Review Conference Research Articles

Emerging Policy and Practice Issues (2017)

This paper, presented at the West Government Contracts Year in Review Conference (covering 2016), attempts to identify the key trends and issues in U.S. federal procurement for 2017. Consistent with prior practice, this chapter offers extensive coverage of the federal procurement, grant, and defense spending trends and attempts to predict what lies ahead, particularly with regard to legislative and executive activity (which, this year, was highlighted by the (unexpected) inauguration of the Trump administration). The paper discusses, in addition to data, changes to OFPP and DoD leadership and the likely conclusion of the Defense Department Better Buying Power Initiative, and other potential trends.

Study protocol for a natural experiment in a lower socioeconomic area to examine the health-related effects of refurbishment to parks including built-shade (ShadePlus)

IntroductionParks in disadvantaged suburbs often have low quality and few amenities, which is likely to result in them being underutilised for recreation and physical activity. Refurbishment of parks, including shade,...

Thinking outside the box: preserving the NPT while advancing the Middle East weapons-of-mass-destruction-free zone

ABSTRACTSince 1995, unsuccessful efforts to promote a Middle East weapons-of-mass-destruction-free zone (MEWMDFZ) within the review process of the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) have weakened the treaty regime. This viewpoint proposes establishing a designated Middle East Support Unit to work independently from and in parallel to the NPT review process. The Support Unit will contribute to both global and regional security. Globally, its work will increase the ability to reach a consensus-based final document at the 2020 NPT Review Conference, which in turn will strengthen support for the treaty. Regionally, the Support Unit can help reinvigorate dialogue on security measures and nonproliferation in the Middle East. The possibility of resuming a direct dialogue between states in the region is of utmost importance today, as growing regional instability is a source of mutual concern to the Arab states, Iran, and Israel.

A Review of Ultrafine Particle-Related Pollution during Vehicular Motion, Health Effects and Control

Given the increasing vehicular pollution and emission of ultrafine particles (UFP) from it, there is growing concern regarding environmental and health effects worldwide. Although research has been done to examine such effects but a composite literature review of such studies is lacking. It is intended to review the historical developments, present position and forthcoming trends of such research. The scope of this review encompasses formation, release, health effects and control of traffic generated UFPs and re-suspended from the roads and emanating from road tyre abrasion. PRISMA approach for reviewing literature has been followed. A database literature search examining such effects was carried out at Google scholar, PubMed, circulation and web of science etc. The criterion selected was peer-reviewed, empirical, original articles, research and review papers up to July 2017. Overall 279 research and review papers, conference papers, reports, book chapters and lectures were studied and 206 ultimately incorporated in this review article. The developments in this field are discussed and recommendations suggested. This paper analyses the status of UFP related pollution during vehicular motion and reviews the current literature of the research done in this field. More scientific research pertaining to health and environmental effects of vehicular UFPs is needed, especially in developing countries, to support the policy framings.

The Nature of Leadership in the Crime of Aggression: The ICC’s New Concern?

Since the Nuremberg trials, it has been accepted that only the highest echelon of state leadership can be responsible for the crime of aggression. The crime of aggression is distinguished from other core crimes under the International Criminal Court’s (icc) purview by, inter alia, its leadership nature. According to Articles 8bis(1) and 25(3bis) of the Rome Statute, only a person ‘in a position effectively to exercise control over or direct the political or military action of a State’ can be held responsible for aggression. The ‘control or direct’ standard was adopted at the first Review Conference of the Rome Statute in Kampala in 2010 and differs from the customary counterpart (‘shape or influence’) established by the Nuremberg Military Tribunal (nmt). This article will explore how the leadership clause has evolved and whether the new standard is more appropriate for the icc.

Prospective Case Review in Radiation Oncology Prior to Treatment Delivery

Prospective Case Review in Radiation Oncology Prior to Treatment Delivery

Azathioprine or 6-mercaptopurine for induction of remission in Crohn's disease.

