896 resultados para dosage forms
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Ever since the inauguration of EU citizenship, elements of social citizenship have been on the agenda of European integration. European level social benefits were proposed early on, and demands for collective labour rights have followed suit. This chapter uses the theoretical umbrella of transnational social citizenship in order to link transnational access to social benefits and collective labour rights. It promotes transnational rights as the best way to conceptualise EU social citizenship as an institution enabling the enjoyment of EU integration without being forced to forego social rights at other levels. Such a perspective sits well in a collection on EU citizenship and federalism, since it simultaneously challenges demands of renationalisation of social rights in the EU and pleas to reduce EU-level citizenship rights to a merely liberal dimension. Social citizenship as promoted here requires an interactive conceptualisation of regulatory and judicial powers at different levels of government as typical for federal systems.
In linking citizenship with human rights the chapter highlights different statuses of citizens. It argues that the rights constituted by social citizenship derive from a status positivus and a status socialis activus, expanding the time-honoured categories of Jellinek. This concept is developed further by linking the notions of receptive solidarity to the status positivus and the notion of participative solidarity to the status socialis activus. In relation to European Union citizenship it promotes a sustainable transnational social citizenship catering for receptive and participative solidarity.
These ideas contrast with most current discourses on EU citizenship. The stress on social citizenship takes issue with a retreat to mere liberalist notions of EU-level citizenship, and the stress on rights takes issue with conceptualising EU citizenship as a community bond with obligations, downplaying the empowering potential of rights. The difficulty of conceptualising transnational social citizenship is to avoid, on the one hand, taking up the tune of populist discourses imagining those moving beyond state borders as a threat to national social citizenship and, on the other hand, to reject the legitimate fears of those remaining at home of creating rupture in the social fabric of Europe’s society. Promoting transnational social citizenship rights based on receptive and participative solidarity the present chapter aims to contribute to avoiding these pitfalls.
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BACKGROUND: Diabetic retinopathy is an important cause of visual loss. Laser photocoagulation preserves vision in diabetic retinopathy but is currently used at the stage of proliferative diabetic retinopathy (PDR).
OBJECTIVES: The primary aim was to assess the clinical effectiveness and cost-effectiveness of pan-retinal photocoagulation (PRP) given at the non-proliferative stage of diabetic retinopathy (NPDR) compared with waiting until the high-risk PDR (HR-PDR) stage was reached. There have been recent advances in laser photocoagulation techniques, and in the use of laser treatments combined with anti-vascular endothelial growth factor (VEGF) drugs or injected steroids. Our secondary questions were: (1) If PRP were to be used in NPDR, which form of laser treatment should be used? and (2) Is adjuvant therapy with intravitreal drugs clinically effective and cost-effective in PRP?
ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) for efficacy but other designs also used.
REVIEW METHODS: Systematic review and economic modelling.
RESULTS: The Early Treatment Diabetic Retinopathy Study (ETDRS), published in 1991, was the only trial designed to determine the best time to initiate PRP. It randomised one eye of 3711 patients with mild-to-severe NPDR or early PDR to early photocoagulation, and the other to deferral of PRP until HR-PDR developed. The risk of severe visual loss after 5 years for eyes assigned to PRP for NPDR or early PDR compared with deferral of PRP was reduced by 23% (relative risk 0.77, 99% confidence interval 0.56 to 1.06). However, the ETDRS did not provide results separately for NPDR and early PDR. In economic modelling, the base case found that early PRP could be more effective and less costly than deferred PRP. Sensitivity analyses gave similar results, with early PRP continuing to dominate or having low incremental cost-effectiveness ratio. However, there are substantial uncertainties. For our secondary aims we found 12 trials of lasers in DR, with 982 patients in total, ranging from 40 to 150. Most were in PDR but five included some patients with severe NPDR. Three compared multi-spot pattern lasers against argon laser. RCTs comparing laser applied in a lighter manner (less-intensive burns) with conventional methods (more intense burns) reported little difference in efficacy but fewer adverse effects. One RCT suggested that selective laser treatment targeting only ischaemic areas was effective. Observational studies showed that the most important adverse effect of PRP was macular oedema (MO), which can cause visual impairment, usually temporary. Ten trials of laser and anti-VEGF or steroid drug combinations were consistent in reporting a reduction in risk of PRP-induced MO.
