How is the language of medicines use review leaflets symbolising the service?

Introduction The medicines use review (MUR), a new community pharmacy ‘service’, was launched in England and Wales to improve patients’ knowledge and use of medicines through a private, patient–pharmacist appointment. After 18 months, only 30% of pharmacies are providing MURs; at an average of 120 per annum (maximum 400 allowed).1 One reason linked to low delivery is patient recruitment.2 Our aim was to examine how the MUR is symbolised and given meaning via printed patient information, and potential implications. Method The language of 10 MUR patient leaflets, including the NHS booklet,3 and leaflets from multiples and wholesalers was evaluated by discourse analysis. Results and Discussion Before experiencing MURs, patients conceivably ‘categorise’ relationships with pharmacists based on traditional interactions.4 Yet none of the leaflets explicitly describe the MUR as ‘new’ and presuppose patients would become involved in activities outside of their pre-existing relationship with pharmacists such as appointments, self-completion of charts, and pharmacy action plans. The MUR process is described inconsistently, with interchangeable use of formal (‘review meeting‘) and informal (‘friendly’) terminology, the latter presumably to portray an intended ‘negotiation model’ of interaction.5 Assumptions exist about attitudes (‘not understanding’; ‘problems’) that might lead patients to an appointment. However, research has identified a multitude of reasons why patients choose (or not) to consult practitioners,6 and marketing of MURs should also consider other barriers. For example, it may be prudent to remove time limits to avoid implying patients might not be listened to fully, during what is for them an additional practitioner consultation.

The private sector, poverty reduction and international development

The private sector, after shifting fortunes in development theory and practice over the years, is now widely recognised as the key to economic growth, which itself is indispensable for poverty reduction. The Development Studies Association (DSA) Annual Conference in 2006 brought together academics, private sector actors, NGOs and policy makers to share insights and experiences on how this vital contribution to growth, development and poverty reduction can be realised. This paper summarises the main themes and discussions of the conference and introduces the papers selected for inclusion in this conference issue.

High temperature stress and spikelet fertility in rice (Oryza sativa L.)

In future climates, greater heat tolerance at anthesis will be required in rice. The effect of high temperature at anthesis on spikelet fertility was studied on IR64 (lowland indica) and Azucena (upland Japonica) at 29.6 degrees C (control), 33.7 degrees C, and 36.2 degrees C tissue temperatures. The objectives of the study were to: (i) determine the effect of temperature on flowering pattern; (ii) examine the effect of time of day of spikelet anthesis relative to a high temperature episode on spikelet fertility; and (iii) study the interactions between duration of exposure and temperature on spikelet fertility. Plants were grown at 30/24 degrees C day/night temperature in a greenhouse and transferred to growth cabinets for the temperature treatments. Individual spikelets were marked with paint to relate fertility to the time of exposure to different temperatures and durations. In both genotypes the pattern of flowering was similar, and peak anthesis occurred between 10.30 h and 11.30 h at 29.2 degrees C, and about 45 min earlier at 36.2 degrees C. In IR64, high temperature increased the number of spikelets reaching anthesis, whereas in Azucena numbers were reduced. In both genotypes :511 h exposure to >= 33.7 degrees C at anthesis caused sterility. In IR64, there was no interaction between temperature and duration of exposure, and spikelet fertility was reduced by about 7% per degrees C > 29.6 degrees C. In Azucena there was a significant interaction and spikelet fertility was reduced by 2.4% degrees Cd-1 above a threshold of 33 degrees C. Marking individual spikelets is an effective method to phenotype genotypes and lines for heat tolerance that removes any apparent tolerance due to temporal escape.

A comparative evaluation of functions for describing the relationship between live-weight gain and metabolizable energy intake in turkeys

The suitability of models specifically re-parameterized for analyzing energy balance data relating metabolizable energy intake to growth rate has recently been investigated in male broilers. In this study, the more adequate of those models was applied to growing turkeys to provide estimates of their energy needs for maintenance and growth. Three functional forms were used. They were: two equations representing diminishing returns behaviour (monomolecular and rectangular hyperbola); and one equation describing smooth sigmoidal behaviour with a fixed point of inflexion (Gompertz). The models estimated the metabolizable energy requirement for maintenance in turkeys to be 359-415 kJ/kg of live-weight/day. The predicted values of average net energy requirement for producing 1 g of gain in live-weight, between 1 and 4 times maintenance, varied from 8.7 to 10.9 kJ. These results and those previously reported for broilers are a basis for accepting the general validity of these models.

Regulation of the cardiomyocyte transcriptome vs translatome by endothelin-1 and insulin: translational regulation of 5' terminal oligopyrimidine tract (TOP) mRNAs by insulin

Background: Changes in cellular phenotype result from underlying changes in mRNA transcription and translation. Endothelin-1 stimulates cardiomyocyte hypertrophy with associated changes in mRNA/protein expression and an increase in the rate of protein synthesis. Insulin also increases the rate of translation but does not promote overt cardiomyocyte hypertrophy. One mechanism of translational regulation is through 5' terminal oligopyrimidine tracts (TOPs) that, in response to growth stimuli, promote mRNA recruitment to polysomes for increased translation. TOP mRNAs include those encoding ribosomal proteins, but the full panoply remains to be established. Here, we used microarrays to compare the effects of endothelin-1 and insulin on the global transcriptome of neonatal rat cardiomyocytes, and on mRNA recruitment to polysomes (i.e. the translatome). Results: Globally, endothelin-1 and insulin (1 h) promoted >1.5-fold significant (false discovery rate < 0.05) changes in expression of 341 and 38 RNAs, respectively. For these transcripts with this level of change there was little evidence of translational regulation. However, 1336 and 712 RNAs had >1.25-fold significant changes in expression in total and/or polysomal RNA induced by endothelin-1 or insulin, respectively, of which ~35% of endothelin-1-responsive and ~56% of insulin-responsive transcripts were translationally regulated. Of mRNAs for established proteins recruited to polysomes in response to insulin, 49 were known TOP mRNAs with a further 15 probable/possible TOP mRNAs, but 49 had no identifiable TOP sequences or other consistent features in the 5' untranslated region. Conclusions: Endothelin-1, rather than insulin, substantially affects global transcript expression to promote cardiomyocyte hypertrophy. Effects on RNA recruitment to polysomes are subtle, with differential effects of endothelin-1 and insulin on specific transcripts. Furthermore, although insulin promotes recruitment of TOP mRNAs to cardiomyocyte polysomes, not all recruited mRNAs are TOP mRNAs.

Can REDD+ reconcile local priorities and needs with global mitigation benefits? lessons from Angai Forest, Tanzania

The scope of the reducing emissions from deforestation and forest degradation (REDD) mechanism has broadened REDD+ to accommodate different country interests such as natural forests, protected areas, as well as forests under community-based management. In Tanzania the REDD+ mechanism is still under development and pilot projects are at an early stage. In this paper, we seek to understand how local priorities and needs could be met in REDD+ implementation and how these expectations match with global mitigation benefits. We examine the local priorities and needs in the use of land and forest resources in the Angai Villages Land Forest Reserve (AVLFR) in the Liwale District of Lindi Region in Tanzania. Primary data was collected in two villages, Mihumo and Lilombe, using semistructured key informant interviews and participatory rural appraisal methods. In addition, the key informant interviews were conducted with other village, district, and national level actors, as well as international donors. Findings show that in the two communities REDD+ is seen as something new and is generating new expectations among communities. However, the Angai villagers highlight three key priorities that have yet to be integrated into the design of REDD+: water scarcity, rural development, and food security. At the local level improved forest governance and sustainable management of forest resources have been identified as one way to achieve livelihood diversification. Although the national goals of REDD+ include poverty reduction, these goals are not necessarily conducive to the goals of these communities. There exist both structural and cultural limits to the ability of the Angai villages to implement these goals and to improve forestry governance. Given the vulnerability to current and future climate variability and change it will be important to consider how the AVLFR will be managed and for whose benefit?

Environmental regulation and colonization attributes of the long polar fimbriae (LPF) of Escherichia coli O157:H7

The ability of Escherichia coli O157:H7 to colonize the intestinal epithelia is dependent on the expression of intimin and other adhesins. The chromosome of E. coli O157:H7 carries two loci encoding long polar fimbriae (LPF). These fimbriae mediate adherence to epithelial cells and are associated with colonization of the intestine. In order to increase our knowledge about the conditions controlling their expression and their role in colonization of an animal model, the environmental cues that promote expression of lpf genes and the role of E. coli O157:H7 LPF in intestinal colonization of lambs were investigated. We found that expression of lpf1 was regulated in response to growth phase, osmolarity, and pH; that lpf2 transcription was stimulated during late exponential growth and iron depletion; and that LPF impacts the ability of E. coli O157:H7 to persist in the intestine of infected 6-week-old lambs.

The economic theory of the firm as a foundation for international business theory

The economic theory of the firm is central to the theory of the multinational enterprise. Recent literature on multinationals, however, makes only limited reference to the economic theory of the firm. Multinationals play an important role in coordinating the international division of labour through internal markets. The paper reviews the economic principles that underlie this view. Optimal internalisation equates marginal benefits and costs. The benefits of internalisation stem mainly from the difficulties of licensing proprietary knowledge, reflecting the view that MNEs possess an ‘ownership’ or ‘firm-specific’ advantage. The costs of internalisation, it is argued, reflect managerial capability, and in particular the capability to manage a large firm. The paper argues that management capability is a complement to ownership advantage. Ownership advantage determines the potential of the firm, and management capability governs the fulfilment of this potential through overcoming barriers to growth. The analysis is applied to a variety of issues, including out-sourcing, geographical dispersion of production, and regional specialisation in marketing.

