Economic Asymmetries, Trade Liberalization and Integration: Issues and Policy Implications for CARICOM Countries

Much has been written about the challenges facing CARICOM as a result of the liberalization, globalization and integration phenomena. This paper adds value to the conversation by addressing the nexus between and among economic asymmetries, trade liberalization and economic integration, as it relates to CARICOM as small developing economies. The paper seeks to highlight the salient issues of CARICOM economic adjustment challenges under trade liberalization and integration imperatives, particularly as they may be subjected to the constraints of economic asymmetries. In doing so, it steps away from the conventional approach of reciting a series of data usually associated with the issues and instead, engages in commentary and assessment regarding the changing economic landscape in the Region and elsewhere. The issues are indeed very complex and the arguments and conclusions flowing from this type of evaluation may not be in lock-step with the conventional wisdom. However, it is our contention that the regional trade and development policy solutions does not lie in denial of the existence of the problems; but rather, in tackling them head-on and incorporating them into existing and proposed systems of economic relations.International Relations/Trade,

FDA Oversight of Autologous Stem Cell Therapies: Legitimate Regulation of Drugs and Devices or Groundless Interference with the Practice of Medicine?

From the introduction: Just as slight variations between different sources of stem cells are crucial to understanding the real policy debate over when life begins under the law, slight permutations in the federal regulations and guidelines for stem cell research can have serious ramifications for advancing the science of stem cell research and therapeutic applications. As human embryonic stem cell ( ESC ) research has garnered widespread press coverage and generated enormous public controversy for over a decade, scientists and physicians have been finding generous amounts of less controversial, adult stem cells ( ASCs ) in an increasingly wide array of human tissue. These discoveries promise new and urgently needed therapies for patients but also pose novel challenges for regulators. This is especially so here, where many ASC therapies are emerging from the offices of practicing physicians instead of the laboratories of university or commercial research scientists

Is your EPL attractive? Classification of publications through download statistics

Here we consider the download statistics of EPL publications. We find that papers in the journal are characterised by fast accumulations of downloads during the first couple of months after publication, followed by slower rates thereafter, behaviour which can be represented by a model with predictive power. We also find that individual papers can be classified in various ways, allowing us to compare categories for open-access and non-open-access papers. For example, for the latter publications, which comprise the bulk of EPL papers, a small proportion (2%) display intense bursts of download activity, possibly following an extended period of less remarkable behaviour. About 18% have an especially high degree of attractiveness over and above what is typical for the journal. One can also classify the ageing of attractiveness by examining download half-lives. Approximately 18% have strong interest initially, waning in time. A further 20% exhibit "delayed recognition" with relatively late spurs in download activity. Although open-access papers enjoy more downloads on average, the proportions falling into each category are similar.Comment: 6 pages, 8 figures, accepted for publication in EP

Lessons from Katrina – What Went Wrong, What Was Learned, Who’s Most Vulnerable

If humans did not occupy the planet, disasters would never occur. Massive climatic events, earthquakes, volcanic eruptions, and tsunamis would be regular occurrences, of course, and the earth would look like a dynamic cauldron of natural activity, changing the look and the balance of nature and natural events continuously and randomly. What morphs these natural phenomenon into catastrophic events we call “disasters” is simply the presence of human beings who by choice, chance, or necessity find themselves in harm’s way. The “human factors” may be straightforward and benign. For instance, people making their livelihood from the sea are at risk from coastal storms and tsunamis. Similarly, people are found living in areas at considerable risk for mudslides and volcanoes. It could even be said that living in New Orleans, a coastal city actually below sea level, is a gamble, as was so dramatically emphasized by the storms and subsequent flooding of August and September 2005

Diagnosis, assessment and treatment of childhood eczema in primary care:cross-sectional study

