Irish general practitioner attitudes toward decriminalisation and medical use of cannabis: results from a national survey.

BACKGROUND: Governmental debate in Ireland on the de facto decriminalisation of cannabis and legalisation for medical use is ongoing. A cannabis-based medicinal product (Sativex®) has recently been granted market authorisation in Ireland. This unique study aimed to investigate Irish general practitioner (GP) attitudes toward decriminalisation of cannabis and assess levels of support for use of cannabis for therapeutic purposes (CTP). METHODS: General practitioners in the Irish College of General Practitioner (ICGP) database were invited to complete an online survey. Anonymous data yielded descriptive statistics (frequencies, percentages) to summarise participant demographic information and agreement with attitudinal statements. Chi-square tests and multi-nominal logistic regression were included. RESULTS: The response rate was 15% (n = 565) which is similar to other Irish national GP attitudinal surveys. Over half of Irish GPs did not support the decriminalisation of cannabis (56.8%). In terms of gender, a significantly higher proportion of males compared with females (40.6 vs. 15%; p < 0.0001) agreed or strongly agreed with this drug policy approach. A higher percentage of GPs with advanced addiction specialist training (level 2) agreed/strongly agreed that cannabis should be decriminalised (54.1 vs. 31.5%; p = 0.021). Over 80% of both genders supported the view that cannabis use has a significant effect on patients' mental health and increases the risk of schizophrenia (77.3%). Over half of Irish GPs supported the legalisation of cannabis for medical use (58.6%). A higher percentage of those who were level 1-trained (trained in addiction treatment but not to an advanced level) agreed/strongly agreed cannabis should be legalised for medical use (p = 0.003). Over 60% agreed that cannabis can have a role in palliative care, pain management and treatment of multiple sclerosis (MS). In the regression response predicator analysis, females were 66.2% less likely to agree that cannabis should be decriminalised, 42.5% less likely to agree that cannabis should be legalised for medical use and 59.8 and 37.6% less likely to agree that cannabis has a role in palliative care and in the treatment of multiple sclerosis (respectively) than males. CONCLUSIONS: The majority of Irish GPs do not support the present Irish governmental drug policy of decriminalisation of cannabis but do support the legalisation of cannabis for therapeutic purposes. Male GPs and those with higher levels of addiction training are more likely to support a more liberal drug policy approach to cannabis for personal use. A clear majority of GPs expressed significant concerns regarding both the mental and physical health risks of cannabis use. Ongoing research into the health and other effects of drug policy changes on cannabis use is required

Risk factors for the detection of Salmonella in ileocolic lymph nodes in US slaughtered pigs.

Salmonella harborage at slaughter can be viewed as a nsk for human health through contammation of the pork food cham. Better understanding of herd level factors associated with this harborage would be useful to prioritize further study of epidemiology and control of Salmonella in pork production. Ileocolic lymph node samples collected at slaughter from 115 Midwest US sw1ne herds were assayed for Salmonella entenca. A subset of these herds was collected sequentially one or two additional times. Herd characteristics and management factors were assessed by a written survey. Risk factors were screened at the univariate level (p \u3c 0.3), then offered for Inclusion by stepw1se analysis including herd I sample as a random statistical effect. Pigs at increased risk of Salmonella harborage at slaughter included those placed in finisher barns at heaver weights (OR 1.2 per 10 kg Increased we1ght), those from larger herds (OR 2 0 comparing upper quintile to lower quintile of herd size), those from herds that allowed VISitors w1th recent (\u3c8 h) contact with other herds (OR 2.2), or those fed pelleted feeds (OR 2.1 ). Further invest1gat1on of these risk factors and potential biological mechanisms will requ1re further study

Repeated observations on the Salmonella culture status of midwest U.S. herds

Mesenteric lymph nodes were collected from pigs from 115 Midwest U.S. swine herds at slaughter on two occasions separated by 6-9 months. These herds were sampled up to three additional times during a three-year period, with 30 herds sampled five times. Thirty pigs were sampled at each collection. Herds were categorized positive if one or more samples revealed Salmonella spp. While culture status at collection one was associated with the second sampling collection (p \u3c 0.01), the association was only moderate in strength (OR = 2.6). Herds with three consecutive positive tests (9 of 38) were all positive on sample four. Prevalence estimates were weakly or not correlated between samplings. In conclusion, Salmonella culture status of these swine herds was weakly predictive of future culture results. Accurate description of Salmonella status based on bacterial culture appears to require repeated or ongoing testing

Salmonella prevalence in market weight pigs before and after shipment to slaughter

