was not affected during the first, third and fourth year of life. Stable isotope analyses on opercula from 2-year-old perch showed that the increase in growth coincided with a change in carbon source in the diet. Stable nitrogen ratio did not change, indicating that the increased growth was not an effect of any change in trophic position. 3. Following the expansion of submerged vegetation, perch size range and abundance of piscivorous perch increased in central, unvegetated areas of the lake. In stands of stoneworts, however, mainly benthivorous perch were caught, and size range did not change with time. 4. Our findings provide empirical support for the notion that establishment of submerged vegetation may lead to increased recruitment of piscivorous perch, because of improved competitive conditions for perch during the benthivorous stage. This is likely to constitute a benthic-pelagic feedback coupling, in which submerged vegetation and clear water promote the recruitment of piscivorous perch, which, in turn, may increase water clarity through top-down effects in the pelagic. [source] Respiratory carbon loss of calcareous grasslands in winter shows no effects of 4 years' CO2 enrichmentFUNCTIONAL ECOLOGY, Issue 2 2002M. Volk Summary 1CO2 exchange measurements in long-term CO2 -enrichment experiments suggest large net carbon gains by ecosystems during the growing season that are not accounted for by above-ground plant biomass. Considerable amounts of C might therefore be allocated below ground. 2Winter ecosystem respiration from temperate grasslands under elevated CO2 may account for the loss of a significant part of the extra C gained during the growing season. To test this hypothesis, dark respiration was assessed throughout the winter of the fourth year of CO2 enrichment in a calcareous grassland. 3Using these data, a model was parameterized to estimate whole-winter respiratory CO2 losses. From November to February, 154 9 g C m,2 were respired under elevated CO2 and 144 5 g C m,2 under ambient [CO2], with no significant difference between the CO2 treatments. 4We conclude that (i) wintertime respiration does not constitute a larger C loss from the ecosystem at elevated CO2; and (ii) the absence of respiratory responses implies no extra growing-season C inputs with month-to-year turnover times at elevated CO2. [source] Evaluation of a clinical examination skills training course in an undergraduate pharmacy programmeINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2008Dr. Andy Wearn senior lecturer, director Objective To introduce and evaluate a short clinical examination skills course in a BPharm programme. The study objectives were to assess needs, explore attitudes, record perceived competence requirements and assess the value of physical examination skills learning. Setting BPharm programme in Auckland, New Zealand. Participants were students enrolled in years 3 and 4 of the programme (2003). Method The design was a longitudinal, dual cohort, educational intervention evaluation using a self-completed questionnaire. An examination skills component was added to the fourth year of the pharmacy programme. Year 3 and 4 students were recruited, and completed the questionnaire at two points. Year 3 students were sampled one year before and soon after the skills sessions. Year 4 students were sampled after the sessions and 18 months later (once registered). The questionnaire sought their attitudes towards clinical skills training and practical relevance for future practice, and evaluated their learning experience. Key findings Response rates at the four points were 42,67%. Year 3 students identified a similar set of appropriate skills to those actually taught in year 4. Overall, attitudes to introducing examination skills learning were positive at all points. At follow-up, both cohorts agreed more strongly that examination skills training should be core (significantly for registered pharmacists versus year 3, P < 0.006). Measuring manual blood pressure was deemed the most difficult skill. All taught skills were used in practice except for respiratory rate; most used were body mass index (BMI), temperature and peak flow measurement. Conclusions There was a close correlation between what was offered in the course, what students felt they needed to learn and what was relevant in practice. Once registered, pharmacists were aware of their limitations and level of competence in relation to clinical skills. The small changes in attitudinal scores appear to reflect maturity and experience. The study design allowed us to adapt the educational component to student need. Health professional educators need to be aware of and respond to changes in professional scopes of practice. [source] Spatial organization, group living and ecological correlates in low-density populations of Eurasian badgers, Meles melesJOURNAL OF ANIMAL ECOLOGY, Issue 3 2002Eloy Revilla Summary 1,Territoriality and group living are described in a low-density population of Eurasian badgers, Meles meles L., by studying the patterns of spatial grouping and territory marking, as well as the differences between individuals in some of their characteristics (body condition and dispersal) and in their space use (seasonally, periods of activity and interaction between pairs of individuals) under strong seasonal fluctuations in the availability of the key resource (young rabbits, Oryctolagus cuniculus L.). Finally, the role of the spatial distribution of the main prey (young rabbits) in the development of sociality was also studied in order to test some of the assumptions and predictions of the resource dispersion hypothesis (RDH). 2,Badgers were territorial, showing a flexible system of territory marking, which includes the marking of the most used areas (sett-latrines at the centres of activity) and additionally, at the smaller territories, a system of border-latrines in the areas of contact between territories. The maximum use of border-latrines was associated with the reproductive season, and that of sett-latrines with the season of food scarcity. 3,In the study area where badgers had rabbits as main prey, territories were occupied by small groups of animals, formed by one adult female who reproduced, one adult male who also showed signs of reproductive activity, the cubs of the year (if there was reproduction) and some animals born during previous years, which remained in their natal territory until their dispersal (normally during the mating season of their third or fourth year of life). This system was not strictly fixed as males, given the opportunity, expanded their territories to encompass additional females. Territories in another study site were occupied by one adult female (marked), plus the cubs of the year and another adult individual (unmarked). 4,In winter and spring dominant females and subordinates used only a small fraction of their territories, moved short distances, at a low speed and covering small areas per night. These seasons corresponded with the reproduction of rabbits (highest food availability). Dominant females were the only individuals using all the territory available in the summer (lowest food availability), when badgers had the worst body condition. Food availability increased again in autumn, as did body condition, while range sizes were again reduced. Dominant males used the same proportion of their territories over all seasons. However, in winter (reproductive season) they moved faster, over longer distances, and covered larger areas per period of activity. These results indicate that use of space by dominant males was affected by different factors from that of dominant females and subordinates. 5,RDH does not seem to explain group living in our populations because: (a) territoriality in each pair of primary animals was driven by different factors (trophic resources for females and females for males); (b) dominant males acted as expansionists; and (c) territory size was related to its richness and not to patch dispersion. 6,We propose an integrative hypothesis to explain not only group formation but also interpopulation variability in the social organization of badgers within ecological, demographic and behavioural constraints and in the light of current theory on delayed dispersal. [source] Four years of lamivudine treatment in Chinese patients with chronic hepatitis BJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 11 2004TING-TSUNG CHANG Abstract Background and Aims:, This study assessed the efficacy and safety of up to 4 years of lamivudine treatment and the clinical relevance of the emergence of YMDD-variant hepatitis B virus (HBV). Methods:, Fifty-eight Chinese adult patients with chronic hepatitis B (CHB) were randomized to lamivudine 100 mg/day for up to 5 years and were monitored for YMDD-variant HBV, hepatitis B e antigen (HBeAg) seroconversion (loss of HBeAg and detectable antibody to HBeAg) and serum alanine aminotransferase (ALT) concentrations. Four-year data are reported here. Results:, The rate of HBeAg seroconversion increased with extended therapy and also with higher baseline ALT concentrations. YMDD-variant HBV was detected in 67% (39/58) of patients at some point during treatment. After 4 years, a total of 47% (27/58) of patients achieved HBeAg seroconversion. Thirty-three per cent (13/39) of patients with YMDD-variant HBV achieved HBeAg seroconversion; this increased to 57% (8/14) in patients with moderately elevated (>2,5 × upper limit of normal) pre-treatment ALT concentrations. The proportion of patients that achieved normal serum ALT increased from 29% (17/58) at baseline to 69% (31/45) following 4 years of treatment. That included 68% (23/34) of patients with YMDD-variant HBV and 73% (8/11) of those without the variant. All patients receiving lamivudine had reduced serum concentrations of HBV-DNA compared with baseline, despite the emergence of YMDD-variant HBV in 39 patients. Lamivudine was generally well tolerated; there was little change in the number or type of drug-related adverse events in the fourth year of the study. Conclusions:, Despite the emergence of YMDD-variant HBV, Chinese patients showed increased HBeAg seroconversion and improvement in ALT levels with an increased duration of treatment with lamivudine. [source] Media use as a reason for meal skipping and fast eating in secondary school childrenJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 2 2006J. Van den Bulck Abstract Objective, This study examined self-reported meal skipping and eating faster than usual with the goal of watching television or playing computer games. Method, Respondents reported their media use and indicated how often they skipped a meal to watch a favourite television programme or to play a computer game, and how often they ate faster than usual in order to watch television or play a computer game. Subjects, Respondents were 2546 adolescents of 13 (first year of secondary school) and 16 years (fourth year of secondary school) of age. Results, About one respondent in 10 skipped at least one meal every week for either television viewing or computer game playing. Weekly meal skipping for television viewing occurs more regularly in boys