Correlates of spontaneous reporting of adverse drug reactions within primary care: the paradox of low prescribers who are high reporters

AIM(S) To examine Primary Care Trust (PCT) demographics influencing general practitioner (GP) involvement in pharmacovigilance. METHODS PCT adverse drug reaction (ADR) reports to the Yellow Card scheme between April 2004 and March 2006 were obtained for the UK West Midlands region. Reports were analysed by all drugs, and most commonly reported drugs (‘top drugs’). PCT data, adjusted for population size, were aggregated. Prescribing statistics and other characteristics were obtained for each PCT, and associations between these characteristics and ADR reporting rates were examined. RESULTS During 2004–06, 1175 reports were received from PCTs. Two hundred and eighty (24%) of these reports were for 14 ‘top drugs’. The mean rate of reporting for PCTs was 213 reports per million population. A total of 153 million items were prescribed during 2004–06, of which 33% were ‘top drugs’. Reports for all drugs and ‘top drugs’ were inversely correlated with the number of prescriptions issued per thousand population (rs = -0.413, 95% CI -0.673, -0.062, P < 0.05, and r = -0.420, 95% CI -0.678, -0.071, P < 0.05, respectively). Reporting was significantly negatively correlated with the percentages of male GPs within a PCT, GPs over 55 years of age, single-handed GPs within a PCT, the average list size of a GP within a PCT, the overall deprivation scores and average QOF total points. ADR reports did not correlate significantly with the proportion of the population over 65 years old. CONCLUSIONS Some PCT characteristics appear to be associated with low levels of ADR reporting. The association of low prescribing areas with high ADR reporting rates replicates previous findings.

20-km distributed temperature sensor based on spontaneous Brillouin scattering

We report on a novel experimental setup for distributed measurement of temperature, based on spontaneous Brillouin scattering in optical fiber. We have developed a mode-locked Brillouin fiber ring laser in order to generate the dual frequency source required for a heterodyne detection of the backscattered signal. This relatively simple system enables temperature measurements over 20 km with a spatial resolution of 7 m.

Cyclin-dependent kinase 9 activity regulates neutrophil spontaneous apoptosis

Neutrophils are the most abundant leukocyte and play a central role in the immune defense against rapidly dividing bacteria. However, they are also the shortest lived cell in the blood with a lifespan in the circulation of 5.4 days. The mechanisms underlying their short lifespan and spontaneous entry into apoptosis are poorly understood. Recently, the broad range cyclin-dependent kinase (CDK) inhibitor R-roscovitine was shown to increase neutrophil apoptosis, implicating CDKs in the regulation of neutrophil lifespan. To determine which CDKs were involved in regulating neutrophil lifespan we first examined CDK expression in human neutrophils and found that only three CDKs: CDK5, CDK7 and CDK9 were expressed in these cells. The use of CDK inhibitors with differing selectivity towards the various CDKs suggested that CDK9 activity regulates neutrophil lifespan. Furthermore CDK9 activity and the expression of its activating partner cyclin T1 both declined as neutrophils aged and entered apoptosis spontaneously. CDK9 is a component of the P-TEFb complex involved in transcriptional regulation and its inhibition will preferentially affect proteins with short half-lives. Treatment of neutrophils with flavopiridol, a potent CDK9 inhibitor, increased apoptosis and caused a rapid decline in the level of the anti-apoptotic protein Mcl-1, whilst Bcl2A was unaffected. We propose that CDK9 activity is a key regulator of neutrophil lifespan, preventing apoptosis by maintaining levels of short lived anti-apoptotic proteins such as Mcl-1. Furthermore, as inappropriate inhibition of neutrophil apoptosis contributes to chronic inflammatory diseases such as Rheumatoid Arthritis, CDK9 represents a novel therapeutic target in such diseases.

