Direct-to-Consumer Advertising of Prescription Drugs: Constitutionally Protected Speech or Misinformation?

This Note will argue that the United States can and should regulate direct-to-consumer (DTC) prescription drug advertisements on television more strictly—preferably by proscribing them altogether. In Part I, this Note will discuss the issues of soaring drug prices, disappointing health care outcomes, a glut of misleading drug advertisements affecting the doctor-patient relationship and personal health, and the problem with the current approach to prescription drug advertising. Part I will also discuss the misleading nature of DTC prescription drug advertisements and some examples of the harm they have caused. Additionally, Part I will propose a solution that focuses on limiting the influence of DTC advertising to reduce consumer confusion and deception. Part II will introduce and discuss the constitutional test for restrictions on commercial speech. In Part III, this Note will apply the constitutional test, enunciated in the Central Hudson case, to demonstrate that proscribing DTC prescription drug ads or confining them to certain, more fitting places would be a constitutional policy. Part III will also explain how the Note’s proposed solutions fit into the existing statutory framework and refute some anticipated counterarguments to this Note’s proposed solutions. This abstract has been taken from the author\u27s introduction

Echinochloa polystachya management in Louisiana rice

E. polystachya introduced at stand densities (SD) of 10,000 through 70,000 stolon segments/ha produced 5.4 to 6 stolons/introduced segment; however, 130,000 through 520,000 SD produced 1.4 to 2.1 stolons per introduced segment indicating increased intra- and inter-specific competition. Stolon production was greater than 160,000 plants/ha with 30,000 through 520,000 SD. The 520,000 SD produced a total stolon length of 318 km/ha and no difference was observed for the 260,000 SD. Total node production was 290,000 nodes/ha with an average of 29 nodes/introduced segment in the 10,000 SD and 5.4 to 9.8 nodes/introduced segment with 70,000 or greater SD indicating greater inter- and intra-specific competition. Total biomass indicated similar trends with increasing densities. In a depth of emergence study, E. polystachya shoot emergence was 31, 63, and 44% for stolons planted at the 0, 1.3, and 2.5 cm depth, respectively. Shoot emergence was 25% for 5 cm depth, which was similar to the 0 and 2.5 cm depth. In a greenhouse study, glyphosate controlled E. polystachya 91% and control was 65 to 78% for all herbicides evaluated. When treated with glyphosate, biomass production was 19% of the nontreated E. polystachya. Two studies evaluated herbicides labeled for Echinochloa crus-galli (L.) Beauv. control in rice for activity on E. polystachya. The first study included: 448 g/ha clomazone PRE, 448 g/ha clomazone plus 420 g ai/ha quinclorac delayed PRE, 448 g ai/ha pendimethalin plus 420 g/ha quinclorac DPRE, 70 g/ha imazethapyr at EPOST, and 175 g ai/ha mesotrione PRE. Each PRE herbicide was followed by 315 g/ha cyhalofop POST. The second study included: 208 g ai/ha cyhalofop EPOST fb 315 g/ha cyhalofop LPOST, 22 g ai/ha bispyribac EPOST fb 22 g/ha bispyribac LPOST, 66 g ai/ha fenoxaprop EPOST fb 86 g/ha fenoxaprop LPOST, 70 g ai/ha imazethapyr EPOST fb 70 g/ha imazethapyr LPOST and 50 g ai/ha penoxsulam MPOST. Each POST program was assessed with and without 448 g ai/ha clomazone PRE. In the first study, clomazone, imazethapyr, and pendimethalin plus quinclorac controlled E. polystachya 78 to 80%. In the second study, treatments including cyhalofop, imazethapyr, and penoxsulam controlled E. polystachya 76 to 84%

Development and application of a real-time polymerase chain reaction assay for the myxozoan parasite Henneguya ictaluri

Proliferative gill disease (PGD) caused by the myxozoan parasite Henneguya ictaluri is one of the most devastating parasitic infections in channel catfish aquaculture. Currently, there is no effective treatment for H. ictaluri and the unpredictable outbreaks can result in 100% mortality. Management strategies have been developed to prevent losses in newly stocked fingerlings by evaluating the PGD status of a pond prior to stocking, which is difficult since resident fish may not show clinical signs even when actinospore levels are lethal to naive fish. Current diagnostic methods are limited to the identification of an active infection and methods of predicting potential outbreaks have several limitations. The PGD status of a pond to be stocked can be determined using sentinel fish exposures which are labor intensive and require a source of parasite free fish. These limitations necessitated the development of more rapid and efficient means of determining actinospore concentrations to determine the risk of losing fish prior to stocking. The development of a quantitative real-time polymerase chain reaction (QPCR) assay provided a more rapid, sensitive and quantitative method of diagnosing active infections and also provides a means to predict potential PD outbreaks and determine the PGD status of a pond prior to stocking. Another approach in the control of this parasite is the identification of a less susceptible culturable species or to identify traits that could be targeted in a selective breeding program. Challenge studies have shown that the closely related blue catfish (Ictalurus furcatus) does not exhibit as severe an inflammatory response to H. ictaluri and mortalities are significantly lower than in channel catfish. Comparisons of PGD severity and H. ictaluri infection in channel catfish, blue catfish and channel x blue catfish backcross hybrids by gross examination, histopathology and the newly developed H. ictaluri real-time PCR (QPCR) assay supported previous research suggesting the life cycle of the parasite can not be completed as efficiently through the blue catfish host. This dissertation describes the development and validation of a QPCR assay to detect H. ictaluri in both fish tissues and environmental samples and the application of this assay in both research and production settings

