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United States (united + states)
Kinds of United States Terms modified by United States Selected AbstractsPOLICIES IN THE UNITED STATES TO PROVIDE HOUSING ASSISTANCE TO LOW-INCOME HOUSEHOLDS1ECONOMIC AFFAIRS, Issue 2 2008Ronald D. Utt From the 1930s onwards America's housing assistance policies have largely been shaped by the federal government's response to catastrophe, whether of an external nature (the Great Depression, the urban riots of the 1960s) or an internal nature (mismanagement, excessive costs). Consequently, today's collection of federal housing policies resemble more the results of an archaeological dig through 70 years of activity than a coherent approach to a longstanding problem. Nonetheless, one key theme that emerges is the shift from wholly government solutions to a hybrid public,private partnership approach in the early 1970s. [source] UNCERTAINTY AND MONETARY POLICY RULES IN THE UNITED STATESECONOMIC INQUIRY, Issue 2 2009CHRISTOPHER MARTIN This article analyzes the impact of uncertainty about the true state of the economy on monetary policy rules in the United States since the early 1980s. Extending the Taylor rule to allow for this type of uncertainty, we find evidence that the predictions of the theoretical literature on responses to uncertainty are reflected in the behavior of policymakers, suggesting that policymakers are adhering to prescriptions for optimal policy. Our estimates suggest that the effect of uncertainty on interest rates was most marked in 1983, when uncertainty increased interest rates by up to 140 basis points, in 1990,1991, when uncertainty reduced interest rates by up to 80 basis points, and in 1996,2001, when uncertainty reduced interest rates by up to 70 basis points over 5 yr. (JEL C51, C52, E52, E58) [source] FISCAL READJUSTMENTS IN THE UNITED STATES: A NONLINEAR TIME-SERIES ANALYSISECONOMIC INQUIRY, Issue 1 2009ANDREA CIPOLLINI We analyze the fiscal adjustment process in the United States using a multivariate threshold vector error regression model. The shift from single-equation to multivariate setting adds value both in terms of our economic understanding of the fiscal adjustment process and the forecasting performance of nonlinear models. We find evidence that fiscal authorities intervene to reduce real per capita deficit only when it reaches a certain threshold and that fiscal adjustment takes place primarily by cutting government expenditure. The results of out-of-sample density forecast and probability forecasts suggest that a shift from a univariate autoregressive model to a multivariate model improves forecast performance. (JEL C32, C53, E62) [source] HAS WAL-MART BURIED MOM AND POP?: THE IMPACT OF WAL-MART ON SELF-EMPLOYMENT AND SMALL ESTABLISHMENTS IN THE UNITED STATESECONOMIC INQUIRY, Issue 4 2008RUSSELL S. SOBEL This paper explores the widely accepted view that Wal-Mart causes significant harm to the traditional, small "mom and pop" business sector of the U.S. economy. We present the first rigorous econometric investigation of this issue by examining the rate of self-employment and the number of small employer establishments using both time series and cross-sectional data. We also examine alternative measures and empirical techniques for robustness. Contrary to popular belief, our results suggest that the process of creative destruction unleashed by Wal-Mart has had no statistically significant long-run impact on the overall size and profitability of the small business sector in the United States. (JEL L81, D59, C21) [source] SYRINGE EXCHANGE IN THE UNITED STATES: DOING THE SIMPLE THINGS BETTER?ADDICTION, Issue 9 2009LISA MAHER No abstract is available for this article. [source] HARM REDUCTION IN THE UNITED STATES AT A MOMENT OF CHANGE: MOVING INNOVATION FROM GRASSROOTS TO MAINSTREAM?ADDICTION, Issue 9 2009JEAN-PAUL C. GRUND No abstract is available for this article. [source] [Commentary] POOR MEXICO: SO FAR AWAY FROM GOD, SO CLOSE TO THE UNITED STATESADDICTION, Issue 4 2009RAUL CAETANO No abstract is available for this article. [source] BRAZILIAN IMMIGRATION TO THE UNITED STATES AND THE GEOGRAPHICAL IMAGINATION,GEOGRAPHICAL REVIEW, Issue 4 2009ALAN P. MARCUS ABSTRACT. In the late 1980s more than 1 million Brazilians left Brazil without returning. Today an estimated 2 million Brazilians live abroad, 1.2 million of them in the United States. In this article I show that Brazilians migrate for a variety of reasons, including the geographical imagination. Why are so many Brazilians leaving for the United States? What are their geographical imaginations, and how are they described in their migration process? Using primary and secondary data and multiple methods, I address these questions by providing insights into Brazilian migrants' place