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The Women's Health Initiative (WHI) has been a major contributor to diet and chronic disease research among postmenopausal US women over its 30+ year history (1993 to present). The WHI program included full-scale randomized trials of a low-fat dietary pattern high in fruits, vegetables, and grains, and of calcium and vitamin D supplementation, each with designated primary and secondary chronic disease outcomes. The history of these trials will be briefly reviewed here, along with principal findings that included evidence for breast cancer-related benefits for each of the 2 interventions. In recent years, WHI investigators have developed an active research program in nutritional biomarker development and in the application of these biomarkers in WHI cohorts, among various other nutritional epidemiology uses of WHI observational study resources. The intake biomarker work, which primarily relies on blood and urine metabolomics profiles, lends support to the low-fat dietary pattern trial results, and supports chronic disease benefits of higher carbohydrate diets more generally, especially through the fiber component of carbohydrate. [ABSTRACT FROM AUTHOR]

In silico mechanistic modeling approaches have been designed by various stakeholders with the goal of supporting development and approval of generic orally inhaled drug products in the United States. This review summarizes the presentations and panel discussion that comprised a workshop session concentrated on the use of in silico models to predict various outcomes following orally inhaled drug product administration, including the status of such models and how model credibility may be effectively established. [ABSTRACT FROM AUTHOR]

Hiring new dermatology faculty at academic medical centers (AMCs) can be a difficult process. Academic dermatology departments, however, must have the financial freedom to nimbly respond to the needs of their community. To determine the downstream revenue and profitability produced by dermatology faculty, a retrospective review of charges and expenses downstream of professional services was performed to assess dermatology faculty and nurse practitioners from January 2019 to December 2020 at a single AMC in the southern United States. The downstream revenue per dermatology faculty was calculated using institutional data based on the number of services performed and the exact compensation per service. When this was not possible, the Medicare Allowable Charge was used to estimate the compensation for the service provided. Revenue was included from internal referrals to dermatopathology, Mohs surgery and repairs, chemistry and microbiology labs, radiology, and phototherapy. Profitability was calculated using institutional cost data to estimate the expense of each additional unit of services performed. The most valuable source of downstream income was dermatopathology services, which generated $85,395/provider in 2019 and $102,746/provider in 2020. Mohs surgery was also a significant source of downstream revenue contributing $92,715 in 2019 and $96,599 in 2020. Repairs after Mohs surgery internal referrals generated $30,036 in 2019 and $36,507 in 2020. The total contributions of chemistry and microbiology labs, radiology, and phototherapy were considerable but less impactful overall. The total downstream revenue calculated from these services for 2019 was $228,304/provider and $255,549 in 2020. The total downstream profitability for these services was calculated to be $112,597/provider in 2019 and $92,344/provider in 2020. In conclusion, faculty of academic dermatology departments produces a great deal more revenue and profitability for AMCs than the sum of their professional charges. [ABSTRACT FROM AUTHOR]

Introduction/Goals: Over the past decade, cosmetic surgical procedures have become increasingly popular. This trend has been driven by procedural innovations as well as access to Internet and social media. Consequently, patients have been seeking cosmetic surgical procedures at younger ages. In this narrative review, studies assessing attitudes towards cosmetic surgical procedures among college-aged young adults were evaluated. Methods: A search identified 20 studies published from 2002 to 2021 that focused on cosmetic surgical procedures among young adults. Each study used survey-based data to determine attitudes, acceptance, interests, perceptions, and beliefs about cosmetic surgical procedures among college-aged students in the United States. Results: The proportion of college-aged participants who had undergone cosmetic surgical procedures ranged from 1.3% to 6.4% with surveys reporting that between 21 and 43% were interested in procedures in the future. In general, young women were more likely to express interest in cosmetic surgical procedures than young men. Studies consistently demonstrated an inverse relationship between body satisfaction and use of aesthetic procedures among this patient population. Other factors associated with acceptance and approval of cosmetic surgical procedures included importance of appearance to self-worth, concern with social standing and attractiveness, investment in appearance, media influence on body image, and positive attitudes towards celebrities. Exposure to cosmetic surgery advertising was correlated with increased approval of cosmetic surgical procedures, especially the perception that advertising influences "others" more than survey respondents themselves. Conclusion: Interest in cosmetic surgical procedures continues to grow among young adults in the United States. In the future, this cohort is likely to become an increasingly important demographic to target for education, advertising, and research regarding cosmetic surgical procedures. [ABSTRACT FROM AUTHOR]