and first-year students, but particularly in teenagers who view 5 h or more daily (15% of the sample). The category of teenagers who play computer games four times a week or more (25.3% of the sample) is at increased risk of meal skipping; those who play more than four times a week are 10 times more likely weekly to skip a meal. A quarter of the adolescents eat faster at least once a week to be able to watch television or play a computer game. Regardless of gender and school year, teenagers' risk of eating faster progressively increases with their use of the media. Those who watch 4 h or more daily are about seven times more likely to skip a meal for television and those who play computer games at least four times a week are nine times more likely weekly to skip a meal. Conclusions, Unhealthy eating habits can be a side effect of heavy or excessive media use. Teenagers' use of television or game computers during nonworking or out-of-school hours partly displaces the amount of time that needs to be spent at meals. Practitioners and educators may try to encourage or restore a pattern of healthful meal consumption habits by reducing the amount of media use, and by supporting parental rule-making regarding children's eating habits and media use. [source] Circumscribed palmar hypokeratosis: clinical evolution and ultrastructural study after prolonged treatment with topical calcipotriolJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2005F Urbina Abstract Circumscribed palmar hypokeratosis is a recently described condition that consists of a solitary area of depressed skin affecting the palm (or sole). Its histopathological features include a thinned horny layer, a slightly diminished granular cell layer, and intraepidermal vacuolated cells. Prolonged treatment with topical calcipotriol resulted in complete recovery of the affected zone in the case reported here. A second biopsy of the lesion taken at around the fourth year of therapy showed a normalization of the granular layer, a reduction in the intraepidermal vacuolated cells, and a somewhat thicker horny layer. An ultrastructural study carried out at the same time showed a reduction in keratin bundles and keratohyalin granules, and an increase in lipid droplets up to the horny layer. These findings and the therapeutic response to topical calcipotriol support the concept that circumscribed palmar hypokeratosis is a focalized abnormal keratinization defect morphologically expressed at the granular and horny layers. [source] The attitudes of ,tomorrow's doctors' towards mental illness and psychiatry: changes during the final undergraduate yearMEDICAL EDUCATION, Issue 4 2001H. Baxter Aims To compare the efficacy of two teaching styles, didactic teaching and problem based learning, in producing enduring change in final-year medical students' attitudes towards psychiatry and mental illness. Method A 1-year follow-up questionnaire survey of two groups of medical students taught psychiatry in their fourth-year training by two different methods. One-year follow-up scores were compared with pre-attachment and post-attachment scores in the fourth year. Results 70 (68%) students completed both questionnaires at follow-up. The follow-up scores were significantly lower compared with both the fourth-year pre-attachment and post-attachment scores, suggesting that the positive change in attitudes following psychiatric training in the fourth year significantly decayed during the final year. The two teaching methods did not differ in the magnitude of this reduction. Conclusions The positive change that occurs in medical students' attitude towards psychiatry, psychiatrists and mental illness after their fourth-year psychiatric training is transient and decays over the final year. [source] ,Theory of Mind' and Tracking Speakers' IntentionsMIND & LANGUAGE, Issue 1-2 2002Francesca Happé Typical theory of mind tasks assess children's ability to attribute a false belief in order to predict or explain an action. According to these standard tasks, young children do not represent the independent (mistaken) beliefs of others until the fourth year,yet long before this, children are able to track speakers' intentions in order to learn new words. Might communication be a privileged domain for theory of mind? In the present study we explored pre-schoolers' ability to track a false belief in order to acquire a novel word. A puppet labeled a novel object in a false belief condition (contents of a box had been switched without her knowledge), and a true belief condition (contents switched in her presence). Children were significantly better at tracking the puppet's false belief in the word-learning task than in a standard false belief test. Possible reasons for this advantage are discussed, and the suggestion made that representation of mental states may emerge precociously in the service of communication. [source] Changes in heathland vegetation under goat grazing: effects of breed and stocking rateAPPLIED VEGETATION SCIENCE, Issue 1 2010Rafael Celaya Abstract Questions: How are heathland vegetation dynamics affected by different goat grazing management? Location: Cantabrian heathlands in Illano, Asturias, northern Spain. Methods: During 4 years, vegetation dynamics (structural composition, canopy height and floristic diversity) were studied under three goat grazing treatments with three replicates: high stocking rate (11.7 goats ha,1) with a local Celtiberic breed, and high (15 goats ha,1) and low (6.7 goats ha,1) stocking rates with a commercial Cashmere breed. Results: The relative cover of woody