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101.
Jamila R. Rashid Robert F. Spengler Robin M. Wagner Cindi Melanson Elizabeth L. Skillen Robert A. Mays Jr. Suzanne Heurtin-Roberts Judith A. Long 《American journal of public health》2009,99(11):1955-1961
Despite efforts to the contrary, disparities in health and health care persist in the United States. To solve this problem, federal agencies representing different disciplines and perspectives are collaborating on a variety of transdisciplinary research initiatives. The most recent of these initiatives was launched in 2006 when the Centers for Disease Control and Prevention''s Office of Public Health Research and the Department of Health and Human Services’ Office of Minority Health brought together federal partners representing a variety of disciplines to form the Federal Collaboration on Health Disparities Research (FCHDR).FCHDR collaborates with a wide variety of federal and nonfederal partners to support and disseminate research that aims to reduce or eliminate disparities in health and health care. Given the complexity involved in eliminating health disparities, there is a need for more transdisciplinary, collaborative research, and facilitating that research is FCHDR''s mission.
“The greatest single challenge facing our globalized world is to combat and eradicate its disparities.”—Nelson Mandela1OVER THE LAST FEW DECADES, there has been a dramatic decline in disease mortality for many Americans.2–5 However, some groups of Americans have not fully benefited from this progress, as evidenced by their continued higher disease incidence, morbidity, and mortality.6–9 Racial and ethnic minorities, persons with disabilities, women, the medically underserved, and the economically disadvantaged, among others, face many obstacles to accessing and receiving effective health services, such as health promotion, disease prevention, early detection, and high-quality medical treatment.10–12 As a result, many experience suboptimal health outcomes. Barriers to optimum health include inadequate purchasing power; being uninsured and underinsured; geographic, cultural, and language barriers; racial bias; and stereotyping. These factors are key determinants of health disparities.10–13To better address these determinants, in 2000 the federal government established the elimination of health disparities as a goal of the Healthy People 2010 initiative; as part of this effort, the government made a large investment in research into health disparities and health equity.14–16 Although this work yielded important knowledge about the complex interplay of factors that contribute to health disparities, a midcourse review of Healthy People 2010 showed limited success in reducing health disparities in communities across our nation.17 In recognition of the need for greater success, the absence of a broad collaborative approach across the federal government, and the potential benefits of multiagency collaboration, the Federal Collaboration on Health Disparities Research (FCHDR) was launched in 2006. Given the complexity involved in eliminating health disparities, there is a need for more innovative approaches derived from transdisciplinary research and involving multiple federal agencies from different disciplines. 相似文献
102.
D Collins AM Hogan MM Skelly AW Baird DC Winter 《British journal of pharmacology》2009,158(7):1771-1776
Background and purpose:
Prostaglandin F2α (PGF2α) is implicated in the pathogenesis of inflammatory bowel disease and colorectal cancer. This study investigates the effects of PGF2α on electrophysiological parameters in isolated human colonic mucosa.Experimental approach:
Ion transport was measured as changes in short-circuit current across human colonic epithelia mounted in Ussing chambers. Colonic crypts were isolated by calcium chelation and cyclic adenosine monophosphate (cAMP) was measured by ELISA.Key Results:
PGF2α stimulated chloride secretion in a concentration-dependent manner with an EC50 of 130 nM. The PGF2α induced increase in chloride secretion was inhibited by AL8810 (10 µM), a specific PGF2α receptor antagonist. In addition, PGF2α (1 µM) significantly increased levels of cAMP in isolated colonic crypts.Conclusions and implications:
PGF2α stimulated chloride secretion in samples of human colon in vitro through a previously unrecognizd cAMP-mediated mechanism. These findings have implications for inflammatory states. 相似文献103.
KA Maubach RJ Davis DE Clark G Fenton PM Lockey KL Clark AW Oxford RM Hagan C Routledge RA Coleman 《British journal of pharmacology》2009,156(2):316-327
Background and purpose:
Prostanoid EP4 receptor antagonists may have therapeutic utility in the treatment of migraine since EP4 receptors have been shown to be involved in prostaglandin (PG)E2-induced cerebral vascular dilatation, which may be an important contributor to migraine pain. This study reports the pharmacological characterization of BGC20-1531, a novel EP4 receptor antagonist.Experimental approach:
BGC20-1531 was characterized in radioligand binding and in vitro functional assays employing recombinant and native EP4 receptors. Changes in canine carotid haemodynamics were used to assess the pharmacodynamic profile of BGC20-1531 in vivo.Key results:
BGC20-1531 exhibited high affinity at recombinant human EP4 receptors expressed in cell lines (pKB 7.6) and native EP4 receptors in human cerebral and meningeal artery (pKB 7.6–7.8) but showed no appreciable affinity at a wide range of other receptors (including other prostanoid receptors), channels, transporters and enzymes (pKi < 5). BGC20-1531 competitively antagonized PGE2-induced vasodilatation of human middle cerebral (pKB 7.8) and meningeal (pKB 7.6) arteries in vitro, but had no effect on responses induced by PGE2 on coronary, pulmonary or renal arteries in vitro. BGC20-1531 (1–10 mg·kg−1 i.v.) caused a dose-dependent antagonism of the PGE2-induced increase in canine carotid blood flow in vivo.Conclusions and implications:
BGC20-1531 is a potent and selective antagonist at EP4 receptors in vitro and in vivo, with the potential to alleviate the symptoms of migraine that result from cerebral vasodilatation. BGC20-1531 is currently in clinical development for the treatment of migraine headache. 相似文献104.
105.
106.