Background: Skin cancers are the most common malignancies in the United States. Total body skin examination by a physician, especially a dermatologist, is the gold standard for detecting suspicious lesions that may require further evaluation. Non‐medical professionals (NMPs) including massage therapists, estheticians, hairdressers, and cosmetologists have the unique opportunity to frequently examine their client's skin outside of a clinical setting. By evaluating their knowledge of and comfort with evaluation of suspicious lesions, multiple studies have gauged the utility of patient encounters with NMPs for skin cancer detection. Several studies have also focused on assessment of intervention strategies for assessing and improving NMPs ability to detect suspicious lesions and to refer for physician evaluation when necessary. Aims: To conduct a narrative review of skin cancer knowledge, attitudes, and practices among NMPs. Patients/Methods: A systematic search of the databases yielded 16 studies for review. A total of 8 cross‐sectional studies examined the knowledge and attitudes of NMPs toward skin evaluation, and 8 studies assessed interventional strategies for improving NMPs' ability to assess skin lesions for consideration of physician referral. Results: This review finds that NMPs are open to the idea of examining the exposed body surfaces relevant to their work with clients and are willing to refer for physician evaluation when needed. Multiple interventional strategies have demonstrated success with educating NMPs on the importance of skin surveillance and the characteristic physical examination findings associated with skin cancers. Conclusion: Strengthening the readiness of NMPs to examine their client's skin offers an opportunity to reduce time to skin cancer diagnosis, improve patient outcomes, and lower healthcare‐associated costs of skin cancer treatment. [ABSTRACT FROM AUTHOR]

The health benefits and risks of menopausal hormone therapy among women aged 50–59 years are examined in the Women's Health Initiative randomized, placebo-controlled trials using long-term follow-up data and a parsimonious statistical model that leverages data from older participants to increase precision. These trials enrolled 27,347 healthy postmenopausal women aged 50–79 years at 40 US clinical centers during 1993–1998, including 10,739 post-hysterectomy participants in a trial of conjugated equine estrogens and 16,608 participants with a uterus in the trial of these estrogens plus medroxyprogesterone acetate. Over a (median) 18-year follow-up period (1993–2016), risk for a global index (defined as the earliest of coronary heart disease, invasive breast cancer, stroke, pulmonary embolism, colorectal cancer, endometrial cancer, hip fracture, and all-cause mortality) was reduced with conjugated equine estrogens with a hazard ratio of 0.82 (95% confidence interval: 0.71, 0.95), and with nominally significant reductions for coronary heart disease, breast cancer, hip fracture, and all-cause mortality. Corresponding global index hazard ratio estimates of 1.06 (95% confidence interval: 0.95, 1.19) were nonsignificant for combined estrogens plus progestin, but increased breast cancer risk and reduced endometrial cancer risk were observed. These results, among women 50–59 years of age, substantially agree with the worldwide observational literature, with the exception of breast cancer for estrogens alone. [ABSTRACT FROM AUTHOR]

Background: The carbon isotope ratio (CIR) is a proposed biomarker for added sugar (AS) intake in the United States; however, because the CIR is also associated with meat intake in most populations the need for specificity remains. The CIR of amino acids (AAs) has the potential to differentiate sugars from meat intakes, because essential AAs must derive from dietary protein whereas certain nonessential AAs can be synthesized from sugars.Objectives: We tested whether serum CIR-AAs in combination with participant characteristics could meet a prespecified biomarker criterion for AS intake in the Nutrition and Physical Activity Assessment Study Feeding Study (NPAAS-FS) of the Women's Health Initiative, a population in which the whole-serum CIR was not associated with AS intake.Methods: Postmenopausal women (n = 145) from Seattle, WA, were provided with individualized diets that approximated their habitual food intakes for 2 wk. Dietary intakes from consumed foods were characterized over the feeding period using the Nutrition Data System for Research. The CIR of 7 AAs-Ala, Gly, Val, Leu, Ile, Pro, and Phe-were measured in fasting serum collected at the end of the 2-wk feeding period, using gas chromatography-combustion isotope ratio mass spectrometry. Biomarker models were evaluated using regression R2 ≥ 0.36 as a major biomarker criterion, based on the benchmark R2 values of well-established recovery biomarkers in the NPAAS-FS.Results: AS intake was associated with CIR-Ala (ρ = 0.32; P < 0.0001). A model of AS intake based on CIR-Ala, CIR-Gly, CIR-Ile, smoking, leisure physical activity, and body weight met the biomarker criterion (R2 = 0.37). Biomarker-estimated AS intake was not associated with meat or animal protein intake.Conclusions: Results support serum CIR-AAs in combination with participant characteristics as potential biomarkers of AS intake in US populations, including those with low AS intake.The Women's Health Initiative is registered at clinicaltrials.gov (NCT00000611). [ABSTRACT FROM AUTHOR]

The article reports on the market-based evaluation of discretionary accrual models in the U.S. The study examined uses a simple earnings model on 5 discretionary accrual models to develop a managerial discretion hypothesis which assumes an efficient market. Discretionary accruals can aid managers in producing reliable and timely measures of a firm's financial performance. Opportunistic accrual management is used to hide poor performance or slow down uncommonly good earnings until future earnings periods.