plants, particularly heather species, decreased more while herbaceous cover increased more under local Celtiberic than under Cashmere breed grazing. Within Cashmere treatments, the cover and height of live shrubs decreased more and the herbaceous cover increased more under high than under low stocking rate. Redundancy analysis showed a significant effect of treatment × year interaction on floristic composition. Greater species richness was recorded under local goat grazing, but Shannon diversity index fell in the fourth year on these plots because of dominance by two grass species. Conclusions: Local Celtiberic goat grazing at such a high stocking rate (11.7 goats ha,1) hinders the development of sustainable systems on these heathlands, both in environmental and productive terms, owing to the limitations in soil fertility. Nevertheless, Celtiberic goats could be useful for controlling excessive shrub encroachment and reducing fire hazard. Cashmere goat grazing at high stocking rate promoted the highest Shannon diversity by generating a better balance between woody and herbaceous plants, while shrub dominance was not altered under the low stocking rate. [source] Survival, growth and dressing traits of triploid hybrids between rainbow trout and three charr speciesAQUACULTURE RESEARCH, Issue 4 2000J M. Blanc Triploid hybrids between female rainbow trout Oncorhynchus mykiss and male brook charr Salvelinus fontinalis, Arctic charr S. alpinus and lake charr S. namaycush, together with diploid and triploid rainbow trout controls from the same dams, were tested in freshwater farming up to their fourth year of life. All hybrids displayed lower survival rates than the controls, the weakest genotype being the Arctic charr hybrid. Mortalities were mostly observed at the embryonic and larval stages and at the adult stage as a consequence of male sexual maturation. Growth of all hybrids was hindered (compared with controls) during the first year, but only moderate differences remained after 3 years. Sexual maturation resulted in a weight inferiority of males in all genotypes. As to carcass traits, female hybrids displayed a slightly higher dressing percentage than female triploid rainbow trout, as a result of lower visceral losses. These results are discussed with reference to hybrid resistance to rhabdoviruses from the viewpoint of fish farming improvement. [source] Preparing the senior or graduating student for graduate researchBIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION, Issue 4 2005Bor Luen Tang Abstract Senior undergraduates in the honors or graduation year with an intention to further their career in science would soon face the real world of scientific research as a junior scientist. It is important to acquaint these students with and adequately prepare them for the key aspects of a scientist's professional life. These include technical capacities indispensable for continuous and intense appraisal of data and knowledge as well as awareness that would ensure proper professional conduct within the laboratory. We have designed and conducted a module called "Scientific Critique" in the fourth year for Biochemistry majors. The module emphasizes scientific literature review and critique. It also incorporates techniques in preparing research grant proposals and an exercise in peer review of grant proposals as well as lectures and presentations on scientific integrity and research ethics. Positive response and feedback from students are indicative of an appreciation for the module contents, and we believe it of value to include such contents in any senior undergraduate life sciences curriculum. [source] Evidence for prolonged clinical benefit from initial combination antiretroviral therapy: Delta extended follow-upHIV MEDICINE, Issue 3 2001Delta Coordinating Committee Background The findings from therapeutic trials in HIV infection with surrogate endpoints based on laboratory markers are only partially relevant for clinical decisions on treatment. Although the collection of clinical follow-up data from such a trial would be relatively straightforward, this rarely occurs. An important reason for this may be the perception that such data have little value because the number of participants remaining on their original allocated therapy has usually fallen substantially. Methods Delta was an international, multicentre trial in which 3207 HIV infected individuals were randomly allocated to treatment with zidovudine (ZDV) alone, ZDV combined with didanosine (ddI) or ZDV combined with zalcitabine (ddC). Although the trial closed in September 1995, information on vital status, AIDS events, treatment changes and CD4 counts was still collected every 12 months until at least March 1997. This has allowed analyses of the longer term clinical effect of treatment. Results The median follow-up to date of death or last known vital status was 43 months (10th percentile 18 months; 90th percentile 55 months). The proportion of participants remaining on their allocated treatment fell steadily over time; by 4 years after trial entry, 3% remained on ZDV, 20% on ZDV + ddI and 21% on ZDV + ddC. Changes mainly involved the stopping, addition or switching of a nucleoside reverse transcriptase inhibitor (NRTIs). There was little use of protease inhibitors (PIs) or non-nucleoside reverse transcriptase inhibitors (NNRTIs) before the third year of the trial. Between the third and fourth years, regimens included a drug from one of these classes for approximately 17% of person-time in all treatment groups. Relative to ZDV monotherapy, the beneficial effects of combination