Long-term treatment with cinacalcet and conventional therapy reduces parathyroid hyperplasia in severe secondary hyperparathyroidism

Background. The effect of cinacalcet on the structural pattern of hyperplastic parathyroid glands was evaluated, using high-resolution colour Doppler (CD) sonography, in haemodialysis patients with severe, inadequately controlled, secondary hyperparathyroidism (sHPT)

From theory to practice: improving the impact of health services research

BACKGROUND: While significant strides have been made in health research, the incorporation of research evidence into healthcare decision-making has been marginal. The purpose of this paper is to provide an overview of how the utility of health services research can be improved through the use of theory. Integrating theory into health services research can improve research methodology and encourage stronger collaboration with decision-makers. DISCUSSION: Recognizing the importance of theory calls for new expectations in the practice of health services research. These include: the formation of interdisciplinary research teams; broadening the training for those who will practice health services research; and supportive organizational conditions that promote collaboration between researchers and decision makers. Further, funding bodies can provide a significant role in guiding and supporting the use of theory in the practice of health services research. SUMMARY: Institutions and researchers should incorporate the use of theory if health services research is to fulfill its potential for improving the delivery of health care

Freedom of Association: The Attack on Single-Sex College Social Organizations

In 1979, a student at Princeton University named Sally Frank filed a complaint with the New Jersey Division on Civil Rights against three social and eating clubs that restricted their memberships to male students at Princeton University. The clubs - Ivy Club, Cottage Club, and Tiger Inn - are three of a group of eleven clubs that many students at Princeton University traditionally join to receive meals and use social facilities. Frank alleged, and the Division eventually ruled, that the all-male clubs violated the New Jersey Law Against Discrimination, which prohibits discrimination on the basis of sex in places of public accommodation. The Princeton case signals problems for single-sex social organizations at other colleges and universities in New Jersey and around the country. Forty states and the District of Columbia have public accommodation laws similar to the New Jersey statute, and many fraternities, sororities, and other social organizations have characteristics that make them vulnerable to a ruling against their membership policies in light of the Princeton case

Effect of a topical beta‐adrenergic receptor antagonist on the dynamics of steady‐state accommodation

The ocular accommodation response to a stationary near target exhibits microfluctuations which arc characterized by two dominant components of activity: a low‐frequency component (LFC: < 0.5 Hz) and a high‐frequency component (HFC: 1.0–2.2 Hz). We have shown recently that there is a significant correlation between the frequency of arterial pulse (AP) and the peak frequency of the HFC. If the mechanisms by which AP induces the HFC are intraocular they are likely to involve both rhythmic variations in choroidal blood flow and intraocular pressure (IOP) pulse: the former inducing changes in ciliary ring diameter from pulsatile blood volume changes in the ciliary body, the latter producing changes in effective lens power following small shifts in lens position or, with each drop in IOP. reduced resistance to inherenl lens substance and capsule elasticity. In addition to its well‐known ocular hypotensive effect, topical instillation of the beta‐ad renergic receptor antagonist timntol maleate has been shown to reduce significantly the magnitude of the IOP pulse, an effect that has been attributed to the vasoconstrictive action of the drug on the choroidal vasculature. Using li modified Canon IR optometcr we report on the effect of 0.5% timolol maleate on the accommodative microfluctuations for a group of 10 emmetropic subjects viewing a target monocularly at a distance of 25 cm. Following a double‐blind protocol against a saline control, timoloi was shown to reduce the rms for both LFCs and HFCs. An experiment to separate local from systemic effects involved four subjects whose treated and untreated eyes were examined to determine the effects of the consensual reduction in IOP: the results on microfluctuations in the untreated eyes were equivocal but the correlation between arterial pulse frequency and location of the peak frequency of HFC was maintained. The results show that factors relating to IOP and vasculature will affect the magnitude of accommodative microfluctuations. Copyright © 1991, Wiley Blackwell. All rights reserve