The postmodernist war on evidence-based practice

In this paper, we examine the war of words between those who contend that health care practice, including nursing, should primarily be informed by research (the evidence-based practice movement), and those who argue that there should be no restrictions on the sources of knowledge used by practitioners (the postmodernists). We review the postmodernist interventions of Dave Holmes and his colleagues, observing that the postmodernist style to which they adhere, which includes the use of continental philosophy, metaphors, and acerbic delivery, tends to obscure their substantive arguments. The heated nature of some responses to them has tended to have the same effect. However, the substantive arguments are important. Five main postmodernist charges are identified and discussed. The first argument, that the notion of ‘best evidence’ implies a hierarchical and exclusivist approach to knowledge, is persuasive. However, the contention that this hierarchy is maintained by the combined pressures of capitalism and vested interests within academia and the health services, is less well founded. Nevertheless, postmodernist contentions that the hierarchy embraced by the evidence-based practice movement damages health care because it excludes other forms of evidence that are needed to understand the complexity of care, it marginalizes important aspects of clinical knowledge, and it fails to take account of individuals or their experience, are all seen to be of some merit. However, we do not share the postmodernist conclusion that this adds up to a fascist order. Instead, we characterize evidence-based practice as a necessary but not sufficient component of health care knowledge.

MMP expression and abnormal lung permeability are important determinants of outcome in IPF

Matrix metalloproteinases (MMPs) degrade all of the extracellular matrix components of the intersititium and may play a role in abnormal alveolar permeability, which is a feature of idiopathic pulmonary fibrosis (IPF). The aims of the present study were to evaluate MMP protein levels in patients with IPF and determine any relationship to treatment and markers of permeability.

Type XVIII collagen degradation products in acute lung injury

Introduction In acute lung injury, repair of the damaged alveolar-capillary barrier is an essential part of recovery. Endostatin is a 20 to 28 kDa proteolytic fragment of the basement membrane collagen XVIII, which has been shown to inhibit angiogenesis via action on endothelial cells. We hypothesised that endostatin may have a role in inhibiting lung repair in patients with lung injury. The aims of the study were to determine if endostatin is elevated in the plasma/bronchoalveolar lavage fluid of patients with acute lung injury and ascertain whether the levels reflect the severity of injury and alveolar inflammation, and to assess if endostatin changes occur early after the injurious lung stimuli of one lung ventilation and lipopolysaccharide (LPS) challenge.

Soluble endostatin is a novel inhibitor of epithelial repair in idiopathic pulmonary fibrosis

Background and aim: Aberrant angiogenesis and defective epithelial repair are key features of idiopathic pulmonary fibrosis (IPF). Endostatin is an antiangiogenic peptide with known effects on endothelial cells. This study aimed to establish the levels of endostatin in the bronchoalveolar lavage fluid (BALF) in IPF and to investigate its actions on distal lung epithelial cells (DLEC) and primary type II cells.

Two-Photon Inner-Shell Ionization in the Extreme Ultraviolet

We have observed the simultaneous inner-shell absorption of two extreme-ultraviolet photons by a Xe atom in an experiment performed at the short-wavelength free electron laser facility FLASH. Photoelectron spectroscopy permitted us to unambiguously identify a feature resulting from the ionization of a single electron of the 4d subshell of Xe by two photons each of energy (93 +/- similar to 1) eV. The feature's intensity has a quadratic dependence on the pulse energy. The results are discussed and interpreted within the framework of recent results of ion spectroscopy experiments of Xe obtained at ultrahigh irradiance in the extreme-ultraviolet regime.

Climate Change Adaptation for Conservation in Madagascar

Madagascar's imperilled biota are now experiencing the effects of a new threat—climate change (Raxworthy et al. 2008). With more than 90% endemism among plants, mammals, reptiles and amphibians, the stakes are high. The pristine landscapes that allowed this exceptional biodiversity to survive past climate changes are largely gone. Deforestation has claimed approximately 90% of the island's natural forest (Ingram & Dawson 2005; Harper et al. 2007) and what remains is highly fragmented, providing a poor template for large-scale species range shifts. The impacts of current and future climate change may therefore be much different than past impacts, with profound implications for biodiversity.
We review evidence of past response to climate change, models of future change and projected biological response, developing insights to formulate adaptation actions for reducing extinction in Madagascar's biota. We then explore the cost of implementing actions and examine new income opportunities developing through efforts to mitigate climate change.