perceptions, experiences, and reasons for migrating, focusing on the geographical imagination. Those migrants who end up returning to Brazil are more likely to cite financial and curiosity reasons for having migrated. A web of transnational religious and social networks sustains those immigrants who remain in the United States. Reasons for migrating are not economic alone; rather, they are based on interrelated and complex factors that range from adventure to curiosity, the cultural influence of the United States, family members, education, and escape. [source] EXPANSION OF GOLF COURSES IN THE UNITED STATES,GEOGRAPHICAL REVIEW, Issue 1 2008DARRELL E. NAPTON ABSTRACT. Twenty-five million Americans play golf on the nation's 16,000 courses each year. These golf courses constitute a significant national landscape feature. Since 1878, when the game arrived in the United States, golf has filtered down the urban, economic, and social hierarchies to become accepted by and accessible to most Americans. During the ensuing thirteen decades the number, location, and layout of the nation's golf courses have responded to many of the same driving forces that impacted the nation, including decentralization, growth of the middle class, war, economic depression, suburbanization, and the increasing role of the federal government. Four epochs of golf-course growth and diffusion show the growing acceptance of the sport and depict where courses were most likely to be constructed as a result of the prevailing forces of each epoch. [source] MUEBLES RÚSTICOS IN MEXICO AND THE UNITED STATESGEOGRAPHICAL REVIEW, Issue 3 2002Article first published online: 21 APR 2010, JOHN HARNER ABSTRACT. Sales of muebles rústicos, or rustic wooden furniture made in Mexico, have grown rapidly in the United States since 1994. Analysis of the recent rise of the industry tracks manufacturing and marketing methods in major production areas of Mexico. Consumer taste for "authentic" handmade goods of simple design and the vogue of the "Santa Fe" style across the American Southwest mesh with Mexican producers' need to seek foreign markets during an economic crisis. Changing style preferences, along with the furniture's handcrafted appearance, its competitive cost, and the makers' flexible production methods, are reasons for the increased popularity of this folk commodity. [source] CELLULAR TOWER PROLIFERATION IN THE UNITED STATESGEOGRAPHICAL REVIEW, Issue 1 2002THOMAS A. WIKLE ABSTRACT. Since the early 1980s the growing popularity of cellular communication has wrought dramatic landscape changes on the American scene through an invasion of thousands of cellular telephone towers. Objections raised to new tower construction by local residents, interest groups, and regulatory boards range from visual impacts to perceived health risks. This essay traces the origins of wireless telephony, its proliferation across the United States, and the visual impacts associated with tower construction. Three stages in the geographical expansion of wireless networks are identified. [source] RISING OCCUPATIONAL AND INDUSTRY MOBILITY IN THE UNITED STATES: 1968,97,INTERNATIONAL ECONOMIC REVIEW, Issue 1 2008Gueorgui Kambourov We document and analyze the high level and the substantial increase in worker mobility in the United States over the 1968,97 period at various levels of occupational and industry aggregation. This is important in light of the recent findings that human capital of workers is largely occupation- or industry-specific. To control for measurement error in occupation and industry coding, we develop a method that utilizes the PSID Retrospective Occupation-Industry Supplemental Data Files. We emphasize the importance of our findings for understanding a number of issues such as the changes in wage inequality, aggregate productivity, job stability, and life-cycle earnings profiles. [source] SECULARISM AND STATE POLICIES TOWARD RELIGION, THE UNITED STATES, FRANCE, AND TURKEY by Ahmet T. KuruJOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION, Issue 4 2009JONATHAN FOX No abstract is available for this article. [source] COLLEGE-TO-WORK MIGRATION OF TECHNOLOGY GRADUATES AND HOLDERS OF DOCTORATES WITHIN THE UNITED STATESJOURNAL OF REGIONAL SCIENCE, Issue 4 2006Paul D. Gottlieb ABSTRACT This study estimates a series of random parameter logit models of the college-to-work migration decisions of technology graduates and holders of doctorates within the United States. We employ detailed information on the migration-relevant characteristics of individuals, as well as on their actual origins and destinations at the metropolitan scale. In addition to its obvious implications for "brain drain" policies in U.S. metropolitan areas, the study demonstrates the richness of the random parameters technique for behavioral-geographic