Managing change in complex projects: configuration management, asset information and big data

As we enter an era of ‘big data’, asset information is becoming a deliverable of complex projects. Prior research suggests digital technologies enable rapid, flexible forms of project organizing. This research analyses practices of managing change in Airbus, CERN and Crossrail, through desk-based review, interviews, visits and a cross-case workshop. These organizations deliver complex projects, rely on digital technologies to manage large data-sets; and use configuration management, a systems engineering approach with mid-20th century origins, to establish and maintain integrity. In them, configuration management has become more, rather than less, important. Asset information is structured, with change managed through digital systems, using relatively hierarchical, asynchronous and sequential processes. The paper contributes by uncovering limits to flexibility in complex projects where integrity is important. Challenges of managing change are discussed, considering the evolving nature of configuration management; potential use of analytics on complex projects; and implications for research and practice.

Video stimuli reduce object-directed imitation accuracy: a novel two-person motion-tracking approach

Imitation is an important form of social behavior, and research has aimed to discover and explain the neural and kinematic aspects of imitation. However, much of this research has featured single participants imitating in response to pre-recorded video stimuli. This is in spite of findings that show reduced neural activation to video vs. real life movement stimuli, particularly in the motor cortex. We investigated the degree to which video stimuli may affect the imitation process using a novel motion tracking paradigm with high spatial and temporal resolution. We recorded 14 positions on the hands, arms, and heads of two individuals in an imitation experiment. One individual freely moved within given parameters (moving balls across a series of pegs) and a second participant imitated. This task was performed with either simple (one ball) or complex (three balls) movement difficulty, and either face-to-face or via a live video projection. After an exploratory analysis, three dependent variables were chosen for examination: 3D grip position, joint angles in the arm, and grip aperture. A cross-correlation and multivariate analysis revealed that object-directed imitation task accuracy (as represented by grip position) was reduced in video compared to face-to-face feedback, and in complex compared to simple difficulty. This was most prevalent in the left-right and forward-back motions, relevant to the imitator sitting face-to-face with the actor or with a live projected video of the same actor. The results suggest that for tasks which require object-directed imitation, video stimuli may not be an ecologically valid way to present task materials. However, no similar effects were found in the joint angle and grip aperture variables, suggesting that there are limits to the influence of video stimuli on imitation. The implications of these results are discussed with regards to previous findings, and with suggestions for future experimentation.

A novel plant-fungus symbiosis benefits the host without forming mycorrhizal structures

Most terrestrial plants form mutually beneficial symbioses with specific soil-borne fungi known as mycorrhiza. In a typical mycorrhizal association, fungal hyphae colonize plant roots, explore the soil beyond the rhizosphere and provide host plants with nutrients that might be chemically or physically inaccessible to root systems. Here, we combined nutritional, radioisotopic (33P) and genetic approaches to describe a plant growth promoting symbiosis between the basidiomycete fungus Austroboletus occidentalis and jarrah (Eucalyptus marginata), which has quite different characteristics. We show that the fungal partner does not colonize plant roots; hyphae are localized to the rhizosphere soil and vicinity and consequently do not transfer nutrients located beyond the rhizosphere. Transcript profiling of two high-affinity phosphate (Pi) transporter genes (EmPHT1;1 and EmPHT1;2) and hyphal-mediated 33Pi uptake suggest that the Pi uptake shifts from an epidermal to a hyphal pathway in ectomycorrhizal plants (Scleroderma sp.), similar to arbuscular mycorrhizal symbioses, whereas A. occidentalis benefits its host indirectly. The enhanced rhizosphere carboxylates are linked to growth and nutritional benefits in the novel symbiosis. This work is a starting point for detailed mechanistic studies on other basidiomycete–woody plant relationships, where a continuum between heterotrophic rhizosphere fungi and plant beneficial symbioses is likely to exist.

Rotation effect on geodesic and zonal flow modes in tokamak plasmas with isothermal magnetic surfaces

The electrostatic geodesic mode oscillations are investigated in rotating large aspect ratio tokamak plasmas with circular isothermal magnetic surfaces. The analysis is carried out within the magnetohydrodynamic model including heat flux to compensate for the non-adiabatic pressure distribution along the magnetic surfaces in plasmas with poloidal rotation. Instead of two standard geodesic modes, three geodesic continua are found. The two higher branches of the geodesic modes have a small frequency up-shift from ordinary geodesic acoustic and sonic modes due to rotation. The lower geodesic continuum is a newzonal flowmode (geodesic Doppler mode) in plasmas with mainly poloidal rotation. Limits to standard geodesic modes are found. Bifurcation of Alfven continuum by geodesic modes at the rational surfaces is also discussed. Due to that, the frequency of combined geodesic continuum extends from the poloidal rotation frequency to the ion-sound band that can have an important role in suppressing plasma turbulence.

