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Kinds of Study Terms modified by Study Selected AbstractsThe family impact of skin diseases: the Greater Patient conceptBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2007M.K.A. Basra Summary Background, Although the impact of skin disease on patients' health-related quality of life (HRQoL) is well known, little work has been carried out to determine the secondary impact of a patient's skin disease on the patient's family or partner. Objectives, The aim of this study was to identify the different aspects of a family member's QoL that may be affected by having a family member with skin disease. Methods, Qualitative interviews were conducted with 50 family members/partners of patients attending the outpatient clinic of a university hospital, with a wide range of dermatological conditions (n = 21). Subjects were invited to discuss in detail all the ways that their lives were affected by living with a patient with skin disease. Results, The mean age of subjects (M = 19; F = 31) was 48·1 years (SD = 15·7) most were either parents (44%) or spouses/partners (44%) of the patients. Patients' ages (M = 16; F = 34) ranged from 5 months to 84 years. Fifty-nine aspects of QoL of family members were identified that were adversely affected by the patients' skin disease. These were categorized into 18 main topic areas: Emotional distress (98%), Burden of care (54%), Effect on housework (42%), Social life (48%), Holidays (46%), Financial aspect (30%), Physical well-being (22%), Job/study (40%), Leisure activities (26%), Sleep (20%), Food/drink (12%), Restriction of liked activities (14%), Need for support (12%), People's attitude (10%), Dissatisfaction with medical care (14%), Effect on sex life (8%), Role of religious faith (8%) and Miscellaneous (16%). There was no significant difference between male and female subjects regarding main QoL areas affected. The median number of main topic areas reported per family member was five (mean = 5·2, range = 1,10, SD = 2·64). Conclusions, This study has demonstrated that skin diseases can significantly impair the HRQoL of the patient's family in very diverse ways. Asking family members about this impact is greatly appreciated by them. We propose the ,Greater Patient' concept to describe the immediate close social group affected by a person having skin disease. [source] PREDICTING THE IMPACT OF ANTICIPATORY ACTION ON U.S. STOCK MARKET,AN EVENT STUDY USING ANFIS (A NEURAL FUZZY MODEL)COMPUTATIONAL INTELLIGENCE, Issue 2 2007P. Cheng In this study, the adaptive neural fuzzy inference system (ANFIS), a hybrid fuzzy neural network, is adopted to predict the actions of the investors (when and whether they buy or sell) in a stock market in anticipation of an event,changes in interest rate, announcement of its earnings by a major corporation in the industry, or the outcome of a political election for example. Generally, the model is relatively more successful in predicting when the investors take actions than what actions they take and the extent of their activities. The findings do demonstrate the learning and predicting potential of the ANFIS model in financial applications, but at the same time, suggest that some of the market behaviors are too complex to be predictable. [source] ADAPTATION KNOWLEDGE ACQUISITION: A CASE STUDY FOR CASE-BASED DECISION SUPPORT IN ONCOLOGYCOMPUTATIONAL INTELLIGENCE, Issue 3-4 2006Mathieu D'Aquin Kasimir is a case-based decision support system in the domain of breast cancer treatment. For this system, a problem is given by the description of a patient and a solution is a set of therapeutic decisions. Given a target problem, Kasimir provides several suggestions of solutions, based on several justified adaptations of source cases. Such adaptation processes are based on adaptation knowledge. The acquisition of this kind of knowledge from experts is presented in this paper. It is shown how the decomposition of adaptation processes by introduction of intermediate problems can highlight simple and generalizable adaptation steps. Moreover, some adaptation knowledge units that are generalized from those acquired for Kasimir are presented. This knowledge can be instantiated in other case-based decision support systems, in particular in medicine. [source] TRAJECTORIES OF CRIME AT PLACES: A LONGITUDINAL STUDY OF STREET SEGMENTS IN THE CITY OF SEATTLE,CRIMINOLOGY, Issue 2 2004DAVID WEISBURD Studies of crime at micro places have generally relied on cross-sectional data and reported the distributions of crime statistics over short periods of time. In this paper we use official crime data to examine the distribution of crime at street segments in Seattle, Washington, over a 14-year period. We go beyond prior research in two ways. First, we view crime trends at places over a much longer period than other studies that have examined micro places. Second, we use group-based trajectory analysis to uncover distinctive developmental trends in our data. Our findings support the view that micro places generally have stable concentrations of crime events over time. However, we also find that a relatively small proportion of places belong to groups with steeply rising or declining crime trajectories and that these places are primarily responsible for overall city trends in crime. These findings are particularly important given the more general decline in crime rates observed in Seattle and many other American cities in the 1990s. Our study suggests that the crime drop can be understood not