analysis. We find that science and technology graduates migrate to better educated places, other things equal; that PhD graduates pay greater attention to amenity characteristics than other degree holders; and that foreign students from some immigrant groups migrate to places where those groups are concentrated. [source] COMPILATION OF MEASURED NUTRIENT LOAD DATA FOR AGRICULTURAL LAND USES IN THE UNITED STATES,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 5 2006Daren Harmel ABSTRACT: Measured field scale data are increasingly used to guide policy and management decisions based on comparative pollutant load information from various land management alternatives. The primary objective of this study was to compile measured annual nitrogen (N) and phosphorus (P) load data representing field scale transport from agricultural land uses. This effort expanded previous work that established an initial nutrient export coefficient dataset. Only measured annual N and P load data published in scientific peer-reviewed studies were included in the present compilation. Additional criteria for inclusion were: spatial scale (field scale or farm scale, minimum 0.009 ha); land use (homogeneous, either cultivated agriculture or pasture/rangeland/hay); natural rainfall (not rainfall simulation); and temporal scale (minimum one year). Annual N and P load data were obtained from 40 publications, resulting in a 163-record database with more than 1,100 watershed years of data. Basic descriptive statistics in relation to N and P loads were tabulated for tillage management, conservation practices, fertilizer application, soil texture, watershed size, and land use (crop type). The resulting Measured Annual Nutrient loads from A Circumlittoral Environments (MANAGE) database provides readily accessible, easily queried watershed characteristic and nutrient load data and establishes a platform suitable for input of additional project specific data. [source] ARSENIC IN THE SHALLOW GROUND WATERS OF CONTERMINOUS UNITED STATES: ASSESSMENT, HEALTH RISKS, AND COSTS FOR MCL COMPLIANCE,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 2 2006Navin Kumar C. Twarakavi ABSTRACT: A methodology consisting of ordinal logistic regression (OLR) is used to predict the probability of occurrence of arsenic concentrations in different threshold limits in shallow ground waters of the conterminous United States (CONUS) subject to a set of influencing variables. The analysis considered a number of maximum contaminant level (MCL) options as threshold values to estimate the probabilities of occurrence of arsenic in ranges defined by a given MCL of 3, 5, 10, 20, and 50 ,g/l and a detection limit of 1 ,g/l. The fit between the observed and predicted probability of occurrence was around 83 percent for all MCL options. The estimated probabilities were used to estimate the median background concentration of arsenic in the CONUS. The shallow ground water of the western United States is more vulnerable than the eastern United States. Arizona, Utah, Nevada, and California in particular are hotspots for arsenic contamination. The risk assessment showed that counties in southern California, Arizona, Florida, and Washington and a few others scattered throughout the CONUS face a high risk from arsenic exposure through untreated ground water consumption. A simple cost effectiveness analysis was performed to understand the household costs for MCL compliance in using arsenic contaminated ground water. The results showed that the current MCL of 10 ,g/l is a good compromise based on existing treatment technologies. [source] USE OF SOIL AND WATER PROTECTION PRACTICES AMONG FARMERS IN THE NORTH CENTRAL REGION OF THE UNITED STATES,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 4 2000Ted L. Napier ABSTRACT: Data were collected in the fall of 1998 and the winter of 1999 from 1,011 land owner-operators within three watersheds in the North Central Region of the United States to assess adoption of soil and water protection practices. Farm owner-operators were asked to indicate how frequently they used 18 different agricultural production practices. Many farmers within the three watersheds had adopted conservation protection practices. However, they also employed production practices that could negate many of the environmental benefits associated with conservation practices in use. Comparison of adoption behaviors used in the three watersheds revealed significant differences among the study groups. Respondents in the Iowa and Ohio watersheds reported greater use of conservation production systems than did farmers in Minnesota. However, there were no significant differences between Ohio and Iowa farmers in terms of use of conservation production practices. This was surprising, since farmers in the Ohio watershed