The results from controlled clinical trials investigating the efficacy of azathioprine and 6-mercaptopurine for the treatment of active Crohn's disease have been conflicting and controversial. An updated meta-analysis was performed to assess the effectiveness of these drugs for the induction of remission in active Crohn's disease. The primary objective was to determine the efficacy and safety of azathioprine and 6-mercaptopurine for induction of remission in active Crohn's disease. We searched MEDLINE, EMBASE and the Cochrane Library from inception to 30 October 2015. Review articles and conference proceedings were also searched to identify additional studies. Randomized controlled trials (RCTs) of oral azathioprine or 6-mercaptopurine compared to placebo or active therapy involving adult patients with active Crohn's disease were selected for inclusion. Data were extracted by two independent observers based on the intention-to-treat principle. Outcomes of interest included: clinical remission, clinical improvement, fistula improvement or healing, steroid sparing, adverse events, withdrawals due to adverse events and serious adverse events. We calculated the pooled relative risk (RR) and 95% confidence intervals (95% CI) for each outcome. The methodological quality of included studies was evaluated using the Cochrane risk of bias tool. The overall quality of the evidence supporting each outcome was assessed using the GRADE criteria. Thirteen RCTs (n = 1211 patients) of azathioprine and 6-mercaptopurine therapy in adult patients were identified: nine included placebo comparators and six included active comparators. The majority of included studies were rated as low risk of bias. There was no statistically significant difference in clinical remission rates between azathioprine or 6-mercaptopurine and placebo. Forty-eight per cent (95/197) of patients receiving antimetabolites achieved remission compared to 37% (68/183) of placebo patients (5 studies, 380 patients; RR 1.23, 95% CI 0.97 to 1.55). There was no statistically significant difference in clinical improvement rates between azathioprine or 6-mercaptopurine and placebo. Forty-eight per cent (107/225) of patients receiving antimetabolites achieved clinical improvement or remission compared to 36% (75/209) of placebo patients (8 studies, 434 patients; RR 1.26, 95% CI 0.98 to 1.62). There was a statistically significant difference in steroid sparing (defined as prednisone dose < 10 mg/day while maintaining remission) between azathioprine and placebo. Sixty-four per cent (47/163) of azathioprine patients were able to reduce their prednisone dose to < 10 mg/day compared to 46% (32/70) of placebo patients (RR 1.34, 95% CI 1.02 to 1.77). GRADE analyses rated the overall quality of the evidence for the outcomes clinical remission, clinical improvement and steroid sparing as moderate due to sparse data. There was no statistically significant difference in withdrawals due to adverse events or serious adverse events between antimetabolites and placebo. Ten percent of patients in the antimetabolite group withdrew due to adverse events compared to 5% of placebo patients (8 studies, 510 patients; RR 1.70, 95% CI 0.94 to 3.08). Serious adverse events were reported in 14% of patients receiving azathioprine compared to 4% of placebo patients (2 studies, 216 patients; RR 2.57, 95% CI 0.92 to 7.13). Common adverse events reported in the placebo controlled studies included: allergic reactions. leukopenia, pancreatitis and nausea. Azathioprine was significantly inferior to infliximab for induction of steroid-free clinical remission. Thirty per cent (51/170) of azathioprine patients achieved steroid-free remission compared to 44% (75/169) of infliximab patients (1 study, 339 patients; RR 0.68, 95% CI 0.51 to 0.90). The combination of azathioprine and infliximab was significantly superior to infliximab alone for induction of steroid-free clinical remission. Sixty per cent (116/194) of patients in the combined azathioprine and infliximab group achieved steroid-free remission compared to 48% (91/189) of infliximab patients (2 studies, 383 patients; RR 1.23, 95% CI 1.02 to 1.47). Azathioprine or 6-mercaptopurine therapy was found to be no better at inducing steroid free clinical remission compared to methotrexate (RR 1.13, 95% CI 0.85 to 1.49) and 5-aminosalicylate or sulfasalazine (RR 1.24, 95% CI 0.80 to 1.91). There were no statistically significant differences in withdrawals due to adverse events between azathioprine or 6-mercaptopurine and methotrexate (RR 0.78, 95% CI 0.23 to 2.71); between azathioprine or 6-mercaptopurine and 5-aminosalicylate or sulfasalazine (RR 0.98, 95% CI 0.38 to 2.54); between azathioprine and infliximab (RR 1.47, 95% CI 0.96 to 2.23); or between the combination of azathioprine and infliximab and infliximab (RR 1.16, 95% CI 0.75 to 1.80). Common adverse events in the active comparator trials included nausea, abdominal pain, pyrexia and headache. Azathioprine and 6-mercaptopurine offer no advantage over placebo for induction of remission or clinical improvement in active Crohn's disease. Antimetaboilte therapy may allow patients to reduce steroid consumption. Adverse events were more common in patients receiving antimetabolites although differences with placebo were not statistically significant. Azathioprine therapy is inferior to infliximab for induction of steroid-free remission. However, the combination of azathioprine and infliximab was superior to infliximab alone for induction of steroid-free remission.

