Just Say No to NOTA: Why the Prohibition of Compensation for Human Transplant Organs in NOTA Should Be Repealed and a Regulated Market for Cadaver Organs Instituted.

The United States faces a shortage of organs for transplantation; thousands of individuals die each year while waiting for organs. The organ donation system relies on altruism because the National Organ Transplantation Act (NOTA) prohibits donors from receiving valuable consideration for organs to be used for transplantation. This paper contains a proposal for a regulated market for cadaveric organs as a mechanism to increase the number of organs available for transplantation. A regulated market for cadaveric organs is appropriate in the United States for the following reasons: (1) it is consistent with the numerous ways in which bodies. are currently treated as commodities; (2) it is unlikely to further disadvantage the poor; (3) it would not expose organ recipients to undue harm; (4) in the current organ transplantation system, everyone except the organ donor, benefits financially; (5) the prohibition in NOTA is inconsistent with laws permitting next of kin to recover for damage to the body of a deceased family member; (6) the protection of the dignitary interests of organs for donation is inconsistent with the current protections of the dignitary interests of human specimens; and (7) permitting a market for organs promotes the American values of autonomy and liberty.

The moral from Sorrell: educate, don't legislate.

This Article argues that in response to the United States Supreme Court's 2011 decision in Sorrell v. IMS Health Inc., state legislators should refrain from enacting prescription confidentiality laws and instead implement policies supporting academic detailing, a form of continuing medical education in which trained health professionals such as physicians, registered nurses, advanced practice nurses, and pharmacists provide evidence-based information about prescription drugs to prescribers. According to Sorrell, pharmaceutical companies may freely use physicians' prescribing data to better promote, or "detail," products to physicians without government interference. While pharmaceutical companies may profit from detailing drugs to physicians, detailing increases health care costs for patients and negatively affects patient health outcomes. These problems motivated Maine, New Hampshire, and Vermont to enact prescription confidentiality laws that banned the use of information about the prescribing habits of physicians to help market drugs to physicians. Recent state attempts to stop drug detailing to physicians have been found to violate the First Amendment. This Article provides a history and background on the pharmaceutical-detailing process and analyzes recent legal decisions relating to prescription confidentiality. It concludes that academic detailing is a viable solution to the negative effects of pharmaceutical detailing and is consistent with the First Amendment.

Evaluating the status of "translating research into practice" at a major academic healthcare system.

OBJECTIVES: The aim of this study was to assess the status of translating research findings into practice at a major academic healthcare system in Central Texas. METHODS: We conducted a cross-sectional survey addressing knowledge of and participation in translational research of physicians, residents, nurses and third- and fourth-year medical students in a major academic healthcare system in Central Texas. RESULTS: Out of 508 respondents, 428 (84.3 percent) completed all questions. A total of 68.9 percent of faculty reported having sufficient education and training to conduct research versus 44.4 percent of residents and 35.6 percent of nurses. Fifty-eight percent of faculty, 53 percent of residents and 9 percent of nurses reported current involvement in research activity. A total of 55.6 percent of residents reported that their departments provide them with protected time for research versus 18.4 percent of faculty and 10.3 percent of nurses. In addition, 33.9 percent of nurses reported interest in participating in research but do not know how to start. There were 86.4 percent of faculty, 77.8 percent of residents, and 58 percent of nurses who indicated they were familiar with translational research. However, only 42.7 percent of faculty, 46.7 percent of residents and 35.6 percent of nurses indicated they were aware of any changes in the delivery of care that resulted from research projects. CONCLUSIONS: The study results suggested failure to leverage members of the healthcare team in a systematic process to ensure translation of research findings into practice. Results highlighted the need to merge culture of safety and quality improvement with research while dealing with the daily pressures of patient care.

Acute changes in blood lipids and enzymes in postmenopausal women after exercise.

The effectiveness of lifestyle intervention strategies to improve blood lipids in women may be dependent on preexisting cholesterol concentrations. We characterized the effects of cholesterol status on blood lipid, lipoprotein lipid, and lipid regulatory enzyme responses to a single session of aerobic exercise in physically active, postmenopausal women. In this study, blood samples were obtained from 12 women with high cholesterol (HC; > or =200 mg/dl) and 13 women with normal cholesterol (NC; <200 mg/dl), 24 h before (Pre), immediately after (IPE), and 24 and 48 h after an exercise session (treadmill walking at 70% peak oxygen consumption, 400 kcal). We found that repeated-measures analysis revealed the following: 1) preexercise cholesterol differences did not influence the lipid or lipoprotein lipid responses to exercise; 2) for both groups, triglyceride was significantly reduced (-8.5%) after exercise; 3) the concentration profile over time for high-density lipoprotein cholesterol was significant for both groups, first falling at IPE then rising back to Pre levels by 24 h after exercise; 4) the lecithin-cholesterol acyltransferase activity (LCATA) exercise response was group dependent, increasing modestly in the NC group at 24 and 48 h; 5) lipoprotein lipase activity (LPLA) increased at IPE (by 17%) in the HC group only and then fell at 24 and 48 h (by 21%) compared with Pre; and 6) cholesterol ester transfer protein activity was unchanged by exercise. From these findings, we conclude that in postmenopausal women, a single session of endurance exercise elicited a short-term, favorable decrease in triglycerides independent of initial blood cholesterol concentrations. However, LCATA and LPLA postexercise changes were influenced by preexercise cholesterol status.