Beyond Poverty: Social Justice in a Global Marketplace

The social justice paradigm, developed in philosophy by John Rawls and others, reaches limits when confronted with diverse populations, unsound governments, and global markets.Its parameters are further limited by a traditional utilitarian approach to both industrial actors and consumer behaviors. Finally, by focusing too exclusively on poverty, as manifest in insufficient incomes or resources, the paradigm overlooks the oppressive role that gender,race, and religious prejudice play in keeping the poor subordinated. The authors of this article suggest three ways in which researchers in marketing could bring their unique expertise to the question of social justice in a global economy: by reinventing the theoretical foundation laid down by thinkers such as Rawls, by documenting and evaluating emergent “feasible fixes” to achieve justice (such as the global resource dividend, cause-related marketing, Fair Trade, and philanthrocapitalism), and by exploring the parameters of the consumption basket that would be minimally required to achieve human capabilities.

Peptide Tyrosine Arginine, a potent immunomodulatory peptide isolated and structurally characterized from the skin secretions of the dusky gopher frog, Rana sevosa

An octadecapeptide was isolated from the skin secretions of the dusky gopher frog (Rana sevosa) on the basis of histamine release from rat peritoneal mast cells. This peptide was purified to homogeneity by HPLC and found to have the following primary structure, YLKGCWTKSYPPKPCFSR, using both Edman degradation chemistry and peptide sequencing using high-resolution mass spectrometry (Q-TOF MS). The peptide, named peptide Tyrosine Arginine (pYR) shares 77.8% homology with peptide Leucine Arginine (pLR). The effects of the natural amidated peptide, non-amidated peptide and C-loop region of pYR on granulopoiesis and neutrophil apoptosis were investigated. All three analogues inhibited the early development of granulocyte macrophage colonies from bone marrow stem cells but did not induce apoptosis of the end stage granulocytes, the mature neutrophil. Thus, pYR is a novel member of an important and emerging new class of amphibian peptides with hemopoietic actions. (c) 2004 Elsevier Inc. All rights reserved.

Scaling of Food-Web Properties with Diversity and Complexity Across Ecosystems

Trophic scaling models describe how topological food-web properties such as the number of predator prey links scale with species richness of the community. Early models predicted that either the link density (i.e. the number of links per species) or the connectance (i.e. the linkage probability between any pair of species) is constant across communities. More recent analyses, however, suggest that both these scaling models have to be rejected, and we discuss several hypotheses that aim to explain the scale dependence of these complexity parameters. Based on a recent, highly resolved food-web compilation, we analysed the scaling behaviour of 16 topological parameters and found significant power law scaling relationships with diversity (i.e. species richness) and complexity (i.e. connectance) for most of them. These results illustrate the lack of universal constants in food-web ecology as a function of diversity or complexity. Nonetheless, our power law scaling relationships suggest that fundamental processes determine food-web topology, and subsequent analyses demonstrated that ecosystem-specific differences in these relationships were of minor importance. As such, these newly described scaling relationships provide robust and testable cornerstones for future structural food-web models.

Climate change and the cost of conserving species in Madagascar

We examined the cost of conserving species as climate changes using Madagascar as an example. We used a Maxent species distribution model to predict the ranges of 74 plant species endemic to the forests of Madagascar from 2000-2080 in three climate scenarios. We set a conservation target of achieving 10,000 hectares of forest cover for each species, and calculated the cost of achieving this target under each climate scenario. We interviewed natural forest restoration project managers and conducted a literature review to obtain the net present cost per hectare of management actions to maintain or establish forest cover. For each species we added hectares of land from lowest to highest cost per additional year of forest cover until the conservation target was achieved throughout the time period. Climate change was predicted to reduce the size of species’ ranges, the overlap between species’ ranges and existing or planned protected areas, and the overlap between species’ ranges and existing forest. As a result, climate change increased the cost of achieving the conservation target by necessitating successively more costly management actions: additional management within existing protected areas (US$0-60/ha), avoidance of forest degradation (loss of biomass) in community-managed areas ($160-576/ha), avoidance of deforestation in unprotected areas ($252-1069/ha), and establishment of forest on non-forested land within protected areas ($802-2710/ha), in community-managed areas ($962-3226/ha), and in unprotected areas ($1054-3719/ha). Our results suggest that though forest restoration may be required for the conservation of some species as climate changes, it is more cost-effective to maintain existing forest wherever possible.

Informed Consent: Autonomy and Self-Ownership

Using the example of an unconsented mouth swab I criticise the view that an action of this kind taken in itself is wrongful in respect of its being a violation of autonomy. This is so much inasmuch as autonomy merits respect only with regard to ‘critical life choices’. I consider the view that such an action is nevertheless harmful or risks serious harm. I also respond to two possible suggestions: that the action is of a kind that violates autonomy; and, that the class of such actions violates autonomy. I suggest that the action is wrongful in as much as it is a bodily trespass. I consider, and criticise, two ways of understanding how morally I stand to my own body: as owner and as sovereign. In respect of the latter I consider Arthur Ripstein’s recent defence of a sovereignty principle. Finally I criticise an attempt by Joel Feinberg to explain bodily trespass in terms of personal autonomy.