bluuebunny/crossref_metadata_2025 huggingface dataset:
Conhecimento popular e utilização dos medicamentos genéricos na população do município de Tubarão, SC
Authors: Blatt Carine Raquel , Trauthman Silvana Cristina , Schmidt Edegar Henrique , Marchesan Samuel , Silva Luana May da , Martins João Luiz
Published: March 2012

Embora os genéricos tenham sido introduzidos no país para oferecer alternativa mais acessível aos medicamentos de referência, representam apenas 14% das vendas em unidades no conjunto do mercado farmacêutico. O objetivo deste trabalho foi pesquisar o nível de conhecimento e o grau de utilização de genéricos em residentes do município de Tubarão, SC. Para isso, realizou-se um estudo transversal com uma amostra de 234 entrevistados, estratificada por bairro. Quanto ao grau de utilização, a maioria dos entrevistados já havia utilizado genéricos, e metade possuía pelo menos um exemplar dessa opção em casa. Para verificar o conhecimento sobre os diferentes tipos de medicamentos, realizou-se um teste de identificação de figuras de embalagens representativas das versões genérico, de referência e similar do paracetamol e do atenolol, 91,0% dos sujeitos identificaram corretamente todas as figuras. Ser de classe econômica mais elevada, já ter utilizado medicamento genérico, acreditar que o genérico tem o mesmo efeito que o medicamento de referência, encontrar medicamentos genéricos nas farmácias com facilidade e costumar comprar o genérico foram fatores associados positivamente com a identificação correta.
Utilização de benzodiazepínicos no Serviço Municipal de Saúde de Coronel Fabriciano, Minas Gerais
Authors: Firmino Karleyla Fassarelo , Abreu Mauro Henrique Nogueira Guimarães de , Perini Édson , Magalhães Sérgia Maria Starling de
Published: March 2012

Neste estudo foram avaliadas as indicações de benzodiazepínicos no Serviço Municipal de Saúde de Coronel FabricianoMG, verificando sua conformidade com o preconizado pela literatura. O estudo avaliou todas as receitas desses medicamentos provenientes das Unidades Municipais de Saúde no período de Setembro a Outubro de 2006, os formulários de indicação clínica preenchidos pelo prescritor e cadastros informatizados do serviço. Analisaram-se 1.866 receitas, sendo 59,7% do Diazepam e o restante do Clonazepam. A Dose Diária Definida por mil habitantes por dia foi de 24,69 para o Diazepam e de 3,58 para o Clonazepam. Cerca de 50% das indicações relatadas pelos médicos foram como hipnótico ou ansiolítico, 21,9% para "uso crônico/dependência" e o restante para outras indicações. Das receitas que atenderam aos critérios de inclusão para análise da adequação da indicação (1618), cerca de 70% foram consideradas não adequadas, tendo em vista a indicação e o tempo de tratamento. Houve um alto percentual de inadequação na utilização de benzodiazepínicos, principalmente pelo uso prolongado e para atender a casos considerados pelos prescritores como uso crônico/dependência. Assim, há responsabilidade do serviço de saúde na manutenção da dependência.
A falta de informação sobre os Organismos Geneticamente Modificados no Brasil
Authors: Ribeiro Isabelle Geoffroy , Marin Victor Augustus
Published: March 2012

O presente artigo apresenta uma revisão sobre a rotulagem de produtos que apresentem em sua composição Organismos Geneticamente Modificados (OGM), também denominados de transgênicos. São abordadas as convenções, as leis e as normas referentes a esses produtos dispostos no mercado, a adequação dos mesmos às normas vigentes e sua aceitação pela sociedade. Dispõe também sobre a importância do princípio da precaução na avaliação da aplicação de novas tecnologias ou de tecnologias das quais não se conhece ou existam conhecimentos científicos relevantes quanto aos seus potenciais riscos ao meio ambiente, à saúde humana e à sociedade.
Regulamentação da propaganda de alimentos infantis como estratégia para a promoção da saúde
Authors: Henriques Patrícia , Sally Enilce Oliveira , Burlandy Luciene , Beiler Renata Mondino
Published: March 2012

As práticas alimentares da população brasileira vêm se alterando nas últimas décadas e a publicidade é um dos fatores que contribuem para esta situação. O objetivo deste trabalho foi avaliar o conteúdo das propagandas de alimentos veiculadas na televisão e dirigidas a crianças, sob a ótica da regulação. As propagandas foram gravadas em fitas VHS de duas grandes emissoras de televisão, no período de férias escolares. Foram utilizadas técnicas de análise de conteúdo e definidas oito categorias de análise a partir do referencial teórico sobre as práticas alimentares e seus determinantes. Para subsidiar a análise utilizou-se a proposta de Regulamento Técnico da Anvisa. Foram contabilizadas 1018 propagandas, das quais foram selecionadas as 132 (12,9%) que anunciavam alimentos dirigidos para as crianças, sendo identificados somente 12 produtos diferentes. De acordo com o Regulamento proposto, todas as propagandas analisadas infringiam pelo menos três artigos, entre os quais se destaca o 4º, Incisos III e VIb. É nítida a urgência do setor público de regular o conteúdo das propagandas de alimentos infantis, cujo consumo pode ser prejudicial à saúde devido à influência que exercem na decisão pela compra, tanto por parte das próprias crianças, quanto dos pais.
Conflitos morais e atenção à saúde em Aids: aportes conceituais para uma ética discursiva do cuidado
Authors: Oliveira Luzia Aparecida , Ayres José Ricardo de Carvalho Mesquita , Zoboli Elma Lourdes Campos Pavone
Published: March 2012

