820 resultados para Inappropriate Prescribing


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Extinction following positively reinforced operant conditioning reduces response frequency, at least in part through the aversive or frustrative effects of non-reinforcement. According to J.A. Gray's theory, non-reinforcement activates the behavioural inhibition system which in turn causes anxiety. As predicted, anxiolytic drugs including benzodiazepines affect the operant extinction process. Recent studies have shown that reducing GABA-mediated neurotransmission retards extinction of aversive conditioning. We have shown in a series of studies that anxiolytic compounds that potentiate GABA facilitate extinction of positively reinforced fixed-ratio operant behaviour in C57B1/6 male mice. This effect does not occur in the early stages of extinction, nor is it dependent on cumulative effects of the compound administered. Potentiation of GABA at later stages has the effect of increasing sensitivity to the extinction contingency and facilitates the inhibition of the behaviour that is no longer required. The GABAergic hypnotic, zolpidem, has the same selective effects on operant extinction in this procedure. The effects of zolpidem are not due to sedative action. There is evidence across our series of experiments that different GABA-A subtype receptors are involved in extinction facilitation and anxiolysis. Consequently, this procedure may not be an appropriate model for anxiolytic drug action, but it may be a useful technique for analysing the neural bases of extinction and designing therapeutic interventions in humans where failure to extinguish inappropriate behaviours can lead to pathological conditions such as post-traumatic stress disorder.

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This paper draws upon fieldwork undertaken across Kenya, Zambia, Mozambique and South Africa to present a reflective overview of the use of financial services amongst the poorest members of society. It considers the role that access to a portfolio of financial products and services may have as a contributory factor in poverty alleviation, but also how inappropriate use of these mechanisms may exacerbate a descent into poverty. This work draws upon the notions of poverty pools and the rise of fall of low income households in and out of poverty, alongside the contributory nature of vicious cycles of economic and political poverty. Drawing on fieldwork experiences it presents a synopsis of the types of financial mechanisms commonly in use on the African continent, as well as examples of public, private and civil society partnerships that are producing services specifically tailored for those in extreme and absolute poverty.

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Previous research has shown that listening to stories supports vocabulary growth in preschool and school-aged children and that lexical entries for even very difficult or rare words can be established if these are defined when they are first introduced. However, little is known about the nature of the lexical representations children form for the words they encounter while listening to stories, or whether these are sufficiently robust to support the child’s own use of such ‘high-level’ vocabulary. This study explored these questions by administering multiple assessments of children’s knowledge about a set of newly-acquired vocabulary. Four- and 6-year-old children were introduced to nine difficult new words (including nouns, verbs and adjectives) through three exposures to a story read by their class teacher. The story included a definition of each new word at its first encounter. Learning of the target vocabulary was assessed by means of two tests of semantic understanding – a forced choice picture-selection task and a definition production task – and a grammaticality judgment task, which asked children to choose between a syntactically-appropriate and syntactically-inappropriate usage of the word. Children in both age groups selected the correct pictorial representation and provided an appropriate definition for the target words in all three word classes significantly more often than they did for a matched set of non-exposed control words. However, only the older group was able to identify the syntactically-appropriate sentence frames in the grammaticality judgment task. Further analyses elucidate some of the components of the lexical representations children lay down when they hear difficult new vocabulary in stories and how different tests of word knowledge might overlap in their assessment of these components.

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The financial crisis of 2008 led to new international regulatory controls for the governance, risk and compliance of financial services firms. Information systems play a critical role here as political, functional and social pressures may lead to the deinstitutionalization of existing structures, processes and practices. This research examines how an investment management system is introduced by a leading IT vendor across eight client sites in the post-crisis era. Using institutional theory, it examines changes in working practices occurring at the environmental and organizational levels and the ways in which technological interventions are used to apply disciplinary effects in order to prevent inappropriate behaviors. The results extend the constructs of deinstitutionalization and identify empirical predictors for the deinstitutionalization of compliance and trading practices within financial organizations.

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Purpose of review There is growing interest in applying metabolic profiling technologies to food science as this approach is now embedded into the foodomics toolbox. This review aims at exploring how metabolic profiling can be applied to the development of functional foods. Recent findings One of the biggest challenges of modern nutrition is to propose a healthy diet to populations worldwide that must suit high inter-individual variability driven by complex gene-nutrient-environment interactions. Although a number of functional foods are now proposed in support of a healthy diet, a one-size-fits-all approach to nutrition is inappropriate and new personalised functional foods are necessary. Metabolic profiling technologies can assist at various levels of the development of functional foods, from screening for food composition to identification of new biomarkers of food intake to support diet intervention and epidemiological studies. Summary Modern ‘omics’ technologies, including metabolic profiling, will support the development of new personalised functional foods of high relevance to twenty-first-century medical challenges such as controlling the worldwide spread of metabolic disorders and ensuring healthy ageing.

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Analysis of microbial gene expression during host colonization provides valuable information on the nature of interaction, beneficial or pathogenic, and the adaptive processes involved. Isolation of bacterial mRNA for in planta analysis can be challenging where host nucleic acid may dominate the preparation, or inhibitory compounds affect downstream analysis, e.g., quantitative reverse transcriptase PCR (qPCR), microarray, or RNA-seq. The goal of this work was to optimize the isolation of bacterial mRNA of food-borne pathogens from living plants. Reported methods for recovery of phytopathogen-infected plant material, using hot phenol extraction and high concentration of bacterial inoculation or large amounts of infected tissues, were found to be inappropriate for plant roots inoculated with Escherichia coli O157:H7. The bacterial RNA yields were too low and increased plant material resulted in a dominance of plant RNA in the sample. To improve the yield of bacterial RNA and reduce the number of plants required, an optimized method was developed which combines bead beating with directed bacterial lysis using SDS and lysozyme. Inhibitory plant compounds, such as phenolics and polysaccharides, were counteracted with the addition of high-molecular-weight polyethylene glycol and hexadecyltrimethyl ammonium bromide. The new method increased the total yield of bacterial mRNA substantially and allowed assessment of gene expression by qPCR. This method can be applied to other bacterial species associated with plant roots, and also in the wider context of food safety.

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Context. Rattus tanezumi (the Asian house rat) is the principal rodent pest of rice and coconut crops in the Philippines. Little is known about the population and breeding ecology of R. tanezumi in complex agroecosystems; thus, current methods of rodent control may be inappropriate or poorly implemented. Aims. To investigate the habitat use, population dynamics and breeding biology of R. tanezumi in complex lowland agroecosystems of the Sierra Madre Biodiversity Corridor, Luzon, and to develop ecologically based rodent management (EBRM) strategies that will target specific habitats at specific times to improve cost-efficiency and minimise non-target risks. Methods. An 18-month trapping study was conducted in rice monoculture, rice adjacent to coconut, coconut groves, coconut-based agroforest and forest habitats. Trapped animals were measured, marked and assessed for breeding condition. Key results. Five species of rodent were captured across all habitats with R. tanezumi the major pest species in both the rice and coconut crops. The stage of the rice crop was a major factor influencing the habitat use and breeding biology of R. tanezumi. In rice fields, R. tanezumi abundance was highest during the tillering to ripening stages of the rice crop and lowest during the seedling stage, whereas in coconut groves abundance was highest from the seedling to tillering stage of nearby rice crops. Peaks in breeding activity occurred from the booting stage of the rice crop until just after harvest, but >10% of females were in breeding condition at each month of the year. Conclusions. In contrast with the practices applied by rice farmers in the study region, the most effective time for lethal management based on the breeding ecology of R. tanezumi is likely to be during the early stages of the rice crop, before the booting stage. Farmers generally apply control actions as individuals. We recommend coordinated community action. Continuous breeding throughout the year may necessitate two community campaigns per rice cropping season. To limit population growth, the most effective time to reduce nesting habitat is from the booting stage until harvest. Implications. By adopting EBRM strategies, we expect a reduction in costs associated with rodent control, as well as improved yield and reduced risk to non-target species.

