An Incomes Policy for the Professions: the Dutch Experience

In 1951 the United States began moving toward an incomes policy, an attempt to end postwar wage and price inflation by linking changes in these prices to gains in productivity. Other countries later followed suit; some countries had already adopted wage and price control policies. The Netherlands moved toward an incomes policy immediately after World War II. Initially, the Dutch program involved wages only, but in the 1970s it became an accepted principle that private professional income should be comparable with the salaries of government officials and civil servants with comparable training and responsibilities. In the Netherlands (as in the United States and, before medicine was socialized, the United Kingdom) health professionals operate on a fee-for-service basis and their incomes escalated as a result of both inflation and monopoly power. So they were subjected to the incomes policy. The policy's effectiveness in curbing income escalation cannot be determined with certainty—reliable data are lacking. However, the evidence indicates that the policy failed to achieve its original purpose.Incomes policy, Netherlands

Do Alternative Therapies Have a Role in Autism?

Interventions considered to be branches of Complementary & Alternative Medicine (CAM) for autism are on the rise. Many new treatments have emerged & traditional beliefs of Ayurveda, Yoga, Behavioral therapy, Speech therapy and Homoeopathy have gained popularity and advocacy among parents. It is imperative that data supporting new treatments should be scrutinized for scientific study design, clinical safety, and scientific validity, before embarking on them as modes of therapy. Practitioners take care in explaining the rationale behind the various approaches that they practice, it is important to indicate possible limitations too during the initial clinical examination and interactive session. Clinicians must remember that parents may have different beliefs regarding the effectiveness of treatment since their information is derived more from the ‘hear-say’ route when they compare benefits/effects of CAM therapies on other children and often underestimate differential tolerance for treatment risks. It is thus significant that practitioners do not assume a "don't ask, don't tell" posture. The scientific validation and support for many interventions is incomplete and very different from the recommendations of the American Academy of Pediatrics Policy Statement. In this article, we discuss the various modes of CAM and their utilities and limitations in relation to autism

Anisotropic Shock Sensitivity of Cyclotrimethylene Trinitramine (RDX) from Compress-and-Shear Reactive Dynamics

We applied the compress-and-shear reactive dynamics (CS-RD) simulation model to study the anisotropic shock sensitivity of cyclotrimethylene trinitramine (RDX) crystals. We predict that, for mechanical shocks between 3 and 7 GPa, RDX is most sensitive to shocks perpendicular to the (100) and (210) planes, whereas it is insensitive for shocks perpendicular to the (120), (111), and (110) planes. These results are all consistent with available experimental information, further validating the CS-RD model for distinguishing between sensitive and insensitive shock directions. We find that, for sensitive directions, the shock impact triggers a slip system that leads to large shear stresses arising from steric hindrance, causing increased energy inputs that increase the temperature, leading to dramatically increased chemical reactions. Thus, our simulations demonstrate that the molecular origin of anisotropic shock sensitivity results from steric hindrance toward shearing of adjacent slip planes during shear deformation. Thus, strain energy density, temperature rise, and molecule decomposition are effective measures to distinguish anisotropic sensitivities. We should emphasize that CS-RD has been developed as a tool to distinguish rapidly (within a few picoseconds) between sensitive and insensitive shock directions of energetic materials. If the high stresses and rates used here continued much longer and for larger systems, it would ultimately result in detonation for all directions, but we have not demonstrated this

THE EFFECT OF CMV INFECTION ON PROGRESSION OF HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE IN A COHORT OF HEMOPHILIC MEN FOLLOWED FOR UP TO 13 YEARS FROM SEROCONVERSION

The effect of prior infection with cytomegalovirus (CMV) on progression of HIV disease in a cohort of 111 men with haemophilia was studied after 13 years followup. The relative hazards associated with CMV positivity on progression to AIDS, death and a CD4 count of 0.05 x 10(9)/l were 2.28, 2.42 and 2.34, respectively. CMV seropositive patients were significantly older than the seronegative and this was controlled for by using a Cox proportional hazards model. The relative hazards for the three endpoints decreased to 1.89, 1.82 and 1.93 respectively and were marginally non-significant (P = 0.05, 0.08 and 0.08 for the three endpoints respectively). We conclude that this cohort continues to show evidence of a 'co-factor' effect associated with prior infection with CMV which is confounded by age but not completely explained by age differences. The potential biological significance of these results is discussed in the context of recent controlled clinical trials which show a survival benefit from long-term high-dose acyclovir, a drug with activity in vivo against CMV and other herpesviruses

Phase stability, ordering tendencies, and magnetism in single-phase fcc Au-Fe nanoalloys

Bulk Au-Fe alloys separate into Au-based fcc and Fe-based bcc phases, but L1$_0$ and L1$_2$ orderings were reported in single-phase Au-Fe nanoparticles. Motivated by these observations, we study the structural and ordering energetics in this alloy by combining density functional theory (DFT) calculations with effective Hamiltonian techniques: a cluster expansion with structural filters, and the configuration-dependent lattice deformation model. The phase separation tendency in Au-Fe persists even if the fcc-bcc decomposition is suppressed. The relative stability of disordered bcc and fcc phases observed in nanoparticles is reproduced, but the fully ordered L1$_0$ AuFe, L1$_2$ Au$_3$Fe, and L1$_2$ AuFe$_3$ structures are unstable in DFT. However, a tendency to form concentration waves at the corresponding [001] ordering vector is revealed in nearly-random alloys in a certain range of concentrations. This incipient ordering requires enrichment by Fe relative to the equiatomic composition, which may occur in the core of a nanoparticle due to the segregation of Au to the surface. Effects of magnetism on the chemical ordering are also discussed.Comment: 23 pages, 11 figure

Assessment of Metabolic Parameters For Autism Spectrum Disorders

Autism is a brain development disorder that first appears during infancy or childhood, and generally follows a steady course without remission. Impairments result from maturation-related changes in various systems of the brain. Autism is one of the five pervasive developmental disorders (PDD), which are characterized by widespread abnormalities of social interactions and communication, and severely restricted interests and highly repetitive behavior. The reported incidence of autism spectrum disorders (ASDs) has increased markedly over the past decade. The Centre for Disease Control and Prevention has recently estimated the prevalence of ASDs in the United States at approximately 5.6 per 1000 (1 of 155 to 1 of 160) children. Several metabolic defects, such as phenylketonuria, are associated with autistic symptoms. In deciding upon the appropriate evaluation scheme a clinician must consider a host of different factors. The guidelines in this article have been developed to assist the clinician in the consideration of these factors

Small deviations of iterated processes in space of trajectories

We derive logarithmic asymptotics of probabilities of small deviations for iterated processes in the space of trajectories. We find conditions under which these asymptotics coincide with those of processes generating iterated processes. When these conditions fail the asymptotics are quite different