LIMITATION: The current evidence is insufficient to recommend PRP for severe NPDR.
CONCLUSIONS: There is, as yet, no convincing evidence that modern laser systems are more effective than the argon laser used in ETDRS, but they appear to have fewer adverse effects. We recommend a trial of PRP for severe NPDR and early PDR compared with deferring PRP till the HR-PDR stage. The trial would use modern laser technologies, and investigate the value adjuvant prophylactic anti-VEGF or steroid drugs.
STUDY REGISTRATION: This study is registered as PROSPERO CRD42013005408.
FUNDING: The National Institute for Health Research Health Technology Assessment programme.
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Kathmandu has been the last few cities in the world which retained its medieval urban culture up until twentieth century. Various Hindu and Buddhist religious practices shaped the arrangement of houses, roads and urban spaces giving the city a distinctive physical form, character and a unique oriental nativeness. In recent decades, the urban culture of the city has been changing with the forces of urbanisation and globalisation and the demand for new buildings and spaces. New residential design is increasingly dominated by distinctive patterns of Western suburban ideal comprising detached or semi-detached homes and high rise tower blocks. This architectural iconoclasm can be construed as a rather crude response to the indigenous spaces and builtform. The paper attempts to dismantle the current tension between traditional and contemporary 'culture' (and hence society) and housing (or builtform) in Kathmandu by engaging in a discussion that cuts across space, time and meaning of building. The paper concludes that residential architecture in Kathmandu today stands disoriented and lost in the transition.
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OBJECTIVE: To evaluate the impact of age, various forms of cataract, and visual acuity on whole-field scotopic sensitivity screening for glaucoma in a rural population. DESIGN: Clinic-based study with population-based recruitment. SETTING: Jin Shan Township near Taipei, Taiwan. SUBJECTS: Three hundred forty-six residents (ages, > or = 40 years) of Jin Shan Township. INTERVENTIONS: Whole-field scotopic testing, ophthalmoscopy with dilation of the pupils, cataract grading against photographic standards, and screening visual field testing in a random one-third subsample. MAIN OUTCOME MEASURES: Whole-field scotopic sensitivity (in decibels) and diagnostic status as a case of glaucoma, glaucoma suspect, or normal. RESULTS: Participants in Jin Shan Township did not differ significantly in the rate of blindness, low visual acuity, or family history of glaucoma from a random sample of nonrespondents. Scotopic sensitivity testing detected 100% (6/6) of subjects with open-angle glaucoma at a specificity of 80.2%. The mean +/- SE scotopic sensitivity for six subjects with open-angle glaucoma (32.78 +/- 1.51 dB) differed significantly from that of 315 normal individuals (38.51 +/- 0.22 dB), when adjusted for age and visual acuity (P = .05, t test). With linear regression modeling, factors that correlated significantly with scotopic sensitivity were intraocular pressure, screening visual field, best corrected visual acuity, presence of cortical cataract, and increasing age. CONCLUSIONS: Although cataract affects the whole-field scotopic threshold, it appears that scotopic testing may be of value in field-based screening for glaucoma.
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Background Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting Five nursing homes in mainland Portugal. Methods A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure Medication regimen complexity index. Results The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion Medication regimen complexity proved to be high. There is certainly potential for the pharmacist’s intervention to reduce it as part as the medication review routine in all the patients.
