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Current Controversies (current + controversy)

Distribution by Scientific Domains

Medical Sciences	70%
Humanities and Social Sciences	11%

Selected Abstracts

Current controversies: Levodopa in the treatment of Parkinson's disease

MOVEMENT DISORDERS, Issue 5 2005
Jagdish C. Sharma FRCP
Companion letters have been published in Movement Disorders: Levodopa in the Treatment of Parkinson's Disease: Current Controversies, by Gerlach, Reichmann, and Riederer and Reply: Levodopa in the Treatment of Parkinson's Disease, by Olanow, Agid, and Mizuno. [source]

On the Future of Reanimatology,

ACADEMIC EMERGENCY MEDICINE, Issue 1 2000
Peter Safar MD
Abstract: This article is adapted from a presentation given at the 1999 SAEM annual meeting by Dr. Peter Safar. Dr. Safar has been involved in resuscitation research for 44 years, and is a distinguished professor and past initiating chairman of the Department of Anesthesiology and Critical Care Medicine at the University of Pittsburgh. He is the founder and director of the Safar Center for Resuscitation Research at the University of Pittsburgh, and has been the research mentor of many critical care and emergency medicine research fellows. Here he presents a brief history of past accomplishments, recent findings, and future potentials for resuscitation research. Additional advances in resuscitation, from acute terminal states and clinical death, will build upon the lessons learned from the history of reanimatology, including optimal delivery by emergency medical services of already documented cardiopulmonary cerebral resuscitation, basic-advanced,prolonged life support, and future scientific breakthroughs. Current controversies, such as how to best educate the public in life-supporting first aid, how to restore normotensive spontaneous circulation after cardiac arrest, how to rapidly induce mild hypothermia for cerebral protection, and how to minimize secondary insult after cerebral ischemia, are discussed, and must be resolved if advances are to be made. Dr. Safar also summarizes future technologies already under preliminary investigation, such as ultra-advanced life support for reversing prolonged cardiac arrest, extending the "golden hour" of shock tolerance, and suspended animation for delayed resuscitation. [source]

Current controversies surrounding liver transplantation for hepatocellular carcinoma

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7 2010
Mauricio F Silva
Abstract Liver transplantation (LT) for hepatocellular carcinoma (HCC) has progressed rapidly over the last decade from a futile therapy to the first choice therapy for suitable patients. Excellent outcomes of LT for HCC can be largely attributed to the use of the Milan Criteria, which have restricted LT to patients with early stage tumors. These criteria may be conservative, and it is likely that a subset of patients with tumors beyond these criteria can have acceptable outcomes. However, there is currently insufficient data to accept more liberal criteria as a standard of care, and a higher quality evidence base must be achieved to prevent poor utilization of valuable donor liver resources. In the future, it is probable that more sophisticated selection criteria will emerge incorporating aspects of tumor biology beyond tumor size and number. Dropout from the waiting list due to tumor progression remains a clinical challenge particularly in regions with prolonged waiting times. Priority allocation using HCC MELD points is a practical and transparent solution that has successfully reduced waitlist dropout for HCC patients. Further refinements of the HCC MELD point system are required to ensure equity of access to LT for non-HCC patients and prioritization of HCC patients with the highest risk of dropout. Improving the evidence base for pre-LT locoregional therapy to prevent waitlist dropout is an urgent and difficult challenge for the LT community. In the interim transplant clinicians must restrict the use of these therapies to those patients who are most likely to benefit from them. [source]

