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PubMed2006

Allogeneic BMT and patient eligibility based on psychosocial criteria: a survey of BMT professionals.

BMT professionals were compared regarding their willingness to proceed with allogeneic BMT given select psychosocial issues. A questionnaire was sent to 660 physician members of ASBMT, 92 social work members of BMT Special Interest Group, Association of Oncology Social Work, and 626 nurse members of BMT Special Interest Group, Oncology Nursing Society; 597 responded with a response rate of 43.5%. Items included background information, followed by 17 case vignettes; each represented a different psychosocial issue to which respondents indicated whether or not they would recommend proceeding with allogeneic BMT. In every vignette, at least 10% of respondents indicated they would not proceed. In six vignettes, at least 64% indicated do not proceed: suicidal ideation (86.8%), uses addictive illicit drugs (81.7%), history of noncompliance (80.5%), no lay caregiver (69.3%), alcoholic (64.8%), and mild dementia/Alzheimer's (64.4%). In 10 vignettes, at least 73% indicated proceed. On four vignettes, professional subgroups differed in their recommendation on whether or not to proceed with allogeneic BMT. Qualitative data suggest that this decision is contingent on the perceived acuity, severity, and currency of the psychosocial issue, patient ability to comply with treatment given the issue, and its manageability as a risk factor for treatment related vulnerability and outcomes.

Bone Marrow Transplantation↗

PubMed2005

Conservative bladder management in advanced multiple sclerosis.

Anticholinergics and intermittent catheterization are the cornerstones of bladder management in early multiple sclerosis (MS). In advanced MS however, bladder management is based more on tradition than on evidence. Nurses seem to deal with catheter problems and chronic incontinence. Despite the abundant use of indwelling catheters, there is a lack for guidelines on catheter-induced problems. The psychosexual and social impact of bladder problems in advanced MS is often neglected. The international multidisciplinary special interest group on sexual, urological and bowel dysfunction in MS (SUBDIMS) as a special interest group of the Rehabilitation in Multiple Sclerosis (RIMS) was confronted with a high variability in practice and a lack of guidelines. A literature review was prepared during three multidisciplinary expert meetings. This review will be the basis of further initiatives to improve the urological treatment of patients with advanced MS.

Evidence-Based Medicine↗

PubMed1996

The politics of mixing older persons and younger persons with disabilities in Federally assisted housing.

Beginning in the late 1980s, government-assisted housing for elderly persons, a popular and successful housing type, began to experience an in-movement of younger persons with disabilities. Advocates for the elderly population expressed alarm about the negative consequences for elderly persons of such "mixing" and of the turnover of this housing to other groups. Based on interviews with key participants and an analysis of documents, this article uses interest group theory and a model of agenda setting to explain why "mixing populations" attained prominence on the Federal housing agenda, the different perspectives of advocates for elderly individuals and younger persons with disabilities concerning the issue, and the implications of the conflict for housing policy and interest group politics.

Adult↗

PubMed2005

Policy perspectives of major nursing organizations. Interview by David M. Keepnews.

Understanding the roles of interest groups is an important element of examining policy change. There are a number of interest groups that affect the policy environment for nursing and that shape the profession's impact on health policy. This article is the first of a series featuring interviews with executive directors/chief executive officers of three major nursing organizations, focusing on their policy priorities and how these priorities are determined. The three organizations featured in this article are the American Nurses Association (ANA), the American Association of Colleges of Nursing (AACN) and the National Council of State Boards of Nursing (NCSBN).

American Nurses' Association↗

PubMed2005

Policy perspectives of major nursing organizations, part II. Interview by David M Keepnews.

Understanding the roles of interest groups is an important element of examining policy change. There are a number of interest groups that affect the policy environment for nursing and that shape the profession's impact on health policy. This article, the second of a two-part series, presents interviews with executive directors and chief executive officers of major nursing organizations about their organizations' policy priorities and policy-related activities. Included in this article are the American Organization of Nurse Executives, the National League for Nursing, Sigma Theta Tau International, and the National Black Nurses Association.

