Medication regimen complexity in institutionalized elderly people in an aging society

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.

Urban Leptospirosis in Africa: A Cross-Sectional Survey of Leptospira Infection in Rodents in the Kibera Urban Settlement, Nairobi, Kenya

Leptospirosis is a widespread but under-reported cause of morbidity and mortality. Global re-emergence of leptospirosis has been associated with the growth of informal urban settlements in which rodents are thought to be important reservoir hosts. Understanding the multi-host epidemiology of leptospirosis is essential to control and prevent disease. A cross-sectional survey of rodents in the Kibera settlement in Nairobi, Kenya was conducted in September–October 2008 to demonstrate the presence of pathogenic leptospires. A real-time quantitative polymerase chain reaction showed that 41 (18.3%) of 224 rodents carried pathogenic leptospires in their kidneys, and sequence data identified Leptospira interrogans and L. kirschneri in this population. Rodents of the genus Mus (37 of 185) were significantly more likely to be positive than those of the genus Rattus (4 of 39; odds ratio = 15.03). Questionnaire data showed frequent contact between humans and rodents in Kibera. This study emphasizes the need to quantify the public health impacts of this neglected disease at this and other urban sites in Africa.

Mid-Century Molecular: The Material Culture of X-ray Crystallographic Visualisation across Postwar British Science and Industrial Design

This thesis investigates the use and significance of X-ray crystallographic visualisations of molecular structures in postwar British material culture across scientific practice and industrial design. It is based on research into artefacts from three areas: X-ray crystallographers’ postwar practices of visualising molecular structures using models and diagrams; the Festival Pattern Group scheme for the 1951 Festival of Britain, in which crystallographic visualisations formed the aesthetic basis of patterns for domestic objects; and postwar furnishings with a ‘ball-and-rod’ form and construction reminiscent of those of molecular models. A key component of the project is methodological. The research brings together subjects, themes and questions traditionally covered separately by two disciplines, the history of design and history of science. This focus necessitated developing an interdisciplinary set of methods, which results in the reassessment of disciplinary borders and productive cross-disciplinary methodological applications. This thesis also identifies new territory for shared methods: it employs network models to examine cross-disciplinary interaction between practitioners in crystallography and design, and a biographical approach to designed objects that over time became mediators of historical narratives about science. Artefact-based, archival and oral interviewing methods illuminate the production, use and circulation of the objects examined in this research. This interdisciplinary approach underpins the generation of new historical narratives in this thesis. It revises existing histories of the cultural transmissions between X-ray crystallography and the production and reception of designed objects in postwar Britain. I argue that these transmissions were more complex than has been acknowledged by historians: they were contingent upon postwar scientific and design practices, material conditions in postwar Britain and the dynamics of historical memory, both scholarly and popular. This thesis comprises four chapters. Chapter one explores X-ray crystallographers’ visualisation practices, conceived here as a form of craft. Chapter two builds on this, demonstrating that the Festival Pattern Group witnesses the encounter between crystallographic practice, design practice and aesthetic ideologies operating within social networks associated with postwar modernisms. Chapters three and four focus on ball-and-rod furnishings in postwar and present-day Britain, respectively. I contend that strong relationships between these designed objects and crystallographic visualisations, for example the appellation ‘atomic design’, have been largely realised through historical narratives active today in the consumption of ‘retro’ and ‘mid-century modern’ artefacts. The attention to contemporary historical narratives necessitates this dual historical focus: the research is rooted in the period from the end of the Second World War until the early 1960s, but extends to the history of now. This thesis responds to the need for practical research on methods for studying cross-disciplinary interactions and their histories. It reveals the effects of submitting historical subjects that are situated on disciplinary boundaries to interdisciplinary interpretation. Old models, such as that of unidirectional ‘influence’, subside and the resulting picture is a refracted one: this study demonstrates that the material form and meaning of crystallographic visualisations, within scientific practice and across their use and echoes in designed objects, are multiple and contingent.

