Informing people about the risks and benefits of medicines: implications for the safe and effective use of medicinal products

Providing effective information about drug risks and benefits has become a major challenge for health professionals, as many people are ill equipped to understand, retain and use the information effectively. This paper reviews the growing evidence that people’s understanding (and health behaviour) is not only affected by the content of medicines information, but also by the particular way in which it is presented. Such presentational factors include whether information is presented verbally or numerically, framed positively or negatively, whether risk reductions are described in relative or absolute terms (and baseline information included), and whether information is personalized or tailored in any way. It also looks at how understanding is affected by the order in which information is presented, and the way in which it is processed. The paper concludes by making a number of recommendations for providers of medicines information, about both the content and presentation of such information, that should enhance safe and effective medicines usage.

The full-spectrum correlated-k method for longwave atmospheric radiative transfer using an effective Planck function

The correlated k-distribution (CKD) method is widely used in the radiative transfer schemes of atmospheric models and involves dividing the spectrum into a number of bands and then reordering the gaseous absorption coefficients within each one. The fluxes and heating rates for each band may then be computed by discretizing the reordered spectrum into of order 10 quadrature points per major gas and performing a monochromatic radiation calculation for each point. In this presentation it is shown that for clear-sky longwave calculations, sufficient accuracy for most applications can be achieved without the need for bands: reordering may be performed on the entire longwave spectrum. The resulting full-spectrum correlated k (FSCK) method requires significantly fewer monochromatic calculations than standard CKD to achieve a given accuracy. The concept is first demonstrated by comparing with line-by-line calculations for an atmosphere containing only water vapor, in which it is shown that the accuracy of heating-rate calculations improves approximately in proportion to the square of the number of quadrature points. For more than around 20 points, the root-mean-squared error flattens out at around 0.015 K/day due to the imperfect rank correlation of absorption spectra at different pressures in the profile. The spectral overlap of m different gases is treated by considering an m-dimensional hypercube where each axis corresponds to the reordered spectrum of one of the gases. This hypercube is then divided up into a number of volumes, each approximated by a single quadrature point, such that the total number of quadrature points is slightly fewer than the sum of the number that would be required to treat each of the gases separately. The gaseous absorptions for each quadrature point are optimized such that they minimize a cost function expressing the deviation of the heating rates and fluxes calculated by the FSCK method from line-by-line calculations for a number of training profiles. This approach is validated for atmospheres containing water vapor, carbon dioxide, and ozone, in which it is found that in the troposphere and most of the stratosphere, heating-rate errors of less than 0.2 K/day can be achieved using a total of 23 quadrature points, decreasing to less than 0.1 K/day for 32 quadrature points. It would be relatively straightforward to extend the method to include other gases.

Health benefits of probiotics: are mixtures more effective than single strains?

PURPOSE: Most studies on probiotics utilise single strains, sometimes incorporated into yoghurts. There are fewer studies on efficacy of mixtures of probiotic strains. This review examines the evidence that (a) probiotic mixtures are beneficial for a range of health-related outcomes and (b) mixtures are more or less effective than their component strains administered separately. RESULTS: Mixtures of probiotics had beneficial effects on the end points including irritable bowel syndrome and gut function, diarrhoea, atopic disease, immune function and respiratory tract infections, gut microbiota modulation, inflammatory bowel disease and treatment of Helicobacter pylori infection. However, only 16 studies compared the effect of a mixture with that of its component strains separately, although in 12 cases (75%), the mixture was more effective. CONCLUSION: Probiotic mixtures appear to be effective against a wide range of end points. Based on a limited number of studies, multi-strain probiotics appear to show greater efficacy than single strains, including strains that are components of the mixtures themselves. However, whether this is due to synergistic interactions between strains or a consequence of the higher probiotic dose used in some studies is at present unclear.

Health benefits of probiotics: are mixtures more effective than single strains?

Probiotic mixtures appear to be effective against a wide range of end points. Based on a limited number of studies, multi-strain probiotics appear to show greater efficacy than single strains, including strains that are components of the mixtures themselves. However, whether this is due to synergistic interactions between strains or a consequence of the higher probiotic dose used in some studies is at present unclear.