The article investigates the economic incentives of managers of corporations to voluntarily provide interim reports in the United States. It analyzes why corporations choose a particular reporting frequency for external purposes. The history of interim reporting requirements is examined. The characteristics of a sample of firms drawn from a time period relatively free of mandated interim reporting are described. The article analyzes the capital structures, asset composition, and monitoring devices employed by the firms.

Importance: Health outcomes from the Women's Health Initiative Estrogen Plus Progestin and Estrogen-Alone Trials have been reported, but previous publications have generally not focused on all-cause and cause-specific mortality.Objective: To examine total and cause-specific cumulative mortality, including during the intervention and extended postintervention follow-up, of the 2 Women's Health Initiative hormone therapy trials.Design, Setting, and Participants: Observational follow-up of US multiethnic postmenopausal women aged 50 to 79 years enrolled in 2 randomized clinical trials between 1993 and 1998 and followed up through December 31, 2014.Interventions: Conjugated equine estrogens (CEE, 0.625 mg/d) plus medroxyprogesterone acetate (MPA, 2.5 mg/d) (n = 8506) vs placebo (n = 8102) for 5.6 years (median) or CEE alone (n = 5310) vs placebo (n = 5429) for 7.2 years (median).Main Outcomes and Measures: All-cause mortality (primary outcome) and cause-specific mortality (cardiovascular disease mortality, cancer mortality, and other major causes of mortality) in the 2 trials pooled and in each trial individually, with prespecified analyses by 10-year age group based on age at time of randomization.Results: Among 27 347 women who were randomized (baseline mean [SD] age, 63.4 [7.2] years; 80.6% white), mortality follow-up was available for more than 98%. During the cumulative 18-year follow-up, 7489 deaths occurred (1088 deaths during the intervention phase and 6401 deaths during postintervention follow-up). All-cause mortality was 27.1% in the hormone therapy group vs 27.6% in the placebo group (hazard ratio [HR], 0.99 [95% CI, 0.94-1.03]) in the overall pooled cohort; with CEE plus MPA, the HR was 1.02 (95% CI, 0.96-1.08); and with CEE alone, the HR was 0.94 (95% CI, 0.88-1.01). In the pooled cohort for cardiovascular mortality, the HR was 1.00 (95% CI, 0.92-1.08 [8.9 % with hormone therapy vs 9.0% with placebo]); for total cancer mortality, the HR was 1.03 (95% CI, 0.95-1.12 [8.2 % with hormone therapy vs 8.0% with placebo]); and for other causes, the HR was 0.95 (95% CI, 0.88-1.02 [10.0% with hormone therapy vs 10.7% with placebo]), and results did not differ significantly between trials. When examined by 10-year age groups comparing younger women (aged 50-59 years) to older women (aged 70-79 years) in the pooled cohort, the ratio of nominal HRs for all-cause mortality was 0.61 (95% CI, 0.43-0.87) during the intervention phase and the ratio was 0.87 (95% CI, 0.76-1.00) during cumulative 18-year follow-up, without significant heterogeneity between trials.Conclusions and Relevance: Among postmenopausal women, hormone therapy with CEE plus MPA for a median of 5.6 years or with CEE alone for a median of 7.2 years was not associated with risk of all-cause, cardiovascular, or cancer mortality during a cumulative follow-up of 18 years.Trial Registration: clinicaltrials.gov Identifier: NCT00000611. [ABSTRACT FROM AUTHOR]

Dietary Reference Intakes (DRIs) are used in Canada and the United States in planning and assessing diets of apparently healthy individuals and population groups. The approaches used to establish DRIs on the basis of classical nutrient deficiencies and/or toxicities have worked well. However, it has proved to be more challenging to base DRI values on chronic disease endpoints; deviations from the traditional framework were often required, and in some cases, DRI values were not established for intakes that affected chronic disease outcomes despite evidence that supported a relation. The increasing proportions of elderly citizens, the growing prevalence of chronic diseases, and the persistently high prevalence of overweight and obesity, which predispose to chronic disease, highlight the importance of understanding the impact of nutrition on chronic disease prevention and control. A multidisciplinary working group sponsored by the Canadian and US government DRI steering committees met from November 2014 to April 2016 to identify options for addressing key scientific challenges encountered in the use of chronic disease endpoints to establish reference values. The working group focused on 3 key questions: 1) What are the important evidentiary challenges for selecting and using chronic disease endpoints in future DRI reviews, 2) what intake-response models can future DRI committees consider when using chronic disease endpoints, and 3) what are the arguments for and against continuing to include chronic disease endpoints in future DRI reviews? This report outlines the range of options identified by the working group for answering these key questions, as well as the strengths and weaknesses of each option. [ABSTRACT FROM AUTHOR]