Health Policy↗

PubMed1992

Streptococcus milleri group: renewed interest in an elusive pathogen.

The following review examines the bacteriological characteristics, epidemiology, pathogenicity and antimicrobial susceptibility of the "Streptococcus milleri group". "Streptococcus milleri group" is a term for a large group of streptococci which includes Streptococcus intermedius, Streptococcus constellatus and Streptococcus anginosus. Usually considered commensals, these organisms are often associated with various pyogenic infections including cardiac, abdominal, skin and central nervous system infections. Organisms of the "Streptococcus milleri group" are often unrecognized pathogens due to the lack of uniformity in classifications and difficulties in microbiological identification. Penicillin G, cephalosporins, clindamycin and vancomycin all possess activity against these streptococci. Use of agents with poor activity may promote infections with "Streptococcus milleri group" and allow it to exhibit its pathogenicity. An understanding of these organisms may aid in their recognition and proper treatment.

Animals↗

PubMed2006

Assessment of a blog as a medium for dermatology education.

Our first year experience with the use of a web log as a communication tool for our dermatology interest group at the University of Texas Medical Branch in Galveston (UTMB) is described. We find the UTMB Dermatology Interest Group Blog facilitates educational opportunities and serves as a dermatology resource for medical students, and improves communication. It is an educational innovation that could be adopted by other dermatology departments.

Communication↗

PubMed1996

The social construction of drug debates.

Drug debates normally proceed without scrutiny of why the particular issues being debated are considered the crucial issues. One plausible influence on the terms of debates is the interest groups involved. Four drug debates are addressed in this paper: neuroleptics, drugs in sport, analgesics and marijuana. The key interest groups and their likely influence on the terms of debates are examined. The implication of this analysis is that more attention should be directed to the terms of drug debates rather than just arguing within those terms.

Analgesics↗

PubMed1978

A second look at the dichotomy between consumers and providers in an HSA.

A study of the voting behavior of both consumers and providers involved in an HSA review committee is undertaken to determine the amount of voting cohesion (solidarity) demonstrated by these two basic interest groups as well as the directions in review decisions desired by both of these groups. The case study, involving the third largest HSA in the country, attempts to discern whether the theory of interest group liberalism can be used to describe correctly consumer and provider behavior relative to review decisions. The conclusions reached are that (1) consumers and providers do have differences in their intra-group voting cohesion, but that more importantly (2) they vote for the same end results in terms of approving or denying project reviews. The paper suggests that rational decision tools can play more of an effective role in achieving cost containment.

Capital Expenditures↗

PubMed2000

Vernal pool conservation in connecticut: an assessment and recommendations.

Vernal pools, a variety of ephemeral wetlands, are threatened in many areas of the United States. As habitat fragmentation and degradation increase, some vernal pool amphibian species are declining in numbers. Uneven implementation of state regulations further hampers effective conservation. To prevent further species decline and vernal pool loss, we evaluated alternatives for improving vernal pool conservation. We used transcripts from a recent vernal pool conference, interviews with members of relevant interest groups, and a literature review to determine opportunities for and constraints on improving vernal pool conservation policy. Participants from different interest groups had very diverse views about appropriate protection strategies. We have examined these different perspectives and alternatives and offer policy recommendations on both the state and local level. These recommendations can foster awareness of vernal pools as unique habitats, increase protection of these areas, and expand citizen participation in the vernal pool regulatory process.

Journal Article↗

PubMed1998

A multi-institutional study confirms the presence and expression of simian virus 40 in human malignant mesotheliomas.