Achieving the Sustainable Development Goals in Africa: Call for a Paradigm Shift.

Achieving the Sustainable Development Goals in Africa: Call for a Paradigm Shift.

Use of the Menopause-Specific Quality of Life (MENQOL) questionnaire in research and clinical practice: a comprehensive scoping review.

The Menopause-Specific Quality of Life (MENQOL) questionnaire was developed as a validated research tool to measure condition-specific QOL in early postmenopausal women. We conducted a comprehensive scoping review to explore the extent of MENQOL's use in research and clinical practice to assess its value in providing effective, adequate, and comparable participant assessment information. Thirteen biomedical and clinical databases were systematically searched with "menqol" as a search term to find articles using MENQOL or its validated derivative MENQOL-Intervention as investigative or clinical tools from 1996 to November 2014 inclusive. Review articles, conference abstracts, proceedings, dissertations, and incomplete trials were excluded. Additional articles were collected from references within key articles. Three independent reviewers extracted data reflecting study design, intervention, sample characteristics, MENQOL questionnaire version, modifications and language, recall period, and analysis detail. Data analyses included categorization and descriptive statistics. The review included 220 eligible papers of various study designs, covering 39 countries worldwide and using MENQOL translated into more than 25 languages. A variety of modifications to the original questionnaire were identified, including omission or addition of items and alterations to the validated methodological analysis. No papers were found that described MENQOL's use in clinical practice. Our study found an extensive and steadily increasing use of MENQOL in clinical and epidemiological research over 18 years postpublication. Our results stress the importance of proper reporting and validation of translations and variations to ensure outcome comparison and transparency of MENQOL's use. The value of MENQOL in clinical practice remains unknown.

Outcomes of the 2010 & 2015 Nonproliferation Treaty Review Conferences

The Treaty on the Non-Proliferation of Nuclear Weapons, aka “the Non-Proliferation Treaty” currently stands as the “only binding commitment in a multilateral treaty to the goal of disarmament.” Recent review conferences of the treaty have been dubbed disappointing and even failures. The objective of this treatise is to examine the impacts of these developments are in the context of rational deterrence theory and organizational deterrence theory.

Time for a New Nuclear Strategy

The treaty is dead; long live the treaty! I guess the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) is not quite dead. During the NPT Review Conference in April/May 2015, many of the sta...