Este artigo apresenta aspectos teóricos que sustentam uma ética do Cuidado de base discursiva, como utilizado em estudo que examinou os conflitos morais na assistência às pessoas vivendo com HIV/Aids. Com base na Bioética deliberativa, define conflito moral como um conflito de deveres. Foram utilizadas a ética do Discurso e as proposições do Cuidado, assumindo que o trabalho em saúde é eminentemente relacional e comunicacional. Conclui que a ética do Cuidado de base discursiva reconhece a racionalidade nas decisões que envolvem aspectos morais no cotidiano da assistência. A busca de solução dos conflitos, sob essa perspectiva, sugere um processo dialético em que as razões para os argumentos são consideradas. Evidenciar argumentos diversos, incluindo aqueles que são contraditórios, mas defensáveis, possibilita a tomada de decisões prudentes.
Capecitabine Monotherapy: Review of Studies in First-Line HER-2-Negative Metastatic Breast Cancer
Authors: O'Shaughnessy Joyce A. , Kaufmann Manfred , Siedentopf Friederike , Dalivoust Philippe , Debled Marc , Robert Nicholas J. , Harbeck Nadia
Published: March 2012

The goals of treatment for metastatic breast cancer (MBC) are to prolong overall survival (OS) while maximizing quality of life, palliating symptoms, and delaying tumor progression. For many years, anthracyclines and taxanes have been the mainstay of treatment for MBC, but these agents are now commonly administered earlier in the course of the disease. A recent meta-analysis revealed adverse effects on OS and overall response rates in patients with MBC receiving first-line anthracycline-based chemotherapy following relapse on adjuvant chemotherapy. Noncrossresistant cytotoxic agents and combinations that combine high clinical activity and acceptable tolerability while being convenient for patients are therefore needed for the first-line treatment of MBC patients. Capecitabine has substantial antitumor activity in the first-line treatment of patients with MBC in prospective, randomized, phase II/III clinical trials as monotherapy and in combination with biologic and novel agents. First-line capecitabine monotherapy has a favorable safety profile, lacking myelosuppression and alopecia, and does not compromise the administration of further lines of chemotherapy. Capecitabine is suitable for long-term administration without the cumulative toxicity that can limit the prolonged use of other chemotherapy agents. Here, we review the available data on capecitabine as a single agent for first-line treatment of patients with human epidermal growth factor receptor 2–negative MBC.
Habitat specialization and the role of trait lability in structuring diverse willow (genusSalix) communities
Authors: Savage Jessica A. , Cavender-Bares Jeannine
Published: March 2012

The co‐occurrence of closely related species is challenging to explain because biotic filters are expected to limit the ecological similarity of species within communities. To investigate the mechanisms important in facilitating species' co‐occurrence in diverse willow and poplar communities, we examined functional diversity and community phylogenetic structure along a hydrologic gradient. We focused on traits related to drought tolerance, leaf hydraulics, and recruitment, and examined species' phylogenetic relatedness and trait lability using a molecular phylogeny. Within habitats, species exhibited phenotypic clustering, and across the landscape, species distributions were correlated with their functional traits in a manner consistent with environmental filtering. With increasing water availability, communities changed from being phylogenetically even to being phylogenetically clustered. We suggest that this shift results from environmental filtering acting on conserved traits in wet habitats and labile traits in dry habitats. Taken together, these results suggest that environmental filtering is important to community assembly along the entire hydrologic gradient within this system. Although many of the traits important to habitat specialization in upland habitats are phylogenetically labile, species' habitat affinity is phylogenetically conserved overall, indicating that niche conservatism can occur as an emergent property despite trait lability. This study demonstrates the complementary nature of trait and community phylogenetic analyses and how these methods can be used to better understand the processes involved in community assembly along environmental gradients.
Implementing Childhood Obesity Policy in a New Educational Environment: The Cases of Mississippi and Tennessee
Authors: Amis John M. , Wright Paul M. , Dyson Ben , Vardaman James M. , Ferry Hugh
Published: March 2012

Objectives. Our purpose was to investigate the processes involved in, and outcomes of, implementing 3 new state-level, school-oriented childhood obesity policies enacted between 2004 and 2007.

Methods. We followed policy implementation in 8 high schools in Mississippi and Tennessee. We collected data between 2006 and 2009 from interviews with policymakers, administrators, teachers, and students; observations of school-based activities; and documents.

Results. Significant barriers to the effective implementation of obesity-related policies emerged. These most notably include a value system that prioritizes performances in standardized tests over physical education (PE) and a varsity sport system that negatively influences opportunities for PE. These and other factors, such as resource constraints and the overloading of school administrators with new policies, mitigate against the implementation of policies designed to promote improvements in student health through PE.