Samples commonly used for microbiological culture of subclinical Salmonella infection in market weight pigs include fecal material, mesenteric lymph nodes, cecal contents, rectal contents, and rectal swabs. In epidemiologic investigations, collection of abanoir samples offers certain advantages over farm collected samples. Sampling at slaughter offers the advantage of a wider range of sample types. For practical reasons, samples collected on the farm for microbiological culture are usually limited to fecal samples, whereas slaughter samples can include lymph node and higher gut contents. The ease of collection at the slaughter plant facilitates sampling a large number of herds. Detection of Salmonella in slaughtered pigs is also a useful indicator of risk to pork safety, because slaughter processing is the primary point where direct risk of entry into the food chain exists. However, it is possible that pigs may become infected during transportation and lairage. Further, it is possible that pigs harbor Salmonella while on the farm, but they do not shed the organism into feces. The stress of events iromediately pre-slaughter may then induce these non-shedding infected pigs to begin shedding

An estimate of Salmonella prevalence on Illinois swine farms using mesenteric lymph node cultures

Accurate description of Salmonella prevalence is an important step toward understanding the epidemiology of the organism. A U.S. national prevalence estimate of fecal prevalence of Salmonella species showed that the organisms were commonly detected on farms. with 58 of 160 farms (38.2%) with one or more positive sample. The same survey, however, suggested that the prevalence rate differed by geographic region, with the southeastern area of the country having more than double the prevalence of the Midwest

Reactivity-Dependent PCR: Direct, Solution-Phase in Vitro Selection for Bond Formation

In vitro selection is a key component of efforts to discover functional nucleic acids and small molecules from libraries of DNA, RNA, and DNA-encoded small molecules. Such selections have been widely used to evolve RNA and DNA catalysts and, more recently, to discover new reactions from DNA-encoded libraries of potential substrates. While effective, current strategies for selections of bond-forming and bond-cleaving reactivity are generally indirect, require the synthesis of biotin-linked substrates, and involve multiple solution-phase and solid-phase manipulations. In this work we report the successful development and validation of reactivity-dependent PCR (RDPCR), a new method that more directly links bond formation or bond cleavage with the amplification of desired sequences and that obviates the need for solid-phase capture, washing, and elution steps. We show that RDPCR can be used to select for bond formation in the context of reaction discovery and for bond cleavage in the context of protease activity profiling.Chemistry and Chemical Biolog

Optimization of percutaneous biopsy for diagnosis and pretreatment risk assessment of neuroblastoma

BackgroundImage- guided percutaneous core needle biopsy (PCNB) is increasingly utilized to diagnose solid tumors. The objective of this study is to determine whether PCNB is adequate for modern biologic characterization of neuroblastoma.ProcedureA multi- institutional retrospective study was performed by the Pediatric Surgical Oncology Research Collaborative on children with neuroblastoma at 12 institutions over a 3- year period. Data collected included demographics, clinical details, biopsy technique, complications, and adequacy of biopsies for cytogenetic markers utilized by the Children’s Oncology Group for risk stratification.ResultsA total of 243 children were identified with a diagnosis of neuroblastoma: 79 (32.5%) tumor excision at diagnosis, 94 (38.7%) open incisional biopsy (IB), and 70 (28.8%) PCNB. Compared to IB, there was no significant difference in ability to accurately obtain a primary diagnosis by PCNB (95.7% vs 98.9%, P = .314) or determine MYCN copy number (92.4% vs 97.8%, P = .111). The yield for loss of heterozygosity and tumor ploidy was lower with PCNB versus IB (56.1% vs 90.9%, P < .05; and 58.0% vs. 88.5%, P < .05). Complications did not differ between groups (2.9 % vs 3.3%, P = 1.000), though the PCNB group had fewer blood transfusions and lower opioid usage. Efficacy of PCNB was improved for loss of heterozygosity when a pediatric pathologist evaluated the fresh specimen for adequacy.ConclusionsPCNB is a less invasive alternative to open biopsy for primary diagnosis and MYCN oncogene status in patients with neuroblastoma. Our data suggest that PCNB could be optimized for complete genetic analysis by standardized protocols and real- time pathology assessment of specimen quality.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154667/1/pbc28153_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154667/2/pbc28153.pd

The rank reversal problem in multi-criteria decision making : a literature review

Despite the importance of multicriteria decision-making (MCDM) techniques for constructing effective decision models, there are many criticisms due to the occurrence of a problem called rank reversal. Nevertheless, there is a lack of a systematic literature review on this important subject which involves different methods. This study reviews the pertinent literature on rank reversal, based on 130 related articles published from 1980 to 2015 in international journals, which were gathered and analyzed according to the following perspectives: multicriteria technique, year and journal in which the papers were published, co-authorship network, rank reversal types, and research goal. Thus our survey provides recommendations for future research, besides useful information and knowledge regarding rank reversal in the MCDM field