scholarly journals Pharmacogenomic and pharmacogenetic-guided therapy as a tool in precision medicine: current state and factors impacting acceptance by stakeholders

2015 ◽  
Vol 97 ◽  
Author(s):  
GREGORY P. HESS ◽  
EILEEN FONSECA ◽  
RACHEL SCOTT ◽  
JESEN FAGERNESS
Keyword(s):  
Precision Medicine ◽  
The United States ◽  
Life Outcomes ◽  
Current State ◽  
Improved Outcomes ◽  
Wide Range ◽  
Clinical Responses ◽  
Care Costs ◽  
Guided Therapy

SummaryPharmacogenetic/pharmacogenomic (PGx) testing is currently available for a wide range of health problems including cardiovascular disease, cancer, diabetes, autoimmune disorders, mental health disorders and infectious diseases. PGx contributes important information to the field of precision medicine by clarifying appropriate treatments for specific disease subtypes. Tangible benefits to patients including improved outcomes and reduced total health care costs have been observed. However, PGx-guided therapy faces many barriers to full integration into clinical practice and acceptance by stakeholders, whether practitioner, patient or payer. Each stakeholder has a unique perspective on the role of PGx testing, although all are similarly challenged with demonstrating or appraising its cost-to-benefit value. Coverage by insurers is a critical step in achieving widespread adoption of PGx testing. The acceleration of adoption of precision medicine in general and for PGx testing in particular will be determined by how quickly robust evidence can be accumulated that shows a return on investment for payers in terms of real dollars, for clinicians in terms of patient clinical responses, and for patients in terms of economic, health and quality of life outcomes. Trends in PGx testing utilization and uptake by payers in real-world practice are discussed; the role of pharmacoeconomics in assessing cost-effectiveness is highlighted using a case study in psychiatric care, and several issues that will affect adoption of PGx testing in the United States (US) over the next few years are reviewed.

Drivers' Perceptions of Unsafe Driving Behaviors and Their Countermeasures: A Study in Saudi Arabia

2014 ◽  
Vol 70 (4) ◽  
Author(s):  
Tanweer Hasan ◽  
Ishtiaque Ahmed ◽  
Hamid O. Al-Bar
Keyword(s):  
Saudi Arabia ◽  
Police Officers ◽  
Time Pressure ◽  
Red Light ◽  
The United States ◽  
Aggressive Driving ◽  
Road Rage ◽  
Driving Behaviors ◽  
Wide Range

There is an increased public concern about the role of aggressive driving and "road rage" in crashes and traffic fatalities. There is no general agreement as to what constitutes aggressive driving. Consequently, the objective of the study was to survey of the perceptions on the specific unsafe driving acts. Perceptions and beliefs of drivers about unsafe and aggressive driving actions and their countermeasures are presented in this paper. The study primarily looked at the wide range of driver attitudes about speeding and other forms of unsafe driving behavior. The study was conducted in Jeddah, the second largest city of Saudi Arabia by interviewing a sample of 300 drivers. The results indicated that the drivers, in general, prefer to drive at higher speeds and could be considered as more aggressive compared to the drivers in the United States. The most dangerous reported driving act was "drive thru red light", followed by "racing another driver". Only 23% of the drivers thought that it was dangerous to drive over 30 km of the legal speed limits. The most often seen unsafe driving action was "speeding (70%), followed by "driving too closely (57%), "failing to use turn signals (53%), "drive inattentively (50%)", and "running red lights (43%)". The main causes of unsafe driving behaviors were "being in a hurry/time pressure (66%)", "aggressive behavior of others (52%)", and "refusing traffic rules (51%)". The countermeasure that was viewed to be the most effective in reducing unsafe driving behaviors was assigning more traffic police officers (66%). The study revealed that, more than half the drivers believed that more frequent ticketing (60%), doubling or tripling fines (54%), and doubling the length of imprisonment (53%) would be effective in reducing unsafe driving behaviors.

Aortic Valve Sinus Vorticity Dynamics and the Potential Role of Coronary Flow

2013 ◽  
Author(s):  
Brandon L. Moore ◽  
Lakshmi P. Dasi
Keyword(s):  
Aortic Valve ◽  
Coronary Flow ◽  
Potential Role ◽  
The United States ◽  
Calcific Aortic Valve Disease ◽  
Wide Range ◽  
Vorticity Dynamics ◽  
Spatio Temporal ◽  
Fluid Wall Shear Stress

Calcific aortic valve disease affects a wide range of the population in the United States. Each year there are approximately 50,000 valve replacements due to this disease [(Freeman & Otto, 2005)]. While it is unclear what the exact causes of CAVD are, it does appear to be correlated to local hemodynamic conditions particularly related to the complex spatio-temporal nature of fluid wall shear stress dynamics that the aortic side of the leaflets experience.