therapy on mortality and disease progression rates increased significantly with time since randomization. The maximum effects on mortality were observed between 2 and 3 years, with a 48% reduction for ZDV + ddI and a 26% reduction for ZDV + ddC. These rates were observed when the original allocated treatment was received 42% and 47% of the time in the ZDV + ddI and ZDV + ddC groups, respectively. The mean CD4 count remained significantly higher (approximately 50 cells/,L) in the combination therapy groups 4 years after randomization, suggesting a projection of a clinical benefit beyond this time point. Conclusions The sustained clinical effect of the initial allocation to combination therapy, particularly ZDV + ddI, was remarkable in light of the convergence of drug regimens actually received across the three treatment groups. Interpretation of this finding is not straightforward. One of the possible explanations is that the effectiveness of ddI and ddC is diminished if first used later in infection or with greater prior exposure to ZDV, although the data do not clearly support either hypothesis. This analysis highlights the value of long-term clinical follow-up of therapeutic trials in HIV infection, which should be considered in the planning of all new studies. [source] The Relationship Between Learning Styles and Visualization Skills Among Interior Design StudentsJOURNAL OF INTERIOR DESIGN, Issue 2 2000Linda L. Nussbaumer OBJECTIVE: The purpose of this study was to determine if learning styles were an influencing factor on visualization skills among interior design students. RESEARCH DESIGN: A sample of 578 interior design students from thirteen universities who were enrolled in interior design courses between fall of 1997 and spring of 1999 completed a biographical data sheet, Kolb's Learning Style Inventory, and Isham's visualization skills test. ANALYSIS: Frequencies, means, and percentages were used to analyze the data. A two-way analysis of variance (ANOVA) was used to test these hypotheses: (a) there is a relationship between students' learning styles and visualization skills, and (b) factors that influence students' visualization skills are their year in current major, preprofessional experience, and cultural background. KEY FINDINGS: Results of this study revealed that there is a relationship between learning styles and visualization skills. Converger and Assimilator learning styles scored the highest on visualization tests. Year in major and cultural background were significant factors influencing skills. As students progress through their courses, visualization skills significantly improve, and the greatest improvement occurs between the second and fourth years. Asian/Asian American students scored highest on the visualization test. CONCLUSIONS: Teaching methods need to be developed to enhance visualization skills for all learning styles for interior design students. [source] Medical student attitudes toward the doctor,patient relationshipMEDICAL EDUCATION, Issue 6 2002Paul Haidet Context, Medical educators have emphasized the importance of teaching patient-centred care. Objectives, To describe and quantify the attitudes of medical students towards patient-centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient-centred attitudes. Methods, We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient,Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor,patient relationship. Total PPOS scores can range from patient-centred (egalitarian, whole person oriented) to disease- or doctor-centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate coursework, family medical background and specialty choice were collected from the fourth year class. Results, A total of 510 students (76%) completed data collection. Female gender (P < 0ˇ001) and earlier year of medical school (P = 0ˇ03) were significantly associated with patient-centred attitudes. Among fourth year students (n = 89), characteristics associated with more patient-centred attitudes included female gender, European-American ethnicity, and primary-care career choice (P < 0ˇ05 for each comparison). Conclusion, Despite emphasis on the need for curricula that foster patient-centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor-centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient-centred care in the current medical environment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centred care. [source] China's Local Political Budget CyclesAMERICAN JOURNAL OF POLITICAL SCIENCE, Issue 3 2009Gang Guo This article examines the political budget cycles in Chinese counties. The shift to a more performance-based cadre evaluation and mobility system during the reform era has created an incentive structure for local leaders to increase government spending at strategically important time points during their tenure to enhance the prospect of official promotion. Such expenditures help local leaders to impress their superiors with economic and political achievements, especially those visible and quantifiable large-scale development projects. At the same time, economic and fiscal decentralization increased the capacity of local leaders to influence government budget expenditures as the need rises. The hypothesized curvilinear relationship between a leader's time in office and increased spending was tested using a comprehensive data set of all Chinese counties from 1997 through 2002. The panel data analysis shows that growth in local government spending per capita is the fastest during a leader's third and fourth years in office. [source] | |||||||||||||||||||