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The residents of developing countries need pharmaceutical products at least as much as the residents of developed countries. Noncommunicable diseases (such as cancers, cardiovascular disease, and mental-health disorders), which typically are most effectively treated with drugs, are now nearly as common in developing countries as in developed countries. And communicable diseases (such as tuberculosis, HIV, and malaria), the prevention or treatment of which also typically require drugs, continue to be substantially more common in the developing world.

To establish national guidelines for the assessment of women's sexual health concerns and the provision of sexual health care for women.Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e .g., sexuality, "sexual dysfunction," "physiological," dyspareunia) and key words (e .g ., sexual dysfunction, sex therapy, anorgasmia). Results were restricted, where possible, to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Each article was screened for relevance and the full text acquired if determined to be relevant. The evidence obtained was reviewed and evaluated by the members of the Expert Workgroup established by The Society of Obstetricians and Gynaecologists of Canada.The quality of evidence was evaluated and recommendations made using the use of criteria described by the Canadian Task Force on Preventive Health Care (Table).

The FDA has approved a multicenter, double-blind, Phase III, pivotal trial testing deep brain stimulation (DBS) in 280 people with very early stage Parkinson's disease (PD; IDE#G050016). In partnership with The Michael J. Fox Foundation for Parkinson's Research, we conducted a survey to investigate motivating factors, barriers, and gender differences among potentially eligible patients for participation in a trial testing DBS in early PD compared to standard medical treatment. The majority of survey respondents (72%) indicated they would consider learning more about participating. Early PD patients are therefore likely to consider enrolling in trials of invasive therapies that may slow symptom progression and help future patients.

This study provides the description, protocol, and results from a novel prospective ambulatory digital hot flash phenomenon diary.This study included 152 midlife women with daily hot flashes who completed an ambulatory electronic hot flash diary continuously for the waking hours of three consecutive days. In this diary, women recorded their hot flashes and accompanying characteristics and associations as the hot flashes occurred.Self-reported hot flash severity on the digital diaries indicated that the majority of hot flashes were rated as mild (41.3%) or moderate (43.7%). Severe (13.1%) and very severe (1.8%) hot flashes were less common. Hot flash bother ratings were rated as mild (43%), or moderate (33.5%), with fewer hot flashes reported bothersome (17.5%) or very bothersome (6%). The majority of hot flashes were reported as occurring on the face (78.9%), neck (74.7%), and chest (61.3%). Of all reported hot flashes, 32% occurred concurrently with prickly skin, 7% with anxiety, and 5% with nausea. A novel finding from the study was that 38% of hot flashes were accompanied by a premonitory aura.A prospective electronic digital hot flash diary allows for a more precise quantitation of hot flashes while overcoming many of the limitations of commonly used retrospective questionnaires and paper diaries. Unique insights into the phenomenology, loci, and associated characteristics of hot flashes were obtained using this device. The digital hot flash phenomenology diary is recommended for future ambulatory studies of hot flashes as a prospective measure of the hot flash experience.

Mobile ions in hybrid perovskite semiconductors introduce a new degree of freedom to electronic devices suggesting applications beyond photovoltaics. An intuitive device model describing the interplay between ionic and electronic charge transfer is needed to unlock the full potential of the technology. We describe the perovskite-contact interfaces as transistors which couple ionic charge redistribution to energetic barriers controlling electronic injection and recombination. This reveals an amplification factor between the out of phase electronic current and the ionic current. Our findings suggest a strategy to design thin film electronic components with large, tuneable, capacitor-like and inductor-like characteristics. The resulting simple equivalent circuit model, which we verified with time-dependent drift-diffusion simulations of measured impedance spectra, allows a general description and interpretation of perovskite solar cell behaviour., Comment: 12 pages main text, total 51 including supplementary information

Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge.We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty. All the patients received once-daily oral rivaroxaban (10 mg) until postoperative day 5 and then were randomly assigned to continue rivaroxaban or switch to aspirin (81 mg daily) for an additional 9 days after total knee arthroplasty or for 30 days after total hip arthroplasty. Patients were followed for 90 days for symptomatic venous thromboembolism (the primary effectiveness outcome) and bleeding complications, including major or clinically relevant nonmajor bleeding (the primary safety outcome).A total of 3424 patients (1804 undergoing total hip arthroplasty and 1620 undergoing total knee arthroplasty) were enrolled in the trial. Venous thromboembolism occurred in 11 of 1707 patients (0.64%) in the aspirin group and in 12 of 1717 patients (0.70%) in the rivaroxaban group (difference, 0.06 percentage points; 95% confidence interval [CI], -0.55 to 0.66; P0.001 for noninferiority and P=0.84 for superiority). Major bleeding complications occurred in 8 patients (0.47%) in the aspirin group and in 5 (0.29%) in the rivaroxaban group (difference, 0.18 percentage points; 95% CI, -0.65 to 0.29; P=0.42). Clinically important bleeding occurred in 22 patients (1.29%) in the aspirin group and in 17 (0.99%) in the rivaroxaban group (difference, 0.30 percentage points; 95% CI, -1.07 to 0.47; P=0.43).Among patients who received 5 days of rivaroxaban prophylaxis after total hip or total knee arthroplasty, extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT01720108 .).

Hypnotic relaxation therapy (HRT) has been shown to reduce hot flashes in postmenopausal women and breast cancer survivors. While the biological mechanism by which HRT reduces hot flashes is unknown, it has been speculated that reduction of stress mediates the intervention’s effectiveness. The purpose of the present study was to examine the effect of HRT on a known biomarker of stress (cortisol) and changes in cortisol as a mediator. Sixty-two postmenopausal women received hypnotic relaxation therapy for hot flashes and completed measures of hot flashes in addition to providing cortisol samples at baseline and endpoint. HRT resulted in significantly decreased early evening salivary cortisol concentrations. However, changes in salivary cortisol concentrations did not mediate the effects of HRT.

Open dating of food products has been practiced for decades, and has been key to achieving stock rotation at retail and providing information to consumers. The open date provides a simple communication tool, which may be based on product quality and/or food safety as determined by the manufacturer or retailer. Date marking is generally open but it can be closed (code intended for managing product at retail, and for recall and traceability), and the terminology and applications vary widely around the world. The variation in date labeling terms and uses contributes to substantial misunderstanding by industry and consumers and leads to significant unnecessary food loss and waste, misapplication of limited resources, unnecessary financial burden for the consumer and the food industry, and may also lead to potential food safety risk in regards to perishable foods. A "use by" or similar date cannot be relied on to indicate or guarantee food safety because absolute temperature control of food products throughout the food supply chain cannot be assured. This paper provides an introduction to the issue of food product date labeling and addresses its history in the United States, different terms used and various practices, U.S. and international frameworks, quality compared with safety, adverse impacts of misconceptions about date labeling, and advantages of technological innovations. Collaboration to develop a simple workable solution to address the challenges faced by stakeholders would have tremendous benefit. Conclusions include a call to action to move toward uniformity in date labeling, thereby decreasing confusion among stakeholders and reducing food waste.

Objective To strengthen the national framework for care of adolescents and women affected by female genital cutting (FGC) in Canada by providing health care professionals with: (1) information intended to strengthen their knowledge and understanding of the practice; (2) directions with regard to the legal issues related to the practice; (3) clinical guidelines for the management of obstetric and gynaecological care, including FGC related complications; and (4) guidance on the provision of culturally competent care to adolescents and women with FGC. Evidence Published literature was retrieved through searches of PubMed, CINAHL, and The Cochrane Library in September 2010 using appropriate controlled vocabulary (e.g., Circumcision, Female) and keywords (e.g., female genital mutilation, clitoridectomy, infibulation). We also searched Social Science Abstracts, Sociological Abstracts, Gender Studies Database, and ProQuest Dissertations and Theses in 2010 and 2011. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2011. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Values The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1).

The Institute of Food Technologists (IFT) provides scientific perspective and science-based evidence for food-related policy activities so that outcomes are not determined without consideration of relevant food science and technology expertise and insight. Being a scientific and technical resource in this arena is essential to IFT's mission and vision. IFT participates in a variety of activities to inform and educate public policymakers and engage in advocacy at the national and global level. The organization provides evidence-based scientific perspectives important to legislative, regulatory, and other activities, and global harmonization of national food-related measures and regulations.

