Safe Therapeutic Economic Pharmaceutical Selection (STEPSelect): development, introduction and use in Northern Ireland

The implementation of a new model for drug selection in Northern Ireland has improved the quality of prescribing, safety and reduced costs.

Utilising a computer game as a therapeutic intervention for youth in residential care: Some preliminary findings on use and acceptability

Mental illness is common amongst young people living in residential care, many of whom are reluctant to avail of therapeutic help. The potential value of computer games as therapeutic tools for these young people has received very little attention, despite indications of their potential for promoting engagement in therapeutic work and improving mental health outcomes. This study aimed to fill this research gap through the development, introduction, and preliminary evaluation of a therapeutic intervention in group care settings. The intervention incorporated a commercially available computer game (The SIMS Life Stories™) and emotion regulation skill coaching. Qualified residential social workers were trained to deliver it to young people in three children's homes in Northern Ireland, where therapeutic approaches to social work had been introduced. The research was framed as an exploratory case study which aimed to determine the acceptability and potential therapeutic value of this intervention. The evidence suggests that computer-game based interventions of this type may have value as therapeutic tools in group care settings and deserve further development and empirical investigation to determine their effectiveness in improving mental health outcomes.

Hydrogel-Forming Microneedle Arrays Allow Detection of Drugs and Glucose In Vivo: Potential for Use in Diagnosis and Therapeutic Drug Monitoring

We describe, for the first time the use of hydrogel-forming microneedle (MN) arrays for minimally-invasive extraction and quantification of drug substances and glucose from skin in vitro and in vivo. MN prepared from aqueous blends of hydrolysed poly(methyl-vinylether-co-maleic anhydride) (11.1% w/w) and poly(ethyleneglycol) 10,000 daltons (5.6% w/w) and crosslinked by esterification swelled upon skin insertion by uptake of fluid. Post-removal, theophylline and caffeine were extracted from MN and determined using HPLC, with glucose quantified using a proprietary kit. In vitro studies using excised neonatal porcine skin bathed on the underside by physiologically-relevant analyte concentrations showed rapid (5 min) analyte uptake. For example, mean concentrations of 0.16 μg/mL and 0.85 μg/mL, respectively, were detected for the lowest (5 μg/mL) and highest (35 μg/mL) Franz cell concentrations of theophylline after 5 min insertion. A mean concentration of 0.10 μg/mL was obtained by extraction of MN inserted for 5 min into skin bathed with 5 μg/mL caffeine, while the mean concentration obtained by extraction of MN inserted into skin bathed with 15 μg/mL caffeine was 0.33 μg/mL. The mean detected glucose concentration after 5 min insertion into skin bathed with 4 mmol/L was 19.46 nmol/L. The highest theophylline concentration detected following extraction from a hydrogel-forming MN inserted for 1 h into the skin of a rat dosed orally with 10 mg/kg was of 0.363 μg/mL, whilst a maximum concentration of 0.063 μg/mL was detected following extraction from a MN inserted for 1 h into the skin of a rat dosed with 5 mg/kg theophylline. In human volunteers, the highest mean concentration of caffeine detected using MN was 91.31 μg/mL over the period from 1 to 2 h post-consumption of 100 mg Proplus® tablets. The highest mean blood glucose level was 7.89 nmol/L detected 1 h following ingestion of 75 g of glucose, while the highest mean glucose concentration extracted from MN was 4.29 nmol/L, detected after 3 hours skin insertion in human volunteers. Whilst not directly correlated, concentrations extracted from MN were clearly indicative of trends in blood in both rats and human volunteers. This work strongly illustrates the potential of hydrogel-forming MN in minimally-invasive patient monitoring and diagnosis. Further studies are now ongoing to reduce clinical insertion times and develop mathematical algorithms enabling determination of blood levels directly from MN measurements.

Selection of candidate coding DNA barcoding regions for use on land plants

An in silico screen of 41 of the 81 coding regions of the Nicotiana plastid genome generated a shortlist of 12 candidates as DNA barcoding loci for land plants. These loci were evaluated for amplification and sequence variation against a reference set of 98 land plant taxa. The deployment of multiple primers and a modified multiplexed tandem polymerase chain reaction yielded 85–94% amplification across taxa, and mean sequence differences between sister taxa of 6.1 from 156 bases of accD to 22 from 493 bases of matK. We conclude that loci should be combined for effective diagnosis, and recommend further investigation of the following six loci: matK, rpoB, rpoC1, ndhJ, ycf5 and accD.

