Development of a dosage strategy in patients receiving enoxaparin by continuous intravenous infusion using modelling and simulation

Aim To develop an appropriate dosing strategy for continuous intravenous infusions (CII) of enoxaparin by minimizing the percentage of steady-state anti-Xa concentration (C-ss) outside the therapeutic range of 0.5-1.2 IU ml(-1). Methods A nonlinear mixed effects model was developed with NONMEM (R) for 48 adult patients who received CII of enoxaparin with infusion durations that ranged from 8 to 894 h at rates between 100 and 1600 IU h(-1). Three hundred and sixty-three anti-Xa concentration measurements were available from patients who received CII. These were combined with 309 anti-Xa concentrations from 35 patients who received subcutaneous enoxaparin. The effects of age, body size, height, sex, creatinine clearance (CrCL) and patient location [intensive care unit (ICU) or general medical unit] on pharmacokinetic (PK) parameters were evaluated. Monte Carlo simulations were used to (i) evaluate covariate effects on C-ss and (ii) compare the impact of different infusion rates on predicted C-ss. The best dose was selected based on the highest probability that the C-ss achieved would lie within the therapeutic range. Results A two-compartment linear model with additive and proportional residual error for general medical unit patients and only a proportional error for patients in ICU provided the best description of the data. Both CrCL and weight were found to affect significantly clearance and volume of distribution of the central compartment, respectively. Simulations suggested that the best doses for patients in the ICU setting were 50 IU kg(-1) per 12 h (4.2 IU kg(-1) h(-1)) if CrCL < 30 ml min(-1); 60 IU kg(-1) per 12 h (5.0 IU kg(-1) h(-1)) if CrCL was 30-50 ml min(-1); and 70 IU kg(-1) per 12 h (5.8 IU kg(-1) h(-1)) if CrCL > 50 ml min(-1). The best doses for patients in the general medical unit were 60 IU kg(-1) per 12 h (5.0 IU kg(-1) h(-1)) if CrCL < 30 ml min(-1); 70 IU kg(-1) per 12 h (5.8 IU kg(-1) h(-1)) if CrCL was 30-50 ml min(-1); and 100 IU kg(-1) per 12 h (8.3 IU kg(-1) h(-1)) if CrCL > 50 ml min(-1). These best doses were selected based on providing the lowest equal probability of either being above or below the therapeutic range and the highest probability that the C-ss achieved would lie within the therapeutic range. Conclusion The dose of enoxaparin should be individualized to the patients' renal function and weight. There is some evidence to support slightly lower doses of CII enoxaparin in patients in the ICU setting.

Development of an animal repellent - selection, efficacy and presentation

Under some circumstances it may be desirable to repel herbivorous pests (e. g. goats and wallabies) from plants (e. g. horticultural or forestry seedlings) rather than to kill them. These circumstances may include using these animals as a resource at a later time, and there may also be welfare, public perception or legislative issues where repelling animals from particular plants or area is preferable to killing them. The first experiment tested the efficacy of 5 different materials (tiger fecal extract, maggot brew-the liquid exudate from a flyblown goat, capsaicin, dog urine, and burnt goat hair, skin and carcass+fat) to repel groups of goats in a feedlot pen from 1 trough of feed when another trough of feed was available to them to eat. Each repellent was tested on 5 groups of mixed age female goats for periods of 3 days. All 5 groups were exposed to the 5 repellents. Both tiger fecal extract and maggot brew reduced intake of feed from the 'protected' feed trough and significantly (P < 0.05) delayed 'normal' feeding behaviour by more than 5 h from that trough. The repellents became less effective with repeated use even with different groups of goats. The reduction in effectiveness was indicated by higher intakes of feed and earlier feeding from the protected trough. This habituation to the repellents, where the effectiveness is reduced with repeated exposure, is of concern. In the second experiment, we selected the most effective repellent (tiger fecal extract) and tested its efficacy under similar conditions, after the repellent had been mixed with a carrier (bentonite) in an endeavour to increase the duration of its effectiveness. This repellent was significantly more effective in repelling groups of 3 goats in a feedlot pen from 1 trough of feed for 3 days, when another trough of feed was available to them to eat.

Does nephron number matter in the development of kidney disease?