Marriage and gender inequality: work–family arrangements of Portuguese and British highly qualified women

This article examines work–family reconciliation processes in order to understand if, over the course of marital life, women become socially closer or further away from their partner. Drawing on work–life interviews with highly qualified women in Portugal and Britain, we compare these processes in two societies with different historical and social backgrounds. Findings reveal three main configurations of social (in)equality which emerge during married life: growing inequality in favour of the man, in favour of the woman or equality between spouses. With due attention to the importance of national specific factors, we present three main conclusions. First, (in) equality is built up over the course of marital life and female strategies for reconciling family and work are at the core of this process. Second, the national specificities can mould the effects of cross-national gender mechanisms. Third, the intersection between cross-cultural phenomena such as conservative attitudes towards domestic work and national specificities (such as the availability of part-time options) is a rather complex process which needs further research.

Effect of cross channel salinity imbalance due to freshwater influence in a narrow estuary

Senior thesis written for Oceanography 445

Examination of the factor structure of the Schizotypal Personality Questionnaire (SPQ) among British and Trinidadian adults

Much debate in schizotypal research has centred on the factor structure of the Schizotypal Personality Questionnaire (SPQ), with research variously showing higher-order dimensionality consisting of two to seven dimensions. In addition, cross-cultural support for the stability of those factors remains limited. Here, we examined the factor structure of the SPQ among British and Trinidadian adults. Participants from a White British sub-sample (n = 351) resident in the UK and from an African Caribbean sub-sample (n = 284) resident in Trinidad completed the SPQ. The higher-order factor structure of the SPQ was analysed through confirmatory factor analysis, followed by multiple-group analysis for the model of best-fit. Between-group differences for sex and ethnicity were investigated using multivariate analysis of variance in relation to the higher-order domains. The model of best-fit was the four-factor structure, which demonstrated measurement invariance across groups. Additionally, these data had an adequate fit for two alternative models: a) 3 factors and b) a modified 4-factor. The British sub-sample had significantly higher scores across all domains than the Trinidadian group, and men scored significantly higher on the disorganised domain than women. The four-factor structure received confirmatory support and, importantly, support for use with populations varying in ethnicity and culture.

The state and the development of an information society: Greek policy and experience

The paper looks into the dynamics of information society policy and its implementation in the Greek context. It argues that information society development is a contested process, influenced by pre-existing state, economy and society relations. Based on this, it looks into the different aspects of the idiosyncratic path which the evolution of the Greek information society has followed, particularly after 2000. Using Bob Jessop's strategic-relational approach (SRA) to the state as an analytical framework and drawing on a number of in-depth interviews with relevant political actors, it provides insights into policy implementation by examining: the public management of information technology projects, how such projects were received in bureaucratic structures and practices, as well as the relationship between the state and the information and communication technology (ICT) sector in public procurement processes. The emphasis is on the period 2000–2008, during which a major operational programme on the information society in Greece was put into effect. The paper also touches upon the post-2008 experience, suggesting that information society developments might include dynamics operating independently and even in contradiction to the state agenda.

Platelets induce Pai-1 mRNA expression in monocytes through TGF-BETA

Introduction: Plasminogen activator inhibitor type-1 (PAI-1) is a physiological modulator of fibrinolysis. High plasma PAI-1 is associated with the 4G/5G promoter polymorphism and with increased cardiovascular risk. Here we explored the role of platelets in regulating expression of the PAI-1 gene in monocytes. Methods: Blood from PAI-1 4G/5G genotyped volunteers (n=6) was incubated with the platelet GPVI-specific agonist, cross-linked collagen related peptide (CRP-XL), in the presence or absence of Mab 9E1 that blocks the binding of P-selectin to PSGL1. Monocytes were isolated by +ve selection on CD14 beads and monocyte PAI-1 mRNA expression was measured by real-time PCR. Results: Activation of platelets with CRP-XL resulted in platelets binding to >70% of monocytes and was accompanied by >5000-fold induction of PAI-1 mRNA, peaking at 4hrs. PAI-1 expression was independent of the 4G/5G genotype. Blocking the binding of platelets to monocytes enhanced PAI-1 induction (p<0.05 at 4 hrs). Incubation of isolated monocytes with the releasate from CRP-XL stimulated platelets also led to PAI-1 mRNA expression. The platelet secretome contains >100 different proteins. To identify the soluble factor(s) responsible for induction of PAI-1, neutralizing antibodies to likely candidates were added to monocytes incubated with the platelet releasate. Anti- TGF-beta inhibited platelet releasate-mediated PAI-1 mRNA induction by >80%. Monocyte PAI-1 was also induced by stimulation of PSGL-1 with a P-selectin-Fc chimera, in the absence of platelets, which was also blocked by the TGF-beta antibody. Conclusions: These results suggest that platelets induce PAI-1 mRNA in monocytes predominantly via TGF-beta, released from both platelets, and monocytes via activation by PSGL-1 signalling.This stimulation is independent of 4G/5G genotype

