An Introduction to 'A Symposium with Professor Roger Brownsword: Super-stewardship in the Context of Public Health'

Introduces the articles in the special issue.

Management of Barrett's esophagus in the UK: Overtreated and underbiopsied but improved by the introduction of a national randomized trial

OBJECTIVES: To assess the variation in practice of Barrett's esophagus (BE) management in comparison with accepted international guidelines before and after the introduction of a large BE randomized controlled trial (RCT) with protocols including those of tissue sampling.
DESIGN: A validated anonymized questionnaire was sent to 401 senior attending gastroenterologists asking for details of their current management of BE, especially histological sampling. Of the 228 respondents, 57 individuals (each from a different center) were in the first group to enter the ASPirin Esomeprazole (BE) Chemoprevention Trial (AspECT), and we assessed change in practice in these centers.
RESULTS: Ninety percent of specialists did not take adequate biopsies for histological diagnosis. Furthermore, 74% would consider aggressive surgical resection for prevalent cases of high-grade dysplasia in BE as their first-line choice despite the associated perioperative mortality. Ninety-two percent claim their lack of adherence to guidelines is because there is a need for stronger evidence for surveillance and medical interventions. Effect of the AspECT trial: Those clinicians in centers where the AspECT trial has started have improved adherence to ACG guidelines compared with their previous practice (P < 0.05). BE patients now get 18.8% more biopsies compared with previous practice, and 37.7% if the patient is entered into the AspECT trial (P < 0.01).
CONCLUSIONS: This large study indicates both wide variation in practice and poor compliance with guidelines. Because optimal histology is arguably the most important facet of BE management, the improvement in practice in centers taking part in the AspECT trial indicates an additional value of large international RCTs.

Investigation into mercury bound to biothiols:structural identification using ESI-ion-trap MS and introduction of a method for their HPLC separation with simultaneous detection by ICP-MS and ESI-MS

Mercury in plants or animal tissue is supposed to occur in the form of complexes formed with biologically relevant thiols (biothiols), rather than as free cation. We describe a technique for the separation and molecular identification of mercury and methylmercury complexes derived from their reactions with cysteine (Cys) and glutathione (GS): Hg(Cys)(2), Hg(GS)(2), MeHgCys, MeHgGS. Complexes were characterised by electrospray mass spectrometry (MS) equipped with an ion trap and the fragmentation pattern of MeHgCys was explained by using MP2 and B3LYP calculations, showing the importance of mercury-amine interactions in the gas phase. Chromatographic baseline separation was performed within 10 min with formic acid as the mobile phase on a reversed-phase column. Detection was done by online simultaneous coupling of ES-MS and inductively coupled plasma MS. When the mercury complexes were spiked in real samples (plant extracts), no perturbation of the separation and detection conditions was observed, suggesting that this method is capable of detecting mercury biothiol complexes in plants.

Introduction

The scholarly interest in norm implementation in the area of minority rights protection emerged during the period of the European accession of post-communist societies, which were characterised by persistent cleavage along ethnic lines. These studies have analysed democratic transition of ethnically segmented societies and developed into a broad field that focuses its attention on inter-ethnic relations, the role of history, interstate cooperation and the impact of international organisations on post-communist states' treatment of domestic minorities. All these are usually conducted from a vantage point of the European conditionality research. In our introduction to the special issue we sketch a number of reasons why it is encouraging and indeed, desirable to move beyond the perusal of conditionality into the domain of implementation research.

Nationalism, Territory, and Organized Violence: Introduction to the Special Issue

Recent decades have seen significant advances in research on the relationship between nationalist ideology and organized violence. New scholarship has paid much closer attention to the microdynamics of violence, the strikingly uneven distribution of violence, the relationship between master cleavages and intimate local and personal struggles, and to process, history, and contingency. Nationalist ideology is understood to be bound up intimately with institutions and with everyday relationships at the local level. We introduce the contributions to this special issue, outlining the way in which they highlight the power of ideas, narratives, and microlevel solidarity in mobilization for violence and how they address the crucial importance of territoriality in linking ideas and action.

Introduction

Introduction to edited collection, including historiographical review and summary of main contributions in ten-chapter volume.