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Aging is associated with comorbidities and increased utilization of healthcare services, which results in a large amount of personal health information (PHI) to manage. Older adults often have difficulty managing this increased load of health information. Although many home healthcare nurses (HCNs) provide assistance to older adults after discharge from medical facilities, little is known about HCNs’ experiences with older adults regarding the management and transfer of PHI in their homes. The purpose of this qualitative study was to 1) determine how HCNs obtain and provide health information, 2) describe the perspective of HCNs regarding older adult PHI and 3) identify the potential role of technology in older adult health information transfer. We conducted and analyzed semi-structured phone interviews with 17 HCNs from two home healthcare agencies. Five thematic areas emerged from interviews with HCNs: 1) common practices of obtaining health information; 2) barriers to obtaining health information; 3) ideal ways to obtain and provide health information; 4) use of patient portals; and 5) HCNs’ use of technology for health information exchange. Most HCNs reported that it would be difficult for older adult patients to update their personal health information without assistance, but HCNS lack the time and resources to assist older adults in PHI management activities.

Objective With age, older adults experience a greater number of chronic diseases and medical visits, and an increased need to manage their health information. Technological advances in consumer health information technologies (HITs) help patients gather, track, and organize their health information within and outside of clinical settings. However, HITs have not focused on the needs of older adults and their caregivers. The goal of the SOARING (Studying Older Adults and Researching their Information Needs and Goals) Project was to understand older adult personal health information management (PHIM) needs and practices to inform the design of HITs that support older adults. Materials and Methods Drawing on the Work System Model, we took an ecological approach to investigate PHIM needs and practices of older adults in different residential settings. We conducted in-depth interviews and surveys with adults 60 years of age and older. Results We performed on-site in-person interview sessions with 88 generally healthy older adults in various settings including independent housing, retirement communities, assisted living, and homelessness. Our analysis revealed 5 key PHIM activities that older adults engage in: seeking, tracking, organizing, sharing health information, and emergency planning. We identified 3 major themes influencing older adults’ practice of PHIM: (1) older adults are most concerned with maintaining health and preventing illness, (2) older adults frequently involve others in PHIM activities, and (3) older adults’ approach to PHIM is situational and context-dependent. Discussion Older adults’ approaches to PHIM are dynamic and sensitive to changes in health, social networks, personal habits, motivations, and goals. Conclusions PHIM tools that meet the needs of older adults should accommodate the dynamic nature of aging and variations in individual, organizational, and social contexts.

The increasing older adult population guarantees that healthcare providers are more likely to encounter patients requiring treatment for unintended weight loss. Due to physiologic changes that occur in the older adult, it is important to know how to assess for, and diagnose unintended weight loss, as well as understand the treatment options. In addition to the use of enteral and parenteral nutrition, appetite stimulants have been used in older adults. Understanding the dosage, side effects, and proper usage of appetite stimulants, such megestrol acetate, mirtazapine, and dronabinol, is crucial in order to provide safe and effective patient care.

ObjectiveAlthough family and friends (FF) often play a significant support role in the health of older adults (OA), we know little about their role in personal health information management (PHIM). To address this gap and inform the design of PHIM tools, we describe the work, needs, and barriers of FF in the context of PHIM for OAs.MethodsWe conducted semi-structured telephone interviews with 52 FF identified by OA as being important in their health and PHIM. We analyzed interview transcripts for themes about FF information work, barriers, and support needs.ResultsFF play a supportive role in OA health maintenance, medical encounters, decision making, and daily activities. Monitoring, the ongoing process of seeking information related to the OA status, emerged as a key activity comprised of 3 phases: detection, interpretation, and action. Barriers to monitoring included OA choices and constraints, FF constraints, and difficulty with technological tools, resources, health information exchange between providers, social network dynamics, and physical distance.ConclusionsFF frequently monitor for change in OA well-being, seeking up-to-date information to facilitate support of OA PHIM. Health information technology tools designed for FF can support all phases of monitoring by providing: (1) timely and granular levels of access to OA health information as the OA ages; (2) tailored health education for FF that is based on OA clinical data; and (3) networking platforms that integrate delegation, volunteering, and relevant resources, along with tools to facilitate support of OA appointment calendars and medication management. Such tools could reduce the burden of PHIM for OA and their loved ones.

