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1.  Increased response to morphine in mice lacking protein kinase C epsilon 
Genes, brain, and behavior  2006;6(4):329-338.
The protein kinase C (PKC) family of serine–threonine kinases has been implicated in behavioral responses to opiates, but little is known about the individual PKC isozymes involved. Here, we show that mice lacking PKCε have increased sensitivity to the rewarding effects of morphine, revealed as the expression of place preference and intravenous self-administration at very low doses of morphine that do not evoke place preference or self-administration in wild-type mice. The PKCε null mice also show prolonged maintenance of morphine place preference in response to repeated testing when compared with wild-type mice. The supraspinal analgesic effects of morphine are enhanced in PKCε null mice, and the development of tolerance to the spinal analgesic effects of morphine is delayed. The density of μ-opioid receptors and their coupling to G-proteins are normal. These studies identify PKCε as a key regulator of opiate sensitivity in mice.
doi:10.1111/j.1601-183X.2006.00261.x
PMCID: PMC4264050  PMID: 16899053
Analgesia; opioid; PKC; place preference; self-administration
2.  A village medical mystery 
BMJ : British Medical Journal  2006;333(7582):1296.
doi:10.1136/bmj.39048.667072.BE
PMCID: PMC1761154
3.  Cost effectiveness of interferon α or peginterferon α with ribavirin for histologically mild chronic hepatitis C 
Gut  2006;55(9):1332-1338.
Background
For patients with mild chronic hepatitis C the cost effectiveness of antiviral therapy is unknown.
Aims
To assess whether antiviral therapy (either interferon α or peginterferon α combined with ribavirin) is cost effective at a mild stage compared with waiting and only treating those cases who progress to moderate disease.
Patients
Cases with mild chronic hepatitis C.
Methods
A cost effectiveness model which estimates long term costs and outcomes for patients with mild chronic hepatitis C. The model uses effectiveness and cost data from the UK mild hepatitis C randomised controlled trial, combined with estimates of disease progression and cost from observational studies.
Results
Antiviral treatment at a mild rather than a moderate stage improved outcomes measured by quality adjusted life years (QALYS) gained. The mean cost per QALY gained from antiviral treatment with interferon α‐2b and ribavirin, compared with no treatment at a mild stage, was £4535 ($7108) for patients with genotype non‐1 and £25 188 ($39 480) for patients with genotype 1. Providing peginterferon α‐2b and ribavirin at a mild rather than a moderate stage was also associated with a gain in QALYS; the costs per QALY gained were £7821 ($12 259) for patients with genotype non‐1 and £28 409 ($44 528) for patients with genotype 1.
Conclusions
For patients with chronic hepatitis C, it is generally more cost effective to provide antiviral treatment at a mild rather than a moderate disease stage. For older patients (aged 65 years or over) with genotype 1, antiviral treatment at a mild stage is not cost effective.
doi:10.1136/gut.2005.064774
PMCID: PMC1860032  PMID: 15994216
cost effectiveness model; cost analysis; antiviral therapy
4.  Health Research Profile to assess the capacity of low and middle income countries for equity-oriented research 
BMC Public Health  2006;6:151.
Background
The Commission on Health Research for Development concluded that "for the most vulnerable people, the benefits of research offer a potential for change that has gone largely untapped." This project was designed to assess low and middle income country capacity and commitment for equity-oriented research.
Methods
A multi-disciplinary team with coordinators from each of four regions (Asia, Latin America, Africa and Central and Eastern Europe) developed a questionnaire through consensus meetings using a mini-Delphi technique. Indicators were selected based on their quality, validity, comprehensiveness, feasibility and relevance to equity. Indicators represented five categories that form the Health Research Profile (HRP): 1) Research priorities; 2) Resources (amount spent on research); 3) Production of knowledge (capacity); 4) Packaging of knowledge and 5) Evidence of research impact on policy and equity. We surveyed three countries from each region.
Results
Most countries reported explicit national health research priorities. Of these, half included specific research priorities to address inequities in health. Data on financing were lacking for most countries due to inadequate centralized collection of this information. The five main components of HRP showed a gradient where countries scoring lower on the Human Development Index (HDI) had a lower capacity to conduct research to meet local health research needs. Packaging such as peer-reviewed journals and policy forums were reported by two thirds of the countries. Seven out of 12 countries demonstrated impact of health research on policies and reported engagement of stakeholders in this process.
Conclusion
Only one out of 12 countries indicated there was research on all fronts of the equity debate. Knowledge sharing and management is needed to strengthen within-country capacity for research and implementation to reduce inequities in health. We recommend that all countries (and external agencies) should invest more in building a certain minimum level of national capacity for equity-oriented research.
doi:10.1186/1471-2458-6-151
PMCID: PMC1539005  PMID: 16768792

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