as a general process that occurred across the city landscape but one that was generated in a relatively small group of micro places with strong declining crime trajectories over time. [source] EXTENDING SOCIAL DISORGANIZATION THEORY: A MULTILEVEL APPROACH TO THE STUDY OF VIOLENCE AMONG PERSONS WITH MENTAL ILLNESSES,CRIMINOLOGY, Issue 4 2000ERIC SILVER Prior studies of violence among individuals with mental illnesses have focused almost exclusively on individual-level characteristics. In this study, I examine whether the structural correlates of neighborhood social disorganization also explain variation in violence. I use data on 270 psychiatric patients who were treated and discharged from an acute inpatient facility combined with tract-level data from the 1990 U.S. Census. I find that living in a socially disorganized neighborhood increased the probability of violence among the sample, an effect that was not mediated by self-reported social supports. Implications for future research in the areas of violence and mental illness are discussed. [source] THE MIRACLE OF THE CELLS: AN EXPERIMENTAL STUDY OF INTERVENTIONS TO INCREASE PAYMENT OF COURT-ORDERED FINANCIAL OBLIGATIONS,CRIMINOLOGY AND PUBLIC POLICY, Issue 1 2008DAVID WEISBURD Research Summary: In this article, we present findings from an experimental study of an innovative program in fine enforcement developed by the Administrative Office of the Courts (AOC) of New Jersey, termed Project MUSTER (MUST Earn Restitution). The project was initiated by the New Jersey AOC as a response to concerns among probation personnel that probationers sentenced to monetary penalties often failed to meet their financial obligations. The program sought to increase payment of court-ordered financial obligations among probationers who are seriously delinquent in paying fines, penalties, and restitution, and was designed to "strengthen the effectiveness of restitution and fine sanctions by forcing those offenders who have the ability to make regular payments to do so." Project MUSTER relied on a combination of intensive probation, threats of violation to court and incarceration, and community service. We find that probationers sentenced to Project MUSTER were significantly more likely to pay court-ordered financial obligations than were those who experienced regular probation supervision. However, probationers sentenced to a second treatment group, in which the only intervention was violation of probation (one part of the MUSTER program), had similar outcomes to the MUSTER condition. These findings suggest that the main cause of fine payment was a deterrent threat of possible incarceration, which is often termed the "miracle of the cells." Policy Implications: Our study shows that it is possible to gain greater compliance with court-ordered financial obligations and that such compliance may be gained with a relatively simple and straightforward criminal justice intervention. Threats of violation of probation are an effective tool for gaining compliance with financial obligations. Given the growing interest in monetary penalties as an alternative to incarceration, these findings have particular policy importance. [source] PLANNING FOR A NATURAL HISTORY MUSEUM IN A UNIVERSITY ENVIRONMENT: A CASE STUDYCURATOR THE MUSEUM JOURNAL, Issue 2 2000Scott M. Lanyon First page of article [source] P-26 CONVENTIONAL V THIN LAYER TECHNIQUES: A COMPARATIVE STUDY OF BRONCHIAL SPECIMENS USING CONVENTIONAL AND TWO LBC METHODS, THINPREP AND SUREPATHCYTOPATHOLOGY, Issue 2006J. L. Conachan The current, conventional method used is quick, easy and reasonably cheap but the nature of bronchial specimens themselves creates the need for a better preparation technique. Bronchial specimens often present with many obscuring features, such as blood and mucus, which can affect definitive diagnosis. In the study, the bronchial specimens underwent routine conventional preparation and that remaining was used to prepare an LBC slide. Both LBC methods were separately evaluated alongside the conventional method where, of the 44 specimens used, half were prepared using the conventional and ThinPrep and half with the conventional and SurePath. Evaluation forms were completed by pathologists who assessed all preparations. The results showed both LBC methods produced superior preparations that were better fixed, more cellular and had improved nuclear detail. They also removed a high percentage of background debris, were more diagnostically accurate and reduced the inadequate rate by a third. The conventional slides prepared from the same specimen as the SurePath had a lower average than those prepared with the ThinPrep. This indicated that the specimens used to evaluate the SurePath method were in fact inferior to those used for ThinPrep, with the SurePath slides showing only a slight improvement in overall quality. Despite LBC preparations reducing pathologist screening and reporting time, both methods are more labour intensive and less cost effective. The majority of laboratories are not in the financial situation to trial new methods that require extra training and more staff hours, and as such this study has highlighted an important question ,Do the benefits of better quality preparation and diagnostic accuracy offset an increase in time and cost'. [source] Effect of Cog Threads under Rat SkinDERMATOLOGIC SURGERY, Issue 12 2005Hyo Jook Jang MD Background. The aging face loses the tensile strength of structural integrity. Cog threads have been used recently to tighten lax skin and