Balanced Justice: Mr. Justice Powell and the Constitution

In his first five years on the United States Supreme Court, Justice Lewis F. Powell, Jr. has become and will most likely continue to be a leading force in shaping the direction of the Court. In many areas, Justice Powell\u27s desire for judicial flexibility as well as judicial restraint has made him a leader in turning the Burger Court away from the bright-line tests enunciated by the Warren Court. However, where the Warren Court had been flexible, Justice Powell has usually preserved this flexibility and expanded it if possible. The tool consistently utilized to achieve this flexibility has been a balancing formula that has sought to accommodate all the competing interests

Persistence of Pathogens with Short Infectious Periods in Seasonal Tick Populations: The Relative Importance of Three Transmission Routes

BACKGROUND: The flaviviruses causing tick-borne encephalitis (TBE) persist at low but consistent levels in tick populations, despite short infectious periods in their mammalian hosts and transmission periods constrained by distinctly seasonal tick life cycles. In addition to systemic and vertical transmission, cofeeding transmission has been proposed as an important route for the persistence of TBE-causing viruses. Because cofeeding transmission requires ticks to feed simultaneously, the timing of tick activity may be critical to pathogen persistence. Existing models of tick-borne diseases do not incorporate all transmission routes and tick seasonality. Our aim is to evaluate the influence of seasonality on the relative importance of different transmission routes by using a comprehensive mathematical model. METHODOLOGY/PRINCIPAL FINDINGS: We developed a stage-structured population model that includes tick seasonality and evaluated the relative importance of the transmission routes for pathogens with short infectious periods, in particular Powassan virus (POWV) and the related "deer tick virus," emergent encephalitis-causing flaviviruses in North America. We used the next generation matrix method to calculate the basic reproductive ratio and performed elasticity analyses. We confirmed that cofeeding transmission is critically important for such pathogens to persist in seasonal tick populations over the reasonable range of parameter values. At higher but still plausible rates of vertical transmission, our model suggests that vertical transmission can strongly enhance pathogen prevalence when it operates in combination with cofeeding transmission. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate that the consistent prevalence of POWV observed in tick populations could be maintained by a combination of low vertical, intermediate cofeeding and high systemic transmission rates. When vertical transmission is weak, nymphal ticks support integral parts of the transmission cycle that are critical for maintaining the pathogen. We also extended the model to pathogens that cause chronic infections in hosts and found that cofeeding transmission could contribute to elevating prevalence even in these systems. Therefore, the common assumption that cofeeding transmission is not relevant in models of chronic host infection, such as Lyme disease, could lead to underestimating pathogen prevalence

An evolutionary perspective on substance abuse

This article describes how recent advances in understanding the evolutionary functions of emotions can help to reconcile diverse approaches to substance abuse. Emotions can be understood as specialized states that prepare individuals to cope with opportunities and threats. Drugs that artificially induce pleasure or block normal suffering disrupt these evolved mechanisms, and thus should tend to interfere with adaptive behavior, even if the drugs are medically safe. Nonetheless, we routinely use drugs quite safely to block defenses like pain, cough, and anxiety. This apparent contradiction is explained by the relatively small costs of defenses compared to the potentially huge costs of not expressing a defensive response when it is needed. An evolutionary perspective has implications for substance abuse research, treatment, and social policy. This perspective suggests that the search for etiology needs to address the human tendency to abuse drugs separately from individual differences in these tendencies, that clinical treatments that take account of the broad range of patients' emotional life are well justified, and that social policies need to address substance use and abuse not as diseases to be cured but as human tendencies that need to be managed. To prepare for future drugs that will likely alter emotions safely, we urgently need a better understanding of the adaptive function of the emotions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31367/1/0000279.pd

Physician Practice Patterns and Variation in the Delivery of Preventive Services

BACKGROUND: Strategies to improve preventive services delivery (PSD) have yielded modest effects. A multidimensional approach that examines distinctive configurations of physician attributes, practice processes, and contextual factors may be informative in understanding delivery of this important form of care. OBJECTIVE: We identified naturally occurring configurations of physician practice characteristics (PPCs) and assessed their association with PSD, including variation within configurations. DESIGN: Cross-sectional study. PARTICIPANTS: One hundred thirty-eight family physicians in 84 community practices and 4,046 outpatient visits. MEASUREMENTS: Physician knowledge, attitudes, use of tools and staff, and practice patterns were assessed by ethnographic and survey methods. PSD was assessed using direct observation of the visit and medical record review. Cluster analysis identified unique configurations of PPCs. A priori hypotheses of the configurations likely to perform the best on PSD were tested using a multilevel random effects model. RESULTS: Six distinct PPC configurations were identified. Although PSD significantly differed across configurations, mean differences between configurations with the lowest and highest PSD were small (i.e., 3.4, 7.7, and 10.8 points for health behavior counseling, screening, and immunizations, respectively, on a 100-point scale). Hypotheses were not confirmed. Considerable variation of PSD rates within configurations was observed. CONCLUSIONS: Similar rates of PSD can be attained through diverse physician practice configurations. Significant within-configuration variation may reflect dynamic interactions between PPCs as well as between these characteristics and the contexts in which physicians function. Striving for a single ideal configuration may be less valuable for improving PSD than understanding and leveraging existing characteristics within primary care practices

Differential modulation of corticospinal excitability during haptic sensing of 2-D patterns vs. textures

<p>Abstract</p> <p>Background</p> <p>Recently, we showed a selective enhancement in corticospinal excitability when participants actively discriminated raised 2-D symbols with the index finger. This extra-facilitation likely reflected activation in the premotor and dorsal prefrontal cortices modulating motor cortical activity during attention to haptic sensing. However, this parieto-frontal network appears to be finely modulated depending upon whether haptic sensing is directed towards material or geometric properties. To examine this issue, we contrasted changes in corticospinal excitability when young adults (n = 18) were engaged in either a roughness discrimination on two gratings with different spatial periods, or a 2-D pattern discrimination of the relative offset in the alignment of a row of small circles in the upward or downward direction.</p> <p>Results</p> <p>A significant effect of task conditions was detected on motor evoked potential amplitudes, reflecting the observation that corticospinal facilitation was, on average, ~18% greater in the pattern discrimination than in the roughness discrimination.</p> <p>Conclusions</p> <p>This differential modulation of corticospinal excitability during haptic sensing of 2-D patterns vs. roughness is consistent with the existence of preferred activation of a visuo-haptic cortical dorsal stream network including frontal motor areas during spatial vs. intensive processing of surface properties in the haptic system.</p

Editorial: Household transport costs, economic stress and energy vulnerability

International audienceSince the early 2000s issues of transport poverty and social exclusion have received increasing attention in transport studies (Dodson et al., 2004; Hine and Mitchell, 2001; Lucas et al., 2001). Although much of this research has focused on low-mobility and/or carless individuals, there has been growing awareness that the costs of daily mobility can have important economic stress impacts. In developed countries with high levels of car dependence, the costs of motoring can be burdensome, raising questions of affordability for households with limited economic resources.A number of developments in the first two decades of this century have contributed to raise the profile of household transport costs as a research topic and a policy concern. First, and more obviously, increasing and increasingly volatile global oil prices have raised concerns for the vulnerability of households to fuel price increases (Dodson and Sipe, 2007). Second, the rise of the climate change agenda has led to consider pricing measures as a key component of sustainable transport policy. Implementation of such measures however, has often been hampered by concerns for the distributional impacts of increasing transport costs faced by households. Third, the global financial crisis of 2007–2008 and its aftermath have highlighted broader issues of living standards, economic stress and affordability, which go beyond the specific case of transport.In this context, a further reason to investigate household transport costs has to do with other competing pressures on household budgets

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead