Asphyxial deaths from the recreational use of nitrous oxide.

The recreational use of nitrous oxide is widespread. Nitrous oxide for recreational use is usually obtained from anesthesia tanks or whipped-cream machine chargers or cans. Twenty previously described deaths associated with recreational nitrous-oxide use describe anesthesia tanks and whipped-cream machine dispensors as a source. Five deaths associated with nitrous oxide use are presented; two involving whipped-cream cannisters as the source, two involving anesthesia tanks, and one involving a racing fuel tank as a source of nitrous oxide. Autopsy findings in our cases were subtle or negative, but usually suggestive of asphyxia. Through a laboratory simulation, we have confirmed that nitrous oxide displaces oxygen in a closed space, which probably leads to asphyxia. A review of the literature, neuropharmacology, and pathophysiology of nitrous oxide use is also presented.     

Entrapment of a cat in a new-style pet food container

Although many regulations exist to protect human consumers from hazardous products, there are no comparable safeguards for products intended for pet use. The authors describe a case in which a new-style cat food container presented a hazard to pets.     

The communal/exchange distinction and some implications for understanding justice in families

This article briefly reviews 10 years of research on a distinction between communal and exchange norms. Communal norms dictate benefits should be given in response to the other's needs. Exchange norms dictate benefits should be given in response to specific benefits received in the past or with the expectation of receiving specific benefits in the future. Choice of norms is shown to be influenced by the type of relationship desired or existing between two people. Evidence of chronic individual differences in tendencies to follow communal and to follow exchange norms in relationships is also presented. We argue that most people believe that communal norms should be followed in family relationships and we outline implications of the research reviewed for understanding justice in the family. Implications of (i) behavior in accord with exchange norms (e.g., quick repayment of benefits received, keeping track of individual inputs into joint tasks), (ii) behavior in accord with communal norms (e.g., helping, expressing emotion) and (iii) individual differences in relationship orientations are discussed.     

Restraint,renewal, and the Treasury Board Secretariat

Abstract: The Public Service 2000 exercise and the June 1993 government reorganization are reviewed in the context of a decade of centrally driven initiatives to improve the management and productivity of the federal public service. The work of the Treasury Board Secretariat during these initiatives is described and the changes in its modus operandi and structure are outlined. It is suggested that the most important shortcoming in the PS 2000 exercise was the failure to reconcile the renewal theme with the continuing requirement for reductions in operating budgets, and to set out the implications of expenditure restraint for the size and nature of the public service in the 1990s. What is needed for the next stage of public service renewal is not a high-profile, service-wide initiative, but a “realistic management posture” that takes adequate account of continuing fiscal restraint, arbitrariness in expenditure reduction, impact on services, technological change, limited applicability of private sector techniques, efficacy of centrally imposed controls, relationship between employment security and renewal, and finally, compensation determination. Sommaire: Cet article passe en revue le projet Fonction publique 2000 et la réorganisation gouvernementale de juin 1993, dans le contexte d'une décennie d'initiatives centrales visant à améliorer la gestion et la productivité de la Fonction publique fédérale. II décrit le travail effectué par le Secrétariat du Conseil du Trésor et précise les modifications apportées a son modus operandi et à sa structure. La principale lacune du projet FP 2000 réside dans le fait qu'on n'a pas pu concilier le thème du renouveau avec le besoin continu de réduction des budgets d'exploitation, ni définir les conséquences de l'austérité budgétaire en ce qui touche la taille et la nature de la Fonction publique dans les années 1990. Ce qu'il faut pour la prochaine étape du renouveau de la Fonction publique, ce n'est pas une initiative tres visible et à l'échelle de toute la Fonction publique mais plutôt une “ position de gestion réaliste ” qui tienne bien compte des éléments suivants: 1) poursuite de l'austérité fiscale, 2) caractère arbitraire des réductions de dépense, 3) répercussions sur les services, 4) changements technologiques, 5) applicabilité restreinte des méthodes du secteur privé, 6) efficacité des contrôles centraux, 7) rapport entre la sécurité d'emploi et le renouveau, et 8) détermination de la compensation.     

Negative expectations and self-evaluations in dysphoria

In a sample of female college students, dysphoric and intermittently dysphoric subjects, in comparison to nondysphoric subjects, were expected to perform more poorly on a game requiring eye-hand coordination. Actual performance showed no differences between these three groups. Following performance, relative to nondysphoric subjects, dysphoric and intermittently dysphoric subjects evaluated their performance more negatively. Results are discussed in terms of cognitive theories of depression and recent research. Implications for future research are suggested.     