had received massive amounts of public and private investments to motivate them to adopt and to continue using conservation production systems. These findings bring into serious question the use of traditional voluntary conservation programs such as those employed in the Ohio watershed. Study findings suggest that new policy approaches should be considered. It is argued that "whole farm planning" should be a significant component of new agricultural conservation policy. [source] AN ORGANIZED SIGNAL IN SNOWMELT RUNOFF OVER THE WESTERN UNITED STATES,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 2 2000D. H. Peterson ABSTRACT: Daily-to-weekly discharge during the snowmelt season is highly correlated among river basins in the upper elevations of the central and southern Sierra Nevada (Carson, Walker, Tuolumne, Merced, San Joaquin, Kings, and Kern Rivers). In many cases, the upper Sierra Nevada watershed operates in a single mode (with varying catchment amplitudes). In some years, with appropriate lags, this mode extends to distant mountains. A reason for this coherence is the broad scale nature of synoptic features in atmospheric circulation, which provide anomalous insolation and temperature forcing that span a large region, sometimes the entire western U.S. These correlations may fall off dramatically, however, in dry years when the snowpack is spatially patchy. [source] REHABILITATION AND RELEASE OF MARINE MAMMALS IN THE UNITED STATES: RISKS AND BENEFITSMARINE MAMMAL SCIENCE, Issue 4 2007Michael Moore Abstract Rehabilitation of stranded marine mammals elicits polarized attitudes: initially done alongside display collections, but release of rehabilitated animals has become more common. Justifications include animal welfare, management of beach use conflict, research, conservation, and public education. Rehabilitation cost and risks have been identified that vary in degree supported by data rather than perception. These include conflict with fisheries for resources, ignorance of recipient population ecology, poor understanding of long-term survival, support of the genetically not-so-fit, introduction of novel or antibiotic-resistant pathogens, harm to human health, and cost. Thus facilities must balance their welfare appeal against public education, habitat restoration, human impact reduction, and other conservation activities. Benefits to rehabilitating marine mammals are the opportunity to support the welfare of disabled animals and to publish good science and so advance our understanding of wild populations. In specific cases, the status of a population may make conservation the main reason for rehabilitation. These three reasons for rehabilitation lead to contrasting, and sometimes conflicting, management needs. We therefore outline a decision tree for rehabilitation managers using criteria for each management decision, based on welfare, logistics, conservation, research, and funding to define limits on the number of animals released to the wild. [source] TESTING WAGE AND PRICE PHILLIPS CURVES FOR THE UNITED STATESMETROECONOMICA, Issue 4 2007Peter Flaschel ABSTRACT This paper demonstrates how the labour and product markets interact in determining as outcome a generalized reduced-form price Phillips curve. For the labour market we consider a wage Phillips curve and for the product market a price Phillips curve. We estimate separately the wage and price Phillips curves for the USA, using ordinary least squares, non-parametric estimation and three-stage least squares techniques. The finding is that wages are always more flexible than prices with respect to their respective demand pressure and that price inflation responds somewhat more to a medium-run cost pressure than does wage inflation. The implications for macroeconomic stability are demonstrated. We also show,as a link between product and labour markets,that employment is related to output as Okun's law states. In comparing linear and non-linear estimates of the wage and price Phillips curves we find furthermore that for some relationships non-linearities are important while not for others. Although overall the non-linear estimates tend to confirm our linear estimates, non-linearities in some relationships of the Phillips curve are important as well. [source] MODELING IMPACTS OF BIOENERGY MARKETS ON NONINDUSTRIAL PRIVATE FOREST MANAGEMENT IN THE SOUTHEASTERN UNITED STATESNATURAL RESOURCE MODELING, Issue 3 2009ANDRES SUSAETA Abstract The potential impacts of bioenergy markets on slash pine plantation management on nonindustrial private forestlands in the southeastern United States were analyzed. We developed an integrated Black,Scholes and modified Hartman model to achieve this task. The risk of damage from catastrophic natural disturbances such as wildfires and pest outbreaks associated