The total number of nephrons in normal human kidneys varies over a 10-fold range. This variation in total nephron number leads us to question whether low nephron number increases the risk of renal disease in adulthood. This review considers the available evidence in humans linking low nephron number/reduced nephron endowment and the susceptibility to renal disease. Total nephron number in humans has been directly correlated with birth weight and inversely correlated with age, mean glomerular volume, and hypertension. Low nephron number may be the result of suboptimal nephrogenesis during kidney development and/or loss of nephrons once nephrogenesis has been completed. Low nephron number is frequently, but not always, associated with hypertrophy of remaining glomeruli. This compensatory hypertrophy has also been associated with a greater susceptibility for kidney disease. Three human studies have reported reduced nelphron number in subjects with a history of hypertension. This correlation has been observed in White Europeans, White Americans (but not African Americans) and Australian Aborigines. Studies in additional populations are required, as well as a greater understanding of the fetal environmental and genetic determinants of low nephron number.

Relationships of activity and sugar drink intake on fat mass development in youths

Purpose: To determine whether a significant relationship exists between fat mass (FM) development and physical activity (PA) and/or sugar-sweetened drink (SD) consumption in healthy boys and girls aged 8-19 yr. Methods: A total of 105 males and 103 females were assessed during childhood and adolescence for a maximum of 7 yr and a median of 5 yr. Height was measured biannually. Fat-free mass (FFM) and FM were assessed annually by dual x-ray absorptiometry (DXA). PA was evaluated two to three times annually using the PAQ-C/A. Energy intake and SD were assessed using a 24-h dietary intake questionnaire also completed two to three times per year. Years from peak height velocity were used as a biological maturity age indicator. Multilevel random effects models were used to test the relationship. Results: When controlling for maturation, FFM, and energy intake adjusted for SD, PA level was negatively related to FM development in males (P < 0.05) but not in females (P > 0.05). In contrast, there was no relationship between SD and FM development of males or females (P > 0.05). There was also no interaction effect between SD and PA (P > 0.05) with FM development. Conclusion: This finding tends support to the idea that increasing PA in male youths aids in the control of FM development. Models employed showed no relationship between SD and FM in either gender.

Comparison of growth and development of the red-tailed phascogale (Phascogale calura) in three captive colonies

The red-tailed phascogale ( Phascogale calura) is an endangered dasyurid species that has recently been brought into captivity in an effort to increase numbers before release back into the wild. As part of investigations into the reproductive biology of the species, information on the growth and development of young was collected throughout lactation from litters raised in three separate colonies. Growth curves for aging young throughout lactation and a timetable of developmental changes were constructed. While two colonies, with fourth- and fifth-generation captive animals, showed no significant difference in growth, animals from a third colony that had been wild caught before breeding displayed a slower rate of growth from 34 days of age. The pattern of development resembled that of other dasyurids, with young left in the nest from 44 days of age, fully furred by 78 days and weaned between 90 and 110 days. Captive phascogales invest heavily in their young, with litters weighing 380 +/- 67% of maternal bodyweight at weaning.

Virtual teams and group member dissimilarity - Consequences for the development of trust

The consequences of demographic dissimilarity for group trust in work teams was examined in a virtual (computer-mediated) and a face-to-face (FTF) environment. Demographic dissimilarity (based on age, gender, country of birth, enrolled degree) was predicted to be negatively associated with group trust in the FTF environment but not in the computer-mediated environment. Participants worked in small groups on a creative task for 3 consecutive days. In the computer-mediated environment, participants worked on the task for an hour per day. In the FTF environment, participants worked on the task for 20 minutes per day. Partial support was found for the effectiveness of computer-mediated groups in reducing the negative consequences of dissimilarity. Age dissimilarity was negatively related to trust in FTF groups but not in computer-mediated groups. Birthplace dissimilarity was positively related to trust in computer-mediated groups. Implications for the successful management of virtual teams are discussed.

Employment services in an age of e-government

The increasing use of information and communications technologies among government departments and non-government agencies has fundamentally changed the implementation of employment services policy in Australia. The administrative arrangements for governing unemployment and unemployed people are now constituted by a complex contractual interplay between government departments as ‘purchasers’ and a range of small and large private organizations as ‘providers’. Assessing, tracking and monitoring the activities of unemployed people through the various parts of the employment services system has been made possible by developments in information technology and tailored computer programs. Consequently, the discretionary capacity that is traditionally associated with ‘street-level bureaucracy’ has been partly transformed into more prescriptive forms of ‘screen-level bureaucracy’. The knowledge embedded in these new computer-based technologies is considered superior because it is based on ‘objective calculations’, rather than subjective assessments of individual employees. The relationship between the sociopolitical context of unemployment policy and emerging forms of e-government is explored using illustrative findings from a qualitative pilot study undertaken in two Australian sites. The findings suggest that some of the new technologies in the employment services system are welcomed, while other applications are experienced as contradictory to the aims of delivering a personalized and respectful service.