Activity-promoting gaming systems in exercise and rehabilitation

Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation

Outcome assessment after hip fracture : is EQ-5D the answer?

Objectives: To study the measurement properties of a joint specific patient reported outcome measure, a measure of capability and a general health-related quality of life (HRQOL) tool in a large cohort of patients with a hip fracture. Methods: Responsiveness and associations between the Oxford Hip Score (a hip specific measure: OHS), ICEpop CAPability (a measure of capability in older people: ICECAP-O) and EuroQol EQ-5D (general health-related quality of life measure: EQ-5D) were assessed using data available from two large prospective studies. The three outcome measures were assessed concurrently at a number of fixed follow-up time-points in a consecutive sequence of patients, allowing direct assessment of change from baseline, inter-measure associations and validity using a range of statistical methods. Results: ICECAP-O was not responsive to change. EQ-5D was responsive to change from baseline, with an estimated standardised effect size for the two datasets of 0.676 and 0.644 at six weeks and four weeks respectively; this was almost as responsive to change as OHS (1.14 at four weeks). EQ-5D correlated strongly with OHS; Pearson correlation coefficients were 0.74, 0.77 and 0.70 at baseline, four weeks and four months. EQ-5D is a moderately good predictor of death at 12 months following hip fracture. Furthermore, EQ-5D reported by proxies (relatives and carers) behaves similarly to self-reported scores. Conclusions: Our findings suggest that a general HRQOL tool such as EQ-5D could be used to measure outcome for patients recovering from hip fracture, including those with cognitive impairment

Warwick hip trauma study : a randomised clinical trial comparing interventions to improve outcomes in internally fixed intracapsular fractures of the proximal femur : protocol for The WHiT Study

Background Controversy exists regarding the optimal treatment for patients with displaced intracapsular fractures of the proximal femur. The recognised treatment alternatives are arthroplasty and internal fixation. The principal criticism of internal fixation is the high rate of non-union; up to 30% of patients will have a failure of the fixation leading to revision surgery. We believe that improved fracture healing may lead to a decreased rate of failure of fixation. We therefore propose to investigate strategies to both accelerate fracture healing and improve fixation that may significantly improve outcomes after internal fixation of intracapsular femoral fractures. We aim to test the clinical effectiveness of the osteoinductive agent platelet rich plasma and conduct a pilot study of a novel fixed-angle fixation system. Design We have planned a three arm, single centre, standard-of-care controlled, double blinded, pragmatic, randomised clinical trial. The trial will include a standard two-way comparison between platelet-rich plasma and standard-of-care fixation versus standard-of-care fixation alone. In addition there will be a subsidiary pilot arm testing a fixed-angle screw and plate fixation system

A randomised controlled trial of total hip arthroplasty versus resurfacing arthroplasty in the treatment of young patients with arthritis of the hip joint

Background: Hip replacement (arthroplasty) surgery is a highly successful treatment for patients with severe symptomatic arthritis of the hip joint. For older patients, several designs of Total Hip Arthroplasty have shown excellent results in terms of both function and value for money. However, in younger more active patients, there is approximately a 50% failure rate at 25 years for traditional implants. Hip resurfacing is a relatively new arthroplasty technique. In a recent review of the literature on resurfacing arthroplasty it was concluded that the short-term functional results appear promising but some potential early disadvantages were identified, including the risk of femoral neck fracture and collapse of the head of the femur. The aim of the current study is to assess whether there is a difference in functional hip scores at one year post-operation between Total Hip Arthroplasty and Resurfacing Arthroplasty. Secondary aims include assessment of complication rates for both procedures as well cost effectiveness. Methods/design: All patients medically fit for surgery and deemed suitable for a resurfacing arthroplasty are eligible to take part in this study. A randomisation sequence will be produced and administered independently. After consenting, all patients will be clinically reviewed and hip function, quality of life and physical activity level will be assessed through questionnaires. The allocated surgery will then be performed with the preferred technique of the surgeon. Six weeks post-operation hip function will be assessed and complications recorded. Three, six and 12 months post-operation hip function, quality of life and physical activity level will be assessed. Additional information about patients' out-of-pocket expenses will also be collected