Exposure to the carcinogen asbestos is a major factor in the development of malignant mesothelioma. However, not all mesotheliomas are associated with asbestos exposure, and only a small minority of people exposed to asbestos develop mesothelioma. Therefore, the identification of the cofactors that render certain individuals more susceptible to asbestos or that cause mesothelioma in people not exposed to asbestos has been a major priority of the International Mesothelioma Interest Group. The possible association of SV40 with mesothelioma was recently discussed in a special session at the Fourth International Mesothelioma Interest Group Conference, and it was decided to conduct a multi-institutional study to independently verify the presence of this tumor virus in mesotheliomas. We report the results of this investigation: (a) DNA and protein analyses revealed SV40 sequences and SV40 large T antigen expression in 10 of 12 mesotheliomas tested (83%); and (b) electron microscopy demonstrated variable amounts of asbestos fibers in 5 (71%) of 7 corresponding lung tissues available for analysis. Our results demonstrate that SV40 DNA is frequently present and expressed in mesotheliomas in the United States. Because our data demonstrate that some patients test positive for both SV40 and asbestos, the possibility that these two carcinogens interact should be investigated in future studies.

Asbestos↗

PubMed2005

Canadian physical therapists' interest in web-based and computer-assisted continuing education.

BACKGROUND AND PURPOSE: Distance education via computer-assisted learning (CAL), including Web-based and CD-ROM learning, confers a number of advantages compared with traditional learning methods. The purposes of this study were (1) to determine the interest of Canadian physical therapists in participating in continuing education using CAL methods and (2) to determine whether interest in CAL was related to type of employment, area of practice, education, computer skill and access, and other demographic variables. SUBJECTS AND METHODS: A random sample of Canadian physical therapists and all members of cardiopulmonary interest groups were surveyed. RESULTS: Of 1,426 survey questionnaires mailed, 69 were returned (58 were unopened and 11 were duplicates). From the remaining 1,357 potential survey responses, 757 responses were received, for an overall response rate of 56%. Seventy-eight percent of the respondents indicated their interest in participating in CAL. Factors associated with interest in CAL included 2 or more hours of Internet access per week, Internet access at both home and work, computer skill, education level, practice area, and belonging to a cardiopulmonary interest group. DISCUSSION AND CONCLUSION: The findings indicate a large positive interest in CAL. Increasing CAL continuing education opportunities could increase options for physical therapists to meet professional expectations for continuing competency.

Attitude of Health Personnel↗

PubMedDate not supplied

Chile's health sector reform: lessons from four reform periods.

This paper applies an interdisciplinary approach to analyze the process of health reform in four significant periods in Chilean history: (1) the consolidation of state responsibility for public health in the 1920s, (2) the creation of the state-run National Health Service in the 1950s, (3) the decentralization of primary care and privatization of health insurance in the 1980s, and (4) the strengthening of the mixed public-private market in the 1990s. Building on the authors' separate disciplines, the paper examines the epidemiological, political and economic contexts of these reforms to test simple hypotheses about how these factors shape reform adoption and implementation. The analysis underlines: (1) the importance of epidemiological data as an impetus to public policy; (2) the inhibiting role of economic recession in adoption and implementation of reforms: and (3) the importance of the congruence of reforms with underlying political ideology in civil society. The paper also tests several hypotheses about the reform processes themselves, exploring the role of antecedents, interest groups, and consensus-building in the policy process. It found that incremental processes building on antecedent trends characterize most reform efforts. However, interest group politics and consensus building were found to be complex processes that are not easily captured by the simple hypotheses that were tested. The interdisciplinary approach is found to be a promising form of analysis and suggests further theoretical and empirical issues to be explored.

Child↗

PubMed2004

Management objective importance in fisheries: an evaluation using the analytic hierarchy process (AHP).

In determining the importance of criteria in the management of fisheries, two key issues stand out-the definition of a succinct set of criteria and the determination of which interest groups play a defining role in the management development process. This is indeed the case for all natural resource management problems, and many other environmental problems as well. The analytic hierarchy process (AHP) provides an effective framework for such an analysis. The AHP is generally used to evaluate importance amongst criteria based on the concept of paired comparison. This paper considers the development of a representative criteria hierarchy, and uses data obtained from a pairwise comparison survey based on the UK fisheries of the English Channel to investigate priorities that exist among different interest groups in the fisheries. The implementation of the AHP in this application provides a useful tool for analysis of criteria amongst groups involved in the management process with diverse interests.