Conclusions. Policies designed to address health and social problems in high-school settings face significant barriers to effective implementation. To have a broad impact, obesity-related policies must be tied to mainstream educational initiatives that both incentivize, and hold accountable, the school-level actors responsible for their implementation.
Strong Tobacco Control Program Requirements and Secure Funding Are Not Enough: Lessons From Florida
Authors: Kennedy Allison , Sullivan Sarah , Hendlin Yogi , Barnes Richard , Glantz Stanton
Published: March 2012

Florida’s Tobacco Pilot Program (TPP; 1998–2003), with its edgy Truth media campaign, achieved unprecedented youth smoking reductions and became a model for tobacco control programming. In 2006, 3 years after the TPP was defunded, public health groups restored funding for tobacco control programming by convincing Florida voters to amend their constitution. Despite the new program’s strong legal structure, Governor Charlie Crist’s Department of Health implemented a low-impact program. Although they secured the program’s strong structure and funding, Florida’s nongovernmental public health organizations did not mobilize to demand a high-impact program. Implementation of Florida’s Amendment 4 demonstrates that a strong programmatic structure and secure funding are insufficient to ensure a successful public health program, without external pressure from nongovernmental groups.
Evidence of Human Papillomavirus Vaccine Effectiveness in Reducing Genital Warts: An Analysis of California Public Family Planning Administrative Claims Data, 2007–2010
Authors: Bauer Heidi M. , Wright Glenn , Chow Joan
Published: March 2012

Because of the rapid development of genital warts (GW) after infection, monitoring GW trends may provide early evidence of population-level human papillomavirus (HPV) vaccine effectiveness. Trends in GW diagnoses were assessed using public family planning administrative data. Between 2007 and 2010, among females younger than 21 years, these diagnoses decreased 35% from 0.94% to 0.61% (Ptrend < .001). Decreases were also observed among males younger than 21 years (19%); and among females and males ages 21-25 (10% and 11%, respectively). The diagnoses stabilized or increased among older age groups. HPV vaccine may be preventing GW among young people.
Payer Status, Race/Ethnicity, and Acceptance of Free Routine Opt-Out Rapid HIV Screening Among Emergency Department Patients
Authors: Sankoff Jeffrey , Hopkins Emily , Sasson Comilla , Al-Tayyib Alia , Bender Brooke , Haukoos Jason S.
Published: March 2012

Objectives. We estimated associations between payer status, race/ethnicity, and acceptance of nontargeted opt-out rapid HIV screening in the emergency department (ED).

Methods. We analyzed data from a prospective clinical trial between 2007 and 2009 at Denver Health. Patients in the ED were offered free HIV testing. Patient demographics and payer status were collected, and we used multivariable logistic regression to estimate associations with HIV testing acceptance.

Results. A total of 31 525 patients made 44 765 unique visits: 40% were White, 37% Hispanic, 14% Black, 1% Asian, and 7% unknown race/ethnicity. Of all visits, 10 237 (23%) agreed to HIV testing; 27% were self-pay, 23% state-sponsored, 18% Medicaid, 13% commercial insurance, 12% Medicare, and 8% another payer source. Compared with commercial insurance patients, self-pay patients (odds ratio [OR] = 1.63; 95% confidence interval [CI] = 1.51, 1.75), state-sponsored patients (OR = 1.64; 95% CI = 1.52, 1.77), and Medicaid patients (OR = 1.24; 95% CI = 1.14, 1.34) had increased odds of accepting testing. Compared with White patients, Black (OR = 1.29; 95% CI = 1.21, 1.38) and Hispanic (OR = 1.17; 95% CI = 1.11, 1.23) patients had increased odds of accepting testing.

Conclusions. Many ED patients are uninsured or subsidized through government programs and are more likely to consent to free rapid HIV testing.
Methods for the Scientific Study of Discrimination and Health: An Ecosocial Approach
Authors: Krieger Nancy
Published: March 2012

The scientific study of how discrimination harms health requires theoretically grounded methods. At issue is how discrimination, as one form of societal injustice, becomes embodied inequality and is manifested as health inequities.

As clarified by ecosocial theory, methods must address the lived realities of discrimination as an exploitative and oppressive societal phenomenon operating at multiple levels and involving myriad pathways across both the life course and historical generations.

An integrated embodied research approach hence must consider (1) the structural level—past and present de jure and de facto discrimination; (2) the individual level—issues of domains, nativity, and use of both explicit and implicit discrimination measures; and (3) how current research methods likely underestimate the impact of racism on health.
Institutional Variation in the Promotion of Racial/Ethnic Minority Faculty at US Medical Schools
Authors: Nunez-Smith Marcella , Ciarleglio Maria M. , Sandoval-Schaefer Teresa , Elumn Johanna , Castillo-Page Laura , Peduzzi Peter , Bradley Elizabeth H.
Published: March 2012

Objectives. We compared faculty promotion rates by race/ethnicity across US academic medical centers.

