Understanding and harnessing genomic variation will contribute significantly to improving the health of people in developing countries. We need to explore the nexus between pharmacogenetics, ...genotyping projects in developing countries, and the evolution of the pharmaceutical industry in both the developed and developing worlds. Here, we argue that, for the foreseeable future, we should focus not on boutique 'personalized' medicine, but on carefully defined differences between populations and ethical ways of using emerging genomics knowledge to develop drugs and improve health.
The notion that developing countries must wait for the developed world to make advances in science and technology that they later import at great cost is being challenged. We have previously argued ...that developing countries can harness human genetic variation to benefit their populations and economies. Based on our empirical studies of large-scale population genotyping projects in Mexico, India and Thailand, we describe how these resources are being adopted to improve public health and create knowledge-based economies. A significant additional benefit is building the capacity for scientific research and internalizing advances in technology, whatever their source.
Pregnant women in developing countries present to antenatal clinics much later in pregnancy than the women in the original studies; they are often anaemic and malnourished, and they live within a ...context in which breast feeding has different implications for newborn infants. ...advice not to breast feed would contradict years of intensive education by the World Health Organization.
The notion that developing countries must wait for the developed world to make advances in science and technology that they later import at great cost is being challenged. We have previously argued ...that developing countries can harness human genetic variation to benefit their populations and economies. Based on our empirical studies of large-scale population genotyping projects in Mexico, India and Thailand, we describe how these resources are being adopted to improve public health and create knowledge-based economies. A significant additional benefit is building the capacity for scientific research and internalizing advances in technology, whatever their source.
Objectives/Hypothesis:
To review malpractice cases involving complications following tonsillectomy.
Study Design:
Retrospective analysis at a tertiary medical center of jury verdict reports within ...the LexisNexis (Dayton, OH) database submitted after tonsillectomy malpractice cases.
Methods:
The LexisNexis MEGA Jury Verdicts and Settlements database was reviewed from 1984 through 2010 for complications resulting from tonsillectomy. Data including year of case, surgical complication, injury, case result, and judgment awarded were collected and analyzed.
Results:
One hundred seventy‐eight reports met inclusion criteria and were reviewed. Postoperative bleeding was the most common complication (33.7%), followed by anoxic events (16.9%), and impaired function (15.7%). Patient death occurred in 40.4% of reports and was most frequently associated with postoperative bleeding (54.2%), followed by anoxic events (18.1%), and postoperative medication issues (16.7%). Monetary awards were available in 24.7% of reports. Anoxic event was noted to have the highest median award at $3,051,296, followed by postoperative medication at $950,000.
Conclusions:
Tonsillectomy carries a large amount of risk from a malpractice standpoint. Postoperative bleeding is the complication most commonly associated with malpractice claims, but may not carry the greatest overall risk from a patient care or monetary standpoint. Hypoxic and anoxic events, although less common, appear to carry more morbidity for the patient and are associated with greater settlements and judgments in malpractice claims. Tonsillectomy continues to carry a significant mortality risk, albeit infrequent, and a high level of vigilance should be employed to help reduce these risks.
Up to now the visual inspection of mobility of isolated anisakid larvae serves as a measure of viability and possible risk of infection. This paper presents a new method to rule out unreliability – ...caused by the temporary immobility of the larvae and by the human uncertainty factor of visual observation. By means of a Near infrared (NIR) imaging method, elastic curvature energies and geometric shape parameters were determined from contours, and used as a measure of viability. It was based on the modelling of larvae as a cylindrical membrane system. The interaction between curvatures, contraction of the longitudinal muscles, and inner pressure enabled the derivation of viability from stationary form data. From series of spectrally signed images within a narrow wavelength range, curvature data of the larvae were determined. Possible mobility of larvae was taken into account in statistical error variables. Experiments on individual living larvae, long-term observations of Anisakis larvae, and comparative studies of the staining method and the VTD measurements of larvae from the tissue of products confirmed the effectiveness of this method. The VTD differentiated clearly between live and dead nematode larvae isolated from marinated, deep-frozen and salted products. The VTD has been proven as excellent method to detect living anisakid nematode larvae in fishery products and is seen as useful tool for fish processing industry and control authorities.
Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited ...guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly.
We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making.
Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly.
Since first proposed 2, there has been some attention to the evolution of CSREs in the literature 3, 4, with much of the focus on how to achieve an appropriate balance between the ...advisory/consulting role of the emerging CSREs and the review, monitoring, and oversight responsibilities of their counterpart institutional review boards (IRBs) 5. ...the importance of integration, of looking for broad applications of narrowly intended solutions, of bringing diverse perspectives to bear on complex ethical challenges, and of rigorous impact evaluation are by no means limited to global health; as such, we hope these lessons may also prove useful for CSREs focused on a wide range of scientific endeavors.
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