Animals↗

PubMed2003

Why is big Pharma getting out of antibacterial drug discovery?

Since the advent of the antibiotic era in the late 1940s drug discovery and development has evolved into an expensive, time consuming, cumbersome and bureaucratic process involving multiple interest groups such as pharmaceutical manufacturers, governmental regulatory authorities, patent officers, academic and clinical researchers and trial lawyers. It would seem that the least involved among the interest groups are the consumers of health care themselves. Politicians and the public alike complain loudly about drug prices although fewer and fewer new therapies are being developed. The cost and complexities of drug discovery and development have shifted the investment equation away from the development of drugs targeting short course therapies for acute diseases and towards long-term treatment of chronic conditions. Coupled with the failure of large investments into target-based approaches to produce novel antibacterial agents, companies large and small have exited from this field despite a growing clinical need.

Anti-Bacterial Agents↗

PubMed1996

Clinical practice issues in consultation-liaison psychiatry.

OBJECTIVE: To overview and highlight the issues currently challenging and confronting consultation-liaison (C-L) psychiatry and to present them for discussion in a wider forum. METHOD: Following preliminary discussions, the authors (members of the New South Wales C-L Interest Group) undertook to selectively review a number of issues relevant to C-L psychiatry. A preliminary paper was prepared and then presented to the membership of the interest group. Feedback from this meeting was incorporated into the final version of the paper. RESULTS: Issues selected as a nidus for further discussion include economic issues, changing models of C-L practice, service issues as well as ethical, issues. In addition, recognition of C-L psychiatry as a true subspeciality is foreshadowed. CONCLUSION: This paper highlights some of the challenges for C-L psychiatry both now and in the future. Intuitive beliefs in our efficacy will not suffice in this era of economic rationalisation. Disciplined and focused research substantiating our value is imperative. Subspeciality recognition is likely to ensure uniformity of standards as well as providing the structure and direction required to consolidate C-L psychiatry's future.

Australia↗

PubMed2001

Framing the nicotine debate: a cultural approach to risk.

This study examined Congressional testimony concerning regulation of tobacco advertising by 3 policy factions representing industry, government, and lay activists. On the basis of the cultural theory of risk, policy disputants were divided into entrepreneurial, bureaucratic, and egalitarian communities, each with a distinct cosmology that impedes discourse among the groups. The authors examined ways in which the 3 policy factions framed the tobacco advertising issues to see the extent to which such unique cosmologies were expressed or whether mutual frames might signal opportunities for negotiation among the interest groups. Major themes in the testimony were identified through semantic network analysis and clustering of associated words that revealed discourse patterns peculiar to each group and reflective of their cultural biases toward health risk. Semantic network analysis can be a tool to clarify these presuppositions and unmask relations among factions, thereby bridging policy solutions across interest groups.

Advertising↗

PubMed2001

Iron polynitroporphyrins bearing up to eight beta-nitro groups as interesting new catalysts for H2O2-dependent hydrocarbon oxidation: unusual regioselectivity in hydroxylation of alkoxybenzenes.

A series of iron porphyrins bearing one to eight beta-nitro substituents were synthesized and evalauted as catalysts for hydrocarbon oxidation with H2O2; iron porphyrins bearing five or six beta-nitro groups were the best catalysts for cyclooctene epoxidation and adamantane or anisole hydroxylation without need of a cocatalyst, and led to very different regioselectivities with either H2O2 or PhIO as oxidants, as shown by an unusual ortho-hydroxylation of alkoxybenzenes highly favored in the H2O2-dependent oxidations.

Journal Article↗