Innovation and public accountability in clinical research.
(9/1382)
For more than 20 years, clinical researchers have expressed alarm about the decline of their field, but they have failed to achieve a consensus on policies to revitalize and sustain it. Although they have traced the plight of clinical research to profound changes in science, medicine, and public expectations, their conservative vision and preference for short-term measures inhibit effective policy formulation. These trends are the outcome of historical developments, and they seem to mandate a new approach to public policy. A potential source for more viable and socially accountable policies lies in practitioners' notion that clinical research bridges basic and applied science (by translating scientific innovations into practical measures). Exploiting that idea, however, would require a major reorientation of the field toward health services research and the institutions that are struggling to support it. (+info)
Income inequality and health: pathways and mechanisms.
(10/1382)
The relationship between income and health is well established: the higher an individual's income, the better his or her health. However, recent research suggests that health may also be affected by the distribution of income within society. We outline the potential mechanisms underlying the so-called relative income hypothesis, which predicts that an individual's health status is better in societies with a more equal distribution of incomes. The effects of income inequality on health may be mediated by underinvestment in social goods, such as public education and health care; disruption of social cohesion and the erosion of social capital; and the harmful psychosocial effects of invidious social comparisons. (+info)
Equality and selection for existence.
(11/1382)
It is argued that the policy of excluding from further life some human gametes and pre-embryos as "unfit" for existence is not at odds with a defensible idea of human equality. Such an idea must be compatible with the obvious fact that the "functional" value of humans differs, that their "use" to themselves and others differs. A defensible idea of human equality is instead grounded in the fact that as this functional difference is genetically determined, it is nothing which makes humans deserve or be worthy of being better or worse off. Rather, nobody is worth a better life than anyone else. This idea of equality is, however, not applicable to gametes and pre-embryos, since they are not human beings, but something out of which human beings develop. (+info)
New federal office will spend millions to regulate herbal remedies, vitamins.
(12/1382)
The new Office of Natural Health Products promises better regulation of herbal remedies, but its creation raises many questions. (+info)
Comparative hazards of chrysotile asbestos and its substitutes: A European perspective.
(13/1382)
Although the use of amphibole asbestos (crocidolite and amosite) has been banned in most European countries because of its known effects on the lung and pleura, chrysotile asbestos remains in use in a number of widely used products, notably asbestos cement and friction linings in vehicle brakes and clutches. A ban on chrysotile throughout the European Union for these remaining applications is currently under consideration, but this requires confidence in the safety of substitute materials. The main substitutes for the residual uses of chrysotile are p-aramid, polyvinyl alcohol (PVA), and cellulose fibers, and it is these materials that are evaluated here. Because it critically affects both exposure concentrations and deposition in the lung, diameter is a key determinant of the intrinsic hazard of a fiber; the propensity of a material to release fibers into the air is also important. It is generally accepted that to be pathogenic to the lung or pleura, fibers must be long, thin, and durable; fiber chemistry may also be significant. These basic principles are used in a pragmatic way to form a judgement on the relative safety of the substitute materials, taking into account what is known about their hazardous properties and also the potential for uncontrolled exposures during a lifetime of use (including disposal). We conclude that chrysotile asbestos is intrinsically more hazardous than p-aramid, PVA, or cellulose fibers and that its continued use in asbestos-cement products and friction materials is not justifiable in the face of available technically adequate substitutes. (+info)
Talking trash: the economic and environmental issues of landfills.
(14/1382)
The U.S. per-capita figure for garbage production has topped four pounds per person per day, and that amount is rising at roughly 5% per year. In the past, municipal solid waste was sent to the nearest local landfill or incinerator. But in 1988, the U.S. Environmental Protection Agency instituted the first federal standards for landfills, designed to make them safer. Over 10,000 small municipal landfills have since been consolidated into an estimated 3,500 newer, safer landfills, some of which are "megafills" that can handle up to 10,000 tons of waste a day. The new landfills are outfitted to prevent air and water pollution and limit the spread of disease by scavengers. Although the new landfills provide better controls against air and water pollution as well as an alternate source of municipal income, they are not entirely problem-free. Some experts believe the new landfill technology has not been properly tested and will therefore not provide protection in the long run. Others feel that poorer, less well-informed communities are targeted as sites for new landfills. In addition, many people that live near megafills, which may draw garbarge from several states, are unhappy about the noise, truck traffic, odors, and pests caused by the facilities. (+info)
Trading trash: why the U.S. won't sign on to the Basel convention.
(15/1382)
Environmentalists worry that hazardous wastes produced in industrialized nations are being dumped in cash-starved developing countries--the countries with the least political or economic clout to resist and the fewest resources for managing these toxic imports. Imported waste can pose a serious threat to the health of human populations and ecosystems if not managed appropriately. In 1989, the international community initiated efforts to reduce the flow of hazardous wastes from industrialized countries to developing countries by drafting a treaty known as the Basel Convention on the Control of Transboundary Wastes and their Disposal. The convention's mission is to strictly regulate the international transfer of hazardous wastes and to ensure that wastes are managed and disposed of in an environmentally sound manner. Although the United States supports the convention in theory, it remains the only industrialized country within the Organization for Economic Cooperation and Development yet to ratify it. However, legislation drafted by the Clinton administration that is soon to go before the 106th Congress could make the United States a party to the convention. (+info)
Childhood asthma.
(16/1382)
Asthma prevalence in children has increased 58% since 1980. Mortality has increased by 78%. The burden of the disease is most acute in urban areas and racial/ethnic minority populations. Hospitalization and morbidity rates for nonwhites are more than twice those for whites. Asthma is characterized by recurrent wheezing, breathlessness, chest tightness, and coughing. Research in the past decade has revealed the importance of inflammation of the airways in asthma and clinical treatment to reduce chronic inflammation. Asthma is associated with production of IgE to common environmental allergens including house dust mite, animal dander, cockroach, fungal spores, and pollens. Some interventions to reduce symptoms through control of dust mite and animal dander have had positive results. Control of symptoms through interventions to reduce exposures to cockroach antigen has not been reported. Studies illustrating causal effects between outdoor air pollution and asthma prevalence are scant. Increases in asthma prevalence have occurred at the same time as general improvements in air quality. However, air quality appears to exacerbate symptoms in the child who already has the disease. Decreased pulmonary function has been associated with exposure to particulates and bronchial hyperresponsiveness to smoke, SO(2) and NO(2). Symptoms have been correlated with increased levels of respirable particulates, ozone, and SO(2). Interventions that reduce the negative outcomes in asthma associated with outdoor environmental factors have not been reported. Control of asthma in children will entail the collaborative efforts of patients, family, clinical professionals, and school personnel, as well as community-wide environmental control measures and conducive national and local policies based on sound research. (+info)