Solid oral forms availability in children:a cost saving investigation

AIM: To assess the suitability and potential cost savings, from both the hospital and community perspective, of prescribed oral liquid medicine substitution with acceptable solid forms for children over 2 years. METHOD: Oral liquid medicines dispensed from a paediatric hospital (UK) in 1 week were assessed by screening for existence of the solid form alternative and evaluating the acceptability of the available solid form, firstly related to the prescribed dose and secondly to acceptable size depending on the child's age. Costs were calculated based on providing treatment for 28 days or prescribed duration for short term treatments. RESULTS: Over 90% (440/476) of liquid formulations were available as a marketed solid form. Considering dosage acceptability (maximum of 10% deviation from prescribed dosage or 0% for narrow therapeutic range drugs, maximum tablet divisions into quarters) 80% of liquids could be substituted with a solid form. The main limitation for liquid substitution would be solid form size. However, two-thirds of prescribed liquids could have been substituted with a suitable solid form for dosage and size, with estimated savings being of 5K and 8K in 1 week, respectively based on hospital and community costs, corresponding to a projected annual saving of 238K and 410K (single institution). CONCLUSION: Whilst not all children over 2 years will be able to swallow tablets, drug cost savings if oral liquid formulations were substituted with suitable solid dosage forms would be considerable. Given the numerous advantages of solid forms compared with liquids, this study may provide a theoretical basis for investing in supporting children to swallow tablets/capsules.

Last Interglacial synthesis of high-latitude temperature: temperature anomalies and associated errors for 4 time slices

The Last Interglacial (LIG, 129-116 thousand of years BP, ka) represents a test bed for climate model feedbacks in warmer-than-present high latitude regions. However, mainly because aligning different palaeoclimatic archives and from different parts of the world is not trivial, a spatio-temporal picture of LIG temperature changes is difficult to obtain. Here, we have selected 47 polar ice core and sub-polar marine sediment records and developed a strategy to align them onto the recent AICC2012 ice core chronology. We provide the first compilation of high-latitude temperature changes across the LIG associated with a coherent temporal framework built between ice core and marine sediment records. Our new data synthesis highlights non-synchronous maximum temperature changes between the two hemispheres with the Southern Ocean and Antarctica records showing an early warming compared to North Atlantic records. We also observe warmer than present-day conditions that occur for a longer time period in southern high latitudes than in northern high latitudes. Finally, the amplitude of temperature changes at high northern latitudes is larger compared to high southern latitude temperature changes recorded at the onset and the demise of the LIG. We have also compiled four data-based time slices with temperature anomalies (compared to present-day conditions) at 115 ka, 120 ka, 125 ka and 130 ka and quantitatively estimated temperature uncertainties that include relative dating errors. This provides an improved benchmark for performing more robust model-data comparison. The surface temperature simulated by two General Circulation Models (CCSM3 and HadCM3) for 130 ka and 125 ka is compared to the corresponding time slice data synthesis. This comparison shows that the models predict warmer than present conditions earlier than documented in the North Atlantic, while neither model is able to produce the reconstructed early Southern Ocean and Antarctic warming. Our results highlight the importance of producing a sequence of time slices rather than one single time slice averaging the LIG climate conditions.

CO2 concentration and stable isotope ratios of three Antarctic ice cores covering the period from 149.4 - 1.5 kyr before 1950