Ratifying the Amendments to the Rome Statute of the International Criminal Court on the Crime of Aggression

The Review Conference of the Rome Statute of the International Criminal Court in Kampala adopted amendments to the Rome Statute, providing for a definition and conditions for the jurisdiction of the crime of aggression (‘Kampala Amendments’). At present, the jurisdiction over crime of aggression has not come into effect at the International Criminal Court (ICC). For the activation of the Court’s jurisdiction over the crime of aggression, two cumulative conditions must be met: first, a minimum of 30 ratifications of the Kampala Amendments must take place; second, a majority of two thirds of States Parties have to make a decision to activate the Court’s jurisdiction after 1 January 2017. This paper analyses salient legal aspects of the activation of the Court’s jurisdiction over the crime of aggression. First, the question whether the requirements of 30 ratifications will be met will be considered. Second, the relationship of the entry into force mechanism of the amendments and the conditions for the exercise of jurisdiction will be analysed. Third, the procedure of ascertainment of the jurisdictional regime of the ICC over the crime of aggression, with particular reference to State referrals and proprio motu investigations, will be dealt with. Fourth, the need for States Parties intending to ratify the Kampala Amendments to implement the crime of aggression into their domestic legislation will be explored. Finally, the paper will explore the question whether the aggressor State (party) must ratify the Kampala Amendments in order for the jurisdictional regime over the crime of aggression to apply, or whether it suffices that the aggressed State is a ratifying State Party. A qualified solution will be suggested: while the latter reading of the law is the better one, consent of the aggressor State (party) is nevertheless upheld pursuant to the sui generis jurisdictional regime of the ICC over the crime of aggression.

The Theological Landscape of the Nuclear Nonproliferation Treaty: the Catholic Church, the World Council of Churches and the Bomb

AbstractCan religion bring something distinct, critical and useful to global politics? Or do the voices of religious actors mimic those of secular NGOs when given opportunities to speak truth to power in international diplomacy? This article examines these questions through the lens of nuclear disarmament, considering the role of the Catholic Church and the World Council of Churches at the 2015 Nuclear Nonproliferation Treaty Review Conference at the United Nations headquarters in New York City. While faith communities have had a potent role in pushing for nuclear disarmament, the article argues that much more can be done by religious actors to argue that nuclear weapons are a stain on the moral conscience of people of faith.

Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis.

Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis.

The Humanitarian Initiative on Nuclear Weapons: An Introduction to Global Policy's Special Section

AbstractThe dominant paradigm of international relations theory has long seen influence over nuclear arsenals as the preserve of presidents, premiers and generals of the world's great powers, not underfunded activists, feminist campaigners, radical nuns or even diplomats of small states. The approach of this special section could not be more different. In fact, we have intentionally curated a collection of articles that try to ‘de‐center’ the academic conversation about nuclear weapons. The inspiration for our approach comes from the Humanitarian Initiative on Nuclear Weapons, which since its emergence after the 2010 Review Conference of the Nuclear Non‐Proliferation Treaty, has dramatically reshaped the diplomatic discussions on nuclear disarmament, led by small states and middle powers. The shift in discourse has been accelerated by revitalized civil society action, represented by the International Campaign to Abolish Nuclear Weapons, a global NGO coalition, as well as renewed calls for disarmament from religious leaders – most notably Pope Francis. This special section, written from the perspective of scholars and practitioners associated with the Humanitarian Initiative, examines its dimensions and its potential impact on global policy making.

Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis.

Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis.

Updated, web-based nutrition management guideline for PKU: An evidence and consensus based approach.

