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The proportionally heavy burden of diseases, particularly infectious diseases, and other environmental factors may affect the results of the studies. The underlying conditions prevalent in the study area may not necessarily apply to the conditions in other countries. For example, in chronic obstructive lung disease, smoking is the most common cause of this condition in the west; the cause may not necessarily be the same in India, where it could be due to cooking fumes, for example; or due to sandstorms in countries such as the Middle East or Sub Saharan Africa. Furthermore, the presence of a core infection may change the pathophysiological milieu of the disease, which may result in a different response to the treatment or to the immunological or the pathophysiological reaction, which makes it difficult to translate the results to the western developed world.
Sen. Tom Harkin, the chairman of the Senate education panel, said none of the proposals being circulating among lawmakers could win passage, and he urged lawmakers to extend the current rates for another year when they return from the July 4 recess. Harkin said his colleagues could retroactively restore the current rates after the holiday.
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