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O vinho tinto é uma importante fonte de compostos fenólicos com atividade antioxidante e que estão relacionados com a prevenção de doenças cardiovasculares e cancro. Estes compostos são um sub-produto do processo de destilação vínica utilizado para produzir aguardente necessária para a produção de Vinho do Porto. Esta tese tem como objetivo valorizar os compostos fenólicos resultantes das destilarias de vinho, através do estudo da sua composição, das interações com o material polimérico do vinho, da sua estabilidade durante o armazenamento e avaliação dos seus potenciais efeitos biológicos in vitro. Isto irá permitir definir aplicações para estes compostos como ingredientes alimentares com propriedades funcionais. Dois vinhos tintos (RW1 e RW2) foram utilizados como fonte de compostos fenólicos. A fim de estudar estes compostos, cada vinho foi evaporado à pressão atmosférica, permitindo obter o respetivo vinho desalcolizado (DW1 e DW2). Os polissacarídeos e compostos fenólicos presentes nos vinhos desalcolizados foram fracionados por extração em fase sólida utilizando cartuchos C18 sep-pak. A fração hidrofóbica, rica em compostos fenólicos, foi separada em frações ricas em ácidos fenólicos, em procianidinas e em antocianinas, as quais foram usadas para avaliar a sua contribuição para a atividade antioxidante total e caracterização fenólica detalhada dos DW. Foram obtidas quantidades comparáveis de compostos fenólicos totais (1.3 g/L para RW1 e DW1, e 3.1 para RW2 e DW2), de taninos (1.2 g/L para RW1 e DW1 e 1.6 para RW2 e DW2) e de antocianinas (0.24 g/L para RW1 e DW1 e 0.41 para RW2 e DW2) para os vinhos e para os respetivos vinhos desalcolizados. A determinação da atividade antioxidante de RW e DW pelos métodos do DPPH e ABTS também originou valores semelhantes, permitindo inferir que o processo de destilação realizado não promoveu uma perda relevante de compostos fenólicos. A atividade antioxidante total de vinho deveu-se essencialmente à fração rica em antocianinas. Os dois DW foram dialisados para se obter o material polimérico dos vinhos (WPM1 e WPM2). O WPM1 e WPM2 apresentavam 1.1 e 1.3 g/L de material sólido, respetivamente. O WPM (WPM1 e WPM2) era composto por polissacarídeos (31 e 36%), proteínas (10 e 12%) e também por compostos fenólicos (32 e 43%). A análise de açúcares mostrou que as manoproteínas e as arabinogalactanas eram os principais polissacarídeos presentes. A extração do WPM com metanol deu origem a um material insolúvel em metanol (PMi) e a uma fração solúvel em metanol, que continuava a conter hidratos de carbono e compostos fenólicos, mostrando uma forte interação entre estes compostos. Para determinar a energia de ativação (Ea) da libertação dos compostos fenólicos de fracções de material polimérico do vinho, foram realizadas diálises do DW, WPM e PMi, utilizando-se quatro concentrações diferentes, a cinco temperaturas (5-40 °C). O valor da Ea foi 25 para o WPM e 61 kJ/mol para o PMi, mostrando que os compostos fenólicos do vinho podem estar associados de forma diferente à matriz polimérica e que uma fração pode estar, ainda, fortemente associada a esta matriz. A fim de avaliar a possível existência de interações seletivas com os compostos fenólicos, o WPM foi fracionado, permitindo a obtenção de uma fração rica em manoproteínas (MP), através de uma cromatografia de afinidade com concanavalina A e 3 frações ricas em arabinogalactanas (AG0, AG1 e AG2) obtidas por cromatografia de troca aniónica. Foi avaliada a difusão de nove antocianinas monoméricas através de uma membrana de diálise, em presença do WPM, e das frações ricas em MP e em AG. A diálise dos compostos fenólicos livres do vinho foi realizada como ensaio em branco. Todas as frações poliméricas mostraram capacidade para reter as antocianinas, embora em diferente extensão. Foi observada uma capacidade de retenção maior para as antocianinas acilglucosiladas do que para as antocianinas glucosiladas. A fração rica em AG teve uma maior contribuição para a capacidade de retenção das antocianinas pelo material polimérico vinho do que a fração rica em MP, principalmente quando as antocianinas estavam acetiladas. Com o objetivo de estudar formas para preservar, a longo prazo, as propriedades antioxidantes dos compostos fenólicos, o extrato de compostos fenólicos (PCE), em pó, foi armazenado em diferentes condições de luz e atmosfera, à temperatura ambiente durante 1 ano. Observou-se que o PCE armazenado no escuro, dentro de um exsicador sob atmosfera de azoto, preservou 95% da atividade antioxidante inicial. Também foram avaliadas as melhores condições para preservar as antocianinas quando em solução, armazenadas a duas temperaturas (5 e 30 ºC) durante 