soft tissue. Objective. A comparative study of the effects of cog, monofilament, and multifilament threads under rat skin. Methods. Each cog, monofilament, and multifilament thread was inserted under the facial skin of a cadaver and the panniculus carnosus of rat dorsal skin. The maximum holding strength (MHS) of the thread and the tearing strength of the skin around the thread were measured with a tensiometer. The thickness of the capsule around the thread and the myofibroblasts was observed histologically. Results. In the cadaver, the MHS of the cog thread was 190.7 ± 65.6 g. It was greater than that of the monofilament (22.4 ± 7.7 g) or multifilament (40.4 ± 19.7 g) thread. In the rat, the MHS of the cog thread was 95.1 ± 18.8 g. It was greater than that of the monofilament (4.3 ± 1.3 g) or multifilament (10.9 ± 2.1 g) thread in the second week. The thickness of the capsule around the cog thread was 93.0 ± 3.2 ,m. It was thicker than the monofilament thread's capsule, 39.2 ± 12.1 ,m, in the fourth week. The number of myofibroblasts presented significantly more in the cog (96.0 ± 72.4) than in the monofilament thread (4.3 ± 4.4). The rumpled in-between skin suspended by each of the three different threads returned to its original state in 2 weeks. Conclusion. The cog thread placed under the rat skin immediately pulled the skin and subcutaneous tissue. The myofibroblasts around the thread played a role in fibrous tissue contracture 4 weeks postinsertion of the thread. These findings could be the basis for clinical application. THIS STUDY WAS SUPPORTED BY A GRANT FROM THE KOREA HEALTH 21 R&D PROJECT, MINISTRY OF HEALTH AND WELFARE, REPUBLIC OF KOREA. [source] The Treatment of Melasma with Fractional Photothermolysis: A Pilot StudyDERMATOLOGIC SURGERY, Issue 12 2005Cameron K. Rokhsar MD Background. Melasma is a common pigmentary disorder that remains resistant to available therapies. Facial resurfacing with the pulsed CO2 laser has been reported successful but requires significant downtime, and there is a risk of adverse sequelae. Objective. To determine if melasma will respond to a new treatment paradigm, fractional resurfacing. Methods. Ten female patients (Fitzpatrick skin types III,V) who were unresponsive to previous treatment were treated at 1- to 2-week intervals with the Fraxel laser (Reliant Technologies, Palo Alto, CA, USA). Wavelengths of 1,535 and 1,550 nm were both used, and 6 to 12 mJ per microthermal zone with 2,000 to 3,500 mtz/cm2 were the treatment parameters. Four to six treatment sessions were performed. Responses were evaluated according to the percentage of lightening of original pigmentation. Two physicians evaluated the photographs, and each patient evaluated her own response. Results. The physician evaluation was that 60% of patients achieved 75 to 100% clearing and 30% had less than 25% improvement. The patients' evaluations agreed, except for one patient, who graded herself as 50 to 75% improved as opposed to the physician grading of over 75%. There was one patient with postinflammatory hyperpigmentation and no patient with hypopigmentation. No downtime was necessary for wound healing. Conclusions. Fractional resurfacing affords a new treatment algorithm for the treatment of melasma that combines decreased risk and downtime with significant efficacy. This treatment modality deserves further exploration to maximize benefits. RELIANT technologies LOANED THE FRAXEL LASER FOR THE STUDY. RICHARD E. FITZPATRICK, MD, IS A PAID CONSULTANT FOR RELIANT AND A STOCKHOLDER. [source] A Comparison of Two Botulinum Type A Toxin Preparations for the Treatment of Glabellar Lines: Double-Blind, Randomized, Pilot StudyDERMATOLOGIC SURGERY, Issue 12 2005Philippa L. Lowe MB ChB Background. Botulinum toxins have been proven effective for reducing facial lines. There are two commercial types of botulinum toxin type A available in many countries but no published comparison studies. Objective. To compare the efficacy and tolerability of Botox Cosmetic and Dysport 50 U in the treatment of glabellar lines (using 20 U of Botox Cosmetic, which is the dose approved by the US Food and Drug Administration for the treatment of glabellar lines, and 50 U of Dysport, which has been reported to be the optimal dose for this formulation). Study Design. Parallel-group double-blind pilot study. Evaluation by observing physician, photographic, and patient evaluations. Conclusion. Botox 20 U provided better and more prolonged efficacy than Dysport 50 U in the treatment of glabellar lines. NICHOLAS LOWE, MD, FRCP, AND RICKIE PATNAIK, MD, HAVE RECEIVED RESEARCH GRANTS FROM ALLERGAN INC. NICHOLAS LOWE OWNS STOCK IN ALLERGAN INC AND HAS RECEIVED CONSULTING PAYMENTS AND EDUCATIONAL GRANTS FROM ALLERGAN INC. THIS STUDY WAS FUNDED BY A GRANT FROM ALLERGAN INC. [source] Novel Approach to the Treatment of Hyperpigmented Photodamaged Skin: 4% Hydroquinone/0.3% Retinol versus Tretinoin 0.05% Emollient CreamDERMATOLOGIC SURGERY, Issue 2005Zoe Diana Draelos MD Background. Mild to moderately photodamaged skin is characterized by dyspigmentation, fine wrinkles, and tactile roughness. An optimal approach to the topical treatment of photoaging would simultaneously address all appearance issues. Objective. This study was undertaken to evaluate the effect of 4% hydroquinone and 0.3% retinol in photoaging. Materials and Methods. A 16-week study was designed to evaluate the efficacy and tolerance of a single cream containing prescription topical 4% hydroquinone for dyspigmentation and the cosmeceutical 