Survival, reproduction and population growth of the bee pollinator, Osmia rufa (Hymenoptera: Megachilidae), along gradients of heavy metal pollution

1. Bees are one of the most important groups of pollinators in the temperate zone. Although heavy metal pollution is recognised to be a problem affecting large parts of the European Union, we currently lack insights into the effects of heavy metals on wild bee survival and reproduction. 2. We investigated the impact of heavy metal pollution on the wild bee Osmia rufa (Hymenoptera: Megachilidae) by comparing their survival, reproduction and population dynamics along two independent gradients of heavy metal pollution, one in Poland and the other in the United Kingdom. We used trap nests to evaluate the response of fitness and survival parameters of O. rufa. To quantify the levels of pollution, we directly measured the heavy metal concentration in provisions collected by O. rufa. 3. We found that with increasing heavy metal concentration, there was a steady decrease in number of brood cells constructed by females and an increase in the proportion of dead offspring. In the most polluted site, there were typically 3–4 cells per female with 50–60% dead offspring, whereas in unpolluted sites there were 8 to 10 cells per female and only 10–30% dead offspring. Moreover, the bee population growth rate (R0) decreased along the heavy metal pollution gradients. In unpolluted sites, R0 was above 1, whereas in contaminated sites, the values tended to be below 1. 4. Our findings reveal a negative relationship between heavy metal pollution and several fitness parameters of the wild bee O. rufa, and highlight a mechanism whereby the detrimental effects of heavy metal pollution may severely impact wild bee communities.

Effective interventions: 25 years outside the mainstream

25 years ago when the Durham conferences were in full swing, I presented results of investigations on language and behaviour in autism. I tentatively proposed that early language in autism might tell us about the cognitive skills of people with ASD and the behaviour might lead to greater understanding of which brain systems might be affected. In this presentation, I will update these topics and present a summary of other work I have been involved with in attempting to improve the lives of people with autism and their families. Data on three people with autism at the early stages of speech development showed an unusual pattern of learning colour and number names early. One possibility was that this skill represented a sign of weak central coherence – they only attended to one dimension. Colleagues of mine were equally puzzled so we tried to find out if my results could be replicated – they were not (see Schafer, Williams & Smith, 2014). Instead we found this pattern was also seen in Down Syndrome, but that early vocabulary in autism was associated with low Colorado Meaningfulness at least in comprehension. The Colorado Meaningfulness of a word is a measure of how many words can be associated with it and often involve extensive use of context. Our data suggest that the number of contexts in which a particular word can appear has a role in determining vocabulary in ASD which is consistent with the weak central coherence theory of autism. In the course of this work I also came across a group of young people with autism who appeared to have a written vocabulary but not a spoken one. It seems possible that print might be a medium of communication when speech is not. Repetitive behaviour in autism remains a mystery. We can use functional analysis to determine why the behaviour occurs, but a worryingly large percentage of behaviours are described as being internally driven or sensory reinforced. What does that mean in terms of brain activity – could it be system analogous to epilepsy, where brain activity becomes inappropriately synchronised? At the moment I cannot claim to have solved this problem, but if sensation is a driver then sensory interventions should make a difference. Data from a recent study will be presented to suggest that for some individuals this is the case. Social behaviour remains the key however, and it remains to be seen whether it is possible for social behaviour to be aided. One route that has potential is direct teaching of skills through drama and working with others who do not have social difficulties of the same type. The picture is complicated by changes in social skills with age and experience, but the failure of people with ASD to interact when in settings of social contact is little researched.

Good practice for pupils learning English as an additional language; lessons from effective literacy teachers in inner city primary schools.

This article presents observations and discussion of the successful teaching of English to pupils, in English primary schools, for whom English is an additional language (EAL). It draws on research in Year 2 (6/7year old) classes in three inner-city primary schools carried out in 2003 and 2005. Three recognised, effective teachers of literacy were selected for case study; all worked in successful schools where results for literacy, measured by national tests, were in line with or better than national averages. Following analyses of lesson observations and interviews with the teachers, their Headteachers and the EAL co-ordinators in the schools, a number of common elements in their practice emerged. Discussion centres on how these pedagogical features supported effective learning environments for the early literacy development of bilingual children, and on the implications for the practice of teaching English to all pupils.