3 meses. A adição de 0.5 g/L de uma fração rica em polissacarídeos a um vinho armazenado a 30 ºC promoveu a proteção das antocianinas, especialmente das antocianinas cumaroiladas. Os potenciais efeitos biológicos dos compostos fenólicos foram avaliados em diferentes sistemas celulares in vitro utilizando as seguintes frações: WPM, WPS (polissacarídeos do vinho), WPC (compostos fenólicos do vinho), PA-E (fração rica em ácidos fenólicos), PR-E (fração rica em procianidinas) e APP-E (fração rica em antocianinas e procianidinas poliméricas). Foi observada uma maior viabilidade celular quando as células do carcinoma do cólon HT-29 foram expostas a dois agentes oxidantes (radiação UV e H2O2) em presença das frações PR-E e APP-E. Além disso, os extratos WPS, WPC, PR-E e APP-E mostraram propriedades anti-inflamatórias, avaliadas pela inibição da produção de NO por células de macrófagos RAW264.7, sendo o extrato APP-E (0.19 mg/mL) o que exibiu a maior capacidade anti-inflamatória. A fim de elucidar as propriedades antioxidantes dos extratos do vinho em células humanas, os glóbulos vermelhos (RBC) foram selecionados como um modelo metabolicamente simples. Os extratos WPM, WPS, WPC, PR-E, e APP-E mostraram efeito anti-hemolítico para a hemólise dos RBC provocada pelo peróxido de hidrogénio (H2O2) e pelo di-hidrocloreto de 2,2'-azo-bis(2-diaminopropano) (AAPH). Os resultados obtidos permitem concluir que o processo de desalcoolização dos vinhos à pressão atmosférica, preservou as principais características antioxidantes dos compostos fenólicos. Estes compostos podem contribuir para a defesa das células contra agentes oxidantes, nomeadamente por terem um potencial de atividades anti-inflamatória e anti-hemolítica, promovendo a viabilidade celular. A interação dos compostos fenólicos do vinho com o material polimérico permite inferir uma dosagem contínua e gradual das antocianinas vinho tinto após a sua ingestão, contribuindo para um período mais longo da sua exposição e, como consequência, dos seus potenciais benefícios para a saúde.
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Résumé : De même degré d’importance que les paramètres de formulation, les conditions de consolidation sont des facteurs déterminants pour la durabilité des bétons conventionnels vibrés. Dans le cas des bétons autoplaçants (BAP), grâce à leur grande fluidité, la mise en place dans les coffrages a lieu par écoulement libre sous l’effet de leur poids propre. Leur consolidation se fait sans vibration grâce à leurs caractéristiques rhéologiques. Il est donc légitime de penser que les caractéristiques rhéologiques des BAP peuvent avoir une influence importante sur les propriétés qui déterminent la durabilité. Cette thèse étudie les liens possibles entre les caractéristiques rhéologiques des BAP et leur durabilité vis-à-vis du transport des agents agressifs. Dix-sept formulations de BAP couvrant une large gamme de caractéristiques rhéologiques et se différenciant uniquement par leur dosage en adjuvants ont été étudiées à cet effet. Trois modèles rhéologiques classiques ont été mis en œuvre pour la détermination des paramètres rhéologiques des bétons étudiés. L’essai de sorptivité et dans une moindre mesure l’essai de carbonatation accélérée ont été utilisés comme indicateur de durabilité vis-à-vis du transport des agressifs. La durabilité de la couche superficielle au contact respectivement avec le coffrage en bois et en PVC a été étudiée et les résultats ont été comparés à la durabilité du béton à cœur. Cette étude a été faite en tenant compte des échanges hydriques et de l’arrangement granulaire au droit du coffrage. D’autre part, l’étude de la durabilité de la couche superficielle dans des conditions de mise en place proches du chantier a été faite sur 6 poutres partiellement armées longues de 2 m ainsi que sur 3 bétons semi-autoplaçants légèrement vibrés. Les résultats montrent qu’il existe une corrélation forte entre la viscosité plastique du modèle Bingham modifié ou le coefficient de consistance du modèle Herschel-Bulkley et la sorptivité. Très probablement, la viscosité agit sur le volume relatif des pores capillaires de gros diamètres. L’étude spécifique de la couche superficielle a montré que sa sorptivité dépend du type de coffrage utilisé à cause des éventuels échanges hydriques opérés entre le béton et la surface du coffrage. De plus, l’arrangement granulaire au droit du coffrage est également influencé. Ainsi, la sorptivité de la couche superficielle au contact du PVC est proche mais inférieure à celle du béton à cœur. La sorptivité de la couche superficielle au contact du bois est significativement inférieure à celle de la couche superficielle au contact du PVC tout en restant corrélé avec la viscosité plastique du modèle Bingham modifié ou le coefficient de consistance du modèle Herschel-Bulkley.