The graying of R&D workgroups: The effects of age diversity on developing publicly usable knowledge

Does the graying of scientific research teams matter? This study addresses how workgroup processes and external environmental factors contribute and inhibit the effect of age diversity in R&D project groups on the production of innovative publicly usable knowledge outcomes in the form of publication outputs. We examined the relationships between group age diversity (age cohort diversity, mean age, age dispersion), R&D workgroup member self-ratings of workgroup processes, their supervisor�s assessment of the external environmental factors the project groups faced, and their supervisor�s ratings of group performance, the number of scientific publicly available publications produced by the group and the use of multiple authorships on publications. Usable data was obtained from 32 R&D workgroups of a large Government Agricultural Research and Development Agency. Consistent with the literature, workgroup processes and external environmental factors were found to directly effect innovation outcomes. Contrary to expectation, but consistent with Social Identity theory, workgroup age diversity generally negatively impacted upon innovation outcomes. An exception was where multiple authorship on publications for project groups increased as the dispersion of age within groups increased. Importantly, workgroups that were both more age homogeneous and perceived to have optimally functioning work processes produced more R&D innovation outcomes than other groups. Generally, these differences appear to be related to the greater division of labor practices (and less multi-tasking) employed by the older and more homogeneous workgroups. Implications for R&D workgroup resource theory and practices are discussed.

Development of a non-intrusive system to monitor radial pulse wave velocity

Understanding arterial distensibility has shown to be important in the pathogenesis of cardiovascular abnormalities like hypertension. It is also known that arterial pulse wave velocity (PWV) is a measure of the elasticity or stiffness of peripheral arterial blood vessels. However, it generally requires complex instrumentations to have an accurate measurement and not suited for continual monitoring. In this paper, it describes a simple and non-intrusive method to detect the cardiovascular pulse from a human wrist above the radial artery and a fingertip. The main components of this proposed method are a piezoelectric transducer and a photo-plethysmography circuitry. 5 healthy adults (4 male) with age ranging from 25 to 38 years were recruited. The timing consistency of the detected pulsations is first evaluated and compared to that obtained from a commercial electrocardiogram. Furthermore, the derived PWV is then assessed by the predicted values attained from regression equations of two previous similar studies. The results show good correlations (p < 0.05) and similarities for the former and latter respectively. The simplicity and non-invasive nature of the proposed method can be attractive for even younger or badly disturbed patients. Moreover, it can be used for prolonged monitoring for the comfort of the patients.

The development of self-recognition in mirrors and live videos

By 24-months of age most children show mirror self-recognition. When surreptitiously marked on their forehead and then presented with a mirror, they explore their own head for the unexpected mark. Here we demonstrate that self-recognition in mirrors does not generalize to other visual feedback. We tested 80 children on mirror and live video versions of the task. Whereas 90% of 24-month olds passed the mirror version, only 35% passed the video version. Seventy percent of 30-month olds showed video selfrecognition and only by age 36-months did the pass rate on the video version reach 90%. It remains to be y 24-months of age most children show mirror self-recognition. When surreptitiously marked on their forehead and then presented with a mirror, they explore their own head for the unexpected mark. Here we demonstrate that self-recognition in mirrors does not generalize to other visual feedback. We tested 80 children on mirror and live video versions of the task. Whereas 90% of 24-month olds passed the mirror version, only 35% passed the video version. Seventy percent of 30-month olds showed video selfrecognition and only by age 36-months did the pass rate on the video version reach 90%. It remains to be

Do lutein, zeaxanthin, and macular pigment optical density differ with age or age-related maculopathy?