Current controversies: Levodopa in the treatment of Parkinson's disease

Levodopa in the treatment of Parkinson's disease: Current controversies

MOVEMENT DISORDERS, Issue 9 2004
C. Warren Olanow
Abstract Levodopa is the most effective symptomatic agent in the treatment of Parkinson's disease (PD) and the "gold standard" against which new agents must be compared. However, there remain two areas of controversy: (1) whether levodopa is toxic, and (2) whether levodopa directly causes motor complications. Levodopa is toxic to cultured dopamine neurons, and this may be a problem in PD where there is evidence of oxidative stress in the nigra. However, there is little firm evidence to suggest that levodopa is toxic in vivo or in PD. Clinical trials have not clarified this situation. Levodopa is also associated with motor complications. Increasing evidence suggests that they are related, at least in part, to the short half-life of the drug (and its potential to induce pulsatile stimulation of dopamine receptors) rather than to specific properties of the molecule. Treatment strategies that provide more continuous stimulation of dopamine receptors provide reduced motor complications in MPTP monkeys and PD patients. These studies raise the possibility that more continuous and physiological delivery of levodopa might reduce the risk of motor complications. Clinical trials to test this hypothesis are underway. We review current evidence relating to these areas of controversy. © 2004 Movement Disorder Society [source]

Marking Difference and Negotiating Belonging: Refugee Women, Volunteering and Employment

GENDER, WORK & ORGANISATION, Issue 3 2010
Frances Tomlinson
Refugee women occupy a position at a neglected point of intersection of many categories of difference. This article draws on a study of pathways from voluntary work into paid employment for refugee women in the UK and reveals how they drew on these markers of difference to express and explain their experiences of exclusion or belonging. Their accounts are considered alongside those of organizational representatives, who drew on vocabularies of equality and diversity to construct refugee women as organizational outsiders or insiders. The article explores the interplay between the active agency of refugee women in negotiating the possibilities of belonging and the effect of discursive practices and structural processes that tend to perpetuate their outsider status. It concludes by briefly considering the relevance of these findings to current controversies concerning the impact of policies of managing diversity and multiculturalism on combating inequality and discrimination. [source]

On future non-medical costs in economic evaluations

HEALTH ECONOMICS, Issue 5 2008
Bengt Liljas
Abstract Economic evaluation in health care is still an evolving discipline. One of the current controversies in cost-effectiveness analysis regards the inclusion or exclusion of future non-medical costs (i.e. consumption net of production) due to increased survival. This paper examines the implications of a symmetry rule stating that there should be consistency between costs included in the numerator and utility aspects included in the denominator. While the observation that no quality-adjusted life year (QALY) instruments explicitly include consumption and leisure seems to give support to the notion that future non-medical costs should be excluded when QALYs are used as the outcome measure, a better understanding of what respondents actually consider when reporting QALY weights is required. However, the more fundamental question is whether QALYs can be interpreted as utilities. Or more precisely, what are the assumptions needed for a general utility model also including consumption and leisure to be consistent with QALYs? Once those assumptions are identified, they need to be experimentally tested to see whether they are at least approximately valid. Until we have answers to these areas for future research, it seems premature to include future non-medical costs. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Techne, Technoscience, and the Circulation of Comestible Commodities: An Introduction

AMERICAN ANTHROPOLOGIST, Issue 4 2007
DEBORAH HEATH Guest Editors
In this "In Focus" introduction, we present the ways in which discourses of techne (craft or artisanship) and technoscience mediate the production, consumption, and circulation of food and drink. The authors in this "In Focus" examine food and drink as localized instances of large-scale spatial and temporal processes and as cultural-material markers of power/knowledge. Our work on the current controversies surrounding foie gras exemplifies how specialty commodities marketed as "artisanal" are simultaneously legitimated through technoscientific practices and invocations of tradition or nature. Claims to distinction based on tradition or "terroir" are also imbricated in global industrial production and distribution. [source]