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Platelets are involved in the maintenance of haemostasis but their inappropriate activation leads to thrombosis, a principal trigger for heart attack and ischemic stroke. Although platelets circulate in isolation, upon activation they accumulate or aggregate together to form a thrombus, where they function in a coordinated manner to prevent loss of blood and control wound repair. Recent reports indicate that the stability and functions of a thrombus are maintained through sustained, contact dependent signalling between platelets. Given the role of gap junctions in the coordination of tissue responses, it was hypothesized that gap junctions may be present within a thrombus and mediate intercellular communication between platelets. Therefore studies were performed to explore the presence and functions of connexins in platelets. In this brief review, the roles of hemichannels and gap junctions in the control of thrombosis and haemostasis and the future directions for this research will be discussed.

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The Pre-Pottery Neolithic A (PPNA) period in Southwest Asia is essential for our understanding of the transition to sedentary, agricultural communities. Developments in architecture are key to understanding this transition, but many aspects of PPNA architecture remain elusive, such as construction techniques, the selection of building materials, and the functional use of space. The primary aim of the research described within this contribution was to build a PPNA-like structure in order to answer questions about PPNA architecture in general, while specifically addressing issues raised by the excavation of structures at the site of WF16, Southern Jordan. The second aim was to display a ‘PPNA’ building to visitors in Wadi Faynan to enhance their understanding of the period. The experimental construction based on one of the WF16 structures showed that 1) required materials can be acquired locally; 2) a construction technique using mud layers as described in this paper was likely used; 3) flat, or very slightly dome-shaped, roofs are functional and can also be used as a solid working platform; 4) the WF16 small semi-subterranean buildings appear inappropriate for housing a nuclear family unit.

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This chapter explores the spatialities of children's rights through a focus on how children's paid and unpaid work in Sub-Saharan Africa intersects with wider debates about child labor, child domestic work and young caregiving. Several tensions surround the universalist and individualistic nature of the rights discourse in the context of Sub-Saharan Africa and policymakers, practitioners, children and community members have emphasized children's responsibilities to their families and communities, as well as their rights. The limitations of ILO definitions of child labor and child domestic work and UNCRC concerns about 'hazardous' and 'harmful' work are highlighted through examining the situation of children providing unpaid domestic and care support to family members in the private space of their own or a relative's home. Differing perspectives towards young caregiving have been adopted to date by policymakers and practitioners in East Africa, ranging from a child labor/ child protection/ abolitionist approach, to a 'young carers'/ child-centered rights perspective. These differing perspectives influence the level and nature of support and resources that children involved in care work may be able to access. A contextual, multi-sectorial approach to young caregiving is needed that seeks to understand children's, family members' and community members' perceptions of what constitutes inappropriate caring responsibilities within particular cultural contexts and how these should best be alleviated.

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Inappropriate platelet aggregation creates a cardiovascular risk that is largely managed with thienopyridines and aspirin. Although effective, these drugs carry risks of increased bleeding and drug 'resistance', underpinning a drive for new antiplatelet agents. To discover such drugs, one strategy is to identify a suitable druggable target and then find small molecules that modulate it. A good and unexploited target is the platelet collagen receptor, GPVI, which promotes thrombus formation. To identify inhibitors of GPVI that are safe and bioavailable, we docked a FDA-approved drug library into the GPVI collagen-binding site in silico. We now report that losartan and cinanserin inhibit GPVI-mediated platelet activation in a selective, competitive and dose-dependent manner. This mechanism of action likely underpins the cardioprotective effects of losartan that could not be ascribed to its antihypertensive effects. We have, therefore, identified small molecule inhibitors of GPVI-mediated platelet activation, and also demonstrated the utility of structure-based repurposing.

