Cognitive, global, and functional benefits of donepezil in Alzheimer's disease and vascular dementia:results from large-scale clinical trials

Alzheimer's disease (AD) and vascular dementia (VaD) are both associated with deficits in cholinergic neurotransmission that are amenable to therapeutic intervention. The cholinesterase inhibitor, donepezil, is clinically effective in both AD and VaD. Results from a 10-study metaanalysis of donepezil (5 or 10 mg/day) in AD and a two-study combined analysis of donepezil (5 or 10 mg/day) in VaD are presented to compare patient characteristics and donepezil treatment outcomes. The analyzed studies were randomized, placebo-controlled, and of up to 24 weeks duration. In both AD and VaD, donepezil provided significant benefits compared with placebo on measures of cognition and global function. Placebo-treated AD patients showed a decline in cognition and global function, whereas placebo-treated VaD patients remained stable, suggesting treatment effects of donepezil in VaD were driven by improvement rather than stabilization or reduced decline. More VaD patients than AD patients received concomitant medications. Cardiovascular adverse events were more common in VaD than AD patients but were not increased by donepezil. In conclusion, although there are differences between AD and VaD patients in comorbid conditions and concomitant medications, donepezil is effective and well tolerated in both types of dementia.

Economic aspects of pharmacotherapy for chronic constipation

Constipation is one of the most common digestive complaints. It is a symptom, not a disease. The subjectivity that this involves means that assessments of clinical epidemiology, socioeconomic costs and pharmacotherapy are difficult, since there is no definition of 'normal' bowel habit. Although constipation can affect all ages, the problem increases with age, and is of particular concern for those who are frail and in long term care. Cultural influences may affect the prevalence in older people. Drug therapy of constipation cannot be considered in isolation, since there are issues in the prevention of constipation and the principles of good management that also apply. Furthermore, some consideration of the pathophysiology and diagnosis is important. This is because a number of remediable causes can be identified, and the diagnostic process involves patient education, which in turn may be effective in reducing costs. It is the complaint of constipation which leads either to self-medication or to consultation with the medical profession. Both of these courses of action have a significant influence on utilisation of laxatives (cathartics), obtained both over-the-counter and by prescription. Although there are a large number of laxative preparations available, therapy has changed little in half a century. Costs may vary considerably, and with such a significant problem there is a need for comparative studies. However, study methodologies are difficult, and a significant placebo response may be found. Education and preventive measures have been shown to reduce laxative use and costs in institutions. Unfortunately, there are few comparative studies of individual laxatives and even fewer cost-effectiveness studies. Those that there are have been based in institutions, and so extrapolation to other situations may be difficult. In general, little attention is given to constipation. It is, however, an area with significant resource implications in which education and preventive measures have been shown to be beneficial. Even so, there is still a need for good comparative studies, particularly where cost effectiveness is concerned.

Understanding the socio-economic distribution of multiple deprivation: An application of self-organising maps

In this paper we seek to contribute to recent efforts to develop and implement multi-dimensional approaches to social exclusion by applying self-organising maps (SOMs) to a set of material deprivation indicators from the Irish component of EU-SILC. The first stage of our analysis involves the identification of sixteen clusters that confirm the multi-dimensional nature of deprivation in contemporary Ireland and the limitations of focusing solely on income. In going beyond this mapping stage, we consider both patterns of socio-economic differentiation in relation to cluster membership and the extent to which such membership contributes to our understanding of economic stress. Our analysis makes clear the continuing importance of traditional forms of stratification relating to factors such as income, social class and housing tenure in accounting for patterns of multiple deprivation. However, it also confirms the role of acute life events and life cycle and location influences. Most importantly, it demonstrates that conclusions relating to the relative impact of different kinds of socio-economic influences are highly dependent on the form of deprivation being considered. Our analysis suggests that debates relating to the extent to which poverty and social exclusion have become individualized should take particular care to distinguish between different kinds of outcomes. Further analysis demonstrates that the SOM approach is considerably more successful than a comparable latent class analysis in identifying those exposed to subjective economic stress. (C) 2010 International Sociological Association Research Committee 28 on Social Stratification and Mobility. Published by Elsevier Ltd. All rights reserved.

Communicating the benefits of wholegrain and functional grain products to European consumers

In order to increase the consumption of wholegrain products or grain products with functional properties, it is important to understand consumer beliefs about such products and the impact of health claims. In a series of consumer studies several differences were found between countries. While consumers in Finland, Italy and the UK saw wholegrain products as having positive attributes, those in Finland had more negative beliefs about refined grain products. Health claims and wholegrain labels increased perceived healthiness but had a less positive impact on likelihood of buying, and in Italy both health claims and wholegrain labels even decreased the likelihood of buying.