Mechanosensitivity of astrocytes on optimized polyacrylamide gels analyzed by quantitative morphometry

Cells are able to detect and respond to mechanical cues from their environment. Previous studies have investigated this mechanosensitivity on various cell types, including neural cells such as astrocytes. In this study, we have carefully optimized polyacrylamide gels, commonly used as compliant growth substrates, considering their homogeneity in surface topography, mechanical properties, and coating density, and identified several potential pitfalls for the purpose of mechanosensitivity studies. The resulting astrocyte response to growth on substrates with shear storage moduli of G` = 100 Pa and G` = 10 kPa was then evaluated as a function of coating density of poly-D-lysine using quantitative morphometric analysis. Astrocytes cultured on stiff substrates showed significantly increased perimeter, area, diameter, elongation, number of extremities and overall complexity if compared to those cultured on compliant substrates. A statistically significant difference in the overall morphological score was confirmed with an artificial intelligence-based shape analysis. The dependence of the cells` morphology on PDL coating density seemed to be weak compared to the effect of the substrate stiffness and was slightly biphasic, with a maximum at 10-100 mu g ml(-1) PDL concentration. Our finding suggests that the compliance of the surrounding tissue in vivo may influence astrocyte morphology and behavior.

Government spending and unemployment : An empirical study on Sweden, 1994-2012

The aim of the study was to see if any relationship between government spending andunemployment could be empirically found. To test if government spending affectsunemployment, a statistical model was applied on data from Sweden. The data was quarterlydata from the year 1994 until 2012, unit-root test were conducted and the variables wheretransformed to its first-difference so ensure stationarity. This transformation changed thevariables to growth rates. This meant that the interpretation deviated a little from the originalgoal. Other studies reviewed indicate that when government spending increases and/or taxesdecreases output increases. Studies show that unemployment decreases when governmentspending/GDP ratio increases. Some studies also indicated that with an already largegovernment sector increasing the spending it could have negative effect on output. The modelwas a VAR-model with unemployment, output, interest rate, taxes and government spending.Also included in the model were a linear and three quarterly dummies. The model used 7lags. The result was not statistically significant for most lags but indicated that as governmentspending growth rate increases holding everything else constant unemployment growth rateincreases. The result for taxes was even less statistically significant and indicates norelationship with unemployment. Post-estimation test indicates that there were problems withnon-normality in the model. So the results should be interpreted with some scepticism.

Insuring cleaner oceans: the economics of oil pollution prevention

The current system of controlling oil spills involves a complex relationship of international, federal and state law, which has not proven to be very effective. The multiple layers of regulation often leave shipowners unsure of the laws facing them. Furthemore, nations have had difficulty enforcing these legal requirements. This thesis deals with the role marine insurance can play within the existing system of legislation to provide a strong preventative influence that is simple and cost-effective to enforce. In principle, insurance has two ways of enforcing higher safety standards and limiting the risk of an accident occurring. The first is through the use of insurance premiums that are based on the level of care taken by the insured. This means that a person engaging in riskier behavior faces a higher insurance premium, because their actions increase the probability of an accident occurring. The second method, available to the insurer, is collectively known as cancellation provisions or underwriting clauses. These are clauses written into an insurance contract that invalidates the agreement when certain conditions are not met by the insured The problem has been that obtaining information about the behavior of an insured party requires monitoring and that incurs a cost to the insurer. The application of these principles proves to be a more complicated matter. The modern marine insurance industry is a complicated system of multiple contracts, through different insurers, that covers the many facets of oil transportation. Their business practices have resulted in policy packages that cross the neat bounds of individual, specific insurance coverage. This paper shows that insurance can improve safety standards in three general areas -crew training, hull and equipment construction and maintenance, and routing schemes and exclusionary zones. With crew, hull and equipment, underwriting clauses can be used to ensure that minimum standards are met by the insured. Premiums can then be structured to reflect the additional care taken by the insured above and beyond these minimum standards. Routing schemes are traffic flow systems applied to congested waterways, such as the entrance to New York harbor. Using natural obstacles or manmade dividers, ships are separated into two lanes of opposing traffic, similar to a road. Exclusionary zones are marine areas designated off limits to tanker traffic either because of a sensitive ecosystem or because local knowledge is required of the region to ensure safe navigation. Underwriting clauses can be used to nullify an insurance contract when a tanker is not in compliance with established exclusionary zones or routing schemes.