Cross-National Differences in Managerial Discretion: Insights from the Middle East

Our study examines the effect of cultural practices on CEO discretion across six Middle Eastern countries. Using a panel of senior management consultants, we extend the national-level framework of managerial discretion and find that an encompassing array of cultural practices play a crucial role in shaping the degree of discretion provided to CEOs’ of public firms headquartered in these countries. We empirically demonstrate that power distance, future and performance orientation along with gender egalitarianism and assertiveness have positive relationships with managerial discretion. However, institutional collectivism, uncertainty avoidance and humane orientation negatively affect the degree of discretion provided to CEOs. As such, our results indicate that executives are able to take idiosyncratic and bold actions to the extent to which the cultural environment allows them to do so. As such, we contribute to the strategic leadership literature by finding new national-level antecedents of managerial discretion that haven’t been considered in earlier studies and confirm the context dependency of the discretion construct.

The Greatest lover: a post-colonial rewriting of My Fair Lady

INTRODUCTION The popular Hong Kong comedy, The Greatest Lover, re-incarnates one of the most popular western musicals, My Fair Lady. OBJECTIVES 1. To find out in what major ways My Fair Lady was rewritten as the Hong Kong Cantonese movie, Gungzi Docing (The Greatest Lover). 2. To find out the socio-political, socio-linguistic, and gender ideology behind the rewriting. METHODOLOGY 1. To note the similarity of the themes for both works – a creator falling in love with his/her creation, and class prejudice and cross-class romance. 2. To note how the times of The Greatest Lover differ from that of My Fair Lady. 3. To note how the main characters in The Greatest Lover differ from My Fair Lady in terms of profession, gender, etc. 4. To note how the plot of The Greatest Lover differs from that of My Fair Lady. 5. To note how focus on language in The Greatest Lover compares with that in My Fair Lady. 6. To discuss the ideological implications of the differences noted above, e.g. women in Hong Kong today have much higher status than women in Victorian England; the conflict between local Hong Kong people and both legal and illegal immigrants from Mainland China is even more serious than that between the British upper middle class and the lower class during the Victorian period. 7. Andre Lefevere (1992) argues that translation and adaptation are rewriting informed and influenced by the rewriter’s ideology, among other things. 8. Both Aline Remael (1995) and Patrick Cattrysse (1992) think that film adaptation is a kind of translation. 9. Sirkkus Aaltonen (2000) argues that drama translation mirrors the ideologies of the target society. CONCLUSION 1. The Greatest Lover projects local cultural significance onto My Fair Lady by helping us to appreciate an important Western work of art through the Hong Kong Cantonese perspective. 2. Broader issues in translation and intercultural studies are also considered.

A cross-sectional survey of attitudes to HIV risk and rapid HIV testing among clients of sex workers in Switzerland.

