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At least 199 records · Page 11Linked to original sources
PubMed2002

Steering the station back on course.

Rising costs of the International Space Station prompted NASA to convene a panel of experts to assess the quality of ISS cost estimates and review program assumptions and requirements. The panel concluded that NASA was unable to accurately predict ISS costs or to support requests for increased funding for the ISS through 2006 and should maintain a U.S. core complete program with three-person crews with 6-month stays on the ISS. International response to the panel report was negative with space agencies from Japan, Russia, Canada, and Europe taking issue with the expected impact on ISS construction and use.

Cost Allocation↗
PubMed2004

Genomics knowledge and equity: a global public goods perspective of the patent system.

Genomics, the comprehensive examination of an organism's entire set of genes and their interactions, will have a major impact on the way disease is diagnosed, prevented and treated in the new millennium. Despite the tremendous potential it holds for improving global health, genomics challenges policy-makers to ensure that its benefits are harnessed equitably across populations and nations. The classification of genomics as a global public good and the inequity encountered in the development and application of genomics knowledge are outlined in this paper, We examine the effect of the current patent system on the distribution of costs and benefits relating to genomics knowledge between countries of different economic strength. The global public goods concept provides a normative economic rationale for the modification of certain aspects of the current patent system and for the creation of complementary mechanisms to respond to the health needs of low-income and middle-income countries.

Genomics↗
PubMed2006

[A free market is unfavourable for health care].

The new health care system in the Netherlands introduces a free market into the health care sector. Because health care lacks some essential conditions, a free market will not provide effective resource allocation in this sector. In addition, a free market leads to more bureaucracy and less solidarity, cooperation and freedom of choice. It also impairs the autonomy of the medical professional.

Capitalism↗
PubMed1995

Ethical issues influencing health for all beyond the year 2000.

The approach of a new millennium gives us an opportunity to voice optimism about the future, the kind of optimism expressed at the 1978 Alma Ata Primary Health Conference under the slogan, "Health for All by the Year 2000." For those interested in real change, the slogan does not mean that everyone should achieve the same standards of health. Instead, it implies a resistance to anyone from the outside imposing a uniform definition of health on any country; each should allow its own definition of health to evolve and whatever level is achieved should be available "for all." This is a beautiful definition of health equity, the principle of primary healthcare.

Community Health Services↗
PubMed1979

Alternate-day versus intermittent prednisone in frequently relapsing nephrotic syndrome. A report of "Arbetsgemeinschaft für Pädiatrische Nephrologie".

23 children with frequently relapsing minimal-change nephrotic syndrome were treated with alternate-day prednisone (35 mg/m2/48 h) and 25 other patients were treated with intermittent prednisone (40 mg/m2 on three consecutive days out of seven) for six months. This was followed by six months without any maintenance steroid treatment except when relapse required a short period of prednisone therapy until remission. The number of relapsers was significantly lower on alternate-day than on intermittent treatment. In the alternate-day group, the number of relapsers and the rate of relapse was significantly less before treatment withdrawal; in the intermittent group, only the number of relapsers was reduced. An alternate-day regiment is therefore preferable to the intermittent regimen in the interrupted steroid treatment of children with nephrotic syndrome.

Adolescent↗
PubMedDate not supplied

Cash income, intrahousehold cooperative conflict, and child health in central Mozambique.

This study presents qualitative data on individual cash income generation and intrahousehold bargaining in a sample of 100 households in central Mozambique. It is now recognized that intrahousehold resource allocation patterns can be critical determinants of children's health in the developing world. Recently developed "bargaining-power" models suggest that individual incomes are often not pooled in households and that decisions are the result of a bargaining process that involves cooperation and conflict between men and women. Women's income, many believe, is more often spent on child welfare. Development projects should target benefits to women for greater impact on child health. Some argue that households consist of separate, gendered spheres of economic responsibility that intersect through a "conjugal contract" that defines the terms of cooperation. The findings here support the "separate-spheres" depiction of the household and reveal women's subordinated position in the external cash economy, which undermines their intrahousehold bargaining power.

Adult↗
PubMed1978

Hematologic observations made in patients with acute respiratory distress syndrome in the cooperative ECMO project.

In a recently completed three-year multicenter trial, 90 individuals with adult acute respiratory distress syndrome (ARDS) were randomly allocated to conventional therapy with or without long-term extracorporeal membrane oxygenation (ECMO). This study conclusively demonstrated that ARDS is associated with frequent major bleeding and thrombotic episodes and that the bleeding correlates best with the degree of thrombocytopenia and is enhanced by the machine. Neither heparin's therapeutic efficacy nor its ability to increase bleeding could be proven. ARDS is associated with a complex coagulation disturbance. Besides thrombocytopenia, there were lowered circulating levels of factors VII and XII which may be related to changes in the pulmonary endothelium. ECMO was associated with relative leukopenia and a marked shift to immature circulating leukocytes. Further studies are needed to better define the clinical importance of thrombosis and bleeding in the lung, the role for heparin in treatment, and the meaning of reductions in coagulation factors in defining the course, prognosis and response to therapy of patients with ARDS.