Legal and regulatory barriers to effective public-private partnership governance in Kazakhstan

Purpose – The purpose of this paper is to provide a critical assessment of legal and regulatory impediments to effective governance of public-private partnerships (PPPs) in Kazakhstan. Design/methodology/approach – The qualitative study develops propositions from the PPP literature and then tests them against findings from in-depth interviews. Interviewees have been selected by a purposeful sampling from PPP projects in Kazakhstan as well as from national and regional PPP centres. Findings – The identified barriers to effective PPP management include irregularities in the PPP legal framework, such as lack of legal definition of a PPP and controversy with the government guarantee’s legal status for its long-term payments to partnerships; bureaucratic tariff setting for partnership services; non-existent opportunity for private asset ownership; and excessive government regulation of PPP workers’ wage rates. Practical implications – The partners’ opposing perspectives on a number of PPP issues show that management needs to identify and carefully reconcile stakeholder values in a partnership in order to achieve more effective PPP governance. Practitioners, particularly those in the public agencies, have to be concerned with ways to reduce the government overregulation of the private operators, which is likely to result in greater PPP flexibility in management and, ultimately, higher efficiency in delivering the public services. Originality/value – By elucidating multiple examples of overregulation and PPPs’ inefficiency, the paper demonstrates that the government dominance in PPP management is conceptually inappropriate. Instead, the government should adopt the concept of co-production and manage its relations with the private sector partner in a collaborative fashion.

Consumption of a Flaxseed-Rich Food Is Not More Effective Than a Placebo in Alleviating the Climacteric Symptoms of Postmenopausal Women

Our objective in this work was to test the effects of daily intake of bread produced with partially defatted ground flaxseed on the climacteric symptoms and endometrial thickness of postmenopausal women. A double-blind, placebo-controlled, randomized clinical trial was performed with 38 women who had been postmenopausal for 1-10 y and consumed 2 slices of bread containing 25 g of flaxseed (46 mg lignans) or wheat bran (<1 mg lignans; control) every day for 12 consecutive weeks. The outcome variables were the daily number of hot flashes, the Kupperman Menopausal Index (KMI), and endometrial thickness. The plasma lipid profile (total cholesterol and HDL, LDL, and VLDL cholesterol fractions and triglycerides) and the hormones estradiol, follicle-stimulating hormone, thyroid-stimulating hormone, and free thyroxine also were measured. Food intake was evaluated by means of 2 24-hrecalls, before and after the treatment. Twenty patients in the study group and 18 in the control group completed the study. The general characteristics did not differ between the 2 groups at the start of the study. Both had significant, but similar, reductions in hot flashes and KMI after 3 mo of treatment. Moreover, endometrial thickness was not affected in either group. Our findings clearly show that although flaxseed is safe, its consumption at this level (46 mg lignans/d) is no more effective than placebo for reducing hot flashes and KMI. J. Nutr. 140: 293-297, 2010.

On the effective potential in higher-derivatives superfield theories

we study the one-loop quantum corrections for higher-derivative superfield theories, generalizing the approach for calculating the superfield effective potential. In particular, we calculate the effective potential for two versions of higher-derivative chiral superfield models. We point out that the equivalence of the higher-derivative theory for the chiral superfield and the one without higher derivatives but with an extended number of chiral superfields occurs only when the mass term is contained in the general Lagrangian. The presence of divergences can be taken as an indication of that equivalence. (C) 2009 Elsevier B.V. All rights reserved.

Number of particle creation and decoherence in the nonideal dynamical Casimir effect at finite temperature

In this work we investigate the dynamical Casimir effect in a nonideal cavity by deriving an effective Hamiltonian. We first compute a general expression for the average number of particle creation, applicable for any law of motion of the cavity boundary, under the only restriction of small velocities. We also compute a general expression for the linear entropy of an arbitrary state prepared in a selected mode, also applicable for any law of motion of a slow moving boundary. As an application of our results we have analyzed both the average number of particle creation and linear entropy within a particular oscillatory motion of the cavity boundary. On the basis of these expressions we develop a comprehensive analysis of the resonances in the number of particle creation in the nonideal dynamical Casimir effect. We also demonstrate the occurrence of resonances in the loss of purity of the initial state and estimate the decoherence times associated with these resonances. Since our results were obtained in the framework of the perturbation theory, they are restricted, under resonant conditions, to a short-time approximation. (C) 2009 Elsevier Inc. All rights reserved.