Assessment in American Higher Education: The Role of Admissions Tests

2019 ◽  
Vol 683 (1) ◽  
pp. 130-148 ◽  
Author(s):  
Rebecca Zwick
Keyword(s):  
Higher Education ◽  
United States ◽  
The United States ◽  
College Performance ◽  
Admissions Tests ◽  
Higher Education System ◽  
Wide Range ◽  
Test Optional ◽  
The Impact

In this article, I review the role of college admissions tests in the United States and consider the fairness issues surrounding their use. The two main tests are the SAT, first administered in 1926, and the ACT, first given in 1959. Scores on these tests have been shown to contribute to the prediction of college performance, but their role in the admissions process varies widely across colleges. Although test scores are consistently listed as one of the most important admissions factors in national surveys of postsecondary institutions, an increasing number of schools have adopted “test-optional” policies. At these institutions, test score requirements are seen as a barrier to campus diversity because of the large performance gaps among ethnic and socioeconomic groups. Fortunately, the decentralized higher education system in the United States can accommodate a wide range of admissions policies. It is essential, however, that the impact of admissions policy changes be studied and that the resource implications of these changes be thoroughly considered.

scholarly journals Death by Numbers: Why Evolving Standards Compel Extending Roper’s Categorical Ban Against Executing Juveniles From 18 to 21

2019 ◽  
Author(s):  
John H. Blume ◽  
Hannah Freedman ◽  
Lindsey Vann ◽  
Amelia C. Hritz
Keyword(s):  
Young People ◽  
The United States ◽  
People Of Color ◽  
Current State ◽  
Jury Verdicts ◽  
Death Sentences ◽  
Eighth Amendment ◽  
The Supreme Court ◽  
Juvenile Sentencing

Texas Law Review, ForthcomingNearly fifteen years ago, the Supreme Court held in Roper v. Simmons that the Eighth Amendment prohibits the execution of people who were under 18 at the time of their offenses. The Court justified the line it drew based on legislative enactments, jury verdicts, and neuroscience. In the intervening years, however, much has changed in juvenile sentencing jurisprudence, the legal treatment of young people, and neuroscience. These changes beg the question: Why 18? Is the bright-line rule that the Court announced in Roper still constitutionally valid or do the changes since 2005 now point to a new cutoff at 21? To answer those questions, this Article considers post-Roper developments in the relevant domains to make the case that the 18-year-old constitutional line should be extended to age 21. It does so by applying the Supreme Court’s evolving-standards-of-decency methodology. Specifically, the Article examines all death sentences and executions imposed in the United States post-Roper and looks at the current state of neuroscientific research that the Court found compelling when it decided Roper. Two predominant trends emerge. First, there is a national consensus against executing people under 21. This consensus comports with what new developments in neuroscience have made clear: people under 21 have brains that look and behave like the brains of younger teenagers, not like adult brains. Second, young people of color are disproportionately sentenced to die — even more so than adult capital defendants. The role of race is amplified when the victim is white. These trends confirm that the logic that compelled the Court to ban executions of people under 18 extends to people under 21.

scholarly journals PRECONDITIONS OF ADMINISTRATIVE RESPONSIBILITY: DOCTRINAL ISSUES

2021 ◽  
Vol 1 ◽  
pp. 102-111
Author(s):  
Oleksandr Gerasymenko
Keyword(s):  
Law Enforcement ◽  
Public Relations ◽  
Practical Significance ◽  
Clear Understanding ◽  
Current State ◽  
Wide Range ◽  
Scientific Approach ◽  
Rule Making ◽  
Administrative Responsibility

A thorough analysis of liability for administrative offence is not possible without clear understanding of its preconditions. The problem of preconditions for administrative responsibility is directly related to administrative delictization of offenses, effectiveness of the fight against delict, prominent state policy in the field of law enforcement and law order. In this aspect, the role of the preconditions for administrative responsibility is a lot more important because they formulate proper foundations for achieving its general objectives. Thus, they determine the effectiveness of administrative responsibility at sectoral and general social levels. The importance of the definition is due to the urgent needs of rule-making and law enforcement practice, the effectiveness of which directly depends on how reasonable and appropriate each administrative delict norm is. Unfortunately, despite all its scientific and practical significance, the issue of preconditions for administrative liability has not been resolved yet. Therefore, there is a need to form unified, consistent scientific approach to understanding the grounds for administrative liability. To this end, the article provides a critical analysis of the basic doctrinal concepts of the preconditions of administrative responsibility. A wide range of social, economic, technical and other factors that determine the effectiveness of administrative responsibility, its current state, its dynamics and prospects for its development have been studied. Discovered the role of these factors in creating a favorable socio-economic and information-technical environment for the implementation of the main tasks of administrative responsibility, in particular: offences prevention, reliable protection of public relations and education of citizens in the spirit of law. The author concluded the scientific and practical expediency of the systematic study of the preconditions for establishing administrative responsibility (preconditions for administrative delictization) and the preconditions for the effectiveness of administrative responsibility.

scholarly journals Training oncoplastic breast surgeons: the Canadian fellowship experience

2017 ◽  
Vol 24 (5) ◽  
pp. 394 ◽  
Author(s):  
J. Maxwell ◽  
A. Aranaout ◽  
R. Hanrahan ◽  
M. Brackstone
Keyword(s):  
Breast Conservation ◽  
The United States ◽  
Oncoplastic Surgery ◽  
Life Outcomes ◽  
Oncoplastic Breast Surgery ◽  
Current State ◽  
Nipple Sparing ◽  
And Training ◽  
Surgical System

Background Oncoplastic breast surgery combines traditional oncologic breast conservation with plastic surgery techniques to achieve improved aesthetic and quality-of-life outcomes without sacrificing oncologic safety. Clinical uptake and training remain limited in the Canadian surgical system. In the present article, we detail the current state of oncoplastic surgery (ops) training in Canada, the United States, and worldwide, as well as the experience of a Canadian clinical fellow in ops.Methods The clinical fellow undertook a 9-month audit of breast surgical cases. All cases performed during the fellow’s ops fellowship were included. The fellowship ran from October 2015 to June 2016.Results During the 9 months of the fellowship, 67 mastectomies were completed (30 simple, 17 modified radical, 12 skin-sparing, and 8 nipple-sparing). The fellow participated in 13 breast reconstructions. Of 126 lumpectomies completed, 79 incorporated oncoplastic techniques.Conclusions The experience of the most recent ops clinical fellow suggests that Canadian ops training is feasible and achievable. Commentary on the current state of Canadian ops training suggests areas for improvement. Oncoplastic surgery is an important skill for breast surgical oncologists, and access to training should be improved for Canadian surgeons.

scholarly journals An Overview of the Current State of Human Issues in Horticulture in the United States

2000 ◽  
Vol 10 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Virginia I. Lohr ◽  
Paula Diane Relf
Keyword(s):  
Social Sciences ◽  
United States ◽  
Well Being ◽  
The United States ◽  
Public Gardens ◽  
Current State ◽  
The Social ◽  
The World ◽  
Plant Sciences

Throughout history, plants have been used to benefit people. In the United States, formal research to document the impacts of plants on people was not published until the 1970s, when papers from social and medical scientists began to appear. In the 1990s, symposia, including the first on “The Role of Horticulture in Human Well-being and Social Development,” brought people together from around the world to share and expand their knowledge in this emerging field. Symposium participants have included researchers in the social sciences and plant sciences, practitioners in horticultural therapy, teachers in colleges and public gardens, industry representatives applying the knowledge, and more. This has formed the basis for current activities in research, teaching, and practice throughout the United States. Examples from research that now documents a variety of beneficial impacts of plants on people are discussed.

scholarly journals Current and Future Best Practices for Pothole Repair in Illinois

2021 ◽  
Author(s):  
Ramez Hajj ◽  
◽  
Yujia Lu ◽  
Keyword(s):  
Best Practices ◽  
Research Team ◽  
Flexible Pavement ◽  
The United States ◽  
Department Of Transportation ◽  
Current State ◽  
Wide Range ◽  
State Of Practice ◽  
Transportation Agencies

This report presents a review of flexible pavement pothole-patching materials, equipment, and techniques within Illinois Department of Transportation as well as other transportation agencies in the United States. The research team conducted a literature review to examine recent studies and available state department of transportation guidance on pothole patching. Overall, this review revealed a lack of recent studies on this topic, and a greater need for them. The review also revealed that most states do not have centralized guidance for pothole repair best practices. The researchers also met with all nine Illinois Department of Transportation districts to determine their current state of practice for pothole patching. The meetings revealed a wide range of materials and techniques in use among the nine districts as well as areas where improvements can be made. The final chapter of this report includes overall recommendations for improvement.

Trafalgar: Back on the Map of British Popular Culture? Assessing the 2005 Bicentenary

2007 ◽  
Author(s):  
Mark Connelly
Keyword(s):  
Popular Culture ◽  
Young People ◽  
National Curriculum ◽  
State Intervention ◽  
Current State ◽  
Wide Range ◽  
Historical Awareness ◽  
Long Term Impact

This chapter explores the current state of knowledge about, and national identification with, Nelson, Trafalgar, and Britain's maritime past, based on observations of a wide range of academic and public bicentenary events, media, and interviews with several groups of (primarily young) people over the course of 2005. The chapter strikes a sceptical note on the long-term impact of 2005 on historical awareness: without direct state intervention in the National Curriculum, it appears difficult to see how the role of the Navy, Nelson, and the sea can be more fully instilled in British life.

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