Support for emergency department screening for intimate partner violence depends on perceived risk

Emergency department (ED) screening for intimate partner violence (IPV) faces logistic difficulties and has uncertain efficacy. We surveyed 146 ED visitors and 108 ED care providers to compare their support for ED IPV screening in three hypothetical scenarios of varying IPV risk. Visitor support for screening was 5 times higher for the high-risk (86%) than for the low-risk (17%) scenario. Providers showed significantly more support for the need for ED IPV screening than visitors. Controlling for confounding by gender, race, experience with IPV, hospital, and marital status did not affect comparisons between groups. These responses indicate greater support for IPV screening in the ED for high-risk than for low-risk cases, particularly among visitors.     

New pitfall for the pharmaceutical industry

Legal context This article reviews the Commission decision thatfined AstraZeneca 60 million for abuse of Article 82 EC. Itlooks at the decision in the context of the EU legal frameworkfor pharmaceuticals and considers the legal basis for the Commissiondecision. Key points The article highlights the key points of the allegedabusive practices that do not appear to be consistent with theEU regulatory legal framework and the ECJ jurisprudence in particular,read in conjunction with the principle of commercial freedom. Practical significance The Commission decision (if upheld bythe courts) would have an significant impact on the way thatpharmaceutical companies run their business. This would constitutean unprecedented interference with the principle of commercialfreedom afforded to pharmaceutical companies and specificallyrecognised by the ECJ.     

La commission parlernentaire: mécanisrne d'imputabilitéà l‘égard des sous-ministres et des dirigeants d'organismes

Sommaire: Plusieurs parlementaires, divers analystes et deux commissions d'étude récentes, l'une au palier fédéral (Lambert) et l'autre au Québec (Bisaillon), ont traité de la possibilité d'implanter un régime d'imputabilité pour les administrateurs publics, particulièrement les sous-ministres et les dirigeants d'organismes. Les modifications apportées, au début de la présente année, aux règles de procédure de l'Assemblée nationale vont permettre une certaine expérimentation à cet égard. Une telle réforme améne l'auteur à examiner diverses contraintes qui pourraient influencer et même jouer contre son implantation, notamment: les principes de la responsabilité et de la solidarité ministérielles, l'évolution des rapports entre le gouvernement et l'administration, les différences de statut entre les sous-ministres et les dirigeants d'organismes et les précédents relatifs à la participation des sous-ministres et des dirigeants d'organismes aux travails de l'Assemblée. Ces contraintes sont assurément sérieuses car elles remettent en cause des éléments majeurs du système politique. Reste à savoir si, comme cela se produit souvent, les hommes politiques réussiront encore une fois à concilier ce qui paraît incompatible. Abstract: Several members of Parliament, various analysts and two recent commissions of inquiry, one federal (Lambert Commission) and the other from Quebec (Bisaillon), have studied the possibility of implementing an accountability system for public administrators, particularly deputy ministers and chief executive officers of agencies. Amendments brought forth earlier this year to the procedures of the National Assembly of Quebec will allow for experimentation in that area. Such a reform leads the author to examine various constraints in its implementation; in particular, the principles of ministerial responsibility and soolidarity; the evolution of relationships between government and administration; the status differences between deputy ministers and chief executive officers of agencies; the precedents concerning the participation of deputy ministers and chief executive officers in the work of the Assembly. Those constraints are of great importance since they challenge some major elements of the political system. It remains to be seen whether politicians will succeed once again in reconciling what appears to be incompatible.     

Allele frequencies and haplotypes of 8 Y-chromosomal STRs in the Santa Catarina population of southern Brazil

Allele frequencies and haplotypes of eight Y-chromosomal short tandem repeats (STRs), DYS19, DYS385, DYS389 I, DYS389 II, DYS390, DYS391, DYS392 and DYS393 were determined in a sample of 109 males from Santa Catarina. The origin of this southern Brazilian population is mainly from Portuguese people, namely from Azores archipelago.     

Recent developments in health law in Poland: new law on the removal, storage and transplantation of cells, tissues and organs

This article describes the new Law on the removal, storage and transplantation of cells, tissues and organs of July 1, 2005, which entered into force on January 1, 2006.     

Influence of blood loss on the pharmacokinetics of citalopram

Extended blood loss results in several compensatory physiological mechanisms, including transfer of extravascular fluid into the blood circulation. If drugs are present in the body, this fluid exchange may imply that blood drug concentrations found in a trauma victim may differ from the concentrations present at the time of the trauma. To address this issue, an animal model was used to investigate the influence of blood loss on pre-existing levels of the antidepressant drug citalopram and its demethylated metabolites. Rats were administered citalopram either acutely (40 mg/kg, orally) or chronically (20 mg/kg daily, subcutaneously) for 6 days using osmotic pumps. In the experimental rats, blood loss was accomplished by withdrawing 0.8 mL blood at 10 min intervals during 70 min. In the control rats, blood was withdrawn at 0 and 70 min only. Blood, brain and lung drug concentrations were analyzed with an enantioselective HPLC method. In the chronically treated rats, the ratios between final and initial citalopram concentrations were 1.08 +/- 0.15 and 1.01 +/- 0.09 in the experimental rats and controls, respectively, indicating no major effect of blood loss. In contrast, acute oral administration resulted in increased ratios in the exsanguinated rats as compared to controls (1.84 +/- 0.50 versus 0.73 +/- 0.07; p = 0.0495). In conclusion, the observation of increased blood drug levels in the acute oral rats indicates that absorption of fluid from the gastrointestinal tract may be important in the intravascular refill. Further, in the interpretation of post-mortem blood levels of drugs, these physiological mechanisms should be taken into account.     

Ecological correlates of neglect in infants and toddlers

Infants and toddlers are more likely to be victims of neglect than any other form of maltreatment. Infants and toddlers are at highest risk of fatality because of maltreatment and experience behavioral, social, academic, medical, and cognitive consequences of neglect during their most formative years. Within an ecological framework, this study examines the correlates of the substantiation of neglect in children 0 to 36 months of age. Using an ex post facto design and a random sample of 148 child protective services cases, bivariate analysis revealed significant differences in families who were substantiated for neglect in the areas of child characteristics, home environment, social environment, caregiver, and maltreatment situations. Multivariate analysis found children who were substantiated for neglect were exposed to greater environmental dangers and had caregivers who had poor parenting skills. Implications for practice and future research are discussed.