Total energy consumption and activity-related energy expenditure (AREE) estimates that have been calibrated using biomarkers to correct for measurement error were simultaneously associated with the risks of cardiovascular disease, cancer, and diabetes among postmenopausal women who were enrolled in the Women's Health Initiative at 40 US clinical centers and followed from 1994 to the present. Calibrated energy consumption was found to be positively related, and AREE inversely related, to the risks of various cardiovascular diseases, cancers, and diabetes. These associations were not evident in most corresponding analyses that did not correct for measurement error. However, an important analytical caveat relates to the role of body mass index (BMI) (weight (kg)/height (m)2). In the calibrated variable analyses, BMI was regarded, along with self-reported data, as a source of information on energy consumption and physical activity, and BMI was otherwise excluded from the disease risk models. This approach cannot be fully justified with available data, and the analyses herein imply a need for improved dietary and physical activity assessment methods and for longitudinal self-reported and biomarker data to test and relax modeling assumptions. Estimated hazard ratios for 20% increases in total energy consumption and AREE, respectively, were as follows: 1.49 (95% confidence interval: 1.18, 1.88) and 0.80 (95% confidence interval: 0.69, 0.92) for total cardiovascular disease; 1.43 (95% confidence interval: 1.17, 1.73) and 0.84 (95% confidence interval: 0.73, 0.96) for total invasive cancer; and 4.17 (95% confidence interval: 2.68, 6.49) and 0.60 (95% confidence interval: 0.44, 0.83) for diabetes. [ABSTRACT FROM PUBLISHER]

Background: The effects of dietary protein on bone health are controversial. Objective: We examined the relation between protein intake with fracture and bone mineral density (BMD) within the Women's Health Initiative (WHI). Design: This prospective analysis included 144,580 women aged 50-79 y at baseline in the WHI clinical trials (CTs) and observational study (OS) that recruited participants in 1993-1998 with follow-up through 2011. Self-reported clinical fractures were collected semiannually through the original end of the trials (WHI CTs) and annually (WHI OS) by questionnaires. Hip fracture was adjudicated by a central review of radiology reports. BMDs for total body, hip, and spine were measured at baseline and 3 and 6 y in 9062 women at 3 WHI clinics by using dual-energy X-ray absorptiometry. Protein intake was assessed via food-frequency questionnaire and calibrated by using biomarkers of energy and protein intakes. Associations between protein intake and fracture were estimated by using Cox proportional hazards regression, and the relation between protein intake and BMD was estimated by using linear regression. Results: Median biomarker-calibrated protein intake was 15% of energy intake. Per 20% increase in calibrated protein intake (percentage of energy), there was no significant association with total fracture (HR: 0.99; 95% CI: 0.97, 1.02) or hip fracture (HR: 0.91; 95% CI: 0.84, 1.00), but there was an inverse association with forearm fracture (HR: 0.93; 95% CI: 0.88, 0.98). Each 20% increase in calibrated protein intake was associated with a significantly higher BMD for total body (mean 3-y change: 0.003 g/cm²; 95% CI: 0.001, 0.005 g/cm²) and hip (mean 3-y change: 0.002 g/cm²; 95% CI: 0.001, 0.004 g/cm²). Conclusions: Higher biomarker-calibrated protein intake within the range of usual intake was inversely associated with forearm fracture and was associated with better maintenance of total and hip BMDs. These data suggest higher protein intake is not detrimental to bone health in postmenopausal women. The WHI program was registered at clinicaltrials.gov as NCT00000611. [ABSTRACT FROM AUTHOR]

Abstract: In 1926, Frederic Wood Jones, professor of Anatomy at the University of Adelaide and a leading figure in the British anatomical world, took a Rockefeller Foundation funded trip to the United States in order to inspect anatomy programmes and medical museums and to meet leading figures in the anatomical and anthropological world. His later reflections paint a picture of a discipline in transition. Physical anthropology and gross anatomy were coming to a crisis point in the United States, increasingly displaced by research in histology, embryology and radiological anatomy. Meanwhile, in Britain and its colonial outposts, anatomists such as Wood Jones were attempting to re-invigorate the discipline in the field, studying biological specimens as functional and active agents in their particular milieus, but with human dissection at the core. Thus, an examination of this trip allows us to see how the interaction between two traditions in anatomy informed the process of the development of human biology in this critical period. [Copyright &y& Elsevier]