Evaluation policy and evaluation practice

NEW DIRECTIONS FOR EVALUATION, Issue 123 2009
William M. K. Trochim
The author develops the basic idea of evaluation policy, describes a practical model for development and revision of evaluation policies (including a taxonomy, structure, and set of principles), and suggests critical challenges and opportunities for the future of evaluation policy. An evaluation policy is any rule or principle that a group or organization uses to guide its decisions and actions when doing evaluation. Every entity that engages in evaluation, including government agencies, private businesses, and nonprofit organizations, has evaluation policies. Sometimes they are explicit and written; more often they are implicit and ad hoc principles or norms that have simply evolved over time. Evaluation policies profoundly affect the day-to-day work of all evaluators and ultimately the quality of the programs they evaluate. Many recent and current controversies or conflicts in the field of evaluation can be viewed, at least in part, as a struggle around evaluation policy. Because evaluation policies typically apply across multiple evaluations, influencing policies directly may have systemic and far-reaching effects for practice. Evaluation practice must play a critical role in informing and shaping the development of evaluation policies. © Wiley Periodicals, Inc. [source]

Type 1 diabetes intervention trials

PEDIATRIC DIABETES, Issue 1 2001
Massimo Pietropaolo
This and the following article address the current controversies for the application of studies to predict and prevent type 1 diabetes, based on currently available methodologies. This article outlines the position of the proponent; the following article outlines the position of the opponent. The intent is to illuminate by intellectual debate. [source]

From Miasma to Fractals: The Epidemiology Revolution and Public Health Nursing

PUBLIC HEALTH NURSING, Issue 4 2004
Marjorie A. MacDonald Ph.D.
Abstract If public health nursing is truly a synthesis of public health science and nursing science, then nurses must keep track of current developments in public health science. Unfortunately, the public health nursing literature has not kept pace with revolutionary developments in epidemiology, one of the sciences that informs population-focused nursing practice. Most epidemiology chapters in community health nursing texts do not reflect the intellectual development that has taken place in epidemiology over the past two decades. The purpose of this article therefore is to facilitate an updated synthesis by (a) reviewing the development of epidemiology and the focus of public health nursing practice through three historical eras, (b) discussing current controversies and tensions within epidemiology, (c) introducing an emerging paradigm in epidemiology based on an ecosocial perspective, and (d) discussing the congruence of this perspective with the evolving theory and practice of public health nursing. [source]

Hormone replacement therapy: current controversies

CLINICAL ENDOCRINOLOGY, Issue 5 2003
I. B. Orija
No abstract is available for this article. [source]

Lung protective ventilatory strategies in acute lung injury and acute respiratory distress syndrome: from experimental findings to clinical application

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 2 2007
Serge J. C. Verbrugge
Summary This review addresses the physiological background and the current status of evidence regarding ventilator-induced lung injury and lung protective strategies. Lung protective ventilatory strategies have been shown to reduce mortality from adult respiratory distress syndrome (ARDS). We review the latest knowledge on the progression of lung injury by mechanical ventilation and correlate the findings of experimental work with results from clinical studies. We describe the experimental and clinical evidence of the effect of lung protective ventilatory strategies and open lung strategies on the progression of lung injury and current controversies surrounding these subjects. We describe a rational strategy, the open lung strategy, to accomplish an open lung, which may further prevent injury caused by mechanical ventilation. Finally, the clinician is offered directions on lung protective ventilation in the early phase of ARDS which can be applied on the intensive care unit. [source]

Acceptance and Commitment Therapy: New Wave or Morita Therapy?

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2008
Stefan G. Hofmann
Acceptance and commitment therapy (ACT) is an approach to treatment that includes potentially useful strategies. Some proponents of ACT view it as part of a third wave movement destined to replace cognitive behavioral therapy (CBT) as the dominant form of psychological therapy. This perception is problematic, because the criticism offered by ACT against CBT is based on a misrepresentation of the empirical evidence. Moreover, the strategies of ACT are not specific to the theory and philosophy underlying ACT. There are considerable similarities between ACT and Eastern holistic approaches, such as Morita therapy, which was developed 80 years ago. Future research on the mechanism of treatment change directly comparing CBT and ACT will help solve many of the current controversies. The term third wave in connection with ACT should be avoided. [source]