with the exclusion/incorporation of thinnings and variation in timber salvage rates was also included. Three scenario sets were considered:,status quo,or,no thinning scenario, thinning scenario for pulpwood,,and,thinning scenario for bioenergy,at differing levels of risk and salvage. The results indicated that the incorporation of thinnings either for pulpwood or bioenergy increases the forestland value regardless of the risk when the salvage value of the stand is 0.8. When the two thinning scenarios were compared, the land expectation value for the,thinning scenario for bioenergy,was greater at any level of risk compared with the,thinning scenario for pulpwood, averaging a difference of 11.5% and 11.7% for salvageable portions of 0.8 and 0, respectively. [source] ADJUSTED ESTIMATES OF UNITED STATES,CHINA BILATERAL TRADE BALANCES: AN UPDATEPACIFIC ECONOMIC REVIEW, Issue 3 2006K. C. Fung In this paper, four adjustments are made to the export and import data of the two governments: (i) freight along side (f.a.s.)-free on board (f.o.b.) and cost, insurance and freight (c.i.f.)-f.o.b. conversions; (ii) re-exports through Hong Kong (and elsewhere); (iii) re-export markups; and (iv) trade in services. After adjustments, our best estimate for the 2005 bilateral trade balance is $US170.7 billion, in China's favour, which is much larger than the official Chinese balance of $US114.2 billion but also much smaller than the official US balance of $US201.6 billion. [source] THE REDISCOVERY OF AMERICAN SACRED SPACESRELIGIOUS STUDIES REVIEW, Issue 4 2004Louis P. Nelson Book reviewed in this article: THE HERMENEUTICS OF SACRED ARCHITECTURE: EXPERIENCE, INTERPRETATION, COMPARISON (2 volumes) By Lindsay Jones TEMPLES OF GRACE: THE MATERIAL TRANSFORMATION OF CONNECTICUT'S CHURCHES, 1790,1840 By Gretchen Buggeln WHEN CHURCH BECAME THEATRE: THE TRANSFORMATION OF EVANGELICAL ARCHITECTURE AND WORSHIP IN THE NINETEENTH-CENTURY AMERICA By Jeanne Kilde PRAYERS IN STONE: CHRISTIAN SCIENCE ARCHITECTURE IN THE UNITED STATES, 1894,1930 By Paul Eli Ivey SHUL WITH A POOL: THE "SYNAGOGUE-CENTER" IN AMERICAN JEWISH HISTORY By David Kaufman MYTHS IN STONE: RELIGIOUS DIMENSIONS OF WASHINGTON, D.C. By Jeffrey F. Meyer UGLY AS SIN: WHY THEY CHANGED OUR CHURCHES FROM SACRED PLACES TO MEETING SPACES AND HOW WE CAN CHANGE THEM BACK AGAIN By Michael S. Rose BUILDING FROM BELIEF: ADVANCE, RETREAT, AND COMPROMISE IN THE REMAKING OF CATHOLIC CHURCH ARCHITECTURE By Michael E. DeSanctis ARCHITECTURE IN COMMUNION: IMPLEMENTING THE SECOND VATICAN COUNCIL THROUGH LITURGY AND ARCHITECTURE By Steven J. Schloeder [source] Emergency Medicine Practitioner Knowledge and Use of Decision Rules for the Evaluation of Patients with Suspected Pulmonary Embolism: Variations by Practice Setting and Training LevelACADEMIC EMERGENCY MEDICINE, Issue 1 2007Michael S. Runyon MD Abstract Background Several clinical decision rules (CDRs) have been validated for pretest probability assessment of pulmonary embolism (PE), but the authors are unaware of any data quantifying and characterizing their use in emergency departments. Objectives To characterize clinicians' knowledge of and attitudes toward two commonly used CDRs for PE. Methods By using a modified Delphi approach, the authors developed a two-page paper survey including 15 multiple-choice questions. The questions were designed to determine the respondents' familiarity, frequency of use, and comprehension of the Canadian and Charlotte rules. The survey also queried the frequency of use of unstructured (gestalt) pretest probability assessment and reasons why physicians choose not to use decision rules. The surveys were sent to physicians, physician assistants, and medical students at 32 academic and community hospitals in the United States and the United Kingdom. Results Respondents included 555 clinicians; 443 (80%) work in academic practice, and 112 (20%) are community based. Significantly more academic practitioners (73%) than community practitioners (49%) indicated familiarity with at least one of the two decision rules. Among all respondents familiar with a rule, 50% reported using it in more than half of applicable cases. A significant number of these respondents could not correctly identify a key component of the rule (23% for the Charlotte rule and 43% for the Canadian rule). Fifty-seven percent of all respondents indicated use of gestalt rather than a decision rule in more than half of cases. Conclusions Academic clinicians were more likely to report familiarity with either of these two specific decision rules. Only one half of all clinicians reporting familiarity with the rules use them in more than 50% of applicable cases. Spontaneous recall of the specific elements of the rules was low to moderate. Future work should consider clinical gestalt in the evaluation