0.3% retinol for fine wrinkles in an emollient vehicle for tactile roughness. This novel formulation was compared with 0.05% tretinoin emollient cream, the standard against which all other topical photoaging treatments are compared. Investigator assessments, subject assessments, and photography represented the evaluation end points. Results. The cosmeceutical emollient 4% hydroquinone/0.3% retinol cream more effectively diminished the collective signs of photodamage than 0.05% tretinoin emollient cream in terms of dyspigmentation, fine wrinkles, and tactile roughness in 16 weeks. Conclusion. Combination therapy of hydroquinone and retinol may improve photoaging-associated hyperpigmentation. THIS STUDY WAS CONDUCTED AS PART OF A RESEARCH GRANT FROM MEDICIS THE DERMATOLOGY COMPANY, PHOENIX, ARIZONA. DR. DRAELOS HAS NO FINANCIAL INTEREST IN ANY OF THE MEDICATIONS DISCUSSED IN THIS RESEARCH. [source] Double-Blind, Randomized, Placebo-Controlled, Dose-Response Study of the Safety and Efficacy of Botulinum Toxin Type A in Subjects with Crow's FeetDERMATOLOGIC SURGERY, Issue 3 2005Nicholas J. Lowe MD Background Published evidence suggests that botulinum toxin type A (BTX-A) is an effective treatment for crow's feet. However, few dose-ranging studies have been performed. Objectives To assess the safety and efficacy of a single treatment with one of four doses of BTX-A (Botox/Vistabel, Allergan Inc) compared with placebo for the improvement of crow's feet. Methods Subjects received a single bilateral treatment of 18, 12, 6, or 3 U of BTX-A or placebo injected into the lateral aspect of the orbicularis oculi muscle (parallel-group, double,blind design). Investigators and subjects rated crow's feet severity at maximum smile on day 7 and at 30-day intervals from days 30 to 180. Results As observed by both investigators and subjects, all doses of BTX-A resulted in improvements in crow's feet severity when compared with placebo. A dose-dependent treatment effect for efficacy was observed, with higher doses having an increased magnitude and duration of effect. However, a clear differentiation between the 18 U and 12 U doses was not apparent. Few adverse events were reported, with no statistically significant differences between BTX-A and placebo in the incidence of subjects experiencing adverse events. Conclusion BTX-A is safe and effective in decreasing the severity of crow's feet, with 12 U per side suggested as the most appropriate dose. THIS STUDY WAS FUNDED BY ALLERGAN, WHICH WAS ALSO INVOLVED IN THE DESIGN AND CONDUCT OF THE STUDY; COLLECTION, MANAGEMENT, ANALYSIS, AND INTERPRETATION OF THE DATA; AND PREPARATION, REVIEW, AND APPROVAL OF THE MANUSCRIPT. DRS. LOWE AND FRACZEK ARE PAID CONSULTANTS FOR ALLERGAN, DRS. KUMAR AND EADIE ARE EMPLOYEES OF ALLERGAN, AND DRS. LOWE AND KUMAR HOLD STOCK OPTIONS. [source] Double-Blind, Randomized, Placebo-Controlled Pilot Study of the Safety and Efficacy of Myobloc (Botulinum Toxin Type B) for the Treatment of Palmar HyperhidrosisDERMATOLOGIC SURGERY, Issue 3 2005Leslie Baumann MD Background Palmar hyperhidrosis is a problem of unknown etiology that affects patients both socially and professionally. Botulinum toxin type B (Myobloc), approved by the Food and Drug Administration for use in the treatment of cervical dystonia in the United States in December 2000, has subsequently been used effectively in an off-label indication to treat hyperhidrosis. There are sparse data, however, in the literature evaluating the safety and efficacy of BTX-B for the treatment of palmar hyperhidrosis. Objective We evaluated the safety and efficacy of Myobloc in the treatment of bilateral palmar hyperhidrosis. This was a double-blind, randomized, placebo-controlled study to report on the safety and efficacy of Myobloc. Methods Twenty participants (10 men, 10 women) diagnosed with palmar hyperhidrosis were injected with either Myobloc (5,000 U per palm) or a 1.0 mL vehicle (100 mM NaCl, 10 mM succinate, and 0.5 mg/mL human albumin) into bilateral palms (15 Myobloc, 5 placebo). The participants were followed until sweating returned to baseline levels. The main outcome measures were safety, efficacy versus placebo, and duration of effect. Results A significant difference was found in treatment response at day 30, as determined by participant assessments, between 15 participants injected with Myobloc and 3 participants injected with placebo. The duration of action, calculated in the 17 participants who received Myobloc injections and completed the study, ranged from 2.3 to 4.9 months, with a mean duration of 3.8 months. The single most reported adverse event was dry mouth or throat, which was reported by 18 of 20 participants. The adverse event profile also included indigestion or heartburn (60%), excessively dry hands (60%), muscle weakness (60%), and decreased grip strength (50%). Conclusion Myobloc proved to be efficacious for the treatment of palmar hyperhidrosis. Myobloc had a rapid onset, with most participants responding within 1 week. The duration of action ranged from 2.3 to 4.9 months, with a mean of 3.8 months. The adverse event profile included dry mouth, indigestion or heartburn, excessively dry hands, muscle weakness, and decreased grip strength. MYOBLOC WAS PROVIDED FOR THIS STUDY BY ELAN PHARMACEUTICALS. [source] Four-Year Follow-up on Endovascular Radiofrequency Obliteration of Great Saphenous RefluxDERMATOLOGIC SURGERY, Issue 2 2005Robert F. Merchant MD Background Endovascular radiofrequency obliteration has been used since 1998 as an alternative to