Objective We describe five neonates with enteroviral (EV) infection to demonstrate central nervous system (CNS) and cardiac complications and report successful treatment of myocarditis with immunoglobulin intravenous (IVIG) in two. Study Design Case series identified during three enteroviral seasons in one neonatal intensive care unit (NICU) by cerebral spinal fluid (CSF) reverse transcriptase polymerase chain reaction (PCR) testing for EV in neonates suspected to have sepsis, but with sterile bacterial cultures. Results Cases were identified in each of three sequential years in a NICU with 800 to 900 admissions/year. Two cases were likely acquired perinatally; all were symptomatic with lethargy and poor feeding by age 5 to 10 days. All had signs of sepsis and/or meningitis; one progressed to periventricular leukomalacia and encephalomalacia. Two recovered from myocarditis after treatment that included IVIG 3 to 5 g/kg. Conclusion Neonates who appear septic without bacterial etiology may have EV CNS infections that can be diagnosed rapidly by CSF PCR testing. Cases may be underdiagnosed in the early neonatal period if specific testing is not performed. Neonates with EV infection should be investigated for evidence of periventricular leukomalacia, screened for myocarditis, and considered for IVIG treatment.

The Coasts, Oceans, Ports and Rivers Institute (COPRI) within the American Society of Civil Engineers (ASCE) is working to produce guidance materials allowing engineers, owners and stakeholders to address the inclusion of sea-level change considerations during the design of marine civil works. The Committee serves the needs of all stakeholders involved in a marine project, with a focus on designers and engineers in particular. The manual will provide designers and engineers with systematic methods for the consideration of risks associated with the uncertainty of sea-level change affecting a facility and offer mechanisms for how to incorporate sea-level change projections into their project designs. Current scientific studies use different methods and data for calculation and thus global mean sea level rise estimates for 2100 generally range from 0.6 – 2.0 meters. However, planning for marine civil works should consider the local sea level scenarios and potential variations associated with regular, periodic water level changes (such as tides) and addressing probabilities associated with potential storm/flood events. In response to the significant challenge of addressing these issues and making sound decisions jointly with stakeholders to understand and manage risk, this Committee is developing recommendations to assist in managing design factors, uncertainty, and to a certain extent, measure implementation. This paper provides an overview of these issues and the recommendations that the Committee is developing.

Background:Evaluation studies of large scale physical activity promotion programs are rare in Latin America. The aim of the current study was to evaluate the association between various forms of exposure to Academia da Cidade (PAC), a professionally supervised intervention in Aracaju (Brazil), and leisure-time physical activity (LTPA).Methods:A population-based study including 2267 adults was carried out. LTPA was assessed using the long version of the International Physical Activity Questionnaire, and a cut-off of 150 minutes per week was used in the analyses.Results:In fully adjusted models, having ever heard about PAC was related to an odds of 1.8 (95% CI 1.4−2.2) for reaching the 150-minutes per week LTPA threshold. Equivalent odds ratios were 1.6 (95% CI 1.1−2.3) for having ever seen a PAC class, 14.3 (95% CI 12.3−16.4) for current and 4.0 (95% CI 1.4−11.3) for past PAC participation.Conclusion:Different sources of exposure to PAC were significantly associated with LTPA, which may suggest that professionally-supervised community classes offered for free may be a successful alternative for promoting physical activity in Brazil. If PAC happens to be expanded to other Brazilian areas, intervention studies may be carried out to evaluate its effectiveness.

