866 resultados para Package inserts of medicines
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This paper presents direct radiocarbon measurements on horse skeletal remains from the Beaker period settlement at the site of Newgrange in Ireland, finds which have previously been argued as the earliest domestic horses in Ireland. The new determinations date the horse remains to the Irish Iron Age and shed important new light on the introduction of domestic horses to Ireland and to north-west Europe more generally. Although the new dates undermine the idea for the introduction of horses as part of a ‘Beaker package’, the early use of horse is not well defined archaeologically or chronologically and the earliest use of domestic horses in Ireland and Britain is still uncertain. This paper also identifies evidence for heavy bitting damage on the Iron Age Newgrange horse teeth and presents some possible parallels between the evidence from Newgrange and that at Tara, which has been previously linked with kingship rituals
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As in any field of scientific inquiry, advancements in the field of second language acquisition (SLA) rely in part on the interpretation and generalizability of study findings using quantitative data analysis and inferential statistics. While statistical techniques such as ANOVA and t-tests are widely used in second language research, this review article provides a review of a class of newer statistical models that have not yet been widely adopted in the field, but have garnered interest in other fields of language research. The class of statistical models called mixed-effects models are introduced, and the potential benefits of these models for the second language researcher are discussed. A simple example of mixed-effects data analysis using the statistical software package R (R Development Core Team, 2011) is provided as an introduction to the use of these statistical techniques, and to exemplify how such analyses can be reported in research articles. It is concluded that mixed-effects models provide the second language researcher with a powerful tool for the analysis of a variety of types of second language acquisition data.
The Impact of office productivity cloud computing on energy consumption and greenhouse gas emissions
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Cloud computing is usually regarded as being energy efficient and thus emitting less greenhouse gases (GHG) than traditional forms of computing. When the energy consumption of Microsoft’s cloud computing Office 365 (O365) and traditional Office 2010 (O2010) software suites were tested and modeled, some cloud services were found to consume more energy than the traditional form. The developed model in this research took into consideration the energy consumption at the three main stages of data transmission; data center, network, and end user device. Comparable products from each suite were selected and activities were defined for each product to represent a different computing type. Microsoft provided highly confidential data for the data center stage, while the networking and user device stages were measured directly. A new measurement and software apportionment approach was defined and utilized allowing the power consumption of cloud services to be directly measured for the user device stage. Results indicated that cloud computing is more energy efficient for Excel and Outlook which consumed less energy and emitted less GHG than the standalone counterpart. The power consumption of the cloud based Outlook (8%) and Excel (17%) was lower than their traditional counterparts. However, the power consumption of the cloud version of Word was 17% higher than its traditional equivalent. A third mixed access method was also measured for Word which emitted 5% more GHG than the traditional version. It is evident that cloud computing may not provide a unified way forward to reduce energy consumption and GHG. Direct conversion from the standalone package into the cloud provision platform can now consider energy and GHG emissions at the software development and cloud service design stage using the methods described in this research.
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Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the Medicines Use Review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services. Impact of findings on practice * Pharmacists and researchers can access the relevant ideas presented here in relation to patient satisfaction with pharmacy adherence services. * Researcher can use the conceptual framework as a basis for measuring the quality of pharmacy adherence services. * Community pharmacists can improve the quality of healthcare they provide by realizing concepts relevant to patient satisfaction with adherence services.
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In this study, the performance, yield and characteristics of a 16 year old photovoltaic (PV) system installation have been investigated. The technology, BP Saturn modules which were steel-blue polycrystalline silicon cells are no longer in production. A bespoke monitoring system has been designed to monitor the characteristics of 6 refurbished strings, of 18 modules connected in series. The total output of the system is configured to 6.5 kWp (series to parallel configuration). In addition to experimental results, the performance ratio (PR) of known values was simulated using PVSyst, a simulation software package. From calculations using experimental values, the PV system showed approximately 10% inferior power outputs to what would have been expected as standard test conditions. However, efficiency values in comparison to standard test conditions and the performance ratio (w75% from PVSyst simulations) over the past decade have remained practically the same. This output though very relevant to the possible performance and stability of aging cells, requires additional parametric studies to develop a more robust argument. The result presented in this paper is part of an on-going investigation into PV system aging effects.
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Objectives A pharmacy Central Intravenous Additives Service (CIVAS) provides ready to use injectable medicines. However, manipulation of a licensed injectable medicine may significantly alter the stability of drug(s) in the final product. The aim of this study was to develop a stability indicating assay for CIVAS produced dobutamine 500 mg in 50 ml dextrose 1% (w/v) prefilled syringes, and to allocate a suitable shelf life. Methods A stability indicating high performance liquid chromatography (HPLC) assay was established for dobutamine. The stability of dobutamine prefilled syringes was evaluated under storage conditions of 4°C (protected from light), room temperature (protected from light), room temperature (exposed to light) and 40°C (protected from light) at various time points (up to 42 days). Results An HPLC method employing a Hypersil column, mobile phase (pH=4.0) consisting of 82:12:6 (v/v/v) 0.05 M KH2PO4:acetonitrile:methanol plus 0.3% (v/v) triethylamine with UV detection at λ=280 nm was specific for dobutamine. Under different storage conditions only samples stored at 40°C showed greater than 5% degradation (5.08%) at 42 days and had the shortest T95% based on this criterion (44.6 days compared with 111.4 days for 4°C). Exposure to light also reduced dobutamine stability. Discolouration on storage was the limiting factor in shelf life allocation, even when dobutamine remained within 5% of the initial concentration. Conclusions A stability indicating HPLC assay for dobutamine was developed. The shelf life recommended for the CIVAS product was 42 days at 4°C and 35 days at room temperature when protected from light.
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In 2003 the CAP underwent a significant reform. Despite a seemingly endless turmoil of CAP reform, in 2005 the British government pressed for a new reform debate, and in the European Council meeting of December 2005 secured a commitment for the Commission “to undertake a full, wide ranging review covering all aspects of EU spending, including the CAP, ...” But but the initiative petered out, and the CAP ‘reform’ package proposed by the Commission, and then adopted by the European Parliament and the Council of Ministers in 2013, fell well short of the UK’s initial ambition. The chapter attempts to explore the reasons leading to the UK’s failed policy initiative.
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Background: UK National Institute of Health and Clinical Excellence guidelines for obsessive compulsive disorder (OCD) specify recommendations for the treatment and management of OCD using a stepped care approach. Steps three to six of this model recommend treatment options for people with OCD that range from low-intensity guided self-help (GSH) to more intensive psychological and pharmacological interventions. Cognitive behavioural therapy (CBT), including exposure and response prevention, is the recommended psychological treatment. However, whilst there is some preliminary evidence that self-managed therapy packages for OCD can be effective, a more robust evidence base of their clinical and cost effectiveness and acceptability is required. Methods/Design: Our proposed study will test two different self-help treatments for OCD: 1) computerised CBT (cCBT) using OCFighter, an internet-delivered OCD treatment package; and 2) GSH using a book. Both treatments will be accompanied by email or telephone support from a mental health professional. We will evaluate the effectiveness, cost and patient and health professional acceptability of the treatments. Discussion: This study will provide more robust evidence of efficacy, cost effectiveness and acceptability of self-help treatments for OCD. If cCBT and/or GSH prove effective, it will provide additional, more accessible treatment options for people with OCD.
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The aim of this work is to build