conventional vein stripping surgery for elimination of saphenous vein insufficiency. Objective To demonstrate the long-term efficacy of this treatment modality. Methods Data were prospectively collected in a multicenter ongoing registry. Only great saphenous vein above-knee treatments were included in this study. Eight hundred ninety patients (1,078 limbs) were treated prior to November 2003 at 32 centers. Clinical and duplex ultrasound follow-up was performed at 1 week, 6 months, and 1, 2, 3, and 4 years. Results Among 1,078 limbs treated, 858 were available for follow-up within 1 week, 446 at 6 months, 384 at 1 year, 210 at 2 years, 114 at 3 years, and 98 at 4 years. The vein occlusion rates were 91.0%, 88.8%, 86.2%, 84.2%, and 88.8%, respectively; the reflux-free rates were 91.0%, 89.3%, 86.2%, 86.0%, and 85.7%, respectively; and the varicose vein recurrence rates were 7.2%, 13.5%, 17.1%, 14.0%, and 21.4%, respectively, at each follow-up time point at 6 months, and 1, 2, 3, and 4 years. Patient symptom improvement persisted over 4 years. Conclusions Endovascular temperature-controlled radiofrequency obliteration of saphenous vein reflux exhibits an enduring treatment efficacy clinically, anatomically, and hemodynamically up to 4 years following treatment. ROBERT F. MERCHANT, MD, AND OLIVIER PICHOT, MD, ARE PAID CONSULTANTS TO VNUS MEDICAL TECHNOLOGIES, WHICH PROVIDED FINANCIAL SUPPORT FOR THIS STUDY. [source] Acquired Melanocytic Lesions and the Decision to Excise: Role of Color Variegation and Distribution as Assessed by DermoscopyDERMATOLOGIC SURGERY, Issue 2 2005Stefania Seidenari MD Background Because melanoma may sometimes be difficult to differentiate from nevi with clinical atypia, many benign lesions also undergo surgical removal. Objective To assess color type and distribution in dermoscopic melanocytic lesion images and to analyze the influence of color parameters on the diagnostic process and the decision to excise. Methods Overall, 603 images, referring to 112 melanomas and 491 nevi, were retrospectively subdivided into four groups: "clearly benign,""follow-up,""dermoscopic atypical nevi," and "dermoscopic melanomas," according to their dermoscopic aspects. The frequency of color type, number, and asymmetry were evaluated on digital images. Results With respect to lesions not eligible for excision according to dermoscopy (but excised for cosmetic reasons), those excised with a suspicion of malignancy showed a higher number of colors, whose distribution was also more asymmetric. Moreover, the frequency of the presence of black and blue-gray progressively increased from clearly benign lesions to atypical nevi and dermoscopic melanomas. Conclusion In dermoscopic images, color parameters are essential elements for the diagnosis of atypical nevus, which can be differentiated from both a clearly benign lesion and a melanoma. Furthermore, pigmentation asymmetry and the presence of blue-gray represent the main color features, which should lead to the decision to excise. THIS STUDY WAS PARTIALLY SUPPORTED BY A GRANT FROM MINISTERO ISTRUZIONE UNIVERSITÇ E RICERCA. [source] ETHICAL PROBLEMS IN CONDUCTING RESEARCH IN ACUTE EPIDEMICS: THE PFIZER MENINGITIS STUDY IN NIGERIA AS AN ILLUSTRATIONDEVELOPING WORLD BIOETHICS, Issue 1 2010EMMANUEL R. EZEOME ABSTRACT The ethics of conducting research in epidemic situations have yet to account fully for differences in the proportion and acuteness of epidemics, among other factors. While epidemics most often arise from infectious diseases, not all infectious diseases are of epidemic proportions, and not all epidemics occur acutely. These and other variations constrain the generalization of ethical decision-making and impose ethical demands on the individual researcher in a way not previously highlighted. This paper discusses a number of such constraints and impositions. It applies the ethical principles enunciated by Emmanuel et al.1 to the controversial Pfizer study in Nigeria in order to highlight the particular ethical concerns of acute epidemic research, and suggest ways of meeting such challenges. The paper recommends that research during epidemics should be partly evaluated on its own merits in order to determine its ethical appropriateness to the specific situation. Snap decisions to conduct research during acute epidemics should be resisted. Community engagement, public notification and good information management are needed to promote the ethics of conducting research during acute epidemics. Individual consent is most at risk of being compromised, and every effort should be made to ensure that it is maintained and valid. Use of data safety management boards should be routine. Acute epidemics also present opportunities to enhance the social value of research and maximize its benefits to communities. Ethical research is possible in acute epidemics, if the potential challenges are thought of ahead of time and appropriate precautions taken. [source] CHALLENGES FACED BY RESEARCH ETHICS COMMITTEES IN EL SALVADOR: RESULTS FROM A FOCUS GROUP STUDYDEVELOPING WORLD BIOETHICS, Issue 1 2009JONATHAN W. CAMP ABSTRACT Objective:, To identify perceived barriers to capacity building for local research ethics oversight in El Salvador, and to set an agenda for international collaborative capacity building. Methods:, Focus groups were formed in El Salvador which included 17 local clinical investigators and members of newly formed research ethics committees. Information about the proposed research was presented to participants during an international