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Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

PUBLIC PREFERENCES FOR REHABILITATION VERSUS INCARCERATION OF JUVENILE OFFENDERS: EVIDENCE FROM A CONTINGENT VALUATION SURVEY,

CRIMINOLOGY AND PUBLIC POLICY, Issue 4 2006
DANIEL S. NAGIN
Research Summary: Accurately gauging the public's support for alternative responses to juvenile offending is important, because policy makers often justify expenditures for punitive juvenile justice reforms on the basis of popular demand for tougher policies. In this study, we assess public support for both punitively and nonpunitively oriented juvenile justice policies by measuring respondents' willingness to pay for various policy proposals. We employ a methodology known as "contingent valuation" (CV) that permits the comparison of respondents' willingness to pay (WTP) for competing policy alternatives. Specifically, we compare CV-based estimates for the public's WTP for two distinctively different responses to serious juvenile crime: incarceration and rehabilitation. An additional focus of our analysis is an examination of the public's WTP for an early childhood prevention program. The analysis indicates that the public is at least as willing to pay for rehabilitation as punishment for juvenile offenders and that WTP for early childhood prevention is also substantial. Implications and future research directions are outlined. Policy Implications: The findings suggest that lawmakers should more actively consider policies grounded in rehabilitation, and, perhaps, be slower to advocate for punitive reforms in response to public concern over high-profile juvenile crimes. Additionally, our willingness to pay findings offer encouragement to lawmakers who are uncomfortable with the recent trend toward punitive juvenile justice policies and would like to initiate more moderate reforms. Such lawmakers may be reassured that the public response to such initiatives will not be hostile. Just as importantly, reforms that emphasize leniency and rehabilitation can be justified economically as welfare-enhancing expenditures of public funds. The evidence that the public values rehabilitation more than increased incarceration should be important information to cost-conscious legislators considering how to allocate public funds. Cost-conscious legislatures may become disenchanted with punitive juvenile justice policies on economic grounds and pursue policies that place greater emphasis on rehabilitation. They may be reassured, on the basis of our findings, that the public will support this move. [source]

Improving vastus medialis obliquus function reduces pressure applied to lateral patellofemoral cartilage

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2009
John J. Elias
Abstract The current study was performed to characterize how improving vastus medialis obliquus (VMO) function influences the pressure applied to patellofemoral cartilage. An additional focus was characterizing how lateral and medial cartilage lesions influence cartilage pressures. Ten knees were flexed to 40°, 60°, and 80° in vitro, and forces were applied to represent the VMO and other muscles of the quadriceps group while a thin film sensor measured joint pressures. The knees were loaded with a normal VMO force, with the VMO force decreased by approximately 50%, and with the VMO unloaded. After tests were performed with the cartilage intact, all tests were repeated with a 12-mm-diameter lesion created within the lateral cartilage, with the lateral lesion repaired with silicone, and with a medial lesion created. Based on a two-way repeated measures ANOVA and post-hoc tests, increasing the force applied by the VMO significantly (p,<,0.05) decreased the maximum lateral pressure and significantly increased the maximum medial pressure at each flexion angle. A lateral cartilage lesion significantly increased the maximum lateral pressure, while a medial lesion did not significantly influence the maximum medial pressure. Improving VMO function can reduce the pressure applied to lateral cartilage when lateral lesions are present. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 578,583, 2009 [source]

Databases for outcomes research: what has 10 years of experience taught us?

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2001
Lynn Bosco MD
Abstract This paper describes how the mission of the Agency for Healthcare Research and Quality (AHRQ) is being executed through the many programs that it has developed and implemented. The Evidence-based Practice Center program was developed to provide systematic reviews on common and expensive conditions and health technologies and to ensure that this information is used to improve health care outcomes and costs. The National Guidelines Clearinghouse provides an internet-based source of clinical practice guidelines that are produced by clinical specialty organizations for the primary purpose of improving health care delivery and outcomes. Relevant to this symposium on databases, AHRQ has supported the development of databases to track hospital utilization on a state-by-state basis. The Healthcare Cost and Utilization Project (HCUP) allows comparisons between states and within regions of individual states. New initiatives have been launched to evaluate interventions across systems rather than focusing on the individual patient (Translating Research into Practice,TRIP). The Centers for Education and Research on Therapeutics (CERTs) program was developed to conduct real world evaluations to better understand the benefits and risks of single and combined therapy. Both programs further the mission of the AHRQ to improve the outcomes and quality of health care, with additional focus on the cost-effectiveness, patient safety, and increasing access to care for all. Information on programs developed by the AHRQ is available in more detail at the Agency Web site http://www.ahrq.gov. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Airway Selectivity: An Update of Pharmacokinetic Factors Affecting Local and Systemic Disposition of Inhaled Steroids

BASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 6 2006
Staffan Edsbäcker
The antiinflammatory properties of these products, combined with the targeting of formulations and optimization of the intrinsic pharmacokinetic features of the newer corticosteroid molecules has resulted in substantially improved airway selectivity. This review sets out to summarize the pharmacokinetic properties of inhaled corticosteroids that are important for the achievement of high levels of airway selectivity, with additional focus on the use of prodrugs/softdrugs relative to those of conventional corticosteroid molecules, mechanisms (such as esterification) by which retention at the target site is achieved while minimizing systemic exposure, and the role of plasma protein binding. [source]