Joseph E. Scherger

Effect of age on response to zafirlukast in patients with asthma in the Accolate Clinical Experience and Pharmacoepidemiology Trial (ACCEPT).

BACKGROUND The Accolate Clinical Experience and Pharmacoepidemiology Trial (ACCEPT), evaluated zafirlukast in a wide spectrum of patients from a variety of clinical practices. OBJECTIVE To determine the effect of age on the response to zafirlukast 20 mg twice daily in 3759 patients with mild, moderate, or severe asthma. METHODS Patients received open-label administration of zafirlukast 20 mg twice daily (bid) for 4 weeks. Pulmonary function was measured twice daily, and overall asthma symptom scores, number of nighttime awakenings, severity of morning asthma symptoms, and beta2-agonist use were recorded daily. Trial results were analyzed to compare the efficacy of zafirlukast in 263 adolescent (12 to 17 years old), 2602 adult (18 to 65 years old), and 321 elderly (66 years old and older) patients (the evaluable population). RESULTS After 4 weeks of zafirlukast therapy, improvements in pulmonary function decreased with age and were significant for all measures in adolescents and adults and for morning peak expiratory flow in elderly patients. Improvements in symptom response were statistically significant across age groups. Reduction in beta2-agonist rescue was similar in adolescents and adults but significantly less in elderly patients. CONCLUSIONS Zafirlukast is an effective treatment for asthma in all patients, regardless of age. In elderly patients, improvement in asthma symptoms rather than pulmonary function may represent a primary marker for efficacy with zafirlukast.

Attitudes and use of complementary and alternative medicine by California family physicians

This paper examines the attitudes and use of complementary and alternative medicine (CAM) by family physicians. A questionnaire was completed by 234 participants at the 1998 California Academy of Family Physicians Annual Scientific Assembly to analyze the recommendation, administration, and attitudes towards CAM by family physicians. This study indicates a large percent of California family physicians recommend and administer CAM to their patients. In addition, the results illustrate the importance of incorporating knowledge of CAM into medical education and the essential role family physicians play in the integration of conventional and CAM therapies.

Principles and Applications

ion In computer science, abstraction means hiding information. In CSS, abstracting from the world “reality”—whether directly experienced (observing a riot downtown) or indirectly learning about it (reading history)—is a process involving stimulus signals, perceptions, interpretation, and cognition. CSS relies on several sources for abstracting key entities, ideas, and processes from raw stimulus signals from the real world. These sources span a hierarchy in terms of their social scientific status. At the very top of the hierarchy are social theories with demonstrable validity 10A little-known fact among many social scientists is that the theory of mechanics in physics is built around the abstraction of singleand two-body problems. Already three-body problems are hugely difficult by comparison; and, most interesting, N -body problems defy mathematical solution in closed form. 11Interestingly, humanistic fields such as music and ballet also use systems of specialized notation, far beyond what is used in traditional social science. In music, Guido d’Arezzo [b. A.D. 991 (or 992), d. 1050] is considered the founder of the modern music staff; in ballet, Rudolf von Laban [b. 1879, d. 1958] invented the symbolic system known as “labanotation” (Morasso and Tagliasco 1986). 2.7 Abstraction, Representation, and Notation 37 in terms of formal structure (internal validity) and empirical observation (external validity). Not all existing social theories meet these stringent requirements, although an increasing number of them do as research progresses. Examples of social theories that meet internal and external validity standards include Heider’s Theory of Cognitive Balance in psychology, Ricardo’s Theory of Comparative Advantage in economics, and Downs’s Median Voter Theory in political science, among others. Social theories are abstractions that point to relevant social entities, variables, and dynamics that matter in understanding and explaining social phenomena. A second source of abstraction consists of social laws. Examples of social laws include the Weber-Fechner Law in psychometrics, the Pareto Law in economics, and Duverger’s Law in political science. Theories explain; laws describe (Stephen Toulmin 1967).12 Some of the most scientifically usefully social laws can be stated mathematically, as in these examples. Social laws also contain relevant entities, variables, and functional relations for describing social phenomena. A third source of abstraction consists of observations that can range from formal (e.g., ethnography, content analysis, automated information extraction, text mining, among others) to informal (historical narratives, media, and other sources about social phenomena). Observations of social phenomena can describe actors, their beliefs, social relations, and other features ranging from individual to collective. Finally, a fourth source of abstraction consists of computational algorithms capable of emulating social phenomena, as in artificial intelligence (AI). Artificial (i.e., not really human) algorithms do not claim to be causal in the same sense as social theories. They “work,” but without causal claims in the same sense as social theories. They are efficient, in the sense that they (sometimes) can closely replicate social phenomena. AI algorithms are typically (and intentionally) efficient and preferably simple; extreme parsimony in this case comes at the expense of realism. Examples of AI algorithms include Heatbugs (Swarm, NetLogo, MASON), Boids (Reynolds 1987), and Conway’s (1970) Game of Life. In spite of their lack of social realism, AI algorithms can be useful sources for abstracting social entities, ideas, or processes because they can highlight features that either elude theories or are hard to observe. An example would be the agglomeration patterns generated in a Heatbugs model, as a function of varying parameters of “social” interaction among the set of agents, or the role of apparent “leadership” in a flock of boids.

Writing a Medical Article

Medical writing for publication is done for various purposes: The publication of original work is integral to an academic career, allows an individual to contribute to the growing body of medical literature, and serves as a vehicle for the worldwide communication of medical information. Medical writing is also a skill, one which, like performing an obstetrical delivery or counseling a dysfunctional family, requires training and practice to be mastered.

Taylor's Musculoskeletal Problems and Injuries A Handbook

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