The IHPBA/AHPBA-sponsored 2016 minimally invasive pancreatic resection (MIPR) conference held on April 20th, 2016 included a session designed to evaluate what would be the most appropriate scientific contribution to help define the increasing role of MIPR internationally. Participants in the conference reviewed the assessment of numerous pertinent scientific designs including randomized controlled trial (RCT), pragmatic international RCT, registry-RCT, non-RCT with propensity matching, and various types of clinical registries including those aiming to create a quality improvement data system or a learning health care system. The strengths and weaknesses of each of these designs, the status of trials which are currently recruiting patients, and pragmatic considerations were evaluated. A recommendation was made to establish a clinical registry to collect data prospectively from around the world to assess current practices and provide a framework for future studies in MIPR.

Hot flashes are prevalent and severe symptoms that can interfere with mood, sleep, and quality of life for women and men with cancer. The purpose of this article is to review existing literature on the risk factors, pathophysiology, and treatment of hot flashes in individuals with cancer. Electronic searches were conducted to identify relevant English-language literature published through June 15, 2012. Results indicated that risk factors for hot flashes in cancer include patient-related factors (eg, age, race/ethnicity, educational level, smoking history, cardiovascular risk including body mass index, and genetics) and disease-related factors (eg, cancer diagnosis and dose/type of treatment). In addition, although the pathophysiology of hot flashes has remained elusive, these symptoms are likely attributable to disruptions in thermoregulation and neurochemicals. Therapies that have been offered or tested fall into 4 broad categories: pharmacological, nutraceutical, surgical, and complementary/behavioral strategies. The evidence base for this broad range of therapies varies, with some treatments not yet having been fully tested or showing equivocal results. The evidence base surrounding all therapies is evaluated to enhance hot flash treatment decision-making by clinicians and patients.

Background The risk of optic disc haemorrhages on visual outcome in idiopathic intracranial hypertension (IIH) is unknown. We report the type and frequency of optic disc haemorrhages and other funduscopic abnormalities at baseline in the study eye of the 133 subjects enrolled in the Idiopathic Intracranial Hypertension Treatment Trial completing 6 months of follow-up. Methods We reviewed optic disc photographs to tabulate the frequency and type of optic disc haemorrhages, other funduscopic abnormalities and papilloedema grades of the study eye at baseline and analyse if their presence is associated with a poor visual outcome. Results 27.2% of subjects had nerve fibre layer haemorrhages in at least one eye. Five of seven, 71% of subjects that met criteria for treatment failure, had nerve fibre layer haemorrhages in at least one eye (Fisher9s exact test: p=0.02). There was a good correlation between presence of nerve fibre layer haemorrhages and Frisen grade (Spearman9s correlation, p=0.002; r=0.271). Subjects with nerve fibre layer haemorrhages had a higher cerebrospinal fluid pressure (40.0 mm water, p=0.04). There was poor correlation between nerve fibre layer haemorrhages at baseline and the perimetric mean deviation change at 6 months. Cotton wool spots were present in 4% of subjects, exudates in 3% and pseudodrusen in 4%. Conclusions Nerve fibre layer haemorrhages are common in patients with IIH with mild visual loss and correlate with the severity of the papilloedema. They occur more frequently in treatment failure subjects and therefore may be associated with poor visual outcomes. Trial registration number NCT01003639, Post-results.

Pain is a serious health care problem and there is growing evidence to support the use of hypnosis and cognitive-behavioral interventions for pain management. This article reviews clinical techniques and methods of cognitive hypnotherapy for pain management. Current research with emphasis given to randomized, controlled trials is presented and the efficacy of hypnotherapy for pain management is discussed. Evidence for cognitive hypnotherapy in the treatment in chronic pain, cancer, osteoarthritis, sickle cell disease, temporomandibular disorder, fibromyalgia, non-cardiac chest pain, and disability related chronic pains are identified. Implications for clinical practice and research are discussed in light of the accumulating evidence in support of the efficacy and effectiveness of cognitive hypnotherapy for pain management.

This paper addresses the preliminary development, construct validity, and psychometric properties of a brief self-report measure of psychological distress. 40 items were originally generated by doctoral level psychologists for use in the preliminary clinical sample. Inpatients from a psychiatric unit ( N = 125) completed the items, and a principal-components analysis with a direct oblimin rotation was used to evaluate construct validity. The study indicated a four-factor solution, using the constructs of Depression, Hopelessness, Anxiety, and Anger, with good estimates of reliability. After evaluation of factor structure, item analyses, and reliability estimates, a redacted 19-item scale was identified.