20-km distributed temperature sensor based on spontaneous Brillouin scattering

We report on a novel experimental setup for distributed measurement of temperature, based on spontaneous Brillouin scattering in optical fiber. We have developed a mode-locked Brillouin fiber ring laser in order to generate the dual frequency source required for a heterodyne detection of the backscattered signal. This relatively simple system enables temperature measurements over 20 km with a spatial resolution of 7 m.

Non-Gaussian statistics of an optical soliton in the presence of amplified spontaneous emission

A study was performed on non-Gaussian statistics of an optical soliton in the presence of amplified spontaneous emission. An approach based on the Fokker-Planck equation was applied to study the optical soliton parameters in the presence of additive noise. The rigorous method not only allowed to reproduce and justify the classical Gordon-Haus formula but also led to new exact results.

The role of Ca2+ in the generation of spontaneous astrocytic Ca2+ oscillations

Astrocytes in the rat thalamus display spontaneous [Ca2+]i oscillations that are due to intracellular release, but are not dependent on neuronal activity. In this study we have investigated the mechanisms involved in these spontaneous [Ca2+]i oscillations using slices loaded with Fluo-4 AM (5 μM) and confocal microscopy. Bafilomycin A1 incubation had no effect on the number of spontaneous [Ca2+]i oscillations indicating that they were not dependent on vesicular neurotransmitter release. Oscillations were also unaffected by ryanodine. Phospholipase C (PLC) inhibition decreased the number of astrocytes responding to metabotropic glutamate receptor (mGluR) activation but did not reduce the number of spontaneously active astrocytes, indicating that [Ca2+]i increases are not due to membrane-coupled PLC activation. Spontaneous [Ca2+]i increases were abolished by an IP3 receptor antagonist, whilst the protein kinase C (PKC) inhibitor chelerythrine chloride prolonged their duration, indicating a role for PKC and inositol 1,4,5,-triphosphate receptor activation. BayK8644 increased the number of astrocytes exhibiting [Ca2+]i oscillations, and prolonged the responses to mGluR activation, indicating a possible effect on store-operated Ca2+ entry. Increasing [Ca2+]o increased the number of spontaneously active astrocytes and the number of transients exhibited by each astrocyte. Inhibition of the endoplasmic reticulum Ca2+ ATPase by cyclopiazonic acid also induced [Ca2+]i transients in astrocytes indicating a role for cytoplasmic Ca2+ in the induction of spontaneous oscillations. Incubation with 20 μM Fluo-4 reduced the number of astrocytes exhibiting spontaneous increases. This study indicates that Ca2+ has a role in triggering Ca2+ release from an inositol 1,4,5,-triphosphate sensitive store in astrocytes during the generation of spontaneous [Ca2+]i oscillations

Spontaneous astrocytic Ca2+ oscillations in situ drive NMDAR-mediated neuronal excitation

Astrocytes respond to chemical, electrical and mechanical stimuli with transient increases in intracellular calcium concentration ([Ca2+]i). We now show that astrocytes in situ display intrinsic [Ca2+]i oscillations that are not driven by neuronal activity. These spontaneous astrocytic oscillations can propagate as waves to neighboring astrocytes and trigger slowly decaying NMDA receptor-mediated inward currents in neurons located along the wave path. These findings show that astrocytes in situ can act as a primary source for generating neuronal activity in the mammalian central nervous system.

The involvement/exclusion paradox of spontaneous volunteering:new lessons from winter flood episodes in England

This article focuses on the involvement and management of spontaneous volunteers (SVs). It develops a new theory—which we call the “involvement/exclusion” paradox—about a situation which is frequently manifested when SVs converge in times of disaster. After reviewing research and policy guidance relating to spontaneous volunteering, we present findings from a study of responses to winter flood episodes in England. Taking together the empirical findings and the literature, the article analyzes elements inherent in the involvement/exclusion paradox and develops a conceptual model to illustrate and explain the paradox. Implications for managers and future research are discussed.

Átmenet vagy spontán rend(etlenség)? = Transition or spontaneous order/disorder?