Norms are being used as a mechanism to regulate the behavior of autonomous, heterogeneous and independently designed agents. Norms describe what can be performed, what must be performed, and what cannot be performed in the multi-agent systems. Due to the number of norms specified to govern a multi-agent system, one important issue that has been considered by several approaches is the checking for normative conflicts. Two norms are said to be in conflict when the fulfillment of one norm violates the other and vice-versa. In this paper, we formally define the concept of an indirect normative conflict as a conflict between two norms that not necessarily have contradictory or contrary deontic modalities and that may govern (different but) related behaviors of (different but) related entities on (different but) related contexts. Finally, we present an ontology-based indirect norm conflict checker that automatically identifies direct and indirect norm conflicts on an ontology describing a set of norms and a set of relationships between the elements identified in the norms (behavior, entity and context).

This article describes how, as environmentalists turn their attention toward sprawl and conservation, biologists warn that habitat destruction is the single largest cause of species extinctions, and the role of local governments in biodiversity preservation deserves much greater attention. Local governments make many of the ?little decisions? that can preserve or destroy species habitat, yet their role under the federal Endangered Species Act (ESA) is remarkably underdeveloped. This article seeks to define the role of local governments with respect to the ESA.

Political borders, which delineate divergent political, social, economic, and demographic systems, affect the management of shared natural resources. Transboundary environmental management will attract increasing global attention as trends of population growth and natural resource scarcity drive coordinated solutions for environmental problems. Water pollution, in particular, will be a high priority for many nations because of the undisputed importance of water to sustain life and the unyielding characteristic of water to flow freely across political borders. The study of the Abbotsford‐Sumas aquifer offers a model to investigate the nature of shared resource management problems within two divergent cultural regions (western Washington and southern British Columbia), bisected by a political boundary (U.S.‐Canada border). Using the newly developed Transboundary Environmental Management Index (TEMI), the coordinated management of the organizations was ranked according to their “institutional capaci...

This paper studies the determinants of patent suits and settlements during 1978-99 by linking information from the U.S. patent office, the federal courts, and industry sources. We find that litigation risk is much higher for patents that are owned by individuals and firms with small patent portfolios. Patentees with a large portfolio of patents to trade, or other characteristics that facilitate "cooperative" resolution of disputes, are much less likely to prosecute infringement suits. However, postsuit outcomes do not depend on these characteristics. These findings show that small patentees are at a significant disadvantage in protecting their patent rights because their greater litigation risk is not offset by more rapid resolution of their suits. Our empirical estimates of the heterogeneity in litigation risk can help in developing private patent litigation insurance to mitigate the adverse affects of high enforcement costs.

Purpose: We investigated the relationship between prostate volume and cancer detection by needle biopsy, and determined the effect of an increased number of cores on the sampling error of needle biopsy on large prostate glands.Materials and Methods: The study cohort included 750 consecutive patients who underwent first time transrectal ultrasound guided prostate needle biopsy from January 1995 to August 2001. Prostate volumes were divided into quartiles (13 to 34, 34.1 to 45, 45.1 to 64 and 64.1 to 244 cc). Multivariate analysis controlling for age, prostate specific antigen (PSA) and biopsy indication was performed to determine the effect of the number of cores and prostate volume on prostate cancer detection.Results: Patients diagnosed with prostate cancer were older (p = 0.0035) and had higher PSA levels (p = 0.0002) than those with no cancer on biopsy. Decreasing cancer detection rates were seen with increasing prostate volume (p = 0.0074). The OR of detection for each additional core was 0.99...

There continues to be widespread criticism of the extension of patent rights on pharmaceuticals in the developing world as required by World Trade Organization membership. This chapter examines arguments in favor and against this strengthening of worldwide patent protection. It emphasizes that these new pharmaceutical patents promise benefits and costs that differ according to the characteristics of diseases. Some diseases primarily affect poor countries. For these diseases, patents will not be sufficient to attract substantial private investment, because purchasing power is low. However, globally available and well-defined patent rights could increase the benefits derived from greater public financing of research on pharmaceutical products for the developing world. For major global diseases the justification for extending patents in poorer countries is less clear. Thus the optimal global framework for pharmaceutical patents might require differentiating the protection given to products in accordance with...