Solar ultraviolet (UV) radiation can have deleterious effects on coral assemblages in tropical and subtropical marine environments, but little information is available on UV penetration into ocean waters surrounding corals. Here we provide an extensive data set of optical properties in the UV domain (280[en]400 nm) that were obtained during 1998-2005 at sites located in the Lower and Middle Keys and the Dry Tortugas. Absorption coefficients of the colored component of the dissolved organic carbon (DOC; colored dissolved organic matter [CDOM]) were 6x to 25 X larger than particulate absorption coefficients in the UV region, indicating that CDOM controls UV penetration in the inshore coastal waters and reef tract. CDOM absorption coefficients (a CDOM ) and DOC were highly correlated to diffuse attenuation coefficients (K d ) in the UV spectral region. Measurements using moored sensors showed that UV penetration at the reef tract in the Lower Keys varies significantly from day to day and diurnally. The diurnal variations were linked to tidal currents that transport CDOM over the reef tract. Summertime stratification of Case 1 bluewaters near the reef tract during periods of low wind resulted in higher temperatures and UV penetration than that observed during well-mixed conditions. This result suggests that higher UV exposure accompanying ocean warming during low-wind doldrums conditions significantly contributes to coral bleaching. Modeling results indicate that changes in underwater sunlight attenuation over the coral reefs can affect UV-induced deoxyribonucleic acid (DNA) damage and inhibition of coral photosynthesis much more strongly than changes in the stratospheric ozone layer.

Hot flashes are a highly prevalent symptom experienced by women transitioning through menopause, as well as by men and women undergoing certain cancer-related treatments. Though many individuals do not find these symptoms troublesome, others suffer from severe and frequent symptoms and related decrements in sleep, psychological well-being, sexual health and overall quality of life. In order to develop a better understanding of the etiology and treatment options for hot flashes, accurate measurement is vital. This chapter provides an overview of hot flash measurement both physiologic, and via self-report measures. It critically evaluates the four categories of hot flash measurement tools: symptom scales based on retrospective reporting over weeks and months, daily diaries completed by end of day, daily diaries completed at the time of the hot flash, and physiologic measures of hot flashes. Further, the impact of psychological/emotional influences, ethnic differences, and body mass on hot flash reporting is discussed. Finally, this chapter provides recommendations for the future development and refinement of hot flash reporting tools and suggestions for best-practice hot flash measurement methodology.

Clinical evidence for the effectiveness of hypnosis in the treatment of acute, procedural pain was critically evaluated based on reports from randomized controlled clinical trials (RCTs). Results from the 29 RCTs meeting inclusion criteria suggest that hypnosis decreases pain compared to standard care and attention control groups and that it is at least as effective as comparable adjunct psychological or behavioral therapies. In addition, applying hypnosis in multiple sessions prior to the day of the procedure produced the highest percentage of significant results. Hypnosis was most effective in minor surgical procedures. However, interpretations are limited by considerable risk of bias. Further studies using minimally effective control conditions and systematic control of intervention dose and timing are required to strengthen conclusions.

Among patients with isolated below-knee fractures, previous studies have detected asymptomatic deep vein thrombosis in 10%-40% using contrast venography. However, the clinical relevance of these thrombi is unknown; there is considerable uncertainty about the risk: benefit of routine thromboprophylaxis and clinical practice guidelines differ in their recommendations.In this multicenter, double-blind trial, 265 patients with isolated lower leg fractures requiring surgery were randomized to subcutaneous dalteparin 5000 units or matching placebo once daily for 2 weeks with bilateral Doppler ultrasound (DUS) of the proximal leg veins on postoperative day 14±2 and 3-month follow-up. The primary effectiveness outcome was clinically important venous thromboembolism (CIVTE), defined as the composite of symptomatic venous thromboembolism within 3 months after surgery and asymptomatic proximal deep vein thrombosis on DUS. The primary safety outcome was major bleeding.Two hundred fifty-eight patients (97%) were included in the primary outcome analysis for effectiveness (130: dalteparin; 128: placebo). Incidence of CIVTE in the dalteparin and placebo groups was 1.5% and 2.3%, respectively (absolute risk reduction, 0.8%; 95% confidence interval, -2.0 to 3.0). There were no fatal pulmonary emboli or major bleeding.The overall incidence of CIVTE after surgically repaired, isolated tibia, fibula, and ankle fractures was low (1.9%; 95% confidence interval, 0.7-4.7), with no observed differences between dalteparin and placebo either for CIVTE or safety. Recruitment was stopped at the first interim analysis. This study also demonstrates the substantial discrepancy in venous thromboembolism rates between trials that use venographic outcomes compared with more clinically relevant outcomes.Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