Regression calibration using biomarkers provides an attractive approach to strengthening nutritional epidemiology. We consider this approach to assessing the relationship of fat and total energy consumption with postmenopausal breast cancer. In analyses that included fat density data, biomarker-calibrated total energy was positively associated with postmenopausal breast cancer incidence in cohorts of the US Women's Health Initiative from 1994–2010. The estimated hazard ratio for a 20% increment in calibrated food frequency questionnaire (FFQ) energy was 1.22 (95% confidence interval (CI): 1.15, 1.30). This association was not evident without biomarker calibration, and it ceased to be apparent following control for body mass index (weight (kg)/height (m)2), suggesting that the association is mediated by body fat deposition over time. The hazard ratio for a corresponding 40% increment in FFQ fat density was 1.05 (95% CI: 1.00, 1.09). A stronger fat density association, with a hazard ratio of 1.19 (95% CI: 1.00, 1.41), emerged from analyses that used 4-day food records for dietary assessment. FFQ-based analyses were also carried out by using a second dietary assessment in place of the biomarker for calibration. This type of calibration did not correct for systematic bias in energy assessment, but may be able to accommodate the “noise” component of dietary measurement error. Implications for epidemiologic applications more generally are described. [ABSTRACT FROM PUBLISHER]

Objectives To determine whether preservation of physical function with aging may be partially met through modification in dietary protein intake. Design Prospective cohort study. Setting Women's Health Initiative (WHI) Clinical Trials (CT) and Observational Study (OS) conducted at 40 clinical centers. Participants Women aged 50 to 79 (N = 134,961) with dietary data and one or more physical function measures. Measurements Physical function was assessed using the short-form RAND-36 at baseline and annually beginning in 2005 for all WHI participants and at closeout for CT participants (average ~7 years after baseline). In a subset of 5,346 participants, physical performance measures (grip strength, number of chair stands in 15 seconds, and timed 6-m walk) were assessed at baseline and Years 1, 3, and 6. Calibrated energy and protein intake were derived from regression equations using baseline food frequency questionnaire data collected on the entire cohort and doubly labeled water and 24-hour urinary nitrogen collected from a representative sample as reference measures. Associations between calibrated protein intake and each of the physical function measures were assessed using generalized estimating equations. Results Calibrated protein intake ranged from 6.6% to 22.3% energy. Higher calibrated protein intake at baseline was associated with higher self-reported physical function (quintile (Q)5, 85.6, 95% confidence interval (CI) = 81.9-87.5; Q1, 75.4, 95% CI = 73.2-78.5, Ptrend = .002) and a slower rate of functional decline (annualized change: Q5, −0.47, 95% CI = −0.63 to −0.39; Q1, −0.98, 95% CI = −1.18 to −0.75, Ptrend = .02). Women with higher calibrated protein intake also had greater grip strength at baseline (Q5, 24.7 kg, 95% CI = 24.3-25.2 kg; Q1, 24.1 kg, 95% CI = 23.6-24.5 kg, Ptrend = .04) and slower declines in grip strength (annualized change: Q5, −0.45 kg, 95% CI = −0.39 to −0.63 kg; Q1, −0.59 kg, 95% CI = −0.50 to −0.66 kg, Ptrend = .03). Women with higher calibrated protein intake also completed more chair stands at baseline (Q5, 7.11, 95% CI = 6.91-7.26; Q1, 6.61, 95% CI = 6.46-6.76, Ptrend = .002). Conclusion Higher calibrated protein intake is associated with better physical function and performance and slower rates of decline in postmenopausal women. [ABSTRACT FROM AUTHOR]

We used a biomarker of activity-related energy expenditure (AREE) to assess measurement properties of self-reported physical activity and to determine the usefulness of AREE regression calibration equations in the Women's Health Initiative. Biomarker AREE, calculated as the total energy expenditure from doubly labeled water minus the resting energy expenditure from indirect calorimetry, was assessed in 450 Women's Health Initiative participants (2007–2009). Self-reported AREE was obtained from the Arizona Activity Frequency Questionnaire (AAFQ), the 7-Day Physical Activity Recall (PAR), and the Women's Health Initiative Personal Habits Questionnaire (PHQ). Eighty-eight participants repeated the protocol 6 months later. Reporting error, measured as log(self-report AREE) minus log(biomarker AREE), was regressed on participant characteristics for each instrument. Body mass index was associated with underreporting on the AAFQ and PHQ but overreporting on PAR. Blacks and Hispanics underreported physical activity levels on the AAFQ and PAR, respectively. Underreporting decreased with age for the PAR and PHQ. Regressing logbiomarker AREE on logself-reported AREE revealed that self-report alone explained minimal biomarker variance (R2 = 7.6, 4.8, and 3.4 for AAFQ, PAR, and PHQ, respectively). R2 increased to 25.2, 21.5, and 21.8, respectively, when participant characteristics were included. Six-month repeatability data adjusted for temporal biomarker variation, improving R2 to 79.4, 67.8, and 68.7 for AAFQ, PAR, and PHQ, respectively. Calibration equations “recover” substantial variation in average AREE and valuably enhance AREE self-assessment. [ABSTRACT FROM PUBLISHER]

