Clinical pharmacy-led disease and medicine management programme for patients with COPD

center dot The concept of self-management plans for patients with chronic obstructive pulmonary disease (COPD) is derived from their success in asthma management.

Potential roles for differential body size and microhabitat complexity in mediating biotic interactions within invasive freshwater amphipod assemblages

Cannibalism and intraguild predation (IGP) are common amongst freshwater amphipod crustacean aswsemblages, particularly between individuals of different body size, with IGP of smaller by larger species. The decline of Gammarus tigrinus Populations in mainland Europe has been accompanied by the arrival of the Ponto-Caspian invader Dikerogammarus villosus and previous studies have implicated IGP of G. tigrinus by the larger D. villosus as the principal driving force in this replacement. We examined how factors such as microhabitat and body size may mediate both cannibalism within G. tigrinus populations and IGP by D. villosus and thus contribute to field patterns of coexistence and exclusion. A field Survey of an invaded Dutch fake indicated that G. tigrinus and D. villosus differed in distribution. with D. villosus being the numerically dominant amphipod (80-96 %) on the rocky boulder Substrate of the shoreline and G. tigrinus being the dominant amphipod (100 %) in the crushed shell/sand matrix immediately adjacent to this. Laboratory microcosm experiments indicated that G. tigrinus cannibalism, particularly of smaller by larger size classes, may be common. In addition, although D. villosus predation of all G. tigrinus size classes was extreme, the smallest size classes Suffered the highest predation. Indeed, when exposed to D. villosus, predation of larger G. tigrinus was lowest when smaller G. tigrinus were also present. Increasing microhabitat complexity from a simple bare substrate littered with Dreissena polymorpha zebra mussels to a Crushed shell/sand matrix significantly reduced both cannibalism and IGP. Our Study emphasizes the need to consider both life history stages and habitat template, when considering the impacts of biotic interactions and it also emphasizes that complex, interacting factors may be mediating the range expansion of D. villosus.

Information Disclosure, Market Discipline and the Management of Bank Capital: Evidence from the Chinese Financial Sector

Is there evidence that market forces effectively discipline risk management behaviour within Chinese financial institutions? This study analyses information from a comprehensive sample of Chinese banks over the 1998-2008 period. Market discipline is captured through the impact of four sets of factors namely, market concentration, interbank deposits, information disclosure, and ownership structure. We find some evidence of a market disciplining effect in that: (i) higher (lower) levels of market concentration lead banks to operate with a lower (higher) capital buffer; (ii) joint-equity banks that disclose more information to the public maintain larger capital ratios; (iii) full state ownership reduces the sensitivity of changes in a bank's capital buffer to its level of risk;(iv) banks that release more transparent financial information hold more capital against their non-performing loans. © 2010 Springer Science+Business Media, LLC.

Staphylococcus epidermidis device-related infections: pathogenesis and clinical management

Staphylococcus epidermidis, the most frequently isolated coagulase-negative staphylococcus, is the leading cause of infection related to implanted medical devices (IMDs). This is directly related to its capability to establish multilayered, highly structured biofilms on artificial surfaces. At present, conventional systemic therapies using standard antimicrobial agents represent the main strategy to treat and prevent medical device-associated infections. However, device-related infections are notoriously difficult to treat and bacteria within biofilm communities on the surface of IMDs frequently outlive treatment, and removal of the medical device is often required for successful therapy. Importantly, major advances in this research area have been made, leading to a greater understanding of the complexities of biofilm formation of S. epidermidis and resulting in significant developments in the treatment and prevention of infections related to this member of the coagulase-negative group of staphylococci. This review will examine the pathogenesis of the clinically significant S. epidermidis and provide an overview of the conventional and emerging antibiofilm approaches in the management of medical device-associated infections related to this important nosocomial pathogen.

Stroke presentation and hospital management: comparison of neighbouring healthcare systems with differing health policies.

Background: Acute stroke care is shaped by healthcare policies. Differing policies in similar populations allow for assessment of policy impact on health and healthcare outcomes. Aims: To compare stroke presentation and hospital care in two adjacent healthcare systems with differing healthcare policies. Methods: Interviews and chart review of consecutive acute stroke admissions in Northern Ireland (n=103) and the Republic of Ireland (n=100). Results: Marked regional contrasts were evident for key aspects of hospital care. Northern Ireland performed significantly better on 15 of 16 quality of care (Sentinel Audit) items. Delivery on standards was significantly better in Northern Ireland for early assessment (Northern Ireland 72%; Republic of Ireland 54%, p

Body mass and sex-biased parasitism in wood mice Apodemus sylvaticus

Male sex-biased parasitism (SBP) occurs across a range of mammalian taxa and two contrasting sets of hypotheses have been suggested for its establishment. The first invokes body size per se and suggests that larger individuals are either a larger target for parasites, trade off growth at the expense of immunity or cope better with parasitism than smaller individuals. The second suggests a sex-specific handicap whereby males have reduced immunocompetence compared to females due to the immunodepressive effects of testosterone. The current study investigated whether sex-biased parasitism is driven by host 'body size' or 'sex' using a rodent-tick (Apodemus sylvaticus-. Ixodes ricinus) system. Moreover, the presence or absence of large mammals at study sites were used to control the presence of immature ticks infesting wood mice, allowing the impacts of parasitism on host body mass and female reproduction to be assessed. As expected, male mice had greater tick loads than females and analyses suggested this sex-bias was driven by body mass as opposed to sex. It is therefore likely that larger individuals are a larger target for parasites, trade off growth at the expense of immunity or adapt behavioural responses to parasitism based on their body size. Parasite load had no effect on host body mass or female reproductive output suggesting individuals may alter behaviour or life history strategies to compensate for costs incurred through parasitism. Overall, this study lends support to the 'body size' hypothesis for the formation of sex-biased parasitism.

Policing for peace in Northern Ireland: Change, conflict and community confidence

The fundamental change in policing that began in 2001 was a critical part of the Northern Ireland peace process. Seventy years after its establishment the Royal Ulster Constabulary (RUC) remained distrusted and unrepresentative of the Catholic – nationalist community. This book explores how policing changed and the significant contribution that overhaul made to the most successful conflict transformation process in recent decades. It looks at policing from an organizational perspective and focuses on leadership, strategy and culture as it traces the journey from RUC to PSNI. In this way it reflects the views of many key figures inside the organization and of key political decision makers outside of it. This book will be of tremendous interest to those seeking to explore the underlying dynamics of one of the most radical and challenging change processes in recent history and is a must read for anyone interested in the Northern Irish peace process.