Recent developments in reading therapy: a review of the literature

This paper defines the term 'reading therapy' and discusses its early development in the United Kingdom and the USA. A review of the recent literature in the field is followed by some recommendations on the implementation of reading therapy in health and community care libraries.     

Recent developments in time-dose modelling.

Two recent innovations in time-dose models are reviewed: the linear-quadratic (L-Q) and the variable-exponent Time-Dose Factor (TDF) models. The basic L-Q equations for fractionated and continuous (brachytherapy) regimes are presented as well as those for incomplete repair and short half life radionuclides. None of these equations has provision for a repopulation factor, so a "wasted ERD" parameter is introduced, which is a linear function of overall treatment time, with incorporation of a lag time if desired. For low dose rate therapy, an effective treatment time is defined, at which the ERD reaches its maximum value when the rate of increase due to irradiation equals the rate of decrease due to repopulation. The variable-exponent TDF model has a volume-effect parameter and scaling factors which make TDFs of 100 correspond to tolerance for all volumes of tissue treated, for both fractionated and continuous therapy. These, as well as the exponents, are all tissue-specific. Volume-effect and scaling factors are also appropriate for the L-Q equations. With these it is possible to apply the TDF and L-Q models to problems which involve inhomogeneous dose distributions. Several examples of the use of these models are presented.     

Recent developments in STDs: I. Bacterial diseases

Bacterial pathogens account for a significant portion of the current STD epidemic in the United States. Gonorrhea, syphilis, and chancroid are especially rife in the nation's poverty pockets. Chlamydial infection, the most common bacterial STD, is prevalent at all socioeconomic levels. A recurrent theme in these diseases is coexisting infection, sometimes involving HIV.     

Recent developments in diabetes epidemiology in Europe.

Recent developments in diabetes epidemiology in Europe have included the completion of the European Community sponsored Concerted Action on the Epidemiology and Prevention of Diabetes (Eurodiab), further studies of diabetes and coronary heart disease prevalence in ethnic minority groups in the United Kingdom, and studies of the effect of poor fetal and early post-natal nutrition on the risk of developing non-insulin dependent diabetes (NIDDM). The EURODIAB Concerted Action Programme has provided valuable new information on the incidence of insulin-dependent diabetes mellitus (IDDM) throughout Europe and has drawn attention to an unexpectedly high incidence in Sardinia. In the EURODIAB IDDM complications study, the prevalence of both large- and small-vessel complications of diabetes has been examined, using standardized methods, in 3,279 IDDM patients from 31 centres throughout Europe. The data on risk factors for complications obtained from this study will have significant health policy implications for diabetes in Europe which will be utilized by the current St. Vincent Declaration Action Programme for Diabetes Care and Research in Europe. In another part of the EURODIAB Concerted Action Programme, important information has been obtained on the validity of routinely-collected diabetes health information, such as mortality statistics based on death certificates, and estimates of diabetes prevalence obtained from drug-utilization data.     

Recent developments in meta-analysis

The art and science of meta-analysis, the combination of results from multiple independent studies, is now more than a century old. In the last 30 years, however, as the need for medical research and clinical practice to be based on the totality of relevant and sound evidence has been increasingly recognized, the impact of meta-analysis has grown enormously. In this paper, we review highlights of recent developments in meta-analysis in medical research. We outline in particular how emphasis has been placed on (i) heterogeneity and random-effects analyses; (ii) special consideration in different areas of application; (iii) assessing bias within and across studies; and (iv) extension of ideas to complex evidence synthesis. We conclude the paper with some remarks on ongoing challenges and possible directions for the future.     

Recent developments in short-chain fatty acid metabolism.

Bacterial translocation across the bowel wall has recently been proposed as a major problem in the stressed patient. Consequently, there has been considerable interest in fostering bowel wall integrity as a barrier to bacteria and endotoxin. One postulated means to promote this barrier function has been through the provision of the preferred fuels of the bowel wall. Among these are the short-chain fatty acids (SCFAs) which are found to a limited extent in the diet but are primarily produced through the fermentation of non-digestible carbohydrates by the bacterial flora of the colon. In both animal and human studies, SCFAs have been shown to stimulate intestinal mucosal growth. Because non-digestible carbohydrates, after colonic fermentation, are precursors to SCFAs, similar effects to those found with direct provision of SCFAs may be anticipated. Pectin, beta-glucan, and lactulose are among the many available nonabsorbable carbohydrates that could serve as a source of these trophic stimulants to colonic mucosa. Short-chain fatty acids and their precursors deserve extensive and clinical evaluation to define their ultimate role in human disease.