The scientific understanding of common chronic disease began in the mid-19th century, driven in large part by the development of the modern autopsy. For cardiovascular disease, the recognition that rigid plaques were obstructing muscular arteries, especially in the coronary arteries, provided a mechanism to explain what had been a mysterious "chest pain–sudden collapse" syndrome. The origin of these plaques was totally obscure, however, and they were given the descriptive name of "atherosclerosis," or "hardened porridge" in Greek. Not until 50 years (...) later, when animal experimental models serendipitously revealed the hyper-lipidemic consequences of a diet high in animal fat, followed by accretion of lipid... (shrink)

In El Salvador from 1978 to 1988, contraceptive use among married women 15–44 years of age increased from 34% to 47%, and the total fertility rate declined from 6·3 to 4·6 children per woman. Most of this change took place from 1978 to 1985. Sterilization is the most prevalent method used, but nearly one-half of the women who are sterilized did not use any contraception before their operation. Few young couples use reversible methods of contraception to space births or delay (...) the start of childbearing. On average, women wait 8 years after marriage and have nearly three children before they use contraception. (shrink)

Every constitution defines and is defined by a period in time. Like all law the creation and application of constitutions require reference to the past and future respectively. Every instance of constitution‐making is an attempt to control behavior over an extended period of time. Therefore constitutions will be drafted, both in style and substance, to reflect that temporal ambition. The effectiveness of a constitution also requires that its interpretation makes reference to the understanding of its rules held by the constitution‐makers. (...) As a result, and notwithstanding the efforts to make it suitable over a long period by its creators, every constitution is bound to become unsuitable. Courts employ a number of devices to cope with the inevitable obsolescence of constitutions but, sooner or later, every constitution will have to be discarded and a new constitutional era begun. (shrink)

Knowledge and expertise -- Knowledge and action -- The nature of professional action in urban planning.

The evolutionarily conserved genomic organization of the Hox genes has been a puzzle ever since it was discovered that their order along the chromosome is similar to the order of their functional domains along the antero‐posterior axis. Why has this colinearity been maintained throughout evolution? A close look at regulatory sequences from the mouse Hox clusters(1,2) suggests that enhancer sharing between adjacent Hox genes may be one reason. Moreover, characterizing the activity of one of these mouse enhancers in Drosophila(2) illustrates (...) that despite many similarities, not all Hox clusters are built in the same way. (shrink)

Safety testing of biological pharmaceuticals is often carried out by contract testing laboratories which perform these tests on behalf of the drug’s developer. These laboratories are confronted with a number of ethical issues related to selling their services, maintaining confidentiality, and the handling of results. This paper outlines these issues, and, by way of illustration, discusses how one such laboratory addresses them.

As a result of health care reform, medicine has entered a new era of comparative effectiveness. The Patient Protection and Affordable Care Act created the nation’s first comprehensive comparative effectiveness research program, investing in CER at record levels and establishing a new regulatory framework for oversight of the research. CER attracts considerable enthusiasm as a tool for reform because it compares competing interventions to determine which works best, supplying critical information for medical decision-making and health policy. In theory, better evidence (...) of how treatments fare relative to one another will translate to better medical care. According to some optimistic accounts, CER can lead to a “revolution” in clinical practice, has transformative power “to reshape major portions of the practice of medicine,” and represents a major “turning point” for the health care system. (shrink)

The human science or qualitative approaches to research have always argued that methodology must be determined by the subject matter under study. Yet the same approaches to data collection (i.e., the qualitative interview) and data analysis have been utilized by these approaches since their inception. The most essential lesson of van den Berg's metabletics is that no phenomenon is static or absolute. If human phenomena are ever-changing then the methodologies we use to study them must also change and adapt, so (...) that we can more fully and authentically capture their meaning structures. This paper will develop this argument, and demonstrate the limitation of interviews for the study of the changing nature of human phenomena, utilizing psychotherapy research as an example. (shrink)