Preparation for the Occupation of Japan
In the twenty years since Japan's surrender, new materials and greater perspective allow for more effective probing than heretofore of American policies on the occupation of Japan. This study aims to further this task by posing and answering—at least in part—several questions which underlay these policies.
Stability Operations and State-Building: Continuities and Contingencies
Abstract : The purpose of this academic colloquium was to identify principles and supporting policies of state-building that will enhance America's ability "to win the peace" while stabilizing chaotic regions. Basic to the concept of the colloquium was the idea that just as there are acknowledged principles of war that enhance the possibility of victory on the battlefield, there should be principles that, if applied during the state-building process, will enhance the chances of "winning the peace." The idea that principles should constitute the foundation of state-building and that supporting policies and procedures then flow from those principles was fundamental to the colloquium's process. The participants included scholars from a wide range of academic disciplines, active duty military personnel, nongovernmental organization staff, and governmental administrators. The colloquium's sponsors endeavored to blend the expertise of civilian academics and military professionals. Each speaker was asked to nominate several principles of peace that represent parallel ideas to the principles of war. As expected, some duplication in naming the principles occurred. The speakers addressed their respective lists of principles during their presentations. After all scheduled presentations, six independent breakout groups distilled the consolidated list of principles to a common core for each group. Next, a plenary session considered the resulting six lists of principles for further consolidation into a core list of six principles. Those principles are as follows: (1) rule of law, (2) security (military, economic, and civil), (3) legitimacy, (4) development (the encouragement thereof), (5) self-empowerment/self-sufficiency, and (6) communications (intergovernmental and international). In the process of refining these principles, the group also identified 15 specific policies and procedures which will serve to assist in implementing the principles.
Sources of Information on Lymphoma Associated with Anti-Tumour Necrosis Factor Agents
AbstractBackground: Anti-tumour necrosis factor (TNF) agents, through their intense immunoregulatory effect, have been suspected to increase the risk of malignant lymphoma. However, the classical epidemiological approaches conducted over about the last 10 years have not totally succeeded in addressing the question of a causal or artifactual association. Therefore, the analysis of a substantial set of case reports, although usually considered as poorly generalizable to the general population, could be particularly informative. Two main sources of case reports in postmarketing settings are available; publications in medical journals and reports to pharmacovigilance systems.
 Objective: The aim of the study was to compare the characteristics of case reports from both these sources in order to understand whether they provided the same information for the investigation of the causal link between lymphoma and anti-TNF agents.
 Methods: All case reports of malignant lymphoma in patients treated with an anti-TNF agent published in MEDLINE and all reports to the French pharmacovigilance system up to 1 February 2010 were identified. Cases of malignant lymphoma identified in postmarketing surveillance from both sources were compared regarding the following variables: age, sex, anti-TNF agent involved, indication for use, type of lymphoma, prior or concomitant immunosuppressive drugs and time to onset of lymphoma.
 Results: A total of 81 published case reports and 61 cases reported to the French pharmacovigilance system were compared. In published reports, patients were younger (p = 0.03) and more frequently receiving a first anti-TNF treatment (p = 0.03), particularly infliximab (p = 0.03). Conversely, in the pharmacovigilance system reports, a succession of different anti-TNFs (p = 0.03) and adalimumab (p< 0.0001) were more frequently reported. Lymphomas in patients treated with anti-TNF agents for Crohn’s disease were more prevalent in published cases than in pharmacovigilance reports (p< 0.0001), and in particular involved hepatosplenic T-cell lymphoma. Conversely, rheumatoid arthritis was the main indication for anti-TNF agents in pharmacovigilance reports (p = 0.01). Time to onset was markedly shorter in published cases (median 12 months) than in pharmacovigilance reports (median 30 months; p = 0.0001).
 Conclusions: Characteristics of published cases and those reported to the French pharmacovigilance system differed markedly for all characteristics tested, except sex and the use of prior or concomitant immunosuppressive drugs. Published case reports favoured convincing arguments for drug causation whereas cases reported to the pharmacovigilance system were more disparate but could describe more accurately the reality of lymphoma occurrence in this particular population. These results argue for the use of the pharmacovigilance reports when case reports are used to investigate the causal link between lymphoma and anti-TNF agents at the population level. Data from cases notified to the French pharmacovigilance system did not indicate an increased risk of lymphoma during the early phase of anti-TNF treatment. To confirm this hypothesis, a study combining pharmacovigilance reports from several countries, or, if feasible, a cohort study both with a large sample size and a long duration of follow-up would be required.