We present new d13C measurements of atmospheric CO2 covering the last glacial/interglacial cycle, complementing previous records covering Terminations I and II. Most prominent in the new record is a significant depletion in d13C(atm) of 0.5 permil occurring during marine isotope stage (MIS) 4, followed by an enrichment of the same magnitude at the beginning of MIS 3. Such a significant excursion in the record is otherwise only observed at glacial terminations, suggesting that similar processes were at play, such as changing sea surface temperatures, changes in marine biological export in the Southern Ocean (SO) due to variations in aeolian iron fluxes, changes in the Atlantic meridional overturning circulation, upwelling of deep water in the SO, and long-term trends in terrestrial carbon storage. Based on previous modeling studies, we propose constraints on some of these processes during specific time intervals. The decrease in d13C(atm) at the end of MIS 4 starting approximately 64 kyr B.P. was accompanied by increasing [CO2]. This period is also marked by a decrease in aeolian iron flux to the SO, followed by an increase in SO upwelling during Heinrich event 6, indicating that it is likely that a large amount of d13C-depleted carbon was transferred to the deep oceans previously, i.e., at the onset of MIS 4. Apart from the upwelling event at the end of MIS 4 (and potentially smaller events during Heinrich events in MIS 3), upwelling of deep water in the SO remained reduced until the last glacial termination, whereupon a second pulse of isotopically light carbon was released into the atmosphere.

Registry of selected samples from the Tara Oceans Expedition (2009-2013)

The present data set is a registry of samples from the Tara Oceans Expedition (2009-2013) that were selected for publication in a special issue of the SCIENCE journal (see related references below). The registry provides details about the sampling location and methodology of each sample. Uniform resource locators (URLs) offer direct links to additional contextual environmental data and to the corresponding sequence runs used for analysis in the related literature publications in the SCIENCE journal.

Biodiversity context of selected samples from the Tara Oceans Expedition (2009-2013)

The present data set provides contextual data for samples from the Tara Oceans Expedition (2009-2013) that were selected for publication in a special issue of the SCIENCE journal (see related references below). Contextual data include various diversity indexes calculated for the sampling location using satellite and model climatologies (Darwin project, Physat) and results from the sequencing of Tara Oceans samples.

Patient «difficile» ou «relation difficile»: Comment agir en physiothérapie?

Travail d’intégration présenté en vue de l’obtention du grade de physiothérapeute en Maîtrise en physiothérapie

Rôles des gènes Pitx dans le développement des membres postérieurs : régulation transcriptionnelle de Tbx4

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Patient «difficile» ou «relation difficile»: Comment agir en physiothérapie?

Travail d’intégration présenté en vue de l’obtention du grade de physiothérapeute en Maîtrise en physiothérapie

Rôles des gènes Pitx dans le développement des membres postérieurs : régulation transcriptionnelle de Tbx4

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Application of an Education Research Lab (ERL) Model to a Community Sailing Program

This presentation showcases the application of a university-based education research lab (ERL) model to the evaluation of a community sailing program for individuals with disabilities. Presenters conceptualize the ERL model as a mutually beneficial relationship between universities and community education agencies.

First evidence of altered sensory quality in a shellfish exposed to decreased pH relevant to ocean acidification

Understanding how seafood will be influenced by coming environmental changes such as ocean acidification is a research priority. One major gap in knowledge relates to the fact that many experiments are not considering relevant end points related directly to production (e.g., size, survival) and product quality (e.g., sensory quality) that can have important repercussions for consumers and the seafood market. The aim of this experiment was to compare the survival and sensory quality of the adult northern shrimp (Pandalus borealis) exposed for 3 wk to a temperature at the extreme of its thermal tolerance (11°C) and 2 pH treatments: pH 8.0 (the current average pH at the sampling site) and pH 7.5 (which is out of the current natural variability and relevant to near-future ocean acidification). Results show that decreased pH increased mortality significantly, by 63%. Sensory quality was assessed through semiqualitative scoring by a panel of 30 local connoisseurs. They were asked to rate 4 shrimp (2 from each pH treatment) for 3 parameters: appearance, texture and taste. Decreased pH reduced the score significantly for appearance and taste, but not texture. As a consequence, shrimp maintained in pH8.0 had a 3.4 times increased probability to be scored as the best shrimp on the plate, whereas shrimp from the pH 7.5 treatment had a 2.6 times more chance to be scored as the least desirable shrimp on the plate. These results help to prove the concept that ocean acidification can modulate sensory quality of the northern shrimp P. borealis. More research is now needed to evaluate impacts on other seafood species, socioeconomic consequences, and potential options.

