Update on the Pharmaceutical Industry

The Sunday Times Business Times published a supplement on the pharmaceutical industry on 30 November 2003. This has been an extremely dynamic environment and one that will be affected by impending legislative change. The objective of the survey was to provide some insight into the current status of the industry – special attention was paid to costs of medication, generic medication and antiretroviral therapy. This article aims to provide a summary of the publication and provide background information where necessary. Southern African Journal of HIV Medicine Vol. 5 (1) 2004: 46-4

Regrouping in Defence of Minority Rights: Kymlicka\u27s Multicultural Citizenship

This article outlines and critically examines Will Kymlicka\u27s reconstructed defence of minority rights. Although various doubts are cast on Kymlicka\u27s own thesis, it is argued that there are alternative strategies-strategies that Kymlicka too hastily dismisses-available to defenders of (collective) minority rights. Further, any vindication of minority rights makes urgent the separate question of what (if any) institutional expression they should receive. One important question overlooked by Kymlicka is whether, contrary to widespread assumptions, minority rights are in fact appropriate candidates for constitutional entrenchment. Some of the relevant considerations raised by this issue are discussed in the final section of the article

Regrouping in Defence of Minority Rights: Kymlicka\u27s Multicultural Citizenship

This article outlines and critically examines Will Kymlicka\u27s reconstructed defence of minority rights. Although various doubts are cast on Kymlicka\u27s own thesis, it is argued that there are alternative strategies-strategies that Kymlicka too hastily dismisses-available to defenders of (collective) minority rights. Further, any vindication of minority rights makes urgent the separate question of what (if any) institutional expression they should receive. One important question overlooked by Kymlicka is whether, contrary to widespread assumptions, minority rights are in fact appropriate candidates for constitutional entrenchment. Some of the relevant considerations raised by this issue are discussed in the final section of the article

Coevolution of Interacting Fertilization Proteins

Reproductive proteins are among the fastest evolving in the proteome, often due to the consequences of positive selection, and their rapid evolution is frequently attributed to a coevolutionary process between interacting female and male proteins. Such a process could leave characteristic signatures at coevolving genes. One signature of coevolution, predicted by sexual selection theory, is an association of alleles between the two genes. Another predicted signature is a correlation of evolutionary rates during divergence due to compensatory evolution. We studied female–male coevolution in the abalone by resequencing sperm lysin and its interacting egg coat protein, VERL, in populations of two species. As predicted, we found intergenic linkage disequilibrium between lysin and VERL, despite our demonstration that they are not physically linked. This finding supports a central prediction of sexual selection using actual genotypes, that of an association between a male trait and its female preference locus. We also created a novel likelihood method to show that lysin and VERL have experienced correlated rates of evolution. These two signatures of coevolution can provide statistical rigor to hypotheses of coevolution and could be exploited for identifying coevolving proteins a priori. We also present polymorphism-based evidence for positive selection and implicate recent selective events at the specific structural regions of lysin and VERL responsible for their species-specific interaction. Finally, we observed deep subdivision between VERL alleles in one species, which matches a theoretical prediction of sexual conflict. Thus, abalone fertilization proteins illustrate how coevolution can lead to reproductive barriers and potentially drive speciation

Foundations of Collective Cultural Rights in International Human Rights Law

Although collective cultural rights are included in international human rights law, their precise place and their nature and significance are not well-explored or understood. This paper aims to show where collective cultural rights can be found in international human rights law and explore how these rights fit in the general body and framework of international human rights law. The starting point in this chapter is international human rights law, which implies that the analysis of collective cultural rights is framed by positive law and international legal instruments, such as treaties and conventions, as well as by soft law instruments, such as declarations, recommendations and resolutions. In this paper, the two categories of collective rights and cultural rights are defined, drawing a distinction between a) different types of collective rights, including rights for collectivities as such, rights for individuals as members of collectivities, and rights with a collective interest or object; and b) between different types of cultural rights, including rights that explicitly refer to ‘culture’ and rights that relate to culture or have a cultural dimension. This paper furthermore analyses various contentious issues surrounding collective rights and cultural rights in international human rights law, including the lack of clarity on the object and subject of these rights. The paper then outlines the different forms of collective cultural rights in international human rights law, by providing examples of legal provisions in international human rights law that can be classified as collective cultural rights. Finally, the paper elaborates on how collective subjects and collective cultural interests are integrated in international human rights law and analyses how and to what extent collective cultural rights provisions provide answers to the above-noted issues

Cohort profile : demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Purpose: The presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports. Participants: Seven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at. Findings to date: This cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year. Future plans: Analysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared. Trial registration number: NCT03013595

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo