What is the scope for the interpretation of dignity in research involving human subjects?

Drawing on Lennart Nordenfelt's distinction between the four distinct senses of dignity, I elucidate the meaning of dignity in the context of research involving human subjects. I acknowledge that different interpretations of the personal senses of dignity may be acceptable in human subject research, but that inherent dignity (Menschenwürde) is not open to interpretation in the same way. In order to map out the grounds for interpreting dignity, I examine the unique application of the principle of respect for dignity in Canada's research ethics guidelines. These guidelines are unique because they consider dignity to be a foundational concept and the protection of the dignity of research subjects is regarded as a measure that prevents "the impoverishment of humanity as a whole". While the conception of humanity invoked here is incomplete, Canada's research ethics guidelines nevertheless represent a more European approach to biomedical policy. Finally, in order to correct a pervasive blind spot in contemporary policy on research involving human subjects, I sketch a functional model for attributing inherent dignity that avoids the untenable connotations of speciesism.     

What is the role of human contamination by environmental chemicals in the development of type 1 diabetes?

The increasing incidence of type 1 diabetes (T1D) in children around the world is unexplained. Even though various environmental chemicals have been linked to the development of type 2 diabetes as well as other autoimmune diseases, the possibility that environmental chemicals may contribute to the development of T1D has not been adequately evaluated. There is preliminary epidemiological evidence that exposure to certain chemicals, such as N-nitroso compounds, air pollutants and persistent organic pollutants is associated with T1D. Environmental chemicals that can act as endocrine disruptors may affect the development and function of the immune system in ways that could promote autoimmunity, and thereby contribute to the development of T1D. As such, the potential low-dose effects of chemicals should be considered in both epidemiological and experimental study designs of T1D. If chemicals indeed contribute to the development of T1D, then this disease may be partly preventable.     

What is the meaning of threshold in laser injury experiments? Implications for human exposure limits

The derivations of human exposure limits for laser radiation rely heavily upon experimental ocular injury studies. The limits are derived by committees of ophthalmic experts through a review of all available threshold data and an understanding of mechanisms of laser/tissue interaction. A major point of discussion in this derivation process relates to the level of uncertainty of the threshold of injury. An indication of the level of uncertainty relates to the slope of the transformed dose-response curve, or the "probit plot" of the data. The most cited point on the probit plot is the exposure that represents a 50% probability of injury: the ED-50. This value is frequently referred to as the "threshold," even though some experimental damage points exist below this "threshold." An analysis of any number of example data sets reveals that the slope in most experiments cannot be explained by biological variation alone. The optical, thermophysical, and biological factors influencing the probit plot are critically analyzed to provide guidance for deriving exposure limits. By theoretically modeling an experiment, small errors in focus are shown to produce a substantial change in the ED-50 and the slope of the probit plot.     

What is the role of allergic sensitization in Graves' disease?

INTRODUCTION: Recent data supported the presence of T helper 2 dominance in the immune processes of Graves' disease and allergic diseases. A common role of regulatory T cells in the antigen- (or allergen-) specific immune responses was also demonstrated. AIMS: To study whether allergic events may play a role in the initiation or progression of autoimmune Graves' disease. The occurrence of seasonal allergy may explain the fluctuation in the onset of Graves' disease. METHODS: The presence of specific IgE levels against inhalative allergens was investigated in 327 patients with thyroid disease (Graves' disease, Hashimoto's thyroiditis, euthyroid goitre). Western blot method was used for the measurement of allergen-specific IgE levels with densitometric evaluation. RESULTS: Allergic sensitization was found in 88 cases (58%) for Graves' disease, 51 cases (46%) for Hashimoto's thyroiditis and 31 cases (55%) for euthyroid goitre. According to allergens, significant difference was demonstrated by Penicillium notatum, Dermatophagoides farinae, alder - rye (pollens) between Graves' disease (depending ophthalmopathy) and euthyroid goitre. In the four groups based on allergen seasonality, the month of the onset in Graves' disease was associated with the season of early tree and mugwort allergy (P < 0.019 between Graves' disease and Hashimoto's thyroiditis). The number of cases, in whom the onset of Graves' disease in a given month was similar to the month of allergic season, was 17 cases vs 7 cases with Hashimoto's thyroiditis (P < 0.028). CONCLUSIONS: The allergic sensitization was more frequent in Graves' disease, and the allergic seasonality may explain the fluctuation in the onset of Graves' disease.     

What is urban in the contemporary world?

Central concepts of contemporary life such as politics, civilization, and citizenship derive from the city's form and social organization. The city expresses the socio-spatial division of labor, and Henri Lefebvre proposes to view its transformation within a continuum from the political city to the urban, whereby it completes its domination over the countryside. The city's transformation into the urban takes place when industry brings production (and the proletariat) into that space of power. The city, locus of surplus, power, and the fiesta, a privileged scenario for social reproduction, was subordinated to the industrial logic and underwent a dual process: its centrality imploded, and its outskirts exploded on surrounding areas through the urban fabric, bearing with it the seeds of the polis and civitas. The urban praxis, formerly restricted to the city, re-politicized social space as a whole. In Brazil, the urban has its origins in the military governments' centralizing and integrating policies, following Vargas's expansionism and Kubitschek's developmental interiorization (or occupation of the hinterlands). Today, urban-industrial processes impose themselves over virtually all social space, in contemporary extended urbanization.     

What is a human resources strategy?

Attempts to provide a practical framework in which practitioners may develop human resources (HR) strategies in line with their organizations' corporate planning processes. Proposes a four-step approach involving: development of a strategic framework; generating of HR mission statement; application of analysis; and making strategic planning decision between HR options. Outlines a four-dimensional structural focus comprising culture, organization, people and systems. Concludes with a discussion of characteristic of ?good? strategic objectives.     

What is the Role of Nursing Homes in the Surviving Sepsis Campaign?

Recently, there have been several publications advocating for an expansive role for nursing homes (NHs) in the Surviving Sepsis Campaign (SSC). The rationale for this effort is the problem of high rates of 30-day readmissions from NHs and a disproportionate percentage of residents with a diagnosis of sepsis in emergency departments. This article provides a brief history of the SSC and the evolution of the definition of sepsis and of the timing of interventions that make up a “sepsis bundle.” Screening tools for sepsis that may be used in the NH setting are discussed. It is emphasized that there is no gold standard for the diagnosis of sepsis, and this limits the ability to identify a screening tool with high sensitivity. Three recent publications that discuss the recognition and management of sepsis in the NH are reviewed, although there is very little published information about this problem. Despite the lack of information about sepsis in NHs, several states have developed protocols for identification and management of sepsis in NHs but there are no results of the impact of these efforts on hospitalization or readmission rates or resident outcome. Based on the review of this information, the ability of NH providers and staff to identify residents with possible sepsis is unclear given no effective screening tool and the recent change in the definition of sepsis that focuses on a point late in the continuum from infection to sepsis with organ dysfunction. Also, NH capability to perform, in a timely fashion, interventions recommended in a sepsis bundle such as insertion of an intravenous catheter, performing blood cultures, administering antibiotics, and fluid resuscitation will likely vary considerably. There is a need for more intensive study of sepsis in the NH setting to identify screening tools with better sensitivity and identification of interventions suitable for the NH setting and that have an impact on various outcomes.