In 2014, recommendations for the nutrition management of phenylalanine hydroxylase deficiency were published as a companion to the concurrently published American College of Medical Genetics and Genomics guideline for the medical treatment of phenylketonuria (PKU). These were developed primarily from a summary of findings from the PKU scientific review conference sponsored by the National Institutes of Health and Agency for Healthcare Research & Quality along with additional systematic literature review. Since that time, the Genetic Metabolic Dietitians International and the Southeast Regional Newborn Screening and Genetics Collaborative have partnered to create a web-based technology platform for the update and development of nutrition management guidelines for inherited metabolic disorders. The purpose of this PKU guideline is to establish harmonization in treatment and monitoring, to guide the integration of nutrition therapy in the medical management of PKU, and to improve outcomes (nutritional, cognitive, and developmental) for individuals with PKU in all life stages while reducing associated medical, educational, and social costs. Six research questions critical to PKU nutrition management were formulated to support guideline development: Review, critical appraisal, and abstraction of peer-reviewed studies and unpublished practice literature, along with expert Delphi survey feedback, nominal group process, and external review from metabolic physicians and dietitians were utilized for development of recommendations relevant to each question. Recommendations address nutrient intake, including updated protein requirements, optimal blood phenylalanine concentrations, nutrition interventions, monitoring parameters specific to life stages, adjunct therapies, and pregnancy and lactation. Recommendations were graded using a rigorous system derived from the Academy of Nutrition and Dietetics. These guidelines, updated utilizing a thorough and systematic approach to literature analysis and national consensus process, are now easily accessible to the global community via the newly developed digital platform. For additional details on specific topics, readers are encouraged to review materials on the online portal: https://GMDI.org/.

Tu1121 Effectiveness of Weekly Board Review Conference in Improving Trainee in-Service Exam Scores

Tu1121 Effectiveness of Weekly Board Review Conference in Improving Trainee in-Service Exam Scores

Enhanced recovery after surgery (ERAS) pathways in autologous breast reconstruction: a systematic review

Enhanced recovery after surgery (ERAS) pathways aim to achieve earlier recovery and reduced hospital length-of-stay (LOS) by providing multi-modal perioperative care. The tenets of ERAS pathways include pre-operative optimisation, prevention of surgical complications, reduction of physiological stress response to surgery and rehabilitation to normal function. To date, ERAS protocols have gained broad acceptance by many surgical specialities. Contemporary literature has identified decreased LOS, improved quality of care and reduced healthcare expenditures. We aimed to systematically review the current literature and assess the current state of ERAS in autologous breast reconstruction. A systematic review of MEDLINE, EMBASE, ScienceDirect, Cochrane Libraries and Web of Science databases in October 2015 was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Articles pertaining to the use of ERAS in plastic and reconstructive surgery were included for analysis. Review articles, conference proceedings and correspondence were excluded from the assessment. Five hundred fifty-seven articles were identified, of which three suitable articles were included for assessment. Of these, one series outlined the learning curve associated with ERAS pathways and two series were comparative in nature. Meta-analytical analysis was not possible do to insufficient data and heterogeneity in outcome measures. In two of these comparative series, there was no statistical difference in rates of systemic infective (OR 0.91, 95 % CI 0.29 to 2.80, p = 0.86), total flap loss (OR 1.09, 95 % CI 0.37 to 3.19, p = 0.87), partial flap loss (OR 1.64, 95 % CI 0.66 to 4.10, p = 0.29) or wound infection (OR 1.38, 95 % CI 0.78 to 2.34, p = 0.29). LOS was significantly reduced in the ERAS group in both comparative studies from 7.4 to 6.2 days (p < 0.001) and 6.6 to 3.9 days (p < 0.001), respectively. ERAS pathways in breast reconstruction appear to consistently reduce LOS. From the available literature there were no significant detrimental effects on patient care following the implementation of ERAS pathways. Further research is required to definitively determine safety in the assessed cohort and to determine reductions in healthcare-related expenditures.

Emerging Policy and Practice Issues (2016)

This paper, presented at the West Government Contracts Year in Review Conference (covering 2015), attempts to identify the key trends and issues in U.S. federal procurement. Consistent with prior practice, this chapter offers extensive coverage of the federal procurement, grant, and defense spending trends and attempts to predict what lies ahead, particularly with regard to legislative and executive activity. The paper discusses, in addition to the macro-level data, initiatives from OFPP and DoD, including the Better Buying Power 3.0's less-than-obvious focus on innovation, the need for investment in research and development, information technology and category management, acquisition performance measurement (or metrics), and cost drivers.