bioethics colloquium sponsored and organized by the St. Jude Children's Research Hospital in collaboration with the National Ethics Committee of El Salvador and the University of El Salvador. Interviews with the focus group participants were qualitatively analyzed. Results:, Participants expressed the need to tailor the informed consent process and documentation to the local culture; for example, allowing family members to participate in decision-making, and employing shorter consent forms. Participants indicated that economic barriers often impede efforts in local capacity building. Participants valued international collaboration for mutual capacity building in research ethics oversight. Conclusions:, Research ethics committees in El Salvador possess a basic knowledge of locally relevant ethical principles, though they need more training to optimize the application of bioethical principles and models to their particular contexts. Challenges increase the value of collaborative exchanges with ethics committee members in the United States. Further research on facilitating communication between host country and sponsor country ethics committees can maximize local research ethics expertise, and thus raise the standard of protecting human participants involved in international research. [source] RESEARCH VULNERABILITY: AN ILLUSTRATIVE CASE STUDY FROM THE SOUTH AFRICAN MINING INDUSTRYDEVELOPING WORLD BIOETHICS, Issue 3 2007LYN HORN ABSTRACT The concept of ,vulnerability' is well established within the realm of research ethics and most ethical guidelines include a section on ,vulnerable populations'. However, the term ,vulnerability', used within a human research context, has received a lot of negative publicity recently and has been described as being simultaneously ,too broad' and ,too narrow'.1 The aim of the paper is to explore the concept of research vulnerability by using a detailed case study , that of mineworkers in post-apartheid South Africa. In particular, the usefulness of Kipnis's taxonomy of research vulnerability will be examined.2 In recent years the volume of clinical research on human subjects in South Africa has increased significantly. The HIV and TB pandemics have contributed to this increase. These epidemics have impacted negatively on the mining industry; and mining companies have become increasingly interested in research initiatives that address these problems. This case study explores the potential research vulnerability of mineworkers in the context of the South African mining industry and examines measures that can reduce this vulnerability. [source] RISK FACTORS FOR RECURRENT BILE DUCT STONES AFTER ENDOSCOPIC PAPILLARY BALLOON DILATION: LONG-TERM FOLLOW-UP STUDYDIGESTIVE ENDOSCOPY, Issue 2 2009Akira Ohashi Background:, Little is known about the long-term results of endoscopic papillary balloon dilation (EPBD) for bile duct stones. Methods:, Between 1995 and 2000, 204 patients with bile duct stones successfully underwent EPBD and stone removal. Complete stone clearance was confirmed using balloon cholangiography and intraductal ultrasonography (IDUS). Long-term outcomes of EPBD were investigated retrospectively in the year 2007, and risk factors for stone recurrence were multivariately analyzed. Results:, Long-term information was available in 182 cases (89.2%), with a mean overall follow-up duration of 9.3 years. Late biliary complications occurred in 22 patients (12.1%), stone recurrence in 13 (7.1%), cholangitis in 10 (5.5%), cholecystitis in four, and gallstone pancreatitis in one. In 11 of 13 patients (84.6%), stone recurrence developed within 3 years after EPBD. All recurrent stones were bilirubinate. Multivariate analysis identified three risk factors for stone recurrence: dilated bile duct (>15 mm), previous cholecystectomy, and no confirmation of clean duct using IDUS. Conclusion:, Approximately 7% of patients develop stone recurrence after EPBD; however, retreatment with endoscopic retrograde cholangiopancreatography is effective. Careful follow up is necessary in patients with dilated bile duct or previous cholecystectomy. IDUS is useful for reducing stone recurrence after EPBD. [source] DIAGNOSIS OF COLONIC ADENOMAS BY NEW AUTOFLUORESCENCE IMAGING SYSTEM: A PILOT STUDYDIGESTIVE ENDOSCOPY, Issue 2007Noriya Uedo Detection and removal of adenoma by colonoscopy is an important means of preventing cancer. Autofluorescence endoscopy can visualize flat or isochromatic tumor that was not detectable by white light endoscopy by the difference in tissue fluorescence properties. Recently, a new autofluorescence imaging system (AFI, Olympus Medical Systems) using a combination of autofluorescence and reflection imaging has been developed. The purpose of the present paper was to investigate its feasibility in detection of colonic adenoma in a clinical setting. A total of 64 patients were randomly assigned to AFI or white light groups, and the distal sigmoid colon and the rectum was observed under autofluorescence or white light followed by the other mode of observation by a different endoscopist. The diagnostic ability of each method for detection of neoplasms was compared in relation to the histology as a reference standard. Sensitivity and specificity of AFI for detection of neoplastic polyps was 84% and 60%, respectively, and were similar to those of white light colonoscopy: 90% and 64%. Conventional colonoscopy overlooked more flat lesions including one adenocarcinoma. AFI has the potential to detect more flat lesions but efficacy was unable to