Termination of the leprosy isolation policy in the US and Japan : Science, policy changes, and the garbage can model

BACKGROUND: In both the US and Japan, the patient isolation policy for leprosy /Hansen's disease (HD) was preserved along with the isolation facilities, long after it had been proven to be scientifically unnecessary. This delayed policy termination caused a deprivation of civil liberties of the involuntarily confined patients, the fostering of social stigmas attached to the disease, and an inefficient use of health resources. This article seeks to elucidate the political process which hindered timely policy changes congruent with scientific advances. METHODS: Examination of historical materials, supplemented by personal interviews. The role that science played in the process of policy making was scrutinized with particular reference to the Garbage Can model. RESULTS: From the vantage of history, science remained instrumental in all period in the sense that it was not the primary objective for which policy change was discussed or intended, nor was it the principal driving force for policy change. When the argument arose, scientific arguments were employed to justify the patient isolation policy. However, in the early post-WWII period, issues were foregrounded and agendas were set as the inadvertent result of administrative reforms. Subsequently, scientific developments were more or less ignored due to concern about adverse policy outcomes. Finally, in the 1980s and 1990s, scientific arguments were used instrumentally to argue against isolation and for the termination of residential care. CONCLUSION: Contrary to public expectations, health policy is not always rational and scientifically justified. In the process of policy making, the role of science can be limited and instrumental. Policy change may require the opening of policy windows, as a result of convergence of the problem, policy, and political streams, by effective exercise of leadership. Scientists and policymakers should be attentive enough to the political context of policies

Miniaturized flow cytometer with 3D hydrodynamic particle focusing and integrated optical elements applying silicon photodiodes

In this study, the design, realization and measurement results of a novel optofluidic system capable of performing absorbance-based flow cytometric analysis is presented. This miniaturized laboratory platform, fabricated using SU-8 on a silicon substrate, comprises integrated polymer-based waveguides for light guiding and a biconcave cylindrical lens for incident light focusing. The optical structures are detached from the microfluidic sample channel resulting in a significant increase in optical sensitivity. This allows the application of standard solid-state laser and standard silicon-based photodiodes operated by lock-in-amplification resulting in a highly practical and effective detection system. The easy-to-fabricate single-layer microfluidic structure enables independently adjustable 3D hydrodynamic sample focusing to an arbitrary position in the channel. To confirm the fluid dynamics and raytracing simulations and to characterize the system, different sets of microparticles and T-lymphocyte cells (Jurkat cell line) for vital staining were investigated by detecting the extinction (axial light loss) signal. The analytical classification via signal peak height/width demonstrates the high sensitivity and sample discrimination capability of this compact low-cost/low-power microflow cytometer.BiotechnologyApplied Science

Policy functions of smoking control in Japan

Analysis of policy functions, with a focus on their major participants, elicits a clear picture of the decision-making process for smoking control in Japan. Activities of various advocacy groups have affected the functions of policy, including: Intelligence, Promotion, Prescription, Invocation, Application and Appraisal. In fulfilling these functions, they have affected every issue they faced by creating, transforming and propagating information in line with their interests and by influencing government decisions using coalition-building and the lobbying of elected officials. Furthermore, they have determined the development and implementation of various programs, even assuming key roles in substantiating the decisions. On the other hand, political leverage by the tobacco industry, exercised through various policy functions, intimidated the government leadership and eventually controlled its actions. When the nonsmokers’ rights groups emerged, they gradually started to take part in policy functions, sometimes in cooperation with the health agency. The initial and final forms of smoking control policies in society have been deeply affected by the involvement of these groups