Methods. We used the Association of American Medical College's 1983 through 2000 faculty roster data to estimate median institution-specific promotion rates for assistant professor to associate professor and for associate professor to full professor. In unadjusted analyses, we compared medians for Hispanic and Black with White faculty using the Wilcoxon rank sum test. We compared institution-specific promotion rates between racial/ethnic groups with data stratified by institutional characteristic (institution size, proportion racial/ethnic minority faculty, and proportion women faculty) using the χ2 test. Our sample included 128 academic medical centers and 88 432 unique faculty.

Results. The median institution-specific promotion rates for White, Hispanic, and Black faculty, respectively, were 30.2%, 23.5%, and 18.8% (P < .01) from assistant to associate professor and 31.5%, 25.0%, and 16.7% (P < .01) from associate to full professor.

Conclusions. At most academic medical centers, promotion rates for Hispanic and Black were lower than those for White faculty. Equitable faculty promotion rates may reflect institutional climates that support the successful development of racial/ethnic minority trainees, ultimately improving healthcare access and quality for all patients.
A Framework for Mobilizing Communities to Advance Local Tobacco Control Policy: The Los Angeles County Experience
Authors: Weber Mark D. , Simon Paul , Messex Monty , Aragon Linda , Kuo Tony , Fielding Jonathan E.
Published: March 2012

The Los Angeles County Tobacco Control and Prevention Program was significantly restructured in 2004 to improve capacity for local policy adoption. Restructuring included creating a fully staffed and trained policy unit; partnering with state-funded tobacco control organizations to provide high-quality, continuous technical assistance and training; implementing a highly structured policy adoption approach; expanding community capacity building; and establishing local coalitions to mobilize communities. Over the ensuing 6 years (2004–2010), 97 tobacco control policies were enacted in the county’s 88 cities and unincorporated area, including 79 that were attributable to the program. By comparison, only 15 policies were enacted from 1998 to 2003. Expanding policy adoption capacity through program restructuring may be achievable in other local jurisdictions.
Implicit Stereotyping and Medical Decisions: Unconscious Stereotype Activation in Practitioners' Thoughts About African Americans
Authors: Moskowitz Gordon B. , Stone Jeff , Childs Amanda
Published: March 2012

Objectives. We investigated whether stereotypes unconsciously influence the thinking and behavior of physicians, as they have been shown to do in other professional settings, such as among law enforcement personnel and teachers.

Methods. We conducted 2 studies to examine whether stereotypes are implicitly activated in physicians. Study 1 assessed what diseases and treatments doctors associate with African Americans. Study 2 presented these (and control terms) to doctors as part of a computerized task. Subliminal images of African American and White men appeared prior to each word, and reaction times to words were recorded.

Results. When primed with an African American face, doctors reacted more quickly for stereotypical diseases, indicating an implicit association of certain diseases with African Americans. These comprised not only diseases African Americans are genetically predisposed to, but also conditions and social behaviors with no biological association (e.g., obesity, drug abuse).

Conclusions. We found implicit stereotyping among physicians; faces they never consciously saw altered performance. This suggests that diagnoses and treatment of African American patients may be biased, even in the absence of the practitioner's intent or awareness.
Under the Radar: How Unexamined Biases in Decision-Making Processes in Clinical Interactions Can Contribute to Health Care Disparities
Authors: Dovidio John F. , Fiske Susan T.
Published: March 2012

Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities.

Biases are complex but systematic, differing by racial/ethnic group and not limited to love–hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions.

Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health.
The Influence of Implicit Bias on Treatment Recommendations for 4 Common Pediatric Conditions: Pain, Urinary Tract Infection, Attention Deficit Hyperactivity Disorder, and Asthma
Authors: Sabin Janice A. , Greenwald Anthony G.
Published: March 2012

Objectives. We examined the association between pediatricians’ attitudes about race and treatment recommendations by patients’ race.

Methods. We conducted an online survey of academic pediatricians (n = 86). We used 3 Implicit Association Tests to measure implicit attitudes and stereotypes about race. Dependent variables were recommendations for pain management, urinary tract infections, attention deficit hyperactivity disorder, and asthma, measured by case vignettes. We used correlational analysis to assess associations among measures and hierarchical multiple regression to measure the interactive effect of the attitude measures and patients’ race on treatment recommendations.

Results. Pediatricians’ implicit (unconscious) attitudes and stereotypes were associated with treatment recommendations. The association between unconscious bias and patient’s race was statistically significant for prescribing a narcotic medication for pain following surgery. As pediatricians’ implicit pro-White bias increased, prescribing narcotic medication decreased for African American patients but not for the White patients. Self-reported attitudes about race were associated with some treatment recommendations.

Conclusions. Pediatricians’ implicit attitudes about race affect pain management. There is a need to better understand the influence of physicians’ unconscious beliefs about race on pain and other areas of care.
Self-Reported Experience of Racial Discrimination and Health Care Use in New Zealand: Results From the 2006/07 New Zealand Health Survey
Authors: Harris Ricci , Cormack Donna , Tobias Martin , Yeh Li-Chia , Talamaivao Natalie , Minster Joanna , Timutimu Roimata
Published: March 2012

Objectives. We investigated whether reported experience of racial discrimination in health care and in other domains was associated with cancer screening and negative health care experiences.