Recent theoretical advances have brought income and wealth distributions back into a prominent position in growth and development theories, and as determinants of specific socio-economic outcomes, such as health or levels of violence. Empirical investigation of the importance of these relationships, however, has been held back by the lack of sufficiently detailed high quality data on distributions. Household surveys that include reasonable measures of income or consumption can be used to calculate distributional measures, but at low levels of aggregation these samples are rarely representative or of sufficient size to yield statistically reliable estimates. At the same time, census (or other large sample) data of sufficient size to allow disaggregation either have no information about income or consumption, or measure these variables poorly. This note outlines a statistical procedure to combine these types of data to take advantage of the detail in household sample surveys and the comprehensive coverage of a census. It extends the literature on small area statistics (Ghosh and Rao (1994), Rao (1999)) by developing estimators of population parameters that are nonlinear functions of the underlying variable of interest (here unit level consumption), and by deriving them from the full unit level distribution of that variable. In examples using Ecuadorian data, our estimates have levels of precision comparable to those of commonly used survey based welfare estimates—but for populations as small as 15,000 households, a ‘town.’ This is an enormous improvement over survey based estimates, which are typically only consistent for areas encompassing hundreds of thousands, even millions, of households. Experience using the method in South Africa, Brazil, Panama, Madagascar, and Nicaragua suggest that Ecuador is not an unusual case (Alderman et al. (2002), and Elbers et al. (2002)).

The Coasts, Oceans, Ports and Rivers Institute (COPRI) within the American Society of Civil Engineers (ASCE) is developing a Manual of Best Practice to address the inclusion of sea-level change considerations during the design of marine civil works. The committee serves the needs of all stakeholders involved in a marine project and designers and engineers in particular. The manual will provide designers and engineers with systematic methods for incorporating sea-level change projections into their project designs. Studies use different methods and data for calculation and thus global mean sea-level rise estimates for 2100 range from 0.6 to 2.0 m. In addition, planning for marine civil works should consider local sea level variations. In response, this committee is developing recommendations to assist in managing design factors, uncertainty, and to a certain extent, measure implementation. This paper provides an overview of these issues the recommendations that the committee is developing.

Empirical estimates of the private value of patent protection are derived for four technology areas—computers, textiles, combustion engines, and pharmaceuticals—using new patent data for West Germany, 1953–1988. Patentees must pay renewal fees to keep their patents in force as well as legal expenses in order to enforce them. A dynamic stochastic discrete choice model of optimal renewal decisions is developed incorporating both learning and depreciation as well as the potential need to prosecute infringement. The evolution of the distribution of returns over the life of a group of patents is calculated for each technology using a minimum distance simulation estimator. Results indicate that the aggregate value of protection generated per year is on the order of 10% of related R&D expenditure.

Background: Rhinoviruses have long been associated with mild upper respiratory illness in both adults and children. However, the role of rhinoviruses as lower respiratory tract pathogens has not been fully characterized. Previous data suggests that rhinoviruses may cause severe lower respiratory illness in young children or infants. Objectives: The present study describes the clinical presentations, severity of illness and outcomes for a large cohort of pediatric patients with documented rhinovirus infections. Subjects and methods: A retrospective chart review was done on 93 pediatric patients from whom 101 nasopharyngeal or endotracheal specimens were positive by viral culture for a rhinovirus. All patients were hospitalized or seen in the pediatric emergency department at The Children’s Hospital of Philadelphia between 1 January, 1990 and 31 May, 1996.Results: Of the 93 patients, 52 were male and 41 female. The age range was 0 days to 18 years with 25 (27%) less than 3 months, 42 (45%) between 3 and 12 months and 26 (28%) over the age of 12 months. Clinical presentations on evaluation in the emergency department or admission included 78 (84%) patients with acute respiratory illness, 13 (17%) with fever and suspected sepsis and 11 (12%) with other complaints. Reported physical findings on examination included one or more lower respiratory symptoms or signs of acute distress and fever greater than or equal to 38.1°C. A total of 64 (69%) children were noted to have significant past medical histories, including 28 (44%) with prematurity or complicated neonatal courses, 11 (17%) with prior reactive airways, 8 (12%) with congenital cardiac disease and 7 (11%) with neurologic disorders. Of the patients, 29 (31%) were considered to be otherwise healthy children with no underlying dysfunctions. The mean duration of hospitalization for 69 patients admitted with respiratory illness who did not develop subsequent unrelated complications was 3.7 days. No significant bacterial or fungal pathogens were identified in 91% of the cases. Conclusions: This study shows that rhinoviruses were associated with severe lower respiratory illness and hospitalization in a large pediatric population and that rhinovirus infection was a complicating factor in those patients with underlying or predisposing conditions.