Background and aims Current age-related macular disease (ARMD) treatment includes antioxidant supplementation. Lutein (L) and zeaxanthin (Z) are antioxidants that make up macularpigment within the retina and may reduce the risk of developing ARMD. Ageing and smoking are leading risk factors for developing ARMD. We investigated differences in dietary, supplemental and retinal L and Z, and smoking habits in healthy younger eyes (HY), healthy older eyes (HO) and eyes with an early form of ARMD called age-related maculopathy (ARM). Methods HO, HY and ARM groups were assessed for dietary intakes of L and Z using food diaries. Smoking habits and self-administered quantities of L and Z were obtained via questionnaire. Retinal L and Z levels (macularpigmentopticaldensity, or MPOD) were determined using heterochromatic flicker photometry. Results No significant difference was demonstrated for dietary L and Z intake (?2 = 4.983, p = 0.083) or for MPOD between groups (F = 0.40, p = 0.67). There was a significant difference between the HY (mean ± sd: 1.20 ± 2.99), HO (4.51 ± 7.05) ARM groups (9.15 ± 12.28) for pack years smoked (?2 = 11.61, p = 0.03). Conclusions Our results do not support the theory that ARM develops as a result of L and Z deficiency. Higher pack years smoked may be a factor in disease development. Dietary and supplementary L and Z levels must be obtained when assessing MPOD between groups or over time.

An investigation into children’s inductive reasoning strategies:What drives the development of category induction?

In a series of studies, I investigated the developmental changes in children’s inductive reasoning strategy, methodological manipulations affecting the trajectory, and driving mechanisms behind the development of category induction. I systematically controlled the nature of the stimuli used, and employed a triad paradigm in which perceptual cues were directly pitted against category membership, to explore under which circumstances children used perceptual or category induction. My induction tasks were designed for children aged 3-9 years old using biologically plausible novel items. In Study 1, I tested 264 children. Using a wide age range allowed me to systematically investigate the developmental trajectory of induction. I also created two degrees of perceptual distractor – high and low – and explored whether the degree of perceptual similarity between target and test items altered children’s strategy preference. A further 52 children were tested in Study 2, to examine whether children showing a perceptual-bias were in fact basing their choice on maturation categories. A gradual transition was observed from perceptual to category induction. However, this transition could not be due to the inability to inhibit high perceptual distractors as children of all ages were equally distracted. Children were also not basing their strategy choices on maturation categories. In Study 3, I investigated category structure (featural vs. relational category rules) and domain (natural vs. artefact) on inductive preference. I tested 403 children. Each child was assigned to either the featural or relational condition, and completed both a natural kind and an artefact task. A further 98 children were tested in Study 4, on the effect of using stimuli labels during the tasks. I observed the same gradual transition from perceptual to category induction preference in Studies 3 and 4. This pattern was stable across domains, but children developed a category-bias one year later for relational categories, arguably due to the greater demands on executive function (EF) posed by these stimuli. Children who received labels during the task made significantly more category choices than those who did not receive labels, possibly due to priming effects. Having investigated influences affecting the developmental trajectory, I continued by exploring the driving mechanism behind the development of category induction. In Study 5, I tested 60 children on a battery of EF tasks as well as my induction task. None of the EF tasks were able to predict inductive variance, therefore EF development is unlikely to be the driving factor behind the transition. Finally in Study 6, I divided 252 children into either a comparison group or an intervention group. The intervention group took part in an interactive educational session at Twycross Zoo about animal adaptations. Both groups took part in four induction tasks, two before and two a week after the zoo visits. There was a significant increase in the number of category choices made in the intervention condition after the zoo visit, a result not observed in the comparison condition. This highlights the role of knowledge in supporting the transition from perceptual to category induction. I suggest that EF development may support induction development, but the driving mechanism behind the transition is an accumulation of knowledge, and an appreciation for the importance of category membership.

Development of esophageal hypersensitivity following experimental duodenal acidification