"Per aurem intrat Christus in Mariam". Aproximación iconográfica a la "conceptio per aurem" en la pintura italiana del Trecento desde fuentes patrísticas y teológicas

La tesis mariológica de la conceptio per aurem, según la cual la Virgen María habría concebido a Jesucristo por el oído en el momento de escuchar del ángel el mensaje celestial anunciándole que, sin perder su virginidad, sería madre del Hijo de Dios encarnado, ha merecido hasta ahora muy pocos estudios académicos rigurosamente fundados en fuentes primarias. De hecho, en la literatura especializada son muy escasas las referencias a tal teoría y, cuando algún estudioso la evoca, casi siempre se contenta con aludir a ella, sin aportar pruebas documentales. Sin embargo, tal como lo revelan las nueve pinturas italianas aquí analizadas, esa teoría fue ilustrada mediante sutiles metáforas visuales en muchas obras pictóricas medievales, las cuales se inspiraron en una sólida tradición literaria. Además una pléyade de Padres de la Iglesia y teólogos medievales testimonia, mediante afirmaciones explícitas, que semejante teoría gozó de notable aceptación entre los maestros del pensamiento cristiano. Basándose en numerosos textos patrísticos y teológicos, este artículo intenta dos objetivos esenciales: exponer, ante todo, las distintas formulaciones teóricas propuestas por esos pensadores; y además, tratar de poner en luz los significados dogmáticos que subyacen bajo esa sorprendente tesis.

Tropical cyclone perceptions, impacts and adaptation in the Southwest Pacific: an urban perspective from Fiji, Vanuatu and Tonga

The destruction caused by tropical cyclone (TC) Pam in March 2015 is considered one of the worst natural disasters in the history of Vanuatu. It has highlighted the need for a better understanding of TC impacts and adaptation in the Southwest Pacific (SWP) region. Therefore, the key aims of this study are to (i) understand local perceptions of TC activity, (ii) investigate impacts of TC activity and (iii) uncover adaptation strategies used to offset the impacts of TCs. To address these aims, a survey (with 130 participants from urban areas) was conducted across three SWP small island states (SISs): Fiji, Vanuatu and Tonga (FVT). It was found that respondents generally had a high level of risk perception and awareness of TCs and the associated physical impacts, but lacked an understanding of the underlying weather conditions. Responses highlighted that current methods of adaptation generally occur at the local level, immediately prior to a TC event (preparation of property, gathering of food, finding a safe place to shelter). However higher level adaptation measures (such as the modification to building structures) may reduce vulnerability further. Finally, we discuss the potential
of utilising weather-related traditional knowledge and nontraditional knowledge of empirical and climate-model-based weather forecasts to improve TC outlooks, which would ultimately reduce vulnerability and increase adaptive capacity. Importantly, lessons learned from this study may result in the modification and/or development of existing adaptation strategies.

Party rules, party resources and the politics of parliamentary democracies How parties organize in the 21st century

This article introduces the first findings of the Political Party Database Project, a major survey of party organizations in parliamentary and semi-presidential democracies. The project’s first round of data covers 122 parties in 19 countries. In this article, we describe the scope of the database, then investigate what it tells us about contemporary party organization in these countries, focusing on parties’ resources, structures and internal decision-making. We examine organizational patterns by country and party family, and where possible we make temporal comparisons with older data sets. Our analyses suggest a remarkable coexistence of uniformity and diversity. In terms of the major organizational resources on which parties can draw, such as members, staff and finance, the new evidence largely confirms the continuation of trends identified in previous research: that is, declining membership, but enhanced financial resources and more paid staff. We also find remarkable uniformity regarding the core architecture of party organizations. At the same time, however, we find substantial variation between countries and party families in terms of their internal processes, with particular regard to how internally democratic they are, and the forms that this democratization takes.