Plants growing on contaminated and brownfield sites appropriate for use in Organisation for Economic Co-operation and Development terrestrial plant growth test

The Organisation for Economic Co-operation and Development (OECD) Terrestrial plant test is often used for the ecological risk assessment of contaminated land. However, its origins in plant protection product testing mean that the species recommended in the OECD guidelines are unlikely to occur on contaminated land. Six alternative species were tested on contaminated soils from a former Zn smelter and a metal fragmentizer with elevated concentrations of Cd, Cu, Pb, and Zn. The response of the alternative species was compared to two species recommended by the OECD; Lolium perenne (perennial ryegrass) and Trifolium pratense (red clover). Urtica dioica (stinging nettle) and Poa annua (annual meadow-grass) had low emergence rates in the control soil so may be considered unsuitable. Festuca rubra (chewings fescue), Holcus lanatus (Yorkshire fog), Senecio vulgaris (common groundsel), and Verbascum thapsus (great mullein) offer good alternatives to the OECD species. In particular, H. lanatus and S. vulgaris were more sensitive to the soils with moderate concentrations of Cd, Cu, Pb, and Zn than the OECD species.

The use of proteomics to identify novel therapeutic targets for the treatment of disease

The completion of the Human Genome Project has revealed a multitude of potential avenues for the identification of therapeutic targets. Extensive sequence information enables the identification of novel genes but does not facilitate a thorough understanding of how changes in gene expression control the molecular mechanisms underlying the development and regulation of a cell or the progression of disease. Proteomics encompasses the study of proteins expressed by a population of cells, and evaluates changes in protein expression, post-translational modifications, protein interactions, protein structure and splice variants, all of which are imperative for a complete understanding of protein function within the cell. From the outset, proteomics has been used to compare the protein profiles of cells in healthy and diseased states and as such can be used to identify proteins associated with disease development and progression. These candidate proteins might provide novel targets for new therapeutic agents or aid the development of assays for disease biomarkers. This review provides an overview of the current proteomic techniques available and focuses on their application in the search for novel therapeutic targets for the treatment of disease.

Flooding tolerance in four 'Garrigue' landscape plants: implications for their future use in the urban landscapes of north-west Europe?

Within a changing climate, Mediterranean ‘Garrigue’ xerophytes are increasingly recommended as suitable urban landscape plants in north-west Europe, based on their capacity to tolerate high temperature and reduced water availability during summer. Such species, however, have a poor reputation for tolerating waterlogged soils; paradoxically a phenomenon that may also increase in north-west Europe due to predictions for both higher volumes of winter precipitation, and short, but intensive periods of summer rainfall. This study investigated flooding tolerance in four landscape ‘Garrigue’ species, Stachys byzantina, Cistus × hybridus, Lavandula angustifolia and Salvia officinalis. Despite evolving in a dry habitat, the four species tested proved remarkably resilient to flooding. All species survived 17 days flooding in winter, with Stachys and Lavandula also surviving equivalent flooding duration during summer. Photosynthesis and biomass production, however, were strongly inhibited by flooding although the most tolerant species, Stachys quickly restored its photosynthetic capacity on termination of flooding. Overall, survival rates were comparable to previous studies on other terrestrial (including wetland) species. Subsequent experiments using Salvia (a species we identified as ‘intermediate’ in tolerance) clearly demonstrated adaptations to waterlogging, e.g. acclimation against anoxia when pre-treated with hypoxia. Despite anecdotal information to the contrary, we found no evidence to suggest that these xerophytic species are particularly intolerant of waterlogging. Other climatic and biotic factors may restrict the viability and distribution of these species within the urban conurbations of north-west Europe, but we believe increased incidence of flooding per se should not preclude their consideration.

Density of insect-pollinated grassland plants decreases with increasing surrounding land-use intensity

Pollinator declines have raised concerns about the persistence of plant species that depend on insect pollination, in particular by bees, for their reproduction. The impact of pollinator declines remains unknown for species-rich plant communities found in temperate seminatural grasslands. We investigated effects of land-use intensity in the surrounding landscape on the distribution of plant traits related to insect pollination in 239 European seminatural grasslands. Increasing arable land use in the surrounding landscape consistently reduced the density of plants depending on bee and insect pollination. Similarly, the relative abundance of bee-pollination-dependent plants increased with higher proportions of non-arable agricultural land (e.g. permanent grassland). This was paralleled by an overall increase in bee abundance and diversity. By isolating the impact of the surrounding landscape from effects of local habitat quality, we show for the first time that grassland plants dependent on insect pollination are particularly susceptible to increasing land-use intensity in the landscape.