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There were 338 road fatalities on Irish roads in 2007. Research in 2007 by the Road Safety Authority in Ireland states that young male drivers (17 – 25 years) are seven times more likely to be killed on Irish roads than other road users. The car driver fatality rate was found to be approximately 10 times higher for young male drivers than for female drivers in 2000. Young male drivers in particular demonstrate a high proclivity for risky driving behaviours. These risky behaviours include drink driving, speeding, rug-driving and engaging in aggressive driving. Speed is the single largest contributing factor to road deaths in Ireland. Approximately 40% of fatal accidents are caused by excessive or inappropriate speed. This study focuses on how dangerous driving behaviours may be addressed through social marketing. This study analyses the appropriate level of fear that needs to be induced in order to change young male driving behaviour.

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Sparse coding aims to find a more compact representation based on a set of dictionary atoms. A well-known technique looking at 2D sparsity is the low rank representation (LRR). However, in many computer vision applications, data often originate from a manifold, which is equipped with some Riemannian geometry. In this case, the existing LRR becomes inappropriate for modeling and incorporating the intrinsic geometry of the manifold that is potentially important and critical to applications. In this paper, we generalize the LRR over the Euclidean space to the LRR model over a specific Rimannian manifold—the manifold of symmetric positive matrices (SPD). Experiments on several computer vision datasets showcase its noise robustness and superior performance on classification and segmentation compared with state-of-the-art approaches.

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Phagocyte superoxide production by a multicomponent NADPH oxidase is important in host defense against microbial invasion. However inappropriate NADPH oxidase activation causes inflammation. Endothelial cells express NADPH oxidase and endothelial oxidative stress due to prolonged NADPH oxidase activation predisposes many diseases. Discovering the mechanism of NADPH oxidase activation is essential for developing novel treatment of these diseases. The p47phox is a key regulatory subunit of NADPH oxidase; however, due to the lack of full protein structural information, the mechanistic insight of p47phox phosphorylation in NADPH oxidase activation remains incomplete. Based on crystal structures of three functional domains, we generated a computational structural model of the full p47phox protein. Using a combination of in silico phosphorylation, molecular dynamics simulation and protein/protein docking, we discovered that the C-terminal tail of p47phox is critical for stabilizing its autoinhibited structure. Ser-379 phosphorylation disrupts H-bonds that link the C-terminal tail to the autoinhibitory region (AIR) and the tandem Src homology 3 (SH3) domains, allowing the AIR to undergo phosphorylation to expose the SH3 pocket for p22phox binding. These findings were confirmed by site-directed mutagenesis and gene transfection of p47phox_/_ coronary microvascular cells. Compared with wild-type p47phoxcDNAtransfected cells, the single mutation of S379A completely blocked p47phox membrane translocation, binding to p22phox and endothelial O2 . production in response to acute stimulation of PKC. p47phox C-terminal tail plays a key role in stabilizing intramolecular interactions at rest. Ser-379 phosphorylation is a molecular switch which initiates p47phox conformational changes and NADPH oxidase-dependent superoxide production by cells.

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Purpose – The purpose of this paper is to provide a critical assessment of legal and regulatory impediments to effective governance of public-private partnerships (PPPs) in Kazakhstan. Design/methodology/approach – The qualitative study develops propositions from the PPP literature and then tests them against findings from in-depth interviews. Interviewees have been selected by a purposeful sampling from PPP projects in Kazakhstan as well as from national and regional PPP centres. Findings – The identified barriers to effective PPP management include irregularities in the PPP legal framework, such as lack of legal definition of a PPP and controversy with the government guarantee’s legal status for its long-term payments to partnerships; bureaucratic tariff setting for partnership services; non-existent opportunity for private asset ownership; and excessive government regulation of PPP workers’ wage rates. Practical implications – The partners’ opposing perspectives on a number of PPP issues show that management needs to identify and carefully reconcile stakeholder values in a partnership in order to achieve more effective PPP governance. Practitioners, particularly those in the public agencies, have to be concerned with ways to reduce the government overregulation of the private operators, which is likely to result in greater PPP flexibility in management and, ultimately, higher efficiency in delivering the public services. Originality/value – By elucidating multiple examples of overregulation and PPPs’ inefficiency, the paper demonstrates that the government dominance in PPP management is conceptually inappropriate. Instead, the government should adopt the concept of co-production and manage its relations with the private sector partner in a collaborative fashion.