Methods. We used 2006/07 New Zealand Health Survey data (n = 12 488 adults). We used logistic regression to examine the relationship of reported experience of racial discrimination in health care (unfair treatment by a health professional) and in other domains (personal attack, unfair treatment in work and when gaining housing) to breast and cervical cancer screening and negative patient experiences adjusted for other variables.

Results. Racial discrimination by a health professional was associated with lower odds of breast (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.14, 0.996) and cervical cancer (OR = 0.51; 95% CI = 0.30, 0.87) screening among Maori women. Racial discrimination by a health professional (OR = 1.57; 95% CI = 1.15, 2.14) and racial discrimination more widely (OR = 1.55; 95% CI = 1.35, 1.79) were associated with negative patient experiences for all participants.

Conclusions. Experience of racial discrimination in both health care and other settings may influence health care use and experiences of care and is a potential pathway to poor health.
Reporting Guidelines and the American Journal of Public Health’s Adoption of Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Authors: McLeroy Kenneth R. , Northridge Mary E. , Balcazar Hector , Greenberg Michael R. , Landers Stewart J.
Published: March 2012

Widespread recognition of the need to improve the science of published research, as well as the moral and ethical reasons for adequately reporting study results, has spurred recent interest in strengthening journal research reporting through the use of reporting guidelines. Reporting guidelines also provide information for readers to judge study quality.

American Journal of Public Health previously adopted the Consolidated Standards of Reporting Trials and Transparent Reporting of Evaluations With Nonrandomized Designs guidelines and recently endorsed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

In adopting these guidelines, the journal aims to support authors, reviewers, and editors in reporting and evaluating systematic reviews of public health policy and practice priorities.
A Life Course Perspective on How Racism May Be Related to Health Inequities
Authors: Gee Gilbert C. , Walsemann Katrina M. , Brondolo Elizabeth
Published: March 2012

Recent studies show that racism may influence health inequities. As individuals grow from infancy into old age, they encounter social institutions that may create new exposures to racial bias. Yet, few studies have considered this idea fully. We suggest a framework that shows how racism and health inequities may be viewed from a life course perspective. It applies the ideas of age-patterned exposures, sensitive periods, linked lives, latency period, stress proliferation, historic period, and cohorts. It suggests an overarching idea that racism can structure one’s time in asset-building contexts (e.g., education) or disadvantaged contexts (e.g., prison). This variation in time and exposure can contribute to racial inequities in life expectancy and other health outcomes across the life course and over generations.
Research on Discrimination and Health: An Exploratory Study of Unresolved Conceptual and Measurement Issues
Authors: Williams David R. , John Dolly A. , Oyserman Daphna , Sonnega John , Mohammed Selina A. , Jackson James S.
Published: March 2012

Objectives. Our goal in this study was to better understand racial and socioeconomic status (SES) variations in experiences of racial and nonracial discrimination.

Methods. We used 1999 and 2000 data from the YES Health Study, which involved a community sample of 50 Black and 50 White respondents drawn from 4 neighborhoods categorized according to racial group (majority Black or majority White) and SES (≤ 150% or > 250% of the poverty line). Qualitative and quantitative analyses examined experiences of discrimination across these neighborhoods.

Results. More than 90% of Blacks and Whites described the meaning of unfair treatment in terms of injustice and felt certain about the attribution of their experiences of discrimination. These experiences triggered similar emotional reactions (most frequently anger and frustration) and levels of stress across groups, and low-SES Blacks and Whites reported higher levels of discrimination than their moderate-SES counterparts.

Conclusions. Experiences of discrimination were commonplace and linked to similar emotional responses and levels of stress among both Blacks and Whites of low and moderate SES. Effects were the same whether experiences were attributed to race or to other reasons.
Trypanosomatids: Odd Organisms, Devastating Diseases
Authors: H. Lopes Angela , Souto-Padrón Thaïs , A. Dias Felipe , T. Gomes Marta , C. Rodrigues Giseli , T. Zimmermann Luciana , Alves e Silva Thiago L. , B. Vermelho Alane
Published: March 2012

Trypanosomatids cause many diseases in and on animals (including humans) and plants. Altogether, about 37
million people are infected with Trypanosoma brucei (African sleeping sickness), Trypanosoma cruzi (Chagas disease)
and Leishmania species (distinct forms of leishmaniasis worldwide). The class Kinetoplastea is divided into the subclasses
Prokinetoplastina (order Prokinetoplastida) and Metakinetoplastina (orders Eubodonida, Parabodonida, Neobodonida and
Trypanosomatida) [1,2]. The Prokinetoplastida, Eubodonida, Parabodonida and Neobodonida can be free-living, commensalic
or parasitic; however, all members of theTrypanosomatida are parasitic. Although they seem like typical protists
under the microscope the kinetoplastids have some unique features. In this review we will give an overview of the family
Trypanosomatidae, with particular emphasis on some of its “peculiarities” (a single ramified mitochondrion; unusual mitochondrial
DNA, the kinetoplast; a complex form of mitochondrial RNA editing; transcription of all protein-encoding
genes polycistronically; trans-splicing of all mRNA transcripts; the glycolytic pathway within glycosomes; T. brucei variable
surface glycoproteins and T. cruzi ability to escape from the phagocytic vacuoles), as well as the major diseases
caused by members of this family. However, the present review does not cover all trypanosomatids; for example, the insect
trypanosomatids are underrepresented here. On the other hand, reviews on this particular group of parasites have been
written by experts in the field [3-12].
Contributions of Ultrastructural Studies to the Cell Biology of Trypanosmatids: Targets for Anti-Parasitic Drugs
Authors: C. Almeida Camila Marques Adade , Souto-Padrón Thaïs
Published: March 2012