Background: The majority of children with eczema in the UK are looked after in primary care yet we know little about their care in this setting. Aim: To compare the diagnosis, assessment, and treatment of eczema in primary care with published diagnostic criteria and management guidelines. Design & setting: Cross-sectional study using data from a randomised controlled feasibility study. General practices, UK. Method: Baseline data from children aged 1 month to 5 years recruited ‘in-consultation’ for the Choice of Moisturiser in Eczema Treatment (COMET) feasibility study was used. These included clinician diagnosis and global severity assessment; the parent-completed Patient Orientated Eczema Measure (POEM); a questionnaire about eczema treatments, including use of topical corticosteroid (TCS); and, the Eczema Area Severity Index (EASI) carried out by trained researchers. Descriptive analyses were undertaken to compare diagnoses with UK diagnostic criteria, severity assessments, and treatment with the National Institute for Health and Care Excellent (NICE) guidance. Results: Data were available for 90 participants. Only 46% of participants labelled as having eczema met the UK diagnostic criteria. Agreement between the global severity assessment by a healthcare practitioner with the EASI and POEM measures of eczema severity were 44% and 48% respectively. Emollients and TCSs were underused with 44% of participants not using any emollient and 46% using one or more TCSs. The ‘match’ between eczema severity and TCSs potency was poor. Conclusion: Discrepancies were found between the diagnosis, assessment, and treatment of children with eczema in primary care, and UK diagnostic criteria and guidelines. Further investigation to explore the reasons for this discordance, and whether it matters, is needed

Champion Networks in Federated Interorganizational Systems: Case Studies in Telemedicine

Champions are critical to the success of an information system implementation. Research shows that success in implementing a large information system may hinge on there being more than one type of champion. This study investigates the types of champions used in federated inter-organizational systems (FIOS) in a state telemedicine context. Case studies were conducted in Georgia, Pennsylvania, Ohio, and Wisconsin to identify the network of champions in state telemedicine systems. We found that FIOS that relied on a network of champions, including a sponsorship champion at the state level, as well as a technical champion and user champion at site locations, were more successful than those that lacked such a network. We suggest that our model of champions in FIOS applies not only to state telemedicine, but also to any large-scale system implementation spanning a federation of loosely coupled organizations

Dexamethasone induces apoptosis in pulmonary arterial smooth muscle cells

BACKGROUND: Dexamethasone suppressed inflammation and haemodynamic changes in an animal model of pulmonary arterial hypertension (PAH). A major target for dexamethasone actions is NF-κB, which is activated in pulmonary vascular cells and perivascular inflammatory cells in PAH. Reverse remodelling is an important concept in PAH disease therapy, and further to its anti-proliferative effects, we sought to explore whether dexamethasone augments pulmonary arterial smooth muscle cell (PASMC) apoptosis. METHODS: Analysis of apoptosis markers (caspase 3, in-situ DNA fragmentation) and NF-κB (p65 and phospho-IKK-α/β) activation was performed on lung tissue from rats with monocrotaline (MCT)-induced pulmonary hypertension (PH), before and after day 14–28 treatment with dexamethasone (5 mg/kg/day). PASMC were cultured from this rat PH model and from normal human lung following lung cancer surgery. Following stimulation with TNF-α (10 ng/ml), the effects of dexamethasone (10(−8)–10(−6) M) and IKK2 (NF-κB) inhibition (AS602868, 0–3 μM (0-3×10(−6) M) on IL-6 and CXCL8 release and apoptosis was determined by ELISA and by Hoechst staining. NF-κB activation was measured by TransAm assay. RESULTS: Dexamethasone treatment of rats with MCT-induced PH in vivo led to PASMC apoptosis as displayed by increased caspase 3 expression and DNA fragmentation. A similar effect was seen in vitro using TNF-α-simulated human and rat PASMC following both dexamethasone and IKK2 inhibition. Increased apoptosis was associated with a reduction in NF-κB activation and in IL-6 and CXCL8 release from PASMC. CONCLUSIONS: Dexamethasone exerted reverse-remodelling effects by augmenting apoptosis and reversing inflammation in PASMC possibly via inhibition of NF-κB. Future PAH therapies may involve targeting these important inflammatory pathways