Beyond licensing and disarming: A quantitative view on NK-cell education

EUROPEAN JOURNAL OF IMMUNOLOGY, Issue 11 2008
Petter Brodin
Abstract In this article, we will move beyond the current controversy of different models for NK-cell education and instead discuss the properties characterizing MHC class I-guided functional development of NK cells. We will argue that this development, which represents the endpoint of NK-cell education, is a quantitative and dynamic, and perhaps even reversible, process. [source]

Three-dimensional reconstruction of the remodeling of the systemic vasculature in early pig embryos

MICROSCOPY RESEARCH AND TECHNIQUE, Issue 2 2008
Pieter Cornillie
Abstract Current research on angiogenesis and vascular regression is mainly focused on pathological conditions such as tumor growth and diabetic retinopathy, while a suitable physiological model to study the controlling factors in these processes is still lacking. The remodeling pattern of the embryonic vasculature into the adult configuration, such as the branchial arch arterial system developing into the aorta or the early embryonic veins building the caudal vena cava can potentially serve as a model. However, practical applications of the embryonic vascular patterning are impeded by the current controversy over the exact development of the caudal vena cava in mammals. To elucidate these ambiguities, specific developmental stages of vascular development in pig embryos were mapped by means of computer-assisted 3D reconstructions starting from histological serial sections of Bouin's fixed embryos. Special attention was given to venous segments in the lumbar region, as their origin and fate are equivocally described in literature. Here we demonstrate that these venous segments originate from the caudal cardinal veins which are forced to migrate during development into a more dorsal position due to the expansion of the developing metanephroi and the more dorsal relocation of the umbilical arteries. These findings are in contrast with the generally accepted theory that the venous segments in the lumbar region arise from newly formed veins that are located dorsal to the early caudal cardinal system. Microsc. Res. Tech., 2008. © 2007 Wiley-Liss, Inc. [source]

PERSPECTIVE: The World's Top Innovation Management Scholars and Their Social Capital,

THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 3 2007
Jeff Thieme
Using 959 articles reflecting the work of 1,179 scholars, this study ranks the world's top scholars in innovation management (IM) on the basis of the number of research articles published across 14 top academic journals in technology and innovation management, marketing, and management between 1990 and 2004. Twenty-three scholars have at least eight articles in this period. Michael Song has the most (31), followed by Robert Cooper, Roger Calantone, William Souder, and Elko Kleinschmidt, who have published at least 17 articles in the 15-year period. Surprisingly, the list of schools that either trained or currently employ these top scholars is quite different from Linton's (2004) recent ranking of the top business schools in the management of technology. Guided by social capital theory, the present study analyzes the embeddedness characteristics of IM scholars to determine the extent to which social capital explains scholarly productivity. A current controversy in the social capital literature is the embeddedness characteristics that create social capital. On the one hand, the closure perspective argues that social capital results from strong relational ties with others in a dense, local neighborhood of actors who are relatively disconnected from others. On the other hand, the brokerage perspective argues that social capital is created when actors have relational ties that span these dense, local neighborhoods. The findings in the present study support both perspectives. Furthermore, the results suggest that strategic orientation is a contingency variable that clarifies the conditions in which closure- or brokerage-based embeddedness is appropriate. Specifically, scholars pursuing an entrepreneurial publication strategy are more productive when their relational embeddedness is consistent with the brokerage perspective of social capital creation, whereas scholars pursuing a focused publication strategy are more productive when their relational embeddedness is consistent with the closure perspective of social capital creation. The results have implications for both the IM scholar community and the social capital literature. Whether IM scholars are pursuing an entrepreneurial strategy that capitalizes on emergent knowledge across various theories and perspectives or pursuing a focused strategy by concentrating on gaining deep understanding of a specific stream of research, there are many avenues and opportunities for improving publication performance through the formation of new social capital. Finally, the empirical support for the contingency variable strategic orientation is consistent with recent speculation that both perspectives are important and suggests that future work should focus on further identification and clarification of contingency factors associated with them. [source]