W Selby B Crotty T Florin P Pavli AW Morrow 《Journal of gastroenterology and hepatology》2001,16(S1):25-25
Mycobacterium paratuberculosis has been proposed as the cause of Crohn's disease, although this remains controversial. Observational studies of antibiotics with activity against this organism have led to the establishment of an Australian multicentre placebo-controlled trial of clarithromycin, rifabutin and clofazimine in patients with active Crohn's disease. All subjects receive treatment with a tapering regimen of prednisolone for the initial 16 weeks, combined with either antibiotics or matching placebos. If remission is achieved at the end of this period and prednisolone has been ceased they continue the trial medications for 2 years. The primary outcomes – remission rates at 1, 2 and 3 years – aim to determine whether these antibiotics are of long-term benefit in Crohn's disease. Secondary outcomes include rate of remission at 4 months, safety and quality of life.
As of May 2001, 171 of the required 212 subjects have been enrolled. Eighty-seven of 146 potential subjects have reached 16 weeks in remission (60%). Eighty of these are ongoing (92%). Only five withdrawals from the trial have occurred for adverse events thought probably related to trial medications – four subjects with raised LFTs and one who developed a rash. Other withdrawals have been mainly due to lack of response or worsening of Crohn's disease (37), hypomania from steroids (one patient) and pregnancy (one patient on placebo). There have been 11 withdrawals for protocol violations. An Independent Data Monitoring Committee has analysed progress of the trial and unanimously recommended that it continue.
This study is the largest and longest suitably powered randomised controlled trial of antibiotics undertaken in Crohn's disease. It will determine whether this antibiotic combination alters the natural history of this disorder.
This study is being supported by Pharmacia Australia Pty Limited. 相似文献
As of May 2001, 171 of the required 212 subjects have been enrolled. Eighty-seven of 146 potential subjects have reached 16 weeks in remission (60%). Eighty of these are ongoing (92%). Only five withdrawals from the trial have occurred for adverse events thought probably related to trial medications – four subjects with raised LFTs and one who developed a rash. Other withdrawals have been mainly due to lack of response or worsening of Crohn's disease (37), hypomania from steroids (one patient) and pregnancy (one patient on placebo). There have been 11 withdrawals for protocol violations. An Independent Data Monitoring Committee has analysed progress of the trial and unanimously recommended that it continue.
This study is the largest and longest suitably powered randomised controlled trial of antibiotics undertaken in Crohn's disease. It will determine whether this antibiotic combination alters the natural history of this disorder.
This study is being supported by Pharmacia Australia Pty Limited. 相似文献
107.
FM Mutuku MN Bayoh AW Hightower JM Vulule JE Gimnig JM Mueke FA Amimo ED Walker 《International journal of health geographics》2009,8(1):19-13
Background
A supervised land cover classification was developed from very high resolution IKONOS satellite data and extensive ground truth sampling of a ca. 10 sq km malaria-endemic lowland in western Kenya. The classification was then applied to an investigation of distribution of larval Anopheles habitats. The hypothesis was that the distribution and abundance of aquatic habitats of larvae of various species of mosquitoes in the genus Anopheles is associated with identifiable landscape features. 相似文献108.
AW Craft 《Archives of disease in childhood》1996,75(6):536-538
109.
MD Donaldson PH Thomas JG Love GD Murray AW McNinch DC Savage 《Archives of disease in childhood》1994,70(3):214-218
The presentation, pattern of acute illness, and incidence of learning difficulties are described in 63 (33 boys, 30 girls) children with salt wasting 21-hydroxylase deficiency, drawn from a cohort study of congenital adrenal hyperplasia in the South West Region of England between 1968 and 1988. Thirty boys presented with a salt losing crisis from birth whereas the other three boys presented between 2 and 14 months of age with failure to thrive and hyponatraemia. Diagnostic uncertainty led to 13 (43%) of 30 girls developing a salt losing crisis. Five girls were misassigned as boys at birth. There were four deaths in the group, two due to salt losing crisis, one to complications of prematurity possibly compounded by 21-hydroxylase deficiency, and one from heart failure probably related to an excess of steroids. Acute admissions were common, especially during the first year of life, with convulsions in 7% of admissions. The 9% incidence of hypoglycaemia was considered to be an underestimate as blood glucose was measured in only 56 (22%) of 254 admissions. No convulsions occurred in the 38 (15%) admissions where the parents had given intramuscular hydrocortisone before bringing the child to hospital. A high incidence of learning difficulties was found among the 59 surviving children (9/30 (30%) boys and 6/29 (21%) girls), and in only two children could any factor other than 21-hydroxylase deficiency be invoked. Analysis of the subgroup with learning difficulties indicated that they were more ill at presentation with a significantly higher incidence of hypoglycaemia, and that growth in the first year was significantly worse. It is concluded that congenital adrenal hyperplasia remains a formidable disorder with an appreciable mortality and morbidity. The high incidence of learning difficulties seen in salt wasting 21-hydroxylase deficiency needs further attention. A prospective study is indicated to examine the effect of neonatal screening on morbidity from congenital adrenal hyperplasia, particularly the intellectual impairment seen in this study. 相似文献
110.
EA Mitchell KP Nelson JMD Thompson AW Stewart BJ Taylor RPK Ford R Scragg DMO Becroft EA Allen IB Hassall A Roberts 《Acta paediatrica (Oslo, Norway : 1992)》1994,83(8):815-818
We investigated the relationship between travel and changes in routine and the sudden infant death syndrome (SIDS) among 485 SIDS cases compared with 1800 randomly selected control infants. There was no increased risk of SIDS with travel. Special events, such as christenings, were not associated with an increased risk of SIDS. However, visits to and by friends or relatives were associated with a significantly reduced risk of SIDS after controlling for potential confounders (odds ratios = 0.70; 95% confidence interval = 0.52, 0.96). These findings may indicate less social support in SIDS cases. 相似文献