NUCEL (Cell and Molecular Therapy Center): A multidisciplinary center for translational research in Brazil

Social and economical development is closely associated with technological innovation and a well-developed biotechnological industry. In the last few years, Brazil`s scientific production has been steadily increasing; however, the number of patents is lagging behind, with technological and translational research requiring governmental incentive and reinforcement. The Cell and Molecular Therapy Center (NUCEL) was created to develop activities in the translational research field, addressing concrete problems found in biomedical and veterinary areas and actively searching for solutions by employing a genetic engineering approach to generate cell lines over-expressing recombinant proteins to be transferred to local biotech companies, aiming at furthering the development of a national competence for local production of biopharmaceuticals of widespread use and of life-saving importance. To this end, mammalian cell engineering technologies were used to generate cell lines over-expressing several different recombinant proteins of biomedical and biotechnological interest, namely, recombinant human Amylin/IAPP for diabetes treatment, human FVIII and FIX clotting factors for hemophilia, human and bovine FSH for fertility and reproduction, and human bone repair proteins (BMPs). Expression of some of these proteins is also being sought with the baculovirus/insect cell system (BEVS) which, in many cases, is able to deliver high-yield production of recombinant proteins with biological activity comparable to that of mammalian systems, but in a much more cost-effective manner. Transfer of some of these recombinant products to local Biotech companies has been pursued by taking advantage of the Sao Paulo State Foundation (FAPESP) and Federal Government (FINEP, CNPq) incentives for joint Research Development and Innovation partnership projects.

Electoral institutions,cleavage structures,and the number of parties

Theory: A classic question in political science concems ",hat deteImines the number of parties that compete in a given polity. Broadly speaking, there are two approaches to answering this question, one that emphasizes the role of electorallaws in structuring coalitional incentives, another that emphasizes the importance of pre-existing social cleavages. In tbis paper, we view the number of parties as a product of the interaction between these two forces, following Powell (1982) and Ordeshook and Shvetsova (1994). Hypotheses: The effective number of parties in a polity should be a multiplicative rather than an additive function ofthe peImissiveness ofthe electoral system and the heterogeneity ofthe society. Methods: Multiple regression on cross-sectional aggregate electoral statistics. Unlike previous studies, we (1) do not confine attention to developed democracies; (2) explicitly control for the influence of presidential elections, taking account of whether they are concurrent or nonconcurrent, and ofthe effective number ofpresidential candidates; and (3) also control for the presence and operation of upper tiers in legislative elections. Results: The hypothesis is confiImed, both as regards the number of legislative and the number of presidential parties .

Chronic exposure to sub-lethal concentration of a glyphosate-based herbicide alters hormone profiles and affects reproduction of female Jundia (Rhamdia quelen)

This work was carried out to verify the effect of a glyphosate-based herbicide on Jundia hormones (cortisol, 17 beta-estradiol and testosterone), oocyte and swim-up fry production. Earthen ponds containing Jundia females were contaminated with glyphosate (3.6 mg/L); blood samples were collected from eight females from each treatment immediately before, or at 1, 10, 20 30 and 40 days following contamination. A typical post-stress rise in cortisol levels was observed at the 20th and 40th days following exposure to glyphosate. At the 40th day, 17 beta-estradiol was decreased in the exposed females. A similar number of oocytes were stripped out from females from both groups, however, a lower number of viable swim-up fry were obtained from the herbicide exposed females, which also had a higher liver-somatic index (LSI). The results indicate that the presence of glyphosate in water was deleterious to Rhamdia quelen reproduction, altering steroid profiles and egg viability. (c) 2006 Elsevier B.V. All rights reserved.

Effects of photoperiod on reproduction of Siamese fighting fish Betta splendens

This study investigated the effect of different photoperiods (24 h of light (L):0 h of darkness (D); 20L:4D; 16L:8D; 12L:12D; and 8L:16D) on the reproduction and growth of Betta splendens. The results showed that spawning frequency was significantly higher in couples reared under 16L:8D and 12L:12D, in comparison with other treatments. The highest number of eggs per spawn was obtained under 16L:8D (544.76±375.23) and 12L:12D (471.13±261.52), and the lowest values were detected for 24L:0D (128.55±58.14) and 20L:4D (187.87±103.84). Fertility and fecundity also showed significantly higher average values in 16L:8D and 12L:12D when compared with 24L:0D and 20L:4D treatments. Egg volume and perivitelline space were significantly higher in 24L:0D treatments that showed the lowest numbers of eggs per spawn, while the vitelline volume did not show significant differences. Other variables such as breeders weight gain and condition factor (K) were not statistically different. Moreover, the final length varies according to photoperiod and gender. These results demonstrated a key role for the photoperiod upon B. splendens reproduction. The best reproductive performance is achieved under the photoperiods that best approached those that occur in spring and summer (16L:8D and 12L:12D), coinciding with their best seasons for reproduction.