Global economic trends and pressures on governments

Abstract: Over the last decade, Canada and the United States have performed better in relative economic terms than many had predicted. Their combined share of world output is roughly the same as it was in the early 1980s, and their success in economic restructuring suggests that both countries are well placed to meet the challenges of global competition. Global pressures on governments are reviewed under four categories. Competitive pressures will tend to reduce the scope for tax increases and increase demands for government spending in areas previously mandated through regulation. Financial pressures will induce spending to stay in close balance with revenues and will affect many areas of government policy making. “Intellectual pressures” in the form of the unusually strong consensus on what constitutes appropriate economic and social policy will influence decision-making in most countries, for at least the rest of the decade. Institutional pressures in the form of influences of foreign governments and international agencies will be less direct in the case of Canada than for economically weaker countries, but will still play an important role in shaping public policies. These global pressures also have implications for the conduct of public administration in Canada, including the need to streamline some activities, to build up others, and to adjust the compensation framework so it will attract and retain the talent needed to safeguard the competitive advantage provided by Canada's tradition of competent and honest public services. Sommaire: Au cours de la dernière décennie, l'évolution économique relative du Canada et des États-Unis a dépassé les prévisions de nombreux spécialistes. Leur part combinée du produit mondial est à peu près identique à ce qu'elle était au début des années 1980, et leur restructuration économique réussie semble avoir placé les deux pays en bonne position pour faire face aux défis de la concurrence mondiale. Nous examinons ici, dans quatre catégories, les pressions mondiales exercées sur le gouvernement. Les pressions compétitives auront tendance à réduire les possibilités d'augmentation d'impôt et à favoriser les demandes de dépenses par le gouvemement dans les domaines qui étaient auparavant réglementés. Les pressions financières feront que les dépenses resteront en équilibre avec le revenu et elles influeront sur de nombreux domaines de prise de décisions gouvernementales. Les pressions intellectuelles, sous forme d'un consensus exceptionnellement uni sur ce qu'est une politique économique et sociale appropriée, influeront sur la prise de décisions dans la plupart des pays pendant au moins le reste de cette décennie. Les pressions institictionnelles sous forme d'influence des gouvernements étrangers et des organismes internatio-naux seront moins directes dans le cas du Canada que dans celui des pays écono-miquement plus faibles, mais elles joueront néanmoins un rôle important dans la formulation des politiques gouvernementales. Ces pressions mondiales auront aussi des effets sur la conduite de l'administration publique au Canada, par exemple en créant le besoin de simplifier certaines activités, d'en renforcer d'autres et d'ajuster le régime de rémunération afin de pouvoir attirer et garder le personnel nécessaire pour maintenir l'avantage concurrentiel que représente la tradition canadienne d'un fonctionariat compétent et honnête.     

Small area analysis: a review and analysis of the North American literature

Variations in health service use rates by geographic area have long interested researchers and policymakers. Typically, investigators comparing population-based health care utilization rates among geographic areas have demonstrated substantial variations in use among seemingly similar communities. One method of investigation is "small area analysis." Numerous areas in North America have been studied extensively using this technique. This research has attempted to document the amount of variation found in health care use rates among areas; determine whether or not there is a pattern to such use in high- versus low-use areas; and identify the variables that are associated with the variation and explain a portion of the variation. Beyond this, many researchers have attempted to ascertain whether such variables are associated with characteristics of the population, whether they reflect differences in access and need, or whether a substantial portion of the variation is associated with differences in the medical care system itself. This review discusses the methods used to define the areas, the dependent variables that have been studied and the patterns found within them, the independent variables that have been tested, the statistical methods and analysis procedures used, the results of each study, and the policy recommendations emanating from the research. More importantly, based on what has been learned, the paper provides researchers in small area analysis with a set of recommendations for both analyzing and reporting results. These recommendations are designed to facilitate the development of a common research methodology, increase the comparability across studies, and enhance the use of this technique in the health policy formulation process.     

From Foster Care to Adulthood: The Role of Income

This study explores the role of income for young people with experience in foster care transitioning to adulthood. It draws on in-depth structured interviews with eight staff members and 38 current and former foster youths age 18 years and older, who were participants in an innovative program to build their assets and financial capability. Interviews took place in four sites in three states. This study illuminates how those with experience in foster care seek to obtain and manage money to transition successfully to adult financial roles. Findings suggest that early and practical experiences with money are important for gaining financial capability. The study also highlights the need for child welfare professionals to develop expertise in financial literacy and understand the pitfalls that lie in both traditional and nontraditional financial services. By deepening understanding among staff of the economic realities facing the young people today, child welfare agencies will be more likely to prepare former foster youths for life on their own.