of patients with possible PE. [source] A Probabilistic Framework for Bayesian Adaptive Forecasting of Project ProgressCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 3 2007Paolo Gardoni An adaptive Bayesian updating method is used to assess the unknown model parameters based on recorded data and pertinent prior information. Recorded data can include equality, upper bound, and lower bound data. The proposed approach properly accounts for all the prevailing uncertainties, including model errors arising from an inaccurate model form or missing variables, measurement errors, statistical uncertainty, and volitional uncertainty. As an illustration of the proposed approach, the project progress and final time-to-completion of an example project are forecasted. For this illustration construction of civilian nuclear power plants in the United States is considered. This application considers two cases (1) no information is available prior to observing the actual progress data of a specified plant and (2) the construction progress of eight other nuclear power plants is available. The example shows that an informative prior is important to make accurate predictions when only a few records are available. This is also the time when forecasts are most valuable to the project manager. Having or not having prior information does not have any practical effect on the forecast when progress on a significant portion of the project has been recorded. [source] Towards an integrated GIS-based coastal forecast workflowCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 14 2008Gabrielle Allen Abstract The SURA Coastal Ocean Observing and Prediction (SCOOP) program is using geographical information system (GIS) technologies to visualize and integrate distributed data sources from across the United States and Canada. Hydrodynamic models are run at different sites on a developing multi-institutional computational Grid. Some of these predictive simulations of storm surge and wind waves are triggered by tropical and subtropical cyclones in the Atlantic and the Gulf of Mexico. Model predictions and observational data need to be merged and visualized in a geospatial context for a variety of analyses and applications. A data archive at LSU aggregates the model outputs from multiple sources, and a data-driven workflow triggers remotely performed conversion of a subset of model predictions to georeferenced data sets, which are then delivered to a Web Map Service located at Texas A&M University. Other nodes in the distributed system aggregate the observational data. This paper describes the use of GIS within the SCOOP program for the 2005 hurricane season, along with details of the data-driven distributed dataflow and workflow, which results in geospatial products. We also focus on future plans related to the complimentary use of GIS and Grid technologies in the SCOOP program, through which we hope to provide a wider range of tools that can enhance the tools and capabilities of earth science research and hazard planning. Copyright © 2008 John Wiley & Sons, Ltd. [source] Community mediation: Reflections on a quarter century of practiceCONFLICT RESOLUTION QUARTERLY, Issue 4 2000Scott Bradley It is fitting that this issue of Mediation Quarterly, one of the last before it transforms into a joint publication of confederating organizations, is devoted to community mediation. During the past twenty-five years, community mediation has provided much of the momentum for the growth and diversity of the alternative dispute resolution movement in the United States. At the same time, it has faced many challenges as the larger dispute resolution field grows and evolves. How community mediation responds to these challenges will shape its role and place for the next generation. In this issue, we have asked some key leaders and practitioners in the field to reflect on the development of community mediation and the challenges as we move into another century of practice. [source] The impact of victim-offender mediation: A cross-national perspectiveCONFLICT RESOLUTION QUARTERLY, Issue 3 2000Mark S. Umbreit The field of victim-offender mediation, now in its third decade, has grown extensively throughout North America and Europe, with programs in more than twelve hundred communities. This article reports on results from three related studies on the consequences of participating in victim-offender mediation, including programs in four of the United States (Umbreit, 1996, 1994a, 1994b; Umbreit and Coates, 1993), four provinces of Canada (Umbreit, 1999, 1995c), and two cities in England (Umbreit and Roberts, 1996). VOM is implemented differently in various places, reflecting cultural norms and mores. Given innumerable ways of doing victim-offender mediation, are there common experiences shared among