OBJECTIVES: As visceral afferents from different regions of the gastrointestinal tract converge at the level of the spinal cord, we hypothesized that sensitization of one gut organ would induce visceral hypersensitivity in another gut organ, remote to the sensitizing stimulus. METHODS: Protocol 1: Eight healthy male volunteers, age 30 +/- 8.2 yr, underwent three studies on different days. Esophageal pain thresholds (PT) were recorded at 10-min intervals prior to and for 2 h following a 30-min duodenal infusion of either 0.15 M hydrochloric acid (HCl), saline, or no infusion. Five subjects repeated the study to demonstrate reproducibility. Protocol 2: Esophageal evoked potentials (EEP) were studied in six subjects on two occasions prior to and 1 h after a 30-min duodenal infusion of 0.15 M HCl or saline. RESULTS: Protocol 1: After acid infusion, there were reproducible reductions in esophageal PT (ICC = 0.88), which were maximal at 110 min (15.05 +/- 2.25 mA) (p < 0.002). Following saline infusion there was an increase in esophageal PT (ICC = 0.71), which was similar to the no-infusion condition (6.21 +/- 1.54 mA vs 8.5 + 7.6 mA; p > 0.05). Protocol 2: Esophageal sensation scores increased (p= 0.02) after acid, but not after saline infusion (p= 0.1). A comparison of the latencies of EEP components prior to and following acid and saline infusion revealed a reduction in the N1 (p= 0.02) and P2 components (p= 0.04). CONCLUSION: This study provides the first objective evidence that duodenal acidification can induce esophageal hypersensitivity associated with changes in sensitivity of the central visceral pain pathway. As the esophagus was remote from the sensitizing stimulus, central sensitization of spinal dorsal horn neurons is likely to have contributed to these changes.

The development of color categories in two languages: a longitudinal study

This study unites investigations into the linguistic relativity of color categories with research on children's category acquisition. Naming, comprehension, and memory for colors were tracked in 2 populations over a 3-year period. Children from a seminomadic equatorial African culture, whose language contains 5 color terms, were compared with a group of English children. Despite differences in visual environment, language, and education, they showed similar patterns of term acquisition. Both groups acquired color vocabulary slowly and with great individual variation. Those knowing no color terms made recognition errors based on perceptual distance, and the influence of naming on memory increased with age. An initial perceptually driven color continuum appears to be progressively organized into sets appropriate to each culture and language. PsycINFO Database Record (c) 2009 APA, all rights reserved

A comparison of the vocational training system of Britain and West Germany as experienced by minimum-age school leavers.

The sectoral and occupational structure of Britain and West Germany has increasingly changed over the last fifty years from a manual manufacturing based to a non-manual service sector based one. There has been a trend towards more managerial and less menial type occupations. Britain employs a higher proportion of its population in the service sector than in manufacturing compared to West Germany, except in retailing, where West Germany employs twice as many people as Britain. This is a stable sector of the economy in terms of employment, but the requirements of the workforce have changed in line with changes in the industry in both countries. School leavers in the two countries, faced with the same options (FE, training schemes or employment) have opted for the various options in different proportions: young Germans are staying longer in education before embarking on training and young Britons are now less likely to go straight into employment than ten years ago. Training is becoming more accepted as the normal route into employment with government policy leading the way, but public opinion still slow to respond. This study investigates how vocational training has adapted to the changing requirements of industry, often determined by technological advancements. In some areas e.g. manufacturing industry the changes have been radical, in others such as retailing they have not, but skill requirements, not necessarily influenced by technology have changed. Social-communicative skills, frequently not even considered skills and therefore not included in training are coming to the forefront. Vocational training has adapted differently in the two countries: in West Germany on the basis of an established over-defined system and in Britain on the basis of an out-dated ill-defined and almost non-existent system. In retailing German school leavers opt for two or three year apprenticeships whereas British school leavers are offered employment with or without formalised training. The publicly held view of the occupation of sales assistant is one of low-level skill, low intellectual demands and a job anyone can do. The traditional skills - product knowledge, selling and social-communicative skills have steadily been eroded. In the last five years retailers have recognised that a return to customer service, utilising the traditional skills was going to be needed of their staff to remain competitive. This requires training. The German retail training system responded by adapting its training regulations in a long consultative process, whereas the British experimented with YTS, a formalised training scheme nationwide being a new departure. The thesis evaluates the changes in these regulations. The case studies in four retail outlets demonstrate that it is indeed product knowledge and selling and social-communicative skills which are fundamental to being a successful and content sales assistant in either country. When the skills are recognised and taught well and systematically the foundations for career development in retailing are laid in a labour market which is continually looking for better qualified workers. Training, when planned and conducted professionally is appreciated by staff and customers and of benefit to the company. In retailing not enough systematic training, to recognisable standards is carried out in Britain, whereas in West Germany the training system is nevertheless better prepared to show innovative potential as a structure and is in place on which to build. In Britain the reputation of the individual company has a greater role to play, not ensuring a national provision of good training in retailing.