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Background and Aims How plant cell-cycle genes interface with development is unclear. Preliminary evidence from our laboratory suggested that over-expression of the cell cycle checkpoint gene, WEE1, repressed growth and development. Here the hypothesis is tested that the level of WEE1 has a dosage effect on growth and development in Arabidospis thaliana. To do this, a comparison was made of the development of gain- and loss-of-function WEE1 arabidopsis lines both in vivo and in vitro. Methods Hypocotyl explants from an over-expressing Arath;WEE1 line (WEE1oe), two T-DNA insertion lines (wee1-1 and wee1-4) and wild type (WT) were cultured on two-way combinations of kinetin and naphthyl acetic acid. Root growth and meristematic cell size were also examined. Key Results Quantitative data indicated a repressive effect in WEE1oe and a significant increase in morphogenetic capacity in the two T-DNA insertion lines compared with WT. Compared with WT, WEE1oe seedlings exhibited a slower cell-doubling time in the root apical meristem and a shortened primary root, with fewer laterals, whereas there were no consistent differences in the insertion lines compared with WT. However, significantly fewer adventitious roots were recorded for WEE1oe and significantly more for the insertion mutant wee1-1. Compared with WT there was a significant increase in meristem cell size in WEE1oe for all three ground tissues but for wee1-1 only cortical cell size was reduced. Conclusions There is a gene dosage effect of WEE1 on morphogenesis from hypocotyls both in vitro and in vivo.
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Report produced as part of the Green Logistics project (EPSRC and Department for Transport funded). This report contains examples of survey forms used in urban freight studies both in the UK and overseas. The studies from which these examples have been drawn range in data from 1970-2008. The purpose of the report is to provide insight into the types of questions used in different survey techniques and also into the design of survey forms. It is hoped that bringing together in a single document these examples of urban freight survey forms will be of use to researchers involved in such studies in future in planning and designing their survey work. Examples of several different types of survey techniques are provided including: Establishment surveys -- Commodity flow surveys -- Freight operator surveys -- Roadside interview surveys -- Driver surveys -- Vehicle observation surveys -- Parking surveys -- Vehicle trip diaries -- Service provider surveys
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Localism is an active political strategy, developed in a period of austerity by the UK's coalition government as a justification for the restructuring of state-civil society relationships. The deprived neighbourhood has long been a site for service delivery and a scale for intervention and action, giving rise to a variety of forms of neighbourhood governance. Prior international comparative research indicated convergence with the US given the rise of the self-help conjuncture and the decline of neighbourhood governance as a medium of regeneration. The subsequent shift in the UK paradigm from ‘big’ to ‘small state’ localism and deficit-reducing cuts to public expenditure confirm these trends, raising questions about the forms of neighbourhood governance currently being established, the role being played by local and central government, and the implications for neighbourhood regeneration. Two emerging forms of neighbourhood governance are examined in two urban local authorities and compared with prior forms examined in earlier research in the case study sites. The emerging forms differ significantly in their design and purpose, but as both are voluntary and receive no additional funding, better organised and more affluent communities are more likely to pursue their development. While it is still rather early to assess the capacity of these forms to promote neighbourhood regeneration, the potential in a period of austerity appears limited. Reduced funding for local services increases the imperative to self-help, while rights to local voice remain limited and the emerging forms provide little scope to influence (declining) local services and (still centralised) planning decisions, especially in neighbourhoods with regeneration needs which are likely to lack the requisite capacities, particularly stores of linking social capital. Initial conclusions suggest greater polarity and the further containment of deprived neighbourhoods.