Acute Disease↗
PubMed1988

[Participation in a simple large-scale randomized trial organized by EORTC through an international computer network].

Case registration and treatment allocation was achieved in a "Simple large-scale trial against colorectal cancer" designed by the European Organization for Research and Treatment of Cancer (EORTC) using an international computer network system VENUS-P. The access to the central computer "EuroCODE" was obtained by simple equipment including ordinary microcomputer, modem and telephone line. Subscription to the KDD data network VENUS-P using a Packet Assembler/Disassembler (PAD) was necessary to connect to the EuroCODE. Intraoperative patient registration and allocation of treatment were possible through this system regardless of the time difference between countries. To organize a large-scale trial as a means to detect moderate but medically worthwhile treatment differences, this method proved to be particularly effective especially for international cooperative studies.

Colonic Neoplasms↗
PubMed1990

Chemotherapy versus tamoxifen versus chemotherapy plus tamoxifen in node-positive, estrogen receptor-positive breast cancer patients: results of a multicentric Italian study. Breast Cancer Adjuvant Chemo-Hormone Therapy Cooperative Group.

Between November 1, 1983 and June 30, 1987, 510 node-positive, estrogen receptor (ER)-positive breast cancer patients have been randomly allocated to receive either chemotherapy (six intravenous [IV] cyclophosphamide, methotrexate, and fluorouracil [CMF] courses followed by four IV epirubicin courses) or 5 years of tamoxifen treatment or a combination of both therapies. After a median follow-up of 40 months, patients receiving the combined treatment achieved the best results, and those treated with chemotherapy alone achieved the worst, the difference being particularly evident in postmenopausal women. However, while the concurrent use of chemotherapy and tamoxifen did improve the results achieved by chemotherapy alone, particularly in postmenopausal women and in those with four or more involved nodes, it did not significantly improve the results achieved by tamoxifen alone, particularly in patients with higher ER tumor concentrations. Side effects were more numerous and more severe in patients receiving chemotherapy (with or without tamoxifen). Our findings, although still preliminary, confirm that tamoxifen should be the treatment of choice for postmenopausal breast cancer patients with node-positive, ER-positive tumors. In addition, the findings suggest that tamoxifen may represent a safe alternative to chemotherapy (at least to the cytotoxic regimen we used) for younger women, provided they have ER-positive tumors. In patients with ER-positive tumors, the addition of chemotherapy to tamoxifen does not seem to improve significantly the effectiveness of tamoxifen alone.

Adult↗
PubMed1984

Estrogen receptors in mammary cancer: correlation with age, menopausal status, and response to therapy.

The concentration of estrogen receptor protein (ER) in 113 primary or metastatic breast cancers was studied. ER was found to be correlated with the age of the patient. The ER values were generally lower in premenopausal patients (5.6 fmol/mg cytosol protein) than in postmenopausal patients (32.8 fmol/mg cytosol protein). The ER values of perimenopausal patients (0-5 years since the last menstrual period) were heterogeneous but generally closer to those of the premenopausal patients. Use of the ER determination for allocation of the patients either to hormonal (tamoxifen or nandrolonedecanoate) or to cytostatic (adriamycin-cyclophosphamide or Cooper's regimen) therapy was shown to result in highly satisfactory clinical response rates (including complete and partial remissions and stabilized disease) of 68% and 67%, respectively. The practical limit of ER concentration for selection is between 3 and 10 fmol/mg cytosol protein in breast cancer.

Adult↗
PubMed2005

A breast-feeding promotion and support program a randomized trial in The Netherlands.

BACKGROUND: In the Netherlands, the initiation rate of breast-feeding (BF) was 80% in 2002, but only 35% of the mothers continued to breast-feed for 3 months. This study examined the effectiveness of a breast-feeding promotion program to increase the continuation of breast-feeding. METHODS: A cluster-randomized intervention trial was used. Ten child health care centers in three regions of the home health care were randomly allocated to the program or usual care. Elements in the program were health counseling, measures to enhance cooperation, early signaling of breast-feeding problems and continuity of care, and lactation consultancy. Pregnant mothers who applied for home health care in the intervention or usual care regions were enrolled and were followed up from pregnancy until 6 months postpartum (n = 683). The primary outcome measure was the continuation of breast-feeding until at least 3 months. RESULTS: The 3-month breast-feeding rate was 32% in the intervention and 38% in the control groups (OR = 0.79, 95% CI = 0.58-1.08). CONCLUSION: The program was not effective. We discuss possible explanations from the design and execution of the trial and give some points for improvement of our program, such as the categories of caregivers involved and the number and duration of contacts after parturition.

Breast Feeding↗