To determine the lunar moments of inertia (A (C − A) B and (B − A) C come from Lunar Laser Ranging (LLR) measurement of the lunar orientation Spacecraft or lunar orbit perturbations provide J2 Combining five reported J2 results gives a normalized polar moment of inertia C MR 2 = 0.3929 ± 0.0009 Solid-body tides displace the surface about 0.1 m, but can perturb the orbit of a Moon-orbiting spacecraft. The selenocentric coordinates of four lunar retroreflectors are accurately known and can serve as reference points. The orientation and orbit of the Moon are very well known for the time span of the LLR data.

New evidence is presented on environmental innovation and diffusion over the 1970s and 1980s. At a global level, a substantial amount of innovations occurred. In the United States, Japan, and Germany, the share of environmental patents in all patents varied between 0.6 and 3%, and as such was higher than the corresponding share of pollution abatement expenditure in GDP. Japanese environmental innovation rates were consistently high. Certain plausible connections between environmental regulation and innovation also emerge. Across these three countries and over time, innovation responded to pollution abatement expenditure, an indicator of the severity of environmental regulations. Environmental patenting rates in developing countries were also high, reaching 2% in many years in Brazil. Developing country innovators obtained a non-trivial number of patents, most of which appear geared towards adapting imported technologies to local conditions. However, domestic innovation was only one path to new technologies. ‘Imports’ of disembodied environmental technologies (foreign patents registered in developing countries) were substantial. Foreign patents were typically ‘important’ or generic patents; evidence also suggests that such patents protected intellectual property in equipment exported. Developing countries, especially in East Asia, often chose to obtain technologies embodied in pollution abatement equipment.

The Comprehensive Health Enhancement Support System (CHESS) Is an Interactive computer system containing information, social support, and problem-solving tools. It was developed with Intensive input from potential users through needs-assessment surveys and field testing. CHESS had previously been us

Ocular manifestations of cat scratch disease are uncommon. The diagnosis is usually made on the basis of increasing Bartonella henselae serum antibody titers. We report a child presenting with orbital abscess and osteomyelitis who was diagnosed with hepatosplenic cat scratch disease by detection of B. henselae DNA in the orbital abscess fluid.

Global Positioning System (GPS) data were used to estimate Earth rotation variations over an 11-day period during the Epoch '92 campaign in the summer of 1992. Earth orientation was measured simultaneously by several very long baseline interferometry (VLBI) networks. GPS and VLBI estimates of UT1 with 3-hour time resolution were then compared and analyzed. The high frequency behavior of both data sets is similar, although drifts between the two series of approximately 0.1 ms over 2-5 days are evident. The geodetic results were also compared with models for UT1 fluctuations at tidal periods and with estimates of atmospheric angular momentum made at 6-hour intervals. Most of the geodetic signal in the diurnal and semidiurnal frequency bands can be attributed to tidal processes, whereas UT1 variations over a few days are mostly atmospheric in origin.

This article describes the process of using needs assessment data to develop an interactive information technology specifically designed to support patients in a health-related crisis. The Comprehensive Health Enhancement Support System (CHESS) is an interactive information, social support, and problem-solving system that was developed by a team at the University of Wisconsin. This article looks at the program developed for breast cancer patients and their families.