Az írás arra a kérdésre keresi a választ, hogy a két évtized után tartóssá, vagyis trenddé váló gazdasági és társadalmi eltérések a "posztkommunista" országok között milyen okokra vezethetők vissza. Másodsorban azt elemzi, mi a jelentősége e sokrétű különbségek modellszerű kategorizálásának. Ennek alapja az állami szerepvállalás mértéke és minősége. Végül harmadikként azt a kérdéskört vizsgálja, hogy az eltérések milyen következményekkel járnak. A fő következtetés az, hogy a közösségi választások ugyan jelentősek, ezek szerepe azonban a pályafüggőséghez képest sokkal kisebb, mint azt a legtöbb elmélet föltételezi. Az eredmény - Hayekkel szólva (Hayek [1995]) - emberi cselekvés, ámde nem emberi tervezet szülötte. _____ The article seeks to discover what causes can be traced for the economic and social differences that have become permanent or a trend after two decades. Secondly, it analy-ses what importance this model-like categorization of manifold differences bears. Thirdly and lastly, it examines the sphere of questions to do with the consequences of these differences. The main conclusion is that the community choices are significant, but their role is much less, by comparison with career dependence, than most theories assume. Achievement, to quote Hayek (1995) is borne of human endeavour, not human planning.

Spontaneous order and social norms. Hayek’s theory of socio-cultural evolution

Hayek’s theory of socio-cultural evolution is a generalization of his theory on spontaneous market order. Hayek explains both the emergence of market and social institutions serving as a social basis for that order within the framework of a unified evolutionary logic. This logic interprets the emergence and survival of spontaneous order and group-level rules of conduct as an unintended consequence of human action. In order to explain the emergence of social norms exclusively on the basis of methodological individualism, one would have to give up an exclusively evolutionary explanation of these norms. Since Hayek applies the invisible-hand explanation to the investigation of social norms, he combines the position of methodological individualism with functionalist-evolutionary arguments in his analysis. Hayek’s theory of socio-cultural evolution represents a theory in the framework of which methodological individualism and functionalism do not crowd out but complement each other.

Spontaneous order and social norms. Hayek’s theory of socio-cultural evolution

Hayek's theory of socio-cultural evolution is a generalization of his theory on spontaneous market order. Hayek explains both the emergence of market and social institutions serving as a social basis for that order within the framework of a unified evolutionary logic. This logic interprets the emergence and survival of spontaneous order and group-level rules of conduct as an unintended consequence of human action. In order to explain the emergence of social norms exclusively on the basis of methodological individualism, one would have to give up an exclusively evolutionary explanation of these norms. Since Hayek applies the invisiblehand explanation to the investigation of social norms, he combines the position of methodological individualism with functionalist-evolutionary arguments in his analysis. Hayek's theory of socio-cultural evolution represents a theory in the framework of which methodological individualism and functionalism do not crowd out but complement each other.

A framework for investigating the use of face features to identify spontaneous emotions

Emotion-based analysis has raised a lot of interest, particularly in areas such as forensics, medicine, music, psychology, and human-machine interface. Following this trend, the use of facial analysis (either automatic or human-based) is the most common subject to be investigated once this type of data can easily be collected and is well accepted in the literature as a metric for inference of emotional states. Despite this popularity, due to several constraints found in real world scenarios (e.g. lightning, complex backgrounds, facial hair and so on), automatically obtaining affective information from face accurately is a very challenging accomplishment. This work presents a framework which aims to analyse emotional experiences through naturally generated facial expressions. Our main contribution is a new 4-dimensional model to describe emotional experiences in terms of appraisal, facial expressions, mood, and subjective experiences. In addition, we present an experiment using a new protocol proposed to obtain spontaneous emotional reactions. The results have suggested that the initial emotional state described by the participants of the experiment was different from that described after the exposure to the eliciting stimulus, thus showing that the used stimuli were capable of inducing the expected emotional states in most individuals. Moreover, our results pointed out that spontaneous facial reactions to emotions are very different from those in prototypic expressions due to the lack of expressiveness in the latter.