Background: Nutritional epidemiology cohort studies primarily use food frequency questionnaires (FFQs). In part because FFQs are more reliable for nutrient densities than for absolute nutrient consumption, reports from association studies typically present only nutrient density measures in relation to disease risk.Methods: We used objective biomarkers to correct FFQ assessments for measurement error, and examined absolute energy and protein consumption in relation to cardiovascular disease incidence. FFQs and subsequent physician-adjudicated cardiovascular disease incidence were assessed for 80,370 postmenopausal women in the age range 50-79 years at enrollment in the comparison group of the Dietary Modification Trial or the prospective Observational Study in the Women's Health Initiative. Urinary recovery biomarkers of energy and protein were obtained from a subsample of 544 women, with concurrent FFQ information.Results: After biomarker correction, energy consumption was positively associated with coronary heart disease incidence (hazard ratio = 1.18; 95% confidence interval = 1.04-1.33, for 20% consumption increment) and protein density was inversely associated (0.85 [0.75-0.97]). The positive energy association appeared to be mediated by body fat accumulation. Ischemic stroke incidence was inversely associated with energy and protein consumption, but not with protein density.Conclusions: A positive association between energy and coronary heart disease risk can be attributed to body mass accumulation. Ischemic stroke risk is inversely associated with energy and protein consumption, possibly due to correlations between consumption and physical activity. [ABSTRACT FROM AUTHOR]

This paper addresses the issues that confront the FASB and IASB in developing a new conceptual framework document. First, we suggest characteristics that a conceptual framework ought to exhibit. Most of these suggestions are based on our critique of the existing framework and the FASB-IASB work in progress. Second, we present a model framework that exhibits these characteristics. We emphasize up front that this framework is quite explicit. It goes to the heart of what a framework document should do: it places specific restrictions on what constitutes admissible accounting standards. The purpose of our effort is to stimulate broad discussion of alternative approaches to foundational documents and to offer a specific example of such an alternative approach. [ABSTRACT FROM AUTHOR]

The Financial Accounting Standards Board (hereafter, FASB) and the International Accounting Standard Board (hereafter, IASB) issued a joint discussion paper titled Preliminary Views on Financial Statement Presentation. The Boards are seeking comments on whether their proposed model for financial statement presentation would improve the usefulness of the financial statement information for financial decision makers. This paper sets forth the American Accounting Association Financial Accounting Standards Committee (hereafter, the committee) summary comments as well as responses to several of the FASB's and IASB's (hereafter, jointly mentioned, the Boards) specific objectives and principles-related questions. Overall, the committee believes that the model has several appealing features, but also has several potential problems. Many of the problems discussed related to potential learning impediments for users to adapt to the new presentation format. [ABSTRACT FROM AUTHOR]

The Securities and Exchange Commission (hereafter, SEC) issued a call for comment on a proposal to adopt a roadmap for potential use of international financial reporting standards (hereafter, IFRS) by U.S. companies. We comment on five key issues raised by the SEC proposal. First, we propose that the need for a global regulator is overstated. A global regulator is unlikely to help achieve the stated goals of comparability and consistency of financial reporting on a global basis. We favor allowing U.S. companies to choose use of U.S. GAAP or IFRS rather than mandating one global monopoly set of standards. Second, we agree that the focus on auditing is a very relevant issue that deserves more attention from standard setters. Gains from adopting principles-based accounting standards such as IFRS are likely to be realized only if auditors are also principles-based. Third, while we have serious concerns about governance and financing mechanisms of the International Accounting Standards Board (hereafter, IASB), we recommend that all regulatory actions cannot be held to a standstill while structural changes are made to the IASB. Fourth, we are not in favor of requiring reconciliation schedules from U.S. companies using IFRS. We view such reconciliations as being costly and unnecessary. Fifth, we recommend that the SEC pay more explicit attention to the educational and professional judgment consequences of its proposals. [ABSTRACT FROM AUTHOR]

The SEC has proposed a strategic plan that sets out its mission, vision, and values, four strategic goals, a set of desired outcomes associated with each strategic goal, and a list of performance measures for assessing the SEC's effectiveness in attaining its goals. We affirm the need for vigorous enforcement of securities law and offer some research-based insights and performance indicators. We also acknowledge the importance of disclosure, but propose that the SEC needs to develop a disclosure framework and develop better operational indicators of quality of disclosure. It is important to appreciate the benefits of disclosure as well as its limits and potential dysfunctional consequences. We also discuss the need for an independent accounting standard setter and recommend that the SEC take a greater role in enhancing the independence of the FASB. [ABSTRACT FROM AUTHOR]

The article focuses on the Office of Legal Counsel (OLC) at the Department of Justice. The OLC is often referred to as the "Attorney General's" lawyer and is tasked to write legal opinions on behalf of the Attorney General. It derives its authority from both the U.S. Congress and the Attorney General. Ethical considerations with which the OLC must deal and the minimal oversight mechanisms in place are discussed. The lack of oversight at the OLC is stressed and a solution to fix this lack of oversight is proposed.

