Experimental evidence on promotion of electric and improved biomass cookstoves.

Improved cookstoves (ICS) can deliver "triple wins" by improving household health, local environments, and global climate. Yet their potential is in doubt because of low and slow diffusion, likely because of constraints imposed by differences in culture, geography, institutions, and missing markets. We offer insights about this challenge based on a multiyear, multiphase study with nearly 1,000 households in the Indian Himalayas. In phase I, we combined desk reviews, simulations, and focus groups to diagnose barriers to ICS adoption. In phase II, we implemented a set of pilots to simulate a mature market and designed an intervention that upgraded the supply chain (combining marketing and home delivery), provided rebates and financing to lower income and liquidity constraints, and allowed households a choice among ICS. In phase III, we used findings from these pilots to implement a field experiment to rigorously test whether this combination of upgraded supply and demand promotion stimulates adoption. The experiment showed that, compared with zero purchase in control villages, over half of intervention households bought an ICS, although demand was highly price-sensitive. Demand was at least twice as high for electric stoves relative to biomass ICS. Even among households that received a negligible price discount, the upgraded supply chain alone induced a 28 percentage-point increase in ICS ownership. Although the bundled intervention is resource-intensive, the full costs are lower than the social benefits of ICS promotion. Our findings suggest that market analysis, robust supply chains, and price discounts are critical for ICS diffusion.

Review of the score-reporting policy for the United States Medical Licensing Examination.

In 1998, the authors, acting on behalf of the National Board of Medical Examiners (NBME), undertook a review of the scoring policy for the United States Medical Licensing Examination (USMLE). The main goal was to determine the likely effect of changing from numeric score reporting to reporting pass-fail status. Several groups were surveyed across the nation to learn how they felt they would be affected by such a change, and why: all 54 medical boards; 1,600 randomly selected examinees (including 250 foreign medical graduates) who had recently taken either Step 1, Step 2, or Step 3 of the USMLE; 2,000 residency directors; the deans, education deans, and student affairs deans at all 125 U.S. medical schools accredited by the Liaison Committee on Medical Education; and all 17 members of the Council of Medical Specialty Societies. Responses from the different groups surveyed varied from 80% to a little less than half. The authors describe in detail the various views of the respondents and their reasons. Some members in each group favored each of the reporting formats, but the trend was to favor numeric score reporting. The majority of the responding examinees desired that their USMLE scores be sent to them in numeric form but sent to their schools and to residency directors in pass-fail form. Based on the responses and a thorough discussion of their implications, the Composite Committee (which determines USMLE score-reporting policy) decided that there is no basis at this time for changing the current policy, but that it would review the policy in the future when necessary.

A cytophotometric technique for measuring photosynthetic potential of leaves: preliminary research and development.

A novel combined photographic and cytophotometric technique provides information on the physiological state of leaves and a permanent record of each leaf measured in field studies. The method has the ability to determine the distribution of photosynthetic potential within various portions of the leaf and to scale up to the canopy level as well as down to the cellular level. Photographic transparencies are taken in the field, then brought back to the lab to be analyzed cytophotometrically at the investigator's convenience. The image encoded on the film yields an absorption curve that is similar to that of intact leaves with peaks in the blue (450 nm) and red (660 nm) for paper birch. Internal standards of fluorescein and first surface mirrors combined with standardized magnification and illumination (e.g., ring flash) are used to insure precision and accuracy. Two wavelength and plug cytophotometric equations have been modified for use in this technique. Some problems with the two-wavelength method remain, but the usefulness of the plug method for cytophotometry has been expanded through the use of portable leaf area and chlorophyll meters and portable photosynthesis laboratories. Total photosynthetic potential (TPP) is shown to equal leaf area multiplied by the mean optical density of the leaf. With the use of internal standards TPP can be expressed in fluorescein units or adjusted by optical density of the image of the first surface mirror.

Hemiballismus due to an ipsilateral striatal haemorrhage: an unusual localization.

Hemiballismus has been correlated clinico-anatomically with lesions of the contralateral side, most commonly of the subthalamic nucleus. Hemiballismus due to an ipsilateral lesion is extremely rare. We report the case of a 55 year old female who developed a right sided hemiballismus due to a right striatal haemorrhage, which simultaneously caused a left hemiplegia. The hemiballismus subsided on treatment with dopamine-blockers over the next two weeks.