Protozoan parasites cause disease in humans worldwide, and many fall into the genera Trypanosoma and
Leishmania; these parasites are responsible for African trypanosomiasis, Chagas disease and the different forms of
Leishmaniasis. Strategies for the development of new drugs against these protozoans have been based on their cell biology
and biochemistry complemented by the use of electron microscopy. Trypanosoma and Leishmania have special organelles
that are involved in metabolic pathways, which are very distinct from those in mammalian cells; these organelles
are potential drug targets. Scanning and transmission electron microscopy can identify not only the target organelles but
also alterations to the cell surface and ultrastructural changes that characterize distinct forms of programmed cell death.
A framework for pharmaceutical value-based innovations
Authors: Salimi Tehseen , Lehner Jean-Pierre , Epstein Robert S , Tunis Sean R
Published: March 2012

The rapidity of change and increasing complexity of today’s healthcare environment dictates that pharmaceutical companies refine their drug development process to ensure that products provide maximal value to consumers. Innovation should receive the support and encouragement it deserves but the balance between cost of therapy and enhanced benefits to the end users, the patients, must not be compromised. The health or quality-of-life outcomes that therapies are likely to achieve need to be clearly stated for patients so they know what to expect before beginning treatment. A drug development program that incorporates principles of ‘patient-centered medicine’ early on can help define the true value of a health technology. This demands not only demonstrating value as measured by actual patient experience and patient-reported outcomes, but understanding the unmet needs of multiple stakeholders: what is their perception of what represents value? What factors impact healthcare coverage decisions? In this paper, we describe an illustrative framework designed to weave ‘patient-centric’ medical and real-world evidence into the phases of research and development. This evidence and value development framework works iteratively, providing useful insights parallel to product development from early phase to life-cycle management while forming a progressive evidence chain throughout the phases of research and development. This in turn leads to the creation of value-based innovation with robust foundational evidence for clinical decisions, postlaunch coverage and reimbursement evaluations.
Integrating new approaches for clinical development: translational research and relative effectiveness
Authors: Lehner Jean-Pierre , Epstein Robert S , Salimi Tehseen
Published: March 2012

Translational research and relative effectiveness are being incorporated into drug development programs to meet the demands for more robust evidence generation to support the value of new therapies. Translational research includes translating basic research into clinical practice, controlled clinical trials into potential clinical implications, evidence-based guidelines into routine clinical practice and standard practices into population health. These research concepts link with real-world outcomes, and feed into each other to improve the efficiency of research. Translational research can run into road blocks in terms of conveying the added or comparative value of research or during adoption into clinical practice. Understanding these roadblocks and developing solutions are important for success. Comparative effectiveness research can be a useful research technique to accomplish many translational medicine goals. These studies generally include heterogeneous patient populations and evaluate outcomes of relevance to payers and health technology assessors. Comparative effectiveness research can be used in drug development; different methodologies may be useful in different phases. In this article, suggestions and examples of successful use of comparative effectiveness studies are provided. Translational research and comparative effectiveness research, although clearly independent concepts, can provide a focused approach to drug development, resulting in products entering the market that bring added benefit to patients and the healthcare system overall.
Clinical practice change requires more than comparative effectiveness evidence: abdominal aortic aneurysm management in the USA
Authors: Ballard David J , Filardo Giovanni , Graca Briget da , Powell Janet T
Published: March 2012

Adoption of healthcare innovations frequently outpaces the evidence of effectiveness. Endovascular repair (EVAR) for abdominal aortic aneurysms in the USA demonstrates how comparative effectiveness research without evidence-based reimbursement changes may fail to influence clinical practice. Randomized controlled trials for small abdominal aortic aneurysms demonstrate no lasting benefits of EVAR or open surgical repair (OSR) compared with surveillance, and for large abdominal aortic aneurysms demonstrate no lasting survival benefit of EVAR over OSR, and do show poorer durability and higher costs for EVAR. Nonetheless, >50% of elective abdominal aortic aneurysm repairs in the USA use EVAR. Factors that may be driving the high use of EVAR include patient preference, surgeons’ desire to appear ‘up-to-date’ in the procedures they offer, higher hourly surgeon reimbursement for EVAR than OSR, and the expansion of physician specialties able to perform abdominal aortic aneurysm repair from only vascular surgeons with OSR, to vascular surgeons and interventional radiologists/cardiologists with EVAR. By comparison, in Canada, where government health insurance restricts EVAR coverage to high surgical risk patients, only approximately 25% of abdominal aortic aneurysm repairs are performed using EVAR. Country-specific cost studies and a prospective population-based study collecting detailed clinical data to identify patient subgroups that truly benefit from a particular management strategy are needed to inform policy regarding EVAR availability and reimbursement.
Employment modelling in Slovakia: Comparing logit models in 2005 and 2009
Authors: Luckanicová Martina , Ondruseková Ivana , Resovsky Marcel
Published: March 2012

