The Constitutionality of Lobby Reform: Implicating Associational Privacy and the Right to Petition the Government

Lobbyists currently are required to register and report to the United States Congress under the Federal Regulation of Lobbying Act of 1946. Because of poor draftsmanship, the 1946 Act actually covers few lobbyists and is not enforced by the federal government. One recent federal bill attempts to reform lobbying registration by addressing the inadequacies of the current law. If enacted, this bill might be challenged as an impediment to First Amendment rights. Any attempt at lobby reform implicates the First Amendment right to petition the government and the right of associational privacy. These issues have been analyzed by state and federal courts in cases representing challenges to lobbying regulations. An analytical framework can be extracted from these cases which offers the most desirable method of balancing individual liberties with the need for lobbying regulation. The recent federal bill is analyzed under this framework and practical solutions are offered to help ensure the constitutionality of future attempts at lobby reform

Multiwaveband Observations of Quasars with Flat Radio Spectra and Strong Millimeter Emission

We present multiwaveband observations of a well selected sample of 28 quasars and two radio galaxies with flat radio spectra and strong millimeter wave emission (referred to here as FSRQ's). The observations include multifrequency VLBI measurements, X-ray observations with ROSAT and submillimeter observations with the JCMT. Particularly interesting among many findings is a correlation between the X-ray to millimeter spectral index and fraction of flux density contained in the VLBI core. This tendency toward higher X-ray fluxes from sources with stronger jet emission implies that the knots in the jet are the prominent source of X-rays.Comment: 38 pages, 17 figures, 12 tables, accepted for publication in Ap J Suppl, May 199

Formation and utility of reactive ketene intermediates under continuous flow conditions

Continuous flow systems offer unique benefits in the generation and manipulation of sensitive reactive intermediates such as ketenes. To this end, the last decade has witnessed the development of continuous flow methods for the generation of ketenes by means of chemical, thermal, and photochemical activation modes. This perspective covers these advances and the downstream reactivity of ketenes in continuous flow technology

The Management of Decumulation Risks in a Defined Contribution Pension Plan

The aim of the paper is to lay the theoretical foundations for the construction of a flexible tool that can be used by pensioners to find optimal investment and consumption choices in the distribution phase of a defined contribution pension plan. The investment/consumption plan is adopted until the time of compulsory annuitization, taking into account the possibility of earlier death. The effect of the bequest motive and the desire to buy a higher annuity than the one purchasable at retirement are included in the objective function. The mathematical tools provided by dynamic programming techniques are applied to find closed-form solutions: numerical examples are also presented. In the model, the tradeoff between the different desires of the individual regarding consumption and final annuity can be dealt with by choosing appropriate weights for these factors in the setting of the problem. Conclusions are twofold. First, we find that there is a natural time-varying target for the size of the fund, which acts as a sort of safety level for the needs of the pensioner. Second, the personal preferences of the pensioner can be translated into optimal choices, which in turn affect the distribution of the consumption path and of the final annuity

Protocol for the Foot in Juvenile Idiopathic Arthritis trial (FiJIA): a randomised controlled trial of an integrated foot care programme for foot problems in JIA

<b>Background</b>: Foot and ankle problems are a common but relatively neglected manifestation of juvenile idiopathic arthritis. Studies of medical and non-medical interventions have shown that clinical outcome measures can be improved. However existing data has been drawn from small non-randomised clinical studies of single interventions that appear to under-represent the adult population suffering from juvenile idiopathic arthritis. To date, no evidence of combined therapies or integrated care for juvenile idiopathic arthritis patients with foot and ankle problems exists. <b>Methods/design</b>: An exploratory phase II non-pharmacological randomised controlled trial where patients including young children, adolescents and adults with juvenile idiopathic arthritis and associated foot/ankle problems will be randomised to receive integrated podiatric care via a new foot care programme, or to receive standard podiatry care. Sixty patients (30 in each arm) including children, adolescents and adults diagnosed with juvenile idiopathic arthritis who satisfy the inclusion and exclusion criteria will be recruited from 2 outpatient centres of paediatric and adult rheumatology respectively. Participants will be randomised by process of minimisation using the Minim software package. The primary outcome measure is the foot related impairment measured by the Juvenile Arthritis Disability Index questionnaire's impairment domain at 6 and 12 months, with secondary outcomes including disease activity score, foot deformity score, active/limited foot joint counts, spatio-temporal and plantar-pressure gait parameters, health related quality of life and semi-quantitative ultrasonography score for inflammatory foot lesions. The new foot care programme will comprise rapid assessment and investigation, targeted treatment, with detailed outcome assessment and follow-up at minimum intervals of 3 months. Data will be collected at baseline, 6 months and 12 months from baseline. Intention to treat data analysis will be conducted. A full health economic evaluation will be conducted alongside the trial and will evaluate the cost effectiveness of the intervention. This will consider the cost per improvement in Juvenile Arthritis Disability Index, and cost per quality adjusted life year gained. In addition, a discrete choice experiment will elicit willingness to pay values and a cost benefit analysis will also be undertaken

