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Perhaps every six months, the group can devote a few hours to thinking about and discussing its objectives and strategies. Are the objectives still appropriate? Are some redundant? Are new objectives or subobjectives needed? For example, a needle and syringe programme has been introduced but reaches only 30 IDUs. The current programmes therefore need to be expanded. Or, although the needle and syringe programme is running, the evaluation indicated that the quality of services is inadequate. Should the priority of activities be changed? Should some activities be stopped because they are ineffective or because they are too costly in time or resources? Should new activities be added? Have the target audiences changed? Are resources sufficient to carry out all the activities? Is sufficient funding available now and for the remainder of the advocacy period? Is more fundraising needed? Have audiences changed? Does the group know more about audiences? Can policy maps be updated with new audiences and new knowledge about audiences and their attitudes and beliefs? Are there new audiences that can be anticipated? Are messages reaching their target audiences? Which messages did the audience accept best? Which media and methods have worked best for which audiences? Are different messages and advocacy techniques needed for male and female IDUs across age groups? What are the major barriers? How can they be overcome? Have messages reached male and female IDUs, and if not, how could they be improved? Were data presented convincingly? Were they easy to understand? Are there ways that presentation could be improved? What is the state of the advocacy coalition? Do coalition members feel involved in the advocacy process? Do they feel at least partly responsible for successes and failures? Are there any ways to increase participation by coalition members in advocacy activities? Can the current advocacy group carry out all the listed activities? Are new members needed? Are new skills needed? What opportunities are there for advocacy that have not yet been discussed? Is the group responding quickly and appropriately to advocacy opportunities and to opposition? Are other advocacy activities underway, unconnected with HIV AIDS and injecting drug use, from which the group could learn? Have these other advocacy activities been successful? What could be learned from their successes or failures?.
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Bone metastases are common in patients with many types of cancer, especially breast and prostate cancer -- in which the incidence is approximately 70% among patients with advanced metastatic disease. Aminobisphosphonates NBPs ; have entered clinical practice in the treatment of bone metastases from several neoplasms, including breast and prostate adenocarcinoma, as a result of their anti-resorption properties. However, evidence has accumulated on the direct anti-tumour effects of NBPs. This review describes the metabolic pathways that are putative molecular targets of NBPs and that are involved in the prenylation processes of several intracellular small GTP-binding proteins ras family related proteins ; . The latter regulate the intracellular survival and proliferative pathways of tumour cells and could be the intracellular molecular targets of the NBPs responsible for the direct anti-cancer effects, even if definitive conclusions cannot be drawn at present. Different mechanisms have been reported to account for the anti-neoplastic action of NBPs, including: the induction of apoptosis; cell cycle perturbations; and anti-invasive, anti-migration and anti-angiogenic effects. Moreover, this review describes the most important clinical studies that demonstrate the activity of NBPs in preventing skeletal-related events induced by bone metastases. The main pharmacokinetic pitfalls of NBPs are described, and methods of overcoming these pitfalls through the use of liposome vehicles are proposed. Finally, the principal pre-clinical studies on the interaction between NBPs and other biological agents are also described; these studies may enable reductions in the in vivo NBP concentrations required to achieve anti-tumour activity. To date, however, the real molecular targets of NBPs are not completely known and new technological platforms are required in order to detect them and to develop new anti-cancer strategies based on the use of NBPs. Endocrine-Related Cancer 2006 ; 13 726 and zyrtec.
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