In this paper we present models based on a statistical modelling approach
that explain the effects of selected variables on employment in Slovakia in
the years 2005 and 2009. The probability of becoming employed (employability/
odds ratio) was based on individual data from the harmonized EU SILC
statistical survey with some socio-economic factors. For quantification of
the mentioned variables? impact on the dependent variable (employment)
logistic regression was applied. The results confirmed a positive effect of
work experience and the highest level of education attained on employability.
Conversely, in some cases age showed a negative effect on the dependent
variable, and to some extent gender also had a significant effect. In terms
of region, a lower chance of becoming employed was found for inhabitants in
Eastern Slovakia when compared to other regions.
The limitations of microcredit for promoting microenterprises in Bangladesh
Authors: Alam Mahmudul , Molla Islam
Published: March 2012

Microcredit is regarded as a tool for poverty alleviation. A stereotyped
delivery system is designed and used for promoting and serving survival- and
subsistence-level economic activities, particularly for poor female clients.
In Bangladesh its success has raised social expectations as to its potential
as also a promoter of microenterprises, which are growth-yielding small
businesses beyond subsistence-level economic activity. The field survey shows
that about 11.7% of the microcredit borrowers are this kind of potential or
growing microentrepreneur. It also shows that microcredit?s standardised
delivery system, particularly in respect of gender preference, loan size,
loan disbursement, and repayment schedules, is a strong limiting factor in
effectively serving the microenterprises, which require a more flexible
credit package. Therefore a methodological modification is necessary to
accommodate flexibility in the microcredit delivery system.
Gender inequality in the Serbian labour market
Authors: Boskovic Olgica , Njegovan Nikola
Published: March 2012

Many positive changes have been implemented in Serbia since the beginning of
the transition period, and while these improve the position of women in the
labour market the main indicators still show significant gender differences.
Women are the majority of the unemployed and there are significant
differences between regions and districts, in fields of work, experience, and
the length of time taken to find work. An analysis of trends in the labour
market over the past decade shows a worsening of the position of women, with
a lower participation in economic activity and employment, rising
unemployment rates, and an increase in the average time to find work and the
proportion of women in traditionally female occupations. Problems of gender
inequality demand more attention in order to improve existing legislation and
the implementation of economic policies in the labour market which will
ensure higher participation of women with lower education, with special
emphasis on increasing the motivation of these women to undergo continuing
education and training.
Diabetes Disrupts the Response of Retinal Endothelial Cells to the Angiomodulator Lysophosphatidic Acid
Authors: Aranda Jorge , Motiejunaite Ruta , Im Eunok , Kazlauskas Andrius
Published: March 2012

The objectives of this study were to investigate how diabetes mellitus (DM) influences responsiveness of retinal neovessels to lysophosphatidic acid (LPA) and to elucidate the underlying mechanism. To this end, we used an ex vivo assay in which neovessels sprouted from retinal explants (isolated from either control or DM mice) when cultured between two layers of collagen and in the presence of vascular endothelial growth factor-A. While DM had no effect on the formation of neovessels, it prevented LPA-induced regression. High-glucose (HG) treatment of retinal explants mimicked the DM phenotype. Similarly, primary retinal endothelial cells (RECs), which were subjected to HG treatment, organized into tubes that were resistant to LPA. HG caused LPA resistance within RECs by elevating ROS, which activated Src-family kinases that stimulated the extracellular signal–related kinase (Erk) pathway, which antagonized LPA-mediated signaling events that were required for regression. This ROS/Src/Erk pathway mechanism appeared to be the same route by which DM induced LPA resistance of retinal neovessels. We conclude that DM/HG reprograms signaling pathways in RECs to induce a state of LPA resistance.
Liver X Receptor α Is Involved in the Transcriptional Regulation of the 6-Phosphofructo-2-Kinase/Fructose-2,6-Bisphosphatase Gene
Authors: Zhao Li-Feng , Iwasaki Yasumasa , Nishiyama Mitsuru , Taguchi Takafumi , Tsugita Makoto , Okazaki Mizuho , Nakayama Shuichi , Kambayashi Machiko , Fujimoto Shimpei , Hashimoto Koshi , Murao Koji , Terada Yoshio
Published: March 2012