participants that can inform program delivery and justice policy? The VOM model was found to be a highly transportable and flexible program in diverse settings. High levels of client satisfaction with both the process and outcome were found, and a high level of fairness was expressed. VOM continues to be a promising model, reflecting the principles of the restorative justice movement and offering a firm foundation of practice wisdom and research from which other newer forms of victim-offender dialogue, such as family group conferences, circles, and boards, can benefit (Bazemore and Umbreit, 1999). [source] The Long Road to Better ACHD CareCONGENITAL HEART DISEASE, Issue 3 2010Gary Webb MD ABSTRACT The care of adult patients with congenital heart defects in the United States is spotty at best, and needs to improve greatly if the needs of these patients are to be met. The care of American children with congenital heart defects is generally excellent. Pediatric cardiac services are well established and well supported. The care of adults with congenital heart disease (CHD) is well established in only a few American centers. While there are an increasing number of clinics, they are generally poorly resourced with relatively few patients. If located in adult cardiology programs, they are usually minor players. If located in pediatric cardiac programs, they are usually minor players as well. Training programs for adult CHD (ACHD) caregivers are few, informal, and poorly funded. To improve the situation, we need perhaps 25 well-resourced and well-established regional ACHD centers in the United States. We need to stop the loss to care of CHD patients at risk of poor outcomes. We need to educate patients and families about the need for lifelong and skilled surveillance and care. We need to effect an orderly transfer from pediatric to adult care. We need to strengthen the human resource infrastructure of ACHD care through the training and hiring of healthcare professionals of a quality equivalent to those working in the pediatric care environment. We need to demonstrate that adult care is high quality care. We need more high-quality ACHD research. The ACHD community needs to establish its credibility with pediatric cardiac providers, adult cardiology groups, with governments, with professional organizations, and with research funding agencies. Accordingly, there is a need for strong political action on behalf of American ACHD patients. This must be led by patients and families. These efforts should be supported by pediatric cardiologists and children's hospitals, as well as by national professional organizations, governments, and health insurance companies. The goal of this political action should be to see that ACHD patients can receive high-quality lifelong surveillance, that we lose fewer patients to care, and that the staff and other services needed are available nationwide. [source] Pediatric Interventional Cardiology in the United States is Dependent on the Off-label Use of Medical DevicesCONGENITAL HEART DISEASE, Issue 1 2010Jamie S. Sutherell MD ABSTRACT Objective., A substantial unmet medical device need exists in pediatric care. As a result, the off-label use of approved devices is routine in pediatric interventional cardiology, but the extent and nature of this practice has not been previously described. The purpose of this study, therefore, is to evaluate the prevalence and nature of off-label cardiac device use in an active pediatric interventional program in the United States. Study Design., This study is a retrospective review of all interventional cardiac procedures performed at our institution from July 1, 2005 to June 30, 2008. Diagnostic (noninterventional) catheterizations, myocardial biopsies, invasive electrophysiology studies, and studies involving investigational devices were excluded. Interventions performed were compared with the manufacturer's labeled indications for each device. Results., During this 3-year period, 473 patients (median age 4.1 years) underwent 595 transcatheter interventions. An approved device was utilized for an off-label application in 63% of patients, and in 50% of all interventions performed. The most frequent off-label procedures were stent implantations (99% off-label), balloon dilations (78% off-label), and coil embolizations (29% off-label). In contrast, the off-label use of septal and ductal occluders was relatively uncommon. Conclusions., In our routine (noninvestigational) practice of pediatric interventional cardiology, 63% of patients underwent procedures utilizing medical devices for off-label indications. These data underscore the need to enhance cardiac device review and approval processes in the United States to include pediatric applications. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||