OBJECTIVES: To assess attitudes to HIV risk and acceptability of rapid HIV testing among clients of street-based female sex workers (FSW) in Lausanne, Switzerland, where HIV prevalence in the general population is 0.4%. METHODS: The authors conducted a cross-sectional study in the red light district of Lausanne for five nights in September of 2008, 2009 and 2010. Clients of FSW were invited to complete a questionnaire in the street assessing demographic characteristics, attitudes to HIV risk and HIV testing history. All clients interviewed were then offered anonymous finger stick rapid HIV testing in a van parked on-site. RESULTS: The authors interviewed 112, 127 and 79 clients in 2008, 2009 and 2010, respectively. All were men, average age 32-37 years old; 40-60% were in a stable relationship. History of unprotected sex was higher with non-commercial partners (33-50%) than with FSW (6-11%); 29-46% of clients had never undergone an HIV test. Anonymous rapid HIV testing was accepted by 45-50% of clients. Out of 109 HIV tests conducted during the three study periods, none was reactive. CONCLUSIONS: On-site HIV counselling and testing is acceptable among clients of FSW in this urban setting. These individuals represent an unquantified population, a proportion of which has an incomplete understanding of HIV risk in the face of high-risk behaviour, with implications for potential onward transmission to non-commercial sexual partners.

Niagara Lodges of the Loyal Orange Association of British America

The Loyal Orange Association of British America is a Protestant fraternal society. The Loyal Orange Association originated in Ulster, Ireland during the late eighteenth century. Its purpose was to promote Protestant rights and privileges. The association was exclusively Protestant, fraternal, democratic, and benevolent. Orange principles were brought to Upper Canada by Protestant Irish settlers after 1815. The first Canadian Orange Lodge was formally established in Brockville, Leeds County, 1830. By the late 19th and early 20th century, the Loyal Orange Association of British North America had gained considerable popularity and political influence. Many prominent politicians, including several prime ministers, were members. Orangemen were particularly concerned with issues such as separate school funding, language rights, immigration, religious freedom and conscription. Further, they demanded the execution of Louis Riel and opposed the Jesuits Estates settlement. Administrative sketch courtesy Archives of Ontario.

Carling Red Cap Poster

Poster from the 1960s campaign "Carling Red Cap Ale Society"

Second Welland Canal - Book 3, Survey Map 2 - Canal to Chippewa Creek with Port Robinson

Survey map of the Second Welland Canal created by the Welland Canal Company showing the canal as it passes through Port Robinson. Identified structures associated with the Canal include the Guard Lock, Collector Toll Office, towing path, and the New Cut of the canal. The surveyors' measurements and notes can be seen in red and black ink and pencil. Local area landmarks are also identified and include streets and roads (ex. Island Street, Bridge Street, John Street, and Cross Street), bridges (Swing Bridge, and several unnamed bridges), Welland Railroad, Canal to Chippewa Creek (and two old locks and one new lock associated with the canal), Chippewa Creek, Back Water, an unnamed Island, Dry Dock leased to McFarland and Abbey, Abbey's Office, D. McFarland and Co. Saw Mill (Burnt), G. Jordan Tavern, Robert Elliot Store House and Wharf, Isaac Pew's Shop, Colemans Hotel, R. Band and Co. Girst Mill, Donaldson and Co. Grist Mill, H. Marlatt Dwelling House and barn, Henry W. Timms Hotel, Methodist Church, Post Office, Blacksmith Shop, a church, a structure labeled B. Patch, and a number of other structures that are not named. Properties and property owners of note are: Lots 202 and 203, S. Hill, D. McFarland, Church Society, G. Jordan, D. Coleman, John Brown, Rob Coulter, Robert Elliot, Isaac Pew, James McCoppen, William Bell, Charles Stuart, Andrew Elliot, Robert Band, Ed. Feney, John Betty, F. Sharp, William B. Hendershot, A. Brownson, H. Marlatt, J. S. Powell, and the School Trustees. Two reserved properties are labeled in red.The current spelling of Chippewa Creek is Chippawa. Although it not possible to make out the entire name of the H. W. Timms hotel located at Front and Bridge Street on the map itself, it was discovered to belong to Henry W. Timms after consulting the 1851-52 Canada Directory.

The Wine and Food Society Presents: Le diner de Noel Des Pape Clement V

A menu from the event "le Diner de Noel Des Pape Clement V to be held at St. Francis Hotel in San Francisco, California. The menu includes several varieties of wine, all highlighted in red ink.