be demonstrated in the restricted population. Further investigations are needed to determine optimum usage. [source] EX VIVO CASE STUDY OF ENDOCYTOSCOPY IN SUPERFICIAL ESOPHAGEAL CANCERDIGESTIVE ENDOSCOPY, Issue 2007Mototsugu Kato Microscopic observation at the cellular level using endocytoscopy was obtained in surface mucosa of the gastrointestinal tract. This paper describes ex vivo images for endoscopically resected specimens of superficial esophageal cancer using endocytoscopy with methylene blue staining. The endocytoscopy images of cancerous and non-cancerous sites corresponded generally with horizontal histological images. The pattern of the cellular arrangement and the size and shape of cells were similar between endocytoscopy and horizontal histological imaging. Endocytoscopy is an effective tool for diagnosis of esophageal cancer. [source] SQUAMOUS CELL PAPILLOMA OF THE ESOPHAGUS: CLINICOPATHOLOGICAL STUDY OF 24 CASESDIGESTIVE ENDOSCOPY, Issue 4 2004Junya Oguma Background:, Squamous cell papilloma of the esophagus is considered to be a rare condition; however, the number of cases with this condition reported in recent years has increased, perhaps due to advances in endoscopic diagnosis. Methods:, We reviewed the clinicopathological features of 26 lesions of squamous cell papilloma of the esophagus in 24 cases seen at our hospital from 1994 to 2003. There were nine men and 15 women, with a mean age of 60.5 years (range, 31,82 years). Six patients had a history of malignant disease in the past. With regard to the presence of other lesions in the esophagus, six patients had hiatal hernia and four had gastroesophageal re,ux disease. Results:, Two patients each had two lesions of squamous cell papilloma. There were seven lesions in which in,ammatory cell in,ltration was found on hisotological examination, of which four had underlying hiatal hernia; ,ve lesions were found to have mild dysplasia on histological examination of which three had gastroesophageal re,ux disease. The median duration of follow up of the cases was 8 months (range, 1,101 months). During the follow-up period, none of the lesions showed any dramatic change of appearance or malignant transformation. Conclusion:, In principle, while it may be suf,cient to keep patients with squamous cell papilloma of the esophagus under simple follow up, the patients must be investigated to rule out malignancy of other organs, and the small probability of malignant transformation of the tumor must always be borne in mind. [source] SHARED SERVICES IN AUSTRALIAN LOCAL GOVERNMENT: A CASE STUDY OF THE QUEENSLAND LOCAL GOVERNMENT ASSOCIATION MODELECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 4 2008BRIAN DOLLERY Professor of Economics, Director A host of recent public inquiries into Australian local government have recommended increased use of shared services and resource-sharing models between groups of local councils. While little is known about the extent and consequences of service sharing, emphasis has been fixed on ,horizontal' shared service models between different local councils in the same municipal jurisdictions. However, other models of shared services and resource sharing are possible. This paper considers the Queensland Local Government Association (LGAQ) model as a case study of a resource sharing between all councils in a given system of local government. This form of shared service and resource sharing seems to offer excellent prospects for cost savings and capacity enhancement. [source] DISORDER WITH LAW: A PRELIMINARY STUDY OF VIOLENCE IN RESPONSE TO WATER RIGHTS VIOLATION IN COLONIAL NEW SOUTH WALESECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 2 2008EDWYNA HARRIS Scholars argue that violence will not occur in the presence of efficient property rights institutions. Empirical evidence from the Riverina district in New South Wales between 1855 and 1870 contradicts this claim. This paper provides a preliminary analysis of evidence to explain this apparent inconsistency. Violence was directed at upstream users who dammed rivers, preventing flow to downstream users. Evidence suggests violence was a form of social control referred to as self-help employed to enforce conventions of fairness. Dams were perceived as unfair because they reduced the distributive equity embodied in the common law of riparian rights that established water-use rules to allocate water between competing users. Violence in the form of dam destruction occurred primarily during drought years and was the preferred over common law remedies because of the lag time between seeking court intervention and obtaining a remedy. Coasean bargaining was not possible because of high transaction costs. The findings suggest that violence may occur in the presence of efficient property rights institutions if actors violate conventions of fairness. Violence may be more likely if property rights themselves embody these conventions. [source] ECONBASE DOWNLOADS AND THE RANKING OF AUSTRALIAN UNIVERSITY ECONOMICS RESEARCH: A COMPARATIVE STUDYECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 2 2003ROBERT D. BROOKS First page of article [source] ESTIMATING INCUMBENCY EFFECTS IN U.S. STATE LEGISLATURES: A QUASI-EXPERIMENTAL STUDYECONOMICS & POLITICS, Issue 2 2010YOGESH UPPAL This paper estimates the incumbency effects in elections to the House of Representatives of 45 states in the United States using a quasi-experimental research method, regression discontinuity design (RDD). This design isolates the causal effect of incumbency from other