A Web-based voluntary survey of librarians who write book reviews reveals an array of opinions on such topics as classification of book reviews as a “professional activity” within librarianship, how book reviews should be prepared and written, what the book reviewer's current role is, and the future of that role in a world of online reviews.

The 2002 Canadian Contraception Study investigated the contraception and sexual health-related knowledge, attitudes, and practices of a representative sample of Canadian women of childbearing age. In Part 2 of the report of this research, the authors focus on the contraceptive attitudes and practices of adolescent women and women in their later reproductive years, provide data on sexual and reproductive health indicators of Canadian women, describe 2-decade trends in the awareness, opinion, and utilization of contraceptive methods among Canadian women, and describe contraception counselling strategies that may be used to improve patient choice and adherence to method. This report closes with an overall discussion of the findings of the 2002 Canadian Contraception Study.

adopted a policy of passive resistance, which meant laws were simply left unenforced. Chinese traditions, which gave a family control over its female members, including the right to sell, pawn, or pledge them, meant that officials ignored such issues as an organized traffic in women. Had Henriot been more willing to discuss Confucian visions of patriarchy as a central issue, he would have benefited from the feminist scholarship he attacked. In other areas, however, the author is clearly in control of his sources and subject matter. He gives the reader a wonderful sense of the prostitution districts and how a relatively weak state preferred to make bordellos less visible than earn money off the commerce. His statistics on the origins and tender ages of most of the registered prostitutes, as well as those arrested by public authorities, show the impact of regional migration patterns within China, as well as the limited presence of foreign prostitutes. They reinforce a strong cultural argument that Chinese officials, though buffeted by urbanization and modernization, ignored the traffic in women as well as the public health dangers associated with female sexual commerce. Given the author’s predilection for statistical information and his acknowledgment that it is very difficult to obtain information about sexuality given Chinese cultural norms, this is not a book about the erotics of prostitution or about the personal feelings of customers or sex workers. It is, instead, about supply and demand, and from that perspective, Henriot’s portrait is extensive and convincing, even though he had limited access to judicial and police archives—a perpetual problem for studying twentiethcentury criminal issues. For those interested in prostitution in Shanghai, Prostitution and Sexuality in Shanghai should be read along with Dangerous Pleasures: Prostitution and Modernity in Twentieth-Century Shanghai to provide the clearest picture of the topic.

The objective of this study was to examine the potential role of hypnotizability as a moderator of effectiveness of a hypnosis intervention for reducing hot flashes in breast cancer survivors. Sixty women were randomized into either five weekly sessions of hypnosis or a wait list control condition. Nine of the participants dropped out of the study and 24 were randomized to the control condition. There were 27 participants who completed the hypnosis intervention and for whom hypnotizability was assessed. The frequency and severity of hot flashes were measured by daily diaries completed for one week at baseline and at the end of treatment. Hypnotizability was assessed by the Stanford Hypnotic Clinical Scale. Hot flash scores were reduced by 68% on average at the end of treatment. Sequential multiple regression was used to test whether hypnotizability moderated the effect of initial hot flash scores on post-test hot flash scores. The results suggest that the hypnosis intervention was more effective for participants who scored higher on measured hypnotizability. The moderating role of hypnotizability may be useful to consider in treatment of hot flashes with the hypnosis intervention. While this study was limited to breast cancer survivors it may clarify some of the complexity of the response to hypnosis.

The profession remains keenly interested in education-related issues. Recent statements by groups like the California Library Association and the Special Libraries Association provide a strong link between the profession and its educational programs.