Research on the tendency of governments to trade off welfare spending for defense has generated diverse and often contradictory findings. This study attempts to clarify the issue of trade-offs by examining expenditure patterns since 1948 for the four major NA TO allies: United States, United Kingdom, Federal Republic of Germany, and France. When viewed from the perspective of long-term trends in shares of outlays, trade-offs are evident. When short-term changes in expenditure, which are more germane to the potential for one spending category to benefit at the expense of the other are studied, no pattern of trade-off can be detected. A three-equation model is estimated to control for the variety of possible determining factors of public resource allocation. In none of the four nations does a pattern of trade-off emerge, except in periods of wartime or postwar reconstruction. These findings are consistent with the ability of governments to finance new spending through either increased taxes or larger budget deficits. The growing disinclination to use these methods, however, suggests that the potential for trade-offs has perhaps reappeared in the 1980s.

We describe a novel variant in the terminal exon of human elastin, c.2318 GϾA, resulting in an amino acid substitution of glycine 773 to aspartate (G773D) in a pedigree with severe early-onset chronic obstructive pulmonary disease (COPD). Transfection studies with elastin cDNAs demonstrate that the glycine to aspartate change compromises the ability of the mutant protein to undergo normal elastin assembly. Other functional consequences of this amino acid substitution include altered proteolytic susceptibility of the C-terminal region of elastin and reduced interaction of the exon 36 sequence with matrix receptors on cells. These results suggest that the G773D variant confers structural and functional consequences relevant to the pathogenesis of COPD.

This study examines the effects of a home health intervention designed to standardize nursing care, strengthen nurses' support for patient self-management and yield better CHF patient outcomes. Participants were 371 Medicare CHF patients served by 205 nurses randomized to intervention and control groups in a large urban home healthcare agency (HHA). The intervention consisted of an evidence-based nursing protocol, patient self-care guide, and training to improve nurses'teaching and support skills. Outcome measures included home care,physician and emergency department (ED) use, hospital admission, condition-specific quality of life (QoL), satisfaction with home care services and survival at 90 days. The intervention was associated with a marginally significant reduction in the volume of skilled nursing visits (p = .074), and a reduction variation in the typical number of visits provided (p < .05), without a significant increase in physician or ED use or patient mortality. Hypothesized improvement in other outcomes did not occur.

This study is the first to examine adverse events of bivalent rLP2086 in a real-world setting where more than 90% of a college-age population was vaccinated.