The activity of 6-phosphofructo-1-kinase is strictly controlled by fructose-2,6-bisphosphate, the level of which is regulated by another enzyme, 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase (PFK2/FBP2). PFK2/FBP2 is a bifunctional enzyme, having kinase and phosphatase activities, and regulates both glycolysis and gluconeogenesis. Here, we examined the hormonal regulation of the PFK2/FBP2 gene in vitro using the reporter assay, the electromobility shift assay (EMSA), and the chromatin immunoprecipitation (ChIP) assay in HuH7 cells and also using the mouse liver in vivo. We found that the transcriptional activity of the PFK2/FBP2 gene was stimulated by insulin and inhibited by cAMP and glucocorticoid. Liver X receptor (LXR) α showed a potent and specific stimulatory effect on PFK2/FBP2 gene transcription. Deletion and mutagenesis analyses identified the LXR response element (LXRE) in the 5′-promoter region of the PFK2/FBP2 gene. Binding of LXRα was confirmed by the EMSA and ChIP assay. Endogenous PFK2/FBP2 mRNA in the mouse liver was increased in the fasting/refeeding state compared with the fasting state. Altogether, PFK2/FBP2 gene transcription is found to be regulated in a way that is more similar to other glycolytic enzyme genes than to gluconeogenic genes. Furthermore, our data strongly suggest that LXRα is one of the key regulators of PFK2/FBP2 gene transcription.
The ATP-P2X7 Signaling Axis Is Dispensable for Obesity-Associated Inflammasome Activation in Adipose Tissue
Authors: Sun Shengyi , Xia Sheng , Ji Yewei , Kersten Sander , Qi Ling
Published: March 2012

Inflammasome activation in adipose tissue has been implicated in obesity-associated insulin resistance and type 2 diabetes. However, when and how inflammasome is activated in adipose tissue remains speculative. Here we test the hypothesis that extracellular ATP, a potent stimulus of inflammasome in macrophages via purinergic receptor P2X, ligand-gated ion channel, 7 (P2X7), may play a role in inflammasome activation in adipose tissue in obesity. Our data show that inflammasome is activated in adipose tissue upon 8-week feeding of 60% high-fat diet (HFD), coinciding with the onset of hyperglycemia and hyperinsulinemia as well as the induction of P2X7 in adipose tissue. Unexpectedly, P2X7-deficient animals on HFD exhibit no changes in metabolic phenotypes, inflammatory responses, or inflammasome activation when compared with the wild-type controls. Similar observations have been obtained in hematopoietic cell–specific P2X7-deficient animals generated by bone marrow transplantation. Thus, we conclude that inflammasome activation in adipose tissue in obesity coincides with the onset of hyperglycemia and hyperinsulinemia but, unexpectedly, is not mediated by the ATP-P2X7 signaling axis. The nature of the inflammasome-activating danger signal(s) in adipose tissue in obesity remains to be characterized.
Fibroblastic and Myofibroblastic Tumors in Children and Adolescents
Authors: Coffin Cheryl M. , Alaggio Rita
Published: March 2012

Fibroblastic and myofibroblastic tumors in children and adolescents are a relatively common group of soft tissue proliferations that range from reactive to hamartomatous to neoplastic, with a full spectrum of benign, intermediate, and malignant neoplasms. These lesions are diagnostically challenging because of morphologic and immunohistochemical overlap, despite significant clinical, genetic, and prognostic differences. The fibromatoses are a major subgroup, and all types of fibromatoses can occur in the 1st 2 decades of life. Intermediate and malignant fibroblastic-myofibroblastic tumors are an important group that includes variants of fibrosarcoma and other tumors with recurrent cytogenetic or molecular genetic abnormalities and low metastatic potential. Pathologic examination is enhanced by adjunct techniques, such as immunohistochemistry, cytogenetics, and molecular genetics, although morphology provides the ultimate criteria for a specific diagnosis. This article reviews the clinicopathologic features of fibroblastic and myofibroblastic tumors with an emphasis on the unique aspects of these neoplasms in children and adolescents, the use of diagnostic adjuncts, and differential diagnoses.
Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor and Related Tumors
Authors: Tsokos Maria , Alaggio Rita D. , Dehner Louis P. , Dickman Paul S.
Published: March 2012

Ewing sarcoma/peripheral primitive neuroectodermal tumor (EWS/pPNET) and other tumors with EWS gene rearrangements encompass a malignant and intermediate neoplasm with a broad anatomic distribution and a wide age range but a predilection for soft tissue in children, adolescents, and young adults. The overlapping histologic, immunohistochemical and cytogenetic and molecular genetic features create diagnostic challenges despite significant clinical and prognostic differences. Ewing sarcoma is the 3rd most common sarcoma in children and adolescents, and desmoplastic small round cell tumor is a rare neoplasm that occurs more often in older children, adolescents, and young adults. Pathologic examination is complemented by immunohistochemistry, cytogenetics, and molecular genetics. This article reviews the clinicopathologic features of EWS/pPNET and desmoplastic small round cell tumor in the spectrum of tumors with EWS gene rearrangements. Other tumors with different histopathologic features and an EWS gene rearrangement are discussed elsewhere in this volume.
Soft Tissue Tumors of Uncertain Origin
Authors: Alaggio Rita , Coffin Cheryl M. , Vargas Sara O.
Published: March 2012

Many soft tissue tumors of childhood lack obvious differentiation toward a defined mesenchymal tissue type or have a phenotype that does not correspond to any defined normal tissue. These challenging tumors are currently regarded as neoplasms of uncertain differentiation. Nonetheless, there have been great strides in the understanding of their pathologic and genetic features and biologic underpinnings. The application of new genetic information to the pathologic diagnosis among this group of tumors is an emerging area in diagnostic pediatric pathology. This article reviews the clinicopathologic features of tumors of uncertain and/or miscellaneous origin, with an emphasis on the unique aspects of these neoplasms in children and adolescents, use of diagnostic adjuncts, and differential diagnosis.