Gangliosides for acute spinal cord injury.

BACKGROUND: Spinal cord injury (SCI) results in loss of feeling and movement. The consequences can be devastating for the patient and his or her carers. Global estimates of the number of new cases annually range from 15 to 40 per million. Leading causes of acute SCI are road traffic injury, violence, and injuries sustained in sports and other recreational activities. Care for people with SCI has improved, leading to an increase in survival rates. Attempts to improve patients' feeling and movement have involved the use of a wide range of treatments. Gangliosides are compounds that occur naturally in cell membranes. Laboratory studies have suggested they may have protective effects on nerves and even help them to re-grow. Clinical trials have taken place using gangliosides (usually GM1 ganglioside) for a number of neurological conditions. OBJECTIVES: To quantify the evidence for the effectiveness and safety of gangliosides when used to treat acute SCI. SEARCH STRATEGY: We searched the following databases to identify trials for inclusion: CENTRAL, MEDLINE, EMBASE, and the National Research Register. We also searched web-based trials registers, such as Current Controlled Trials. We approached the manufacturers of the most widely used ganglioside and researchers in this field to try to locate any unpublished data. SELECTION CRITERIA: Randomised controlled trials of any ganglioside versus controls, in patients with SCI. Outcome measures specified were: mortality, recovery of motor function, improvement in sensory measures, measures of functional activity, infections and any other adverse events. DATA COLLECTION AND ANALYSIS: Data were extracted from published studies and authors were contacted for further information. All data found was dichotomous and odds ratios (with 95% CIs) were calculated. A fixed-effects model was assumed. MAIN RESULTS: Two studies met the inclusion criteria. There were no deaths in one (n=37). In the other (n=760), there were slightly more deaths in the treatment group than in the control group; odds ratio 1.07 (0.57, 2.00 95%CI) - a result that can be explained by the play of chance. Methodological weaknesses regarding the collection and presentation of data from the two studies made it impossible to reach any conclusions regarding the effect of gangliosides on the other specified outcomes. AUTHORS' CONCLUSIONS: The evidence available does not support the use of ganglioside treatment to reduce the death rate in SCI patients. No evidence has yet emerged that ganglioside treatment improves recovery or quality of life in survivors

Harmful Freedom of Choice: Lessons from the Cellphone Market

This article focuses on the relationship between provider and customer, specifically on the complexity of available contracts in the cellphone market and the ways this complexity might be harmful to consumers. This article aims to elucidate the issues, fleshing them out both as a general phenomenon and as a specific implementation in the cellphone context. The aim is not to provide ultimate solutions, but to show the directions these solutions might take and the difficulties involved

Tragedy of the Regulatory Commons: LightSquared and the Missing Spectrum Rights

The endemic underuse of radio spectrum constitutes a tragedy of the regulatory commons. Like other common interest tragedies, the outcome results from a legal or market structure that prevents economic actors from executing socially efficient bargains. In wireless markets, innovative applications often provoke claims by incumbent radio users that the new traffic will interfere with existing services. Sometimes these concerns are mitigated via market transactions, a la “Coasian bargaining.” Other times, however, solutions cannot be found even when social gains dominate the cost of spillovers. In the recent “LightSquared debacle,” such spectrum allocation failure played out. GPS interests that access frequencies adjacent to the band hosting LightSquared’s new nationwide mobile network complained that the wireless entrant would harm the operation of locational devices. Based on these complaints, regulators then killed LightSquared’s planned 4G network. Conservative estimates placed the prospective 4G consumer gains at least an order of magnitude above GPS losses. “Win win” bargains were theoretically available, fixing GPS vulnerabilities while welcoming the highly valuable wireless innovation. Yet transaction costs—largely caused by policy choices to issue limited and highly fragmented spectrum usage rights (here in the GPS band)—proved prohibitive. This episode provides a template for understanding market and non-market failure in radio spectrum allocation

Reducing the burden of depression in youth: what are the implications of neuroscience and genetics on policies and programs?

Mood disorders are a leading cause of the burden of disease in youth. Three critical lessons emerge from the reviews in this issue that are relevant to our understanding of these common mental disorders: first, that the brain is in a highly dynamic stage of its development during youth; second, that environmental factors interact with genetic factors to influence the probability of risk behaviors and dysphoric states; and third, that shared developmental and genetic factors may account for the bulk of emotional and behavioral outcomes in youth, and that environmental influences may affect the specific expression of the phenotypes associated with these pathways. Although this evidence does not immediately indicate the potential for new interventions, it is consistent with current policy and practice recommendations. Interventions should focus on both improving the early detection and management of depressive disorders as well as preventive strategies that aim to train children and youth to improve cognitive control and manage stress more effectively. Limiting access to harmful risk-taking situations and providing opportunities to engage are less harmful, but equally exciting, alternatives in a pragmatic universal prevention policy option. Key research priorities and paradigms emerge from this evidence, particularly in the context of the grand challenges in global mental health

Patient Guide to Access Quality Health Information Online

A large percentage of patients use online search engines to access health information. However, there is a large amount of health information online that is unregulated and not evidence-based. As a result patients may acquire health information that is incorrect which may negatively affect patient-provider relationships and patient\u27s healthcare. A brochure was created to highlight safe practices for accessing health information online.https://scholarworks.uvm.edu/fmclerk/1492/thumbnail.jp

Foreword

The collection of articles in this Special Issue is based on an international conference on Advances in the Behavioral Analysis of Law: Markets, Institutions, and Contracts that took place on December 8, 2009 at the University of Haifa Faculty of Law in Israel. The conference addressed cuttingedge legal issues at the intersection of law, economics, and psychology from a diverse set of viewpoints, bringing together scholars engaged in both theoretical and experimental behavioral analyses of law

Patent Monopolies and the Costs of Mismarketing Drugs

Patent monopolies have long been used as a mechanism for financing innovation and research. The logic is that the government awards a monopoly on a product or process for a limited period of time in order to reward innovation. However, in addition to providing incentives for innovation and research, patent monopolies also provide incentives for a wide-range of rent-seeking behaviors, many of which can have major social costs. This paper attempts to calculate one category of these costs for prescription drugs. It produces estimates of the costs associated with mismarketing drugs. The estimates are based on assessments of the costs in the form of increased morbidity and mortality associated with five prominent cases of mismarketing over the last two decades

Clinical psychology of Internet addiction: a review of its conceptualization, prevalence, neuronal processes, and implications for treatment

Research into Internet addiction (IA) has grown rapidly over the last decade. The topic has generated a great deal of debate, particularly in relation to how IA can be defined conceptually as well as the many methodological limitations. The present review aims to further elaborate and clarify issues that are relevant to IA research in a number of areas including: definition and characterization, incidence and prevalence rates, associated neuronal processes, and implications for treatment, prevention, and patient-specific considerations. It is concluded that there is no consensual definition for IA. Prevalence rates among nationally representative samples across several countries vary greatly (from 1% to 18.7%), most likely reflecting the lack of methodological consistency and conceptual rigor of the studies. The overlaps between IA and other more traditional substance-based addictions and the possible neural substrates implicated in IA are also highlighted. In terms of treatment and prevention, both psychological and pharmacological treatments are examined in light of existing evidence alongside particular aspects inherent to the patient perspective. Based on the evidence analyzed, it is concluded that IA may pose a serious health hazard to a minority of people