✓ This study of the arterial blood of the spinal cord indicates that, of the 62 radicular branches (rami radiculares), at the most seven or eight truly participate in the vascularization of the spinal cord. The authors have observed that the situation and distribution of these branches enable the distinction of three large arterial areas: cervicothoracic, midthoracic, and thoracolumbar. The fixed nature of the intramedullary arterial distribution contrasts with the variability of the afferent arterial supplies. No demarcation permits separation of the vascularization of the spinal cord into anterior and posterior parts. The anastomotic systems situated on the arterial pathways are potentially valuable, but their functioning is problematical. The anterior spinal artery is not continuous, for in the midthoracic region there exists a critical narrow zone. The perimedullary anastomotic system appears insufficient while intramedullary anastomoses are without functional value.

A computer-based support system was developed to help women cope with the crisis of breast cancer. The system, called Comprehensive Health Enhancement Support System (CHESS)contains integrated information, referral, decision, and social support programs. It was developed with intensive input from potential users through needs-assessment surveys and field testing. This article reports on the results of two pilot studies involving 30 women with breast cancer. The preliminary versions of CHESS were used extensively by older and younger women and by college and high school graduates. Participants in the pilot studies suggested several content enhancements and user-friendly aids for the developing system. User surveys indicated that CHESS was easy to use and would be valuable to other women with breast cancer, their partners, and their adult children. The women reported that they experienced more positive emotions and fewer negative emotions as a result of using the system.

Patient needs have long been elicited only through the use of customer satisfaction surveys, which unfortunately are not designed to obtain the in-depth information needed to guide the improvement of health care services. Through the use of the integrative group process and the help of many patients and hospital staffs, we developed a needs assessment survey for women with breast cancer. This article outlines this process and the results and discusses how we used these results to create a computer program designed to help women with breast cancer and their families.

The advent of easily-accessible tile-drainage and the intensification of agricultural practices have brought widespread decoupling of streams and their riparian floodplains in agricultural streams over the last 150 years. Channelised and deeply incised in the landscape, these streams are more than often reduced to simple drainage ditches – when not simply running in underground pipes. This paper describes a modular approach to bring back the key functions and ecosystem services provided by lowland streams that still must perform their drainage purposes in an agricultural landscape. Five principal restoration measures, also referred to as “building-blocks”, are discussed: re-creation of buffer-strips, alteration of tile drainage, in-channel interventions, creation of riparian wetlands/ponds, and finally daylightening. The complete restoration of a stream ecosystem may not be the most acceptable option to farming communities. In most cases, however, the application of even the most basic measure (i.e. the buffer-strip) can significantly support the return of key ecosystem services provided by a stream; such as flow regulation, water purification and support to biodiversity. Cumulative implementation of the other measures at strategic points of the drainage basin will further ensure that a functional stream/river valley is reinstated.

Data from a worldwide Global Positioning System (GPS) tracking experiment have been used to determine variations in earth rotation (UT1-UTC) over a time period of three weeks. Kalman filtering and smoothing enabled changes in UT1-UTC over intervals of 2 to 24 hrs to be detected with the GPS data. Internal consistency checks and comparisons with other solutions from very long baseline interferometry (VLBI) and satellite laser ranging (SLR) indicate that the GPS UT1-UTC estimates are accurate to about 2 cm. Comparison of GPS-estimated variations in UT1-UTC with 2-hr time resolution over 4 days with predicted variations computed from diurnal and semidiurnal oceanic tidal contributions strongly suggests that the observed periodic sub-daily variations of about 0.1 msec are largely of tidal origin.

This article describes how the patient education program at one Veterans Affairs Medical Center dealt with the literacy issue by implementing a literacy program that is administered and managed by volunteers, to meet the particular needs of each enrolled individual. The evolutionary process, including background, obstacles encountered, disappointments and finally the workable solution, are all detailed. The article provides information and directions that can be followed by other health care organizations in planning similar programs.

We use a public economics framework to consider how pharmaceuticals should be priced when at least some of the R&D incentive comes from sales revenues. We employ familiar techniques of public finance to relax some of the restrictions implied in the standard use of Ramsey pricing. In the more general model, poor countries should not necessarily cover even their own marginal costs, and the pricing structure is not related to that which would be chosen by a monopolist in a simple way. We use this framework to examine on-going debates regarding the international patent system asembodied in the WTO's TRIPS agreement.