Current evidence about nutrition and health is largely from observational studies. A reliance on observational studies may be justified given the many important hypotheses related to the health benefits and risks of foods, nutrients, and dietary patterns, and the cost and logistic challenges of carrying out long-term randomized controlled dietary intervention trials to test such hypotheses. This commentary argues that among the many limitations of observational nutrition studies, measurement error is one of the most serious yet often ignored. [ABSTRACT FROM AUTHOR]

The article discusses the Women's Health Initiative Dietary Modification Trial in the United States and the incidence of breast cancer.The study randomly assigned postmenopausal women to a dietary modification intervention, which reduced total fat intake and increased consumption of fruit, vegetables, and grains, or to a comparison group. Data is provided showing participant demographics, body weight, and nutrient consumption, as well as blood biomarkers, tumor characteristics, and blood hormone concentrations. Clinical outcomes statistics and Kaplan-Meier estimates of risk are illustrated. The authors concluded that a low-fat dietary program did not significantly reduce the breast-cancer risk in postmenopausal women.

The article discusses the Women's Health Initiative Dietary Modification Trial in the United States. The main outcome measures test the hypothesis that dietary intervention can reduce the risk of cardiovascular disease (CVD). Women were randomly assigned to the intervention group, which reduced their total fat intake and increased intake of fruits/vegetables/grains, or to a comparison group. Data is provided showing Kaplan-Meier estimates for coronary heart disease (CHD) and stroke, the risk of CHD in various groups, baseline and follow-up nutrient intakes, and characteristics of the participants. The results indicate there was no significant risk reduction for CHD, stroke, or CVD in postmenopausal women.

Cancer represents a serious threat to the health of women and men living in the USA. As the second leading cause of death, it claims about 500,000 lives annually. Health disparities occur when there are differences in the incidence, prevalence, mortality, and burden of disease among specific sub-populations within a specified region. For decades, disparities have been reported among Americans from racial/ethnic minority groups and those from low income groups. African Americans, the largest racial minority group in the USA, have the highest cancer incidence and mortality rates in the USA; it is about 10% higher in African Americans than in white people. Inequities in insurance status among Americans adversely affect their ability to obtain the entire range of cancer care. Those who are members of ethnic minorities and the working poor are especially apt to have poorer access to care and reduced quality of cancer care services as a result. [ABSTRACT FROM AUTHOR]

Abstract This paper examines the dynamic relationship between belief in conventional morality and minor forms of deviant behavior. It argues that social control theory offers a less-powerful explanation of deviance than cultural deviance perspectives because logically it cannot explain why persons select one deviant act over another. Nevertheless, control theory offers a more parsimonious conceptualization of belief and deviance, and therefore, if supported empirically, should be retained over competing theories. Drawing on this framework, a dynamic model of the reciprocal causal structure of belief and deviance is specified, and hypotheses about substantive and measurement processes are derived. A structural equation model for panel data allowing for response errors is estimated using the maximum likelihood estimator of Joreskog's LISREL approach. The data, drawn from the Youth in Transition Project, provide four waves of data on a national sample of tenth-grade boys. The results fail to replicate previous research, which found support for social control theory's stipulation of the relationship between belief and deviance. Contrary to previous results of cross-sectional studies, the effect of belief on deviance is relatively small and dwarfed by the effect of deviance on belief. [ABSTRACT FROM AUTHOR]

The late Donald R. Cressey (1919–1987) was a central figure in twentieth century American criminology. A distinctive feature of criminology since the 1930s has been the dominance of sociology among the various disciplines studying crime and criminal justice. Cressey's contributions to the sociology of crime and delinquency came from his teaching, scholarship, and involvement in criminal justice policy. He was best known for his carrying on the tradition of Edwin Sutherland in taking Sutherland's criminology textbook through many revised editions after Sutherland's passing and for his pioneering, innovative contributions to the study of organized crime, prisons, and criminological theory. He also made central and lasting contributions to the sociology of criminal law and white collar crime. His ideas in each of these areas are reviewed to produce a portrait or profile of what he added to criminology, to remind those who know it already and to introduce it to those who may not. [ABSTRACT FROM AUTHOR]