Varespladib and cardiovascular events in patients with an acute coronary syndrome: the VISTA-16 randomized clinical trial

IMPORTANCE: Secretory phospholipase A2(sPLA2) generates bioactive phospholipid products implicated in atherosclerosis. The sPLA2inhibitor varespladib has favorable effects on lipid and inflammatory markers; however, its effect on cardiovascular outcomes is unknown. OBJECTIVE: To determine the effects of sPLA2inhibition with varespladib on cardiovascular outcomes. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, randomized, multicenter trial at 362 academic and community hospitals in Europe, Australia, New Zealand, India, and North America of 5145 patients randomized within 96 hours of presentation of an acute coronary syndrome (ACS) to either varespladib (n = 2572) or placebo (n = 2573) with enrollment between June 1, 2010, and March 7, 2012 (study termination on March 9, 2012). INTERVENTIONS: Participants were randomized to receive varespladib (500 mg) or placebo daily for 16 weeks, in addition to atorvastatin and other established therapies. MAIN OUTCOMES AND MEASURES: The primary efficacy measurewas a composite of cardiovascular mortality, nonfatal myocardial infarction (MI), nonfatal stroke, or unstable angina with evidence of ischemia requiring hospitalization at 16 weeks. Six-month survival status was also evaluated. RESULTS: At a prespecified interim analysis, including 212 primary end point events, the independent data and safety monitoring board recommended termination of the trial for futility and possible harm. The primary end point occurred in 136 patients (6.1%) treated with varespladib compared with 109 patients (5.1%) treated with placebo (hazard ratio [HR], 1.25; 95%CI, 0.97-1.61; log-rank P = .08). Varespladib was associated with a greater risk of MI (78 [3.4%] vs 47 [2.2%]; HR, 1.66; 95%CI, 1.16-2.39; log-rank P = .005). The composite secondary end point of cardiovascular mortality, MI, and stroke was observed in 107 patients (4.6%) in the varespladib group and 79 patients (3.8%) in the placebo group (HR, 1.36; 95% CI, 1.02-1.82; P = .04). CONCLUSIONS AND RELEVANCE: In patients with recent ACS, varespladib did not reduce the risk of recurrent cardiovascular events and significantly increased the risk of MI. The sPLA2inhibition with varespladib may be harmful and is not a useful strategy to reduce adverse cardiovascular outcomes after ACS. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01130246. Copyright 2014 American Medical Association. All rights reserved

The Canadian context for evidence-based conservation and environmental management