We consider how patent rights and price regulation affect whether new drugs are marketed in a country, and how quickly. The analysis covers a large sample of 68 countries at all income levels and includes all drug launches over the period 1982-2002. It uses newly compiled information on legal and regulatory policy, and is the first systematic analysis of the determinants of drug launch in poor countries. Price control tends to discourage rapid product entry, while the results for patents are mixed. There is evidence that local capacity to innovate matters and that international pricing externalities may play a role.

To demonstrate the evolution of the clinical presentation and pathologic and biochemical outcomes for patients with clinically localized prostate cancer treated with radical prostatectomy during the prostate-specific antigen (PSA) era.One thousand fifty-nine consecutive men treated with radical prostatectomy from January 1989 to December 2000 comprised the study cohort. A chi-squared metric was used to compare the proportions of patients during three intervals (1989 to 1992, 1993 to 1996, and 1997 to 2000) by categories of PSA level, biopsy Gleason score, clinical T stage, percent positive biopsy cores, age, and risk group, as well as pathologic T stage, Gleason score, margin status, and lymph node status. Actual 2-year PSA recurrence-free survival rates are reported for patients with a minimal follow-up of 24 months, stratified by the interval and preoperative risk group.There was a significant shift in the preoperative characteristics toward younger patients (P0.0001) with nonpalpable disease (P0.0001), lower PSA levels (P0.0001), fewer percent positive biopsies (P0.0001), and lower preoperative risk group classification (P0.0001). Pathologically, a significant downward stage migration was found toward organ-confined disease (P0.0001) and improvement in surgical margin status (P0.001). The actual 2-year PSA recurrence-free survival rates improved during the three intervals spanning the PSA era from 60% to 78% and 82% (P0.0001).With the introduction of serum PSA as a screening tool, we have noted an evolution toward a lower pathologic stage, grade, and improved PSA outcome. These findings provide further support that serum PSA screening increases the proportion of patients potentially curable after radical prostatectomy.

The sphere of influence of space geodesy is ever enlarging, with impressive achievements in the last few decades in many diverse areas (such as geodynamics, planetary and atmospheric sciences, oceanography, tectonics, and ice studies). Earth system studies have made major advances with the advent of accurate space geodetic techniques with high temporal resolution and the increasing availability of complementary geophysical data. Examples include positioning at the millimeter level, enabling determination of crustal deformation and strain with unprecedented accuracy at high time resolution; water vapor monitoring via GPS; and improved gravity modeling and orbit determination, permitting an unparalleled view of the 1997–1998 ENSO event. The new millennium holds even more promise, with many planned developments, such as GOCE, GRACE, and ICESAT missions, densification of GPS networks, and the development of new technologies. This paper will highlight recent geodetic advances and their interdisciplinary impact with a vision towards the future.

We study the determinants of patent suits and their outcomes over the period 1978-1999 by linking detailed information from the U.S. patent office, the federal court system, and industry sources. The probability of being involved in a suit is very heterogeneous, being much higher for valuable patents and for patents owned by individuals and smaller firms. Thus the patent system generates incentives, net of expected enforcement costs, that differ across inventors. Patentees with a large portfolio of patents to trade, or having other characteristics that encourage 'cooperative' interaction with disputants, more successfully avoid court actions. At the same time, key post-suit outcomes do not depend on observed characteristics. This is good news: advantages in settlement are exercised quickly, before extensive legal proceedings consume both court and firm resources. But it is bad news in that the more frequent involvement of smaller patentees in court actions is not offset by a more rapid resolution of their suits. However, our estimates of the heterogeneity in litigation risk can facilitate development of private patent litigation insurance to mitigate this adverse affect of high enforcement costs.