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Urban sprawl is a challenge to the sustainability of many cities around the world. Fragmented urban development and vacant land are widespread problems in many Arab cities (UN-Habitat, 2012) which are, according to Ben-Hamouch, mainly a result of inappropriate modern planning and poor land management (2013). This study addresses the problem of urban fragmentation at the neighbourhood level and examines to what extent the concept of compact urban form can contribute to the improvement of social and environmental sustainability in the Libyan city of Benghazi and Arab cities in general. The objectives and scope of the study have justified a morphological approach, where eleven case studies that present different urban typologies in the city have been investigated. The research strategy and selection of case studies were driven by the availability of data and meant to cover the main urban types and important issues defined within this context. This research, which has been conducted to explore and explain the relationships that exist between local urban forms and their performance in terms of sustainability, has produced valuable knowledge and helped to identify measures which target the improvement of people’s quality of life and environmental sustainability of the city. The research draws on the argument that adopting a type of human scale urban form, which is relatively compact and dense, well-connected and comfortably diverse, coupled with concepts of urban greening and flexible development relevant to the local context, would help to create a high quality urban form that is liveable and accessible, while causing minimum damage to the natural environment. This work is an attempt to respond and add to the ongoing debate on sustainable urban form in the developing countries (see: (Jenks, 2000)). The findings have contributed to the understanding of urban fragmentation and highlighted the relevance of the theory of compact city to sustainable development in Benghazi and the South in general. It is anticipated that this work would raise awareness on the impact of urban fragmentation on the sustainability of the built environment within this context and help to advance research on planning theory and practice based on real-life experience and responses to local circumstances.
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Introduction: Previous research has suggested that visual images are more easily generated, more vivid and more memorable than other sensory modalities. This research examined whether or not imagery is experienced in similar ways by people with and without sight. Specifically, the imabeability of visual, auditory and tactile cue words was compared. The degree to which images were multimodal or unimodal was also examined. Method: Twelve participants totally blind from early infancy and 12 sighted participants generated images in response to 53 sensory and non sensory words, rating imageability and the sensory modality, and describing images. From these 53 items, 4 subgroups of words, which stimulated images that were predominantly visual, tactile, auditory and low-imagery, respectively, were created. Results: T-tests comparing imageability ratings from blind and sighted participants found no differences for auditory and tactile words (both p>.1). Nevertheless, whilst participants without sight found auditory and tactile images equally imageable, sighted participants found images in response to tactile cue words harder to generate than visual cue words (mean difference: -0.51, p=.025). Participants with sight were also more likely to develop multisensory images than were participants without sight (both U≥15.0, N1=12, N2=12, p≤.008). Discussion: For both the blind and sighted, auditory and tactile images were rich and varied and similar language was used. Sighted participants were more likely to generate multimodal images. This was particularly the case for tactile words. Nevertheless, cue words that resulted in multisensory images were not necessarily rated as more imageable. The discussion considers whether or not multimodal imagery represent a method of compensating for impoverished unimodal imagery. Implications for Practitioners: Imagery is important not only as a mnemonic in memory rehabilitation, but also everyday uses for things such as autobiographical memory. This research emphasises both the importance of not only auditory and tactile sensory imagery, but also spatial imagery for people without sight.