Restoration of the Kissimmee River and floodplain ultimately will involve restoring 70 km of river channel and riparian zone and 11,000 ha of wetland over a period of two decades. Restoring ecosystem integrity is a crucial goal of the project, and the evaluation program is designed to assess the success of this endeavor. Major components of the riverine and floodplain ecosystem will be evaluated, guided by conceptual models of their structure and function. These studies will be referenced to historic conditions of the past and to present-day conditions in the channelized system. Enhanced connectivity and interactions between the river and floodplain, the interplay of abiotic and biotic variables, and interactions between trophic levels will restructure the channelized river and the largely drained floodplain that now exist. The key to evaluating the success of this ambitious project will be selecting measurements of the structure and function of the river and floodplain ecosystems that are responsive to this large-scale manipulation. The timing and duration of floodplain inundation, improved dissolved oxygen conditions, germination and establishment of wetland vegetation, and enhancement and expansion of rheophilic benthic invertebrate populations are critical initial elements of restoration. Further expected outcomes are an increase in the primary productivity of the ecosystem, expansion of the fish community into the reopened channels and onto the reflooded floodplain, and improved visitation and use by waterbirds in the restored regions. We highlight predictions of some of these key linkages and primary structural and functional attributes of the restored river and floodplain that should be measured. [ABSTRACT FROM AUTHOR]

Post-1970 nonmetropolitan population shifts are examined by dividing nonmetropolitan counties into ten cohorts based on the duration and direction of consistent population change since 1920. Analysis indicates that the post-1970 gains reported by Beale are pervasive in nonmetropolitan America, occurring even in a majority of the counties that lost population consistently from 1920 to 1970. Growth was greatest in countries adjacent to metropolitan areas but was more than urban spillover effect. In a clear break with traditional patterns, net inmigration contributed significantly to overall population gain and was particularly strong among countries without an urban center. The rate of natural increase continued to slow in the post-1970 period, with natural decrease becoming common among countries with protracted histories of population decline. [ABSTRACT FROM AUTHOR]

The Section 201 of the 1974 U.S. Trade Act states that a domestic industry can obtain a temporary protection against imports by demonstrating, first, that it has been injured and second, that increased imports have been a substantial cause of injury. This article sets forth a straightforward economic and statistical framework for use in Section 201 cases and for more general analyses of the effects of imports on domestic industries. The attribution injury in Section 201 cases is in principle a straightforward task. In practice, however, problems arise. The main one is that statistical analyses that use different data and different specifications can lead to different results in borderline cases.

The article examines the duration of homeless careers. It is believed that during the past decade, homelessness in the United States has been recognized by policymakers, social scientists, and the general citizenry as one of the nation's major social problems. The article further, tries to address issues concerning the individual characteristics and experiences that increase the likelihood of becoming homeless, the circumstances leading to lengthy homeless careers, and the conditions enhancing individuals' chances for exiting homelessness. The analyses reveal four principal findings. First, that childhood placement in foster care substantially increases the length of homeless careers. Second, prehomeless psychiatric hospitalization reduces the length of homeless careers. Third, time worked reduces the length of time homeless. And fourth, several variables often viewed as important determinants of homeless careers have little effect on career length, most notable, alcohol abuse.

Compares the concept of consumerism and consumer progress in the United States. Development of continuing legal education; Impact of consumer problems on the legislative and administrative actions of the government; Problems associated with pollution standards.

The article discusses several books and articles published in the U.S. that shows a shift in the American intellectual life in modern days. A conspicuous phase of the intellectual life of America has been to introduce the techniques and methods of exact science into the mental and social fields. Such a movement was in a sense predestined, in view of the stage to which the natural sciences had advanced. And it was equally inevitable, no doubt, that such a movement should become involved in certain incidental fallacies and minor aberrations. It was equally inevitable, therefore, that a time should shortly come when the ever shifting searchlight of intellectual attention should chance upon those fallacies and aberrations and expose them. One of the books discusses in the article is "The Biological Basis of Human Nature," by H.S. Jennings. No American stands higher as a scientist than he. In the first place he makes no apologies for extra scientific questions or quasi-philosophical techniques. In the second place he repudiates the deterministic assumption of the current science cult. This he does in his introduction of the term "emergent evolution." He also argues against determinism in the name of the scientific method itself. He contends that it is the business, and that therein lies the very promise, of science as such to explore and experiment instead of taking anything for granted a priori.

Focuses on the ethical considerations in donating a second kidney. Limits of living donations; Level of risk; Threats to the commons.

The authors emphasize the importance of investigator and patient blinding as research methodology in minimizing bias in randomized trials. They offer information on the Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycemia in Diabetes (RECORD) trial that shows empirical estimates of the potential bias associated with an open-label design. They also explain how a review of the RECORD trial by the U.S. Food and Drug Administration (FDA) offers evidence of differential outcome ascertainment by treatment group.