Reconsidering Resource Rights: The Case for a Basic Right to the Benefits of Life-Sustaining Ecosystem Services

In the presence of anthropogenic climate change, gross environmental degradation, and mass abject poverty, many political theorists currently debate issues such as people's right to water, the right to food, and the distribution of rights to natural resources more generally. However, thus far many theorists either focus (somewhat arbitrarily) only on one particular resource (e.g. water) or they treat all natural resources alike, meaning that many relevant distinctions within the group of natural resources are overlooked. Hence, the paper will start with an analysis of the various forms which natural resources can take and how this might influence one's conception of resource rights. In so doing, the paper argues that we have to carefully distinguish between the actual physical resources people might control and how we distribute these, and the life-sustaining benefits each and every person draws from sustainable and functioning ecosystems. Based on this distinction, the paper will argue for a right to the benefits of life-sustaining ecosystem services as a universal basic right every person has. Further distributive claims with respect to particular physical resources would thus be limited by the requirements of such a basic right.

Ecological and societal benefits of jellyfish blooms

Jellyfish are often considered as stressors on marine ecosystems or as indicators of highly perturbed systems. Far less attention is given to the potential of such species to provide beneficial ecosystem services in their own right. In an attempt to redress this imbalance we take the liberty of portraying jellyfish in a positive light and suggest that the story is not entirely one of doom and gloom. More specifically, we outline how gelatinous marine species contribute to the four categories of ecosystem services (regulating, supporting, provisioning and cultural) defined by the Millennium Ecosystem Assessment. This discussion ranges from the role of jellyfish in carbon capture and advection to the deep ocean through to the creation of micro habitat for developing fishes and the advancement of citizen science programmes. Attention is paid also to incorporation of gelatinous species into fisheries or ecosystem level models and the mechanisms by which we can improve the transfer of information between jellyfish researchers and the wider non-specialist community.

Controls on stone temperatures and the benefits of interdisciplinary exchange

Data derived from a series of field and laboratory studies of the influence of albedo and thermal conductivity on stone temperatures are reported. They indicate the complexity of surface/subsurface temperature response characteristics of different stone types exposed to the same conditions and highlight the influence of albedo and thermal conductivity on micro-environmental conditions at the rock/air interface – conditions which have significant implications for the nature and rate of weathering activity and which may, over time, affect any surface treatments applied to stone surfaces. Although the studies reviewed were carried out within the subject area of geomorphology, the data reported and the implications for stone weathering arising from them, may be of some relevance to the conservation science perspective on deterioration of contemporary, historical and archaeological stonework.

Politically sensitive encounters: Ethnography, access and the benefits of ‘hanging out’

Negotiating politically sensitive research environments requires both a careful consideration of the methods involved, and a great deal of personal resolve. In drawing upon two distinct yet comparable fieldwork experiences this paper champions the benefits of ethnographic methods in seeking to gain positionality and research legitimacy amongst those identified as future research participants. The authors explore and discuss their use of the ethnographic concept of ‘hanging out’ in politically sensitive environments when seeking to negotiate access to potentially hard to reach participants living in challenging research environments. Through an illustrative examination of their experiences in researching commemorative rituals in Palestine and mental health in a Northern Irish prison, both authors reflect upon their use of hanging out when seeking to break down barriers and gain acceptance amongst their target research participants. Their involvement in a range of activities, not directly related to the overall aims of the research project, highlight a need for qualitative researchers to adopt a flexible research design, one that embraces serendipitous or chance encounters, when seeking to gain access to hard to reach research participants or when issues of researcher legitimacy are particularly pronounced such as is the case in politically sensitive research environments.

Secure Communication in Cellular Networks: The Benefits of Millimeter Wave Mobile Broadband

This paper proposes millimeter wave (mmWave) mobile broadband for achieving secure communication in downlink cellular network. Analog beamforming with phase shifters is adopted for the mmWave transmission. The secrecy throughput is analyzed based on two different transmission modes, namely delay-tolerant transmission and delay-limited transmission. The impact of large antenna arrays at the mmWave frequencies on the secrecy throughput is examined. Numerical results corroborate our analysis and show that mmWave systems can enable significant secrecy improvement. Moreover, it is indicated that with large antenna arrays, multi-gigabit per second secure link at the mmWave frequencies can be reached in the delay-tolerant transmission mode and the adverse effect of secrecy outage vanishes in the delay-limited transmission mode.