Epiphyte plants use by birds in Brazil

This study firstly reviewed the interspecific interaction records between birds and epiphyte plants in Brazil. Forty two documents, including articles, scientific notes, books and thesis, and 35 personal records and from collaborators were argued, totaling 112 species of birds that interacted with 97 species of epiphyte plants. Two articles treated the theme specifically and another 40 treated related subjects, such as: pollination of epiphytes, ecology and feeding behavior of birds. Studies were concentrated mainly in Atlantic Forest, in the southeastern Brazilian region. The epiphyte species more visited by birds was Aechmea nudicaulis (Bromeliaceae). The main visitor of epiphytes was Ramphodon naevius (Trochilidae). According to the number of authors' citations an index of generality in bird-epiphyte interactions was created. As result the index inferred that the ovenbird Cichlocolaptes leucophrus and the bromeliad Nidularium procerum are less generalist and more specialist species in bird-epiphyte interactions. The totality of the papers showed a considerable number of bird species that use the epiphytes plants and its resources, including nectar, fruits, invertebrates, nest material, nesting place, water and bath. Considering the importance of epiphytes to supply a variety of resources for birds, these results highlighted the necessity of additional and specific studies about the theme in various Brazilian regions and biomes.

Use of homeopathic preparations in experimental studies with healthy plants

Background. The last comprehensive review of experimental research on effects of homeopathic treatments on plants was published in 1984, and lacked formal predefined criteria to assess study quality. Since then several new studies with more advanced methods have been published.Objectives: To compile a review of the literature on basic research in homeopathy with healthy plants with particular reference to studies investigating specific effects of homeopathic remedies.Methods: The literature search included English, French, German, Italian, Portuguese and Spanish publications from 1920 to April 2009, using predefined selection criteria. We included experiments with healthy whole plants, seeds, plant parts and cells. The outcomes had to be measured by established procedures and statistically evaluated. We developed a Manuscript Information Score (MIS) and included only publications which provided enough information for proper interpretation (MIS >= 5). A formallised Study Methods Evaluation Procedure (SMEP) was used to evaluate these studies, and the subgroup of studies with adequate controls to identify specific effects.Results: A total of 86 studies in 79 publications was identified, 43 studies included statistics, 29 had MIS >= 5, and 15 studies investigated the specificity of homeopathic preparations. Specific effects of decimal, centesimal and fifty millesimal potencies were found including dilution levels far beyond the Avogadro number. In consecutive series of potencies only some of the tested potencies showed effects. There were many individual studies with diverse methods and very few reproduction trials.Conclusions: Healthy plant models seem an useful approach to investigate basic research questions about the specificity of homeopathic preparations. More investigations with more advanced methods are recommended, especially in the sectors of potentisation techniques, effective potency levels and conditions for reproducibility. Systematic negative control experiments should become a routine procedure to control the stability of the experimental systems. Homeopathy (2009) 98, 228-243.

An integrated approach to identification and conservation of medicinal plants in the tropical forest - A Brazilian experience

An integrated and interdisciplinary research programme with native medicinal plants from tropical forests has been performed in order to obtain new forest products for sustainable use in regional markets vis-à-vis ecosystem conservation. For the success of this programme ethnopharmacological studies are very important with respect to (i) identification of useful plants including medicinal and aromatic species; (ii) recuperation and preservation of traditional knowledge about native plants; and (iii) identification of potential plants with economic value. The plants are selected with a view to evaluate efficacy and safety (pharmacological and toxicological studies), and phytochemical profile and quality control (phytochemical and chromatographic characterization). These studies are very important to add value to plant products and also to mitigate unscrupulous exploitation of medicinal plants by local communities, since multiple use of plants represents an excellent strategy for sustaining the tropical ecosystem through ex situ and in situ conservation. Thus, conservation of tropical resources is possible in conjunction with improvements in the quality of life of the traditional communities and production of new products with therapeutic, cosmetic and 'cosmeceutic' value. © NIAB 2005.