Canada has strong institutional capacity for science-based decision-making related to natural resource conservation and environmental management. Yet, the concept of using systematic reviews (conducted in accordance with established guidelines) to support evidence-based conservation and environmental management in Canada is in its infancy. Here we discuss the Canadian context for implementing more rigorous evidence-based approaches using systematic reviews. Of particular relevance to Canada is its vast size, broad diversity of ecosystems and heavy economic reliance on natural resources that vary widely in the type and scale of their environmental effects. These factors result in a wide variety of environmental monitoring needs over an extensive area that pose challenges to the scientific community charged with overseeing wise use of the environment. In addition, there are diverse and engaged user groups (e.g., hunters, trappers, fishers, bird watchers, foresters) and indigenous peoples that have constitutional rights to their natural resources. Traditional environmental knowledge is a complementary source of evidence in the Canadian environmental impact assessment process and therefore must be a part of evidence synthesis. Systematic reviews are not intended to replace local field studies, but rather have the opportunity to draw upon a broader suite of evidence that can be interfaced with local perspectives. The existing institutional structures in Canada could easily incorporate systematic reviews into their science advice and decision-making frameworks but to date, there are few examples of where this has occurred. Drawing on the expertise of a growing global collaboration for environmental evidence synthesis, Canadian institutions (federal, provincial and NGO) are poised to more broadly incorporate systematic reviews once their benefits are fully realized and the capacity to undertake such systematic reviews is fully developed. Systematic reviews offer a consolidated view of the available scientific literature on a given question. The results may offer significant value when working with stakeholders and decision makers contributing other sources of information to the question. For example, mechanisms to capture and integrate scientific knowledge with stakeholder and traditional knowledge may benefit from the scientific sources being filtered, interpreted and summarized for discussion. In other cases, wher

CdZnTe gamma ray spectrometer for orbital planetary missions

Knowledge of surface elemental composition is needed to understand the formation and evolution of planetary bodies. Gamma rays and neutrons produced by the interaction of galactic cosmic rays with surface materials can be detected from orbit and analyzed to determine composition. Using gamma ray spectroscopy, major rock forming elements such as Fe, Ti, Al, Si, Mg, and Ca can be detected. The accuracy of elemental abundance is limited by the resolution of the spectrometer. For space missions, scintillators such as BGO and NaI(Tl) have been used for gamma ray spectroscopy. New planetary science missions are being planned to explore Mars, Mercury, the asteroid belt, and the outer planets. Significant improvements in the pulse height resolution relative to scintillation detectors can be made using CdZnTe, a new room temperature detector technology. For an orbiting instrument, a CdZnTe detector at least 16 cm{sup 3} in size is needed. A 4 x 4 array of 1-cm{sup 3} coplanar grid detectors can be manufactured that meets requirements for resolution and counting efficiency. The array will shielded from gamma rays produced in the spacecraft by a BGO detector. By improving pulse height resolution by a factor of three at low energy, the CdZnTe detector will be able to make accurate measurements of elements that are currently difficult to measure using scintillation technology. The BGO shield will provide adequate suppression of gamma rays originating in the spacecraft, enabling the gamma ray spectrometer to be mounted on the deck of a spacecraft. To test this concept, we are constructing a flight qualified, prototype CdZnTe detector array. The prototype consists of a 2 x 2 array of coplanar grid detectors. We will present the results of mechanical and electronic testing and radiation damage tests, and the performance of the array for gamma ray spectroscopy

Patient-reported outcome measures for asthma:a systematic review

BACKGROUND: Patient-reported outcome measures (PROMs) are measures of the outcome of treatment(s) reported directly by the patient or carer. There is increasing international policy interest in using these to assess the impact of clinical care. AIMS: To identify suitably validated PROMs for asthma and examine their potential for use in clinical settings. METHODS: We systematically searched MEDLINE, EMBASE and Web of Science databases from 1990 onwards to identify PROMs for asthma. These were critically appraised, then narratively synthesised. We also identified the generic PROMs commonly used alongside asthma-specific PROMs. RESULTS: We identifi ed 68 PROMs for asthma, 13 of which were selected through screening as being adequately developed to warrant full-quality appraisal: 8 for adults, 4 for children and 1 for a child's caregiver. The PROMs found to be sufficiently well validated to offer promise for use in clinical settings were the Asthma Quality of Life Questionnaire (AQLQ) and mini-AQLQ for adults, and Pediatric Asthma Quality of Life Questionnaire for children. Rhinasthma was considered promising in simultaneously assessing the impact of asthma and rhinitis in those with coexistent disease. We identified 28 generic PROMs commonly used in conjunction with asthma-specific instruments. CONCLUSIONS: We identified asthma PROMs that offer the greatest potential for use in clinical settings. Further work is needed to assess whether these are fit-for-purpose for use in clinical practice with individual patients. In particular, there is a need to ensure these are validated for use in clinical settings, acceptable to patients, caregivers and clinicians, and yield meaningful outcomes. © 2014 Primary Care Respiratory Society/Macmillan Publishers Limited