contemporaneous factors, such as candidate quality, by comparing incumbents and non-incumbents in close contests. I find that incumbents in state legislative elections have a significant advantage, and this advantage serves as a strong barrier to re-entry of challengers who had previously been defeated. However, the incumbency advantage estimated using the RDD is much smaller than are the estimates using existing methods, implying a significant selection bias in the latter. [source] FISCAL DECENTRALIZATION AND THE BUSINESS CYCLE: AN EMPIRICAL STUDY OF SEVEN FEDERATIONSECONOMICS & POLITICS, Issue 1 2010JONATHAN RODDEN Although fiscal policies of central governments sometimes provide modest insurance against regional income shocks, this paper shows that procyclical fiscal policy among provincial governments can easily overwhelm these stabilizing effects. We examine the cyclicality of budget items among provincial governments in seven federations, showing that own-source taxes are generally highly procyclical, and contrary to common wisdom, revenue sharing and discretionary transfers are either acyclical or procyclical. Constituent governments are thus left alone to smooth their own shocks, and we document the extent to which various restraints on borrowing and saving undermine their ability to do so. The resulting procyclicality of provincial fiscal policy is likely to have important implications in a world where demands for countercyclical fiscal policy are increasing but considerable fiscal responsibilities are being devolved to subnational governments. [source] PRECLINICAL STUDY: FULL ARTICLE: Altered architecture and functional consequences of the mesolimbic dopamine system in cannabis dependenceADDICTION BIOLOGY, Issue 3 2010Saturnino Spiga ABSTRACT Cannabinoid withdrawal produces a hypofunction of mesencephalic dopamine neurons that impinge upon medium spiny neurons (MSN) of the forebrain. After chronic treatment with two structurally different cannabinoid agonists, ,9 -tetrahydrocannabinol and CP55 940 (CP) rats were withdrawn spontaneously and pharmacologically with the CB1 antagonist SR141716A (SR). In these two conditions, evaluation of tyrosine hydroxylase (TH)-positive neurons revealed significant morphometrical reductions in the ventrotegmental area but not substantia nigra pars compacta of withdrawn rats. Similarly, confocal analysis of Golgi,Cox-stained sections of the nucleus accumbens revealed a decrease in the shell, but not the core, of the spines' density of withdrawn rats. Administration of the CB1 antagonist SR to control rats, provoked structural abnormalities reminiscent of those observed in withdrawal conditions and support the regulatory role of cannabinoids in neurogenesis, axonal growth and synaptogenesis by acting as eu-proliferative signals through the CB1 receptors. Further, these measures were incorporated into a realistic computational model that predicts a strong reduction in the excitability of morphologically altered MSN, yielding a significant reduction in action potential output. These pieces of evidence support the tenet that withdrawal from addictive compounds alters functioning of the mesolimbic system and provide direct morphological evidence for functional abnormalities associated with cannabinoid dependence at the level of dopaminergic neurons and their postsynaptic counterpart and are coherent with recent hypothesis underscoring a hypodopaminergic state as a distinctive feature of the ,addicted brain'. [source] PRECLINICAL STUDY: FULL ARTICLE: Effects of fatty acid amide hydrolase inhibition on neuronal responses to nicotine, cocaine and morphine in the nucleus accumbens shell and ventral tegmental area: involvement of PPAR-, nuclear receptorsADDICTION BIOLOGY, Issue 3 2010Antonio Luchicchi ABSTRACT The endocannabinoid system regulates neurotransmission in brain regions relevant to neurobiological and behavioral actions of addicting drugs. We recently demonstrated that inhibition by URB597 of fatty acid amide hydrolase (FAAH), the main enzyme that degrades the endogenous cannabinoid N-acylethanolamine (NAE) anandamide and the endogenous non-cannabinoid NAEs oleoylethanolamide and palmitoylethanolamide, blocks nicotine-induced excitation of ventral tegmental area (VTA) dopamine (DA) neurons and DA release in the shell of the nucleus accumbens (ShNAc), as well as nicotine-induced drug self-administration, conditioned place preference and relapse in rats. Here, we studied whether effects of FAAH inhibition on nicotine-induced changes in activity of VTA DA neurons were specific for nicotine or extended to two drugs of abuse acting through different mechanisms, cocaine and morphine. We also evaluated whether FAAH inhibition affects nicotine-, cocaine- or morphine-induced actions in the ShNAc. Experiments involved single-unit electrophysiological recordings from DA neurons in the VTA and medium spiny neurons in the ShNAc in anesthetized rats. We found that URB597 blocked effects of nicotine and cocaine in the ShNAc through activation of both surface cannabinoid CB1-receptors and alpha-type peroxisome proliferator-activated nuclear receptor. URB597 did not alter the effects of either cocaine or morphine on VTA DA neurons. These results show that the blockade of nicotine-induced excitation of VTA DA neurons, which we previously described, is selective for nicotine and indicate novel mechanisms recruited to regulate the effects of addicting drugs within the ShNAc of the brain reward system. [source] | ||||||||||||||||||||||||||||||||||