Since the late 1980s the global intellectual property rights (IPR) system has been strengthening dramatically as much of the developing world introduces patent protection for new drug products. This may lead to more research on drugs to address developing country needs. As there are identifiable differences in the drug demands of these countries as compared to those already offering such protection the situation offers a unique opportunity to examine the incentive role of patent protection. We use new survey data from India, the results of interviews with industry, government and multinational institutions, and measures of R&D activity constructed from a variety of statistical sources to determine trends in the allocation of research to products specific to developing country markets. There is some, although limited, evidence of an increase in the mid- to late 1980s which appears to have leveled off in the 1990s. In interpreting the trends we examine factors that might enhance, or dampen, a firm's responsiveness to the availability of product patents. The picture presented here provides a baseline' against which future research activity can be compared once the new global patent regime is fully established and uncertainty about its implementation is resolved.

This paper examines several recent avenues of empirical research into the enforcement of intellectual property rights. To frame these issues, we start with a stylized model of the patent litigation process. The bulk of the paper is devoted to linking the empirical literature on patent litigation to the parameters of this model. The four major areas we consider are (i) how the propensity to litigate patents varies with the expected benefits of litigation, (ii) the ways in which the cost of litigation affects the willingness to enforce patents, (iii) how the cost of enforcing patents changes the private value of patent rights, and (iv) the impact of intellectual property litigation on the innovation process itself.

This paper develops an estimable general equilibrium model of land leasing to test the extent to which information is commonly held in a village and whether village markets are efficient. Information regarding the relative farming skill of households is found to be widespread, but the assumption of perfectly efficient markets within the village is rejected. These results have ramifications for the estimation of agricultural household models and for our understanding of rural institutions. The model is derived from the primitives of the production technology, the extent of information and the distributions of assets and several household unobservables. Simultaneity and selection issues are dealt with explicitly in a two-stage maximum likelihood estimation procedure using panel data from India.

In support of spacecraft tracking and navigation at the Jet Propulsion Laboratory (JPL), Earth orientation measurements are currently acquired, processed, and delivered twice-per-week to the JPL navigation teams by the Time and Earth Motion Precision Observations (TEMPO) project. Because the Earth’s orientation changes rapidly and unpredictably, measurements must be acquired frequently and processed rapidly in order to meet the near-real-time Earth orientation calibration requirements of the navigation teams. These requirements are currently met by (1) conducting twice-per-week single baseline VLBI observing sessions; (2) rapidly processing the VLBI data to determine the baseline variation-of-latitude and UTO components of the Earth’s orientation; and (3) using the Kaiman Earth Orientation Filter (KEOF) to combine the TEMPO VLBI measurements with other publicly available Earth orientation measurements, including determinations and forecasts of the axial component of the atmospheric angular momentum (AAM), in order to generate and deliver the Earth orientation calibrations (polar motion and UT1) required by the navigation teams.

The decision to require that countries grant product patents for pharmaceutical innovations as a condition of membership in the World Trade Organization was very contentious. Almost fifty developing countries were not granting patent monopolies for drugs during the period the Uruguay round of GATT was being debated and these countries fiercely resisted the inclusion of this requirement, claiming that vastly higher drug prices would be associated with such patents. On the other side, business interests in the West urged them to consider the beneficial effects such protection might bring both in terms of focusing more research on tropical diseases and encouraging greater domestic and foreign investment in local research activities. This paper discusses the various theoretical implications for a developing country of introducing product patents for pharmaceuticals. Using India as an example, it then brings together information gathered from both published sources and personal interviews to examine the potential magitude of these effects. While not arriving at a conclusive answer to the question posed in the title, there are some suggestions about the way events might unfold as the policy is implemented.

This paper investigates the characteristics of litigated patents by combining for the first" time information about patent case filings from the U.S. district courts and detailed data from the" U.S. Patent and Trademark Office. We construct a series of indicators for the factors which the" theoretical literature suggests contribute to litigation: the frequency of disputes asymmetry of stakes, the structure of information, and costs. Compared to a random sample of" U.S. patents from the same cohorts and technology areas, we find that more valuable patents and" those with domestic owners are considerably more likely to be involved in litigation. Patents" owned by individuals are at least as likely to be the subject of a case as corporate patents and" litigation is particularly frequent in new technology areas. We interpret the results with reference" to theoretical models of litigation and settlement and discuss what they suggest about the effect" of patent litigation on the incentives to invest in R&D