Treatment Decision-Making in Catastrophic Illness

It is well established that the social and economic environment of medical care distinguishes its provision from that of other goods and services. While scholars have studied the influences of this idiosyncratic environment, there is relatively little empirical knowledge about how it affects decision-making in specific medical contexts. Through general conceptual discussion and consideration of a case study of leukemia chemo-therapy, this paper examines the medical decision-making process in one specific context: the response of physicians to the availability of an innovative treatment for a catastrophic illness. The manner in which the medical profession deals with serious illness is relevant to concerns as diverse as the promotion of economic efficiency and the preservation of human dignity.

Doubly-Fluctuating BPS Solutions in Six Dimensions

We analyze the BPS solutions of minimal supergravity coupled to an anti-self-dual tensor multiplet in six dimensions and find solutions that fluctuate non-trivially as a function of two variables. We consider families of solutions coming from KKM monopoles fibered over Gibbons-Hawking metrics or, equivalently, non-trivial T^2 fibrations over an R3 base. We find smooth microstate geometries that depend upon many functions of one variable, but each such function depends upon a different direction inside the T^2 so that the complete solution depends non-trivially upon the whole T^2 . We comment on the implications of our results for the construction of a general superstratum.Comment: 24 page

Molecular films associated with LDEF

The molecular films deposited on the surface of the Long Duration Exposure Facility (LDEF) originated from the paints and room-temperature-vulcanized (RTV) silicone materials intentionally used on the satellite and not from residual contaminants. The high silicone content of most of the films and the uniformity of the films indicates a homogenization process in the molecular deposition and suggests a chemically most favored composition for the final film. The deposition on interior surfaces and vents indicated multiple bounce trajectories or repeated deposition-reemission cycles. Exterior surface deposits indicated a significant return flux. Ultraviolet light exposure was required to fix the deposited film as is indicated by the distribution of the films on interior surfaces and the thickness of films at the vent locations. Thermal conditions at the time of exposure to ultraviolet light seems to be an important factor in the thickness of the deposit. Sunrise facing (ram direction) surfaces always had the thicker film. These were the coldest surfaces at the time of their exposure to ultraviolet light. The films have a layered structure suggesting cyclic deposition. As many as 34 distinct layers were seen in the films. The cyclic nature of the deposition and the chemical uniformity of the film one layer to the next suggest an early deposition of the films though there is evidence for the deposition of molecular films throughout the nearly six year exposure of the satellite. A final 'spray' of an organic material associated with water soluble salts occurred very late in the mission. This may have been the result of one of the shuttle dump activities

Study of the odd strontium isotopes with stripping and pickup reactions

Odd strontium isotopes induced by deuterons with stripping and pickup reaction

Midwest Technology Assistance Center for Small Public Water Systems Final Report

The Midwest Technology Assistance Center (MTAC) was established October 1, 1998 to provide assistance to small public water systems throughout the Midwest via funding from the United States Environmental Protection Agency (USEPA) under section 1420(f) of the 1996 amendments to the Safe Drinking Water Act. This report summarizes progress made under USEPA Grant# 832591-01 for funds received in Federal Years (FY) 05 and 06. MTAC is a cooperative effort of the 10 states of the Midwest (congruent with USEPA regions 5 and 7), led by the Illinois State Water Survey and the University of Illinois. The director of their Water Resources Institute (WRI) coordinates the participation of each state in MTAC. Dr. Richard Warner (WRI director) and Kent Smothers were the principal investigators for this project. Kent Smothers serves as the managing director of the center, and is responsible for conducting routine activities with the advice and counsel of Dr. Richard Warner.published or submitted for publicationis peer reviewe

Is Private Production of Public Services Cheaper than Public Production? A meta-regression analysis of solid waste and water services

Privatization of local government services is assumed to deliver cost savings but empirical evidence for this from around the world is mixed. We conduct a meta-regression analysis of all econometric studies examining privatization for water distribution and solid waste collection services and find no systematic support for lower costs with private production. Differences in study results are explained by differences in time-period of the analyses, service characteristics, and policy environment. We do not find a genuine empirical effect of cost savings resulting from private production. The results suggest that to ensure cost savings, more attention be given to the cost characteristics of the service, the transaction costs involved, and the policy environment stimulating competition, rather than to the debate over public versus private delivery of these services.Privatization, contracting-out, costs, local governments, meta-regression analysis.

Linear hydrodynamics and viscoelasticity of nematic elastomers

We develop a continuum theory of linear viscoelastic response in oriented monodomain nematic elastomers. The expression for dissipation function is analogous to the Leslie-Ericksen version of anisotropic nematic viscosity; we propose the relations between the anisotropic rubber moduli and new viscous coefficients. A new dimensionless number is introduced, which describes the relative magnitude of viscous and rubber-elastic torques. In an elastic medium with an independently mobile internal degree of freedom, the nematic director with its own relaxation dynamics, the model shows a dramatic decrease in the dynamic modulus in certain deformation geometries. The degree to which the storage modulus does not altogether drop to zero is shown to be both dependent on frequency and to be proportional to the semi-softness, the non-ideality of a nematic network. We consider the most interesting geometry for the implementation of the theory, calculating the dynamic response to an imposed simple shear and making predictions for effective moduli and (exceptionally high) loss factors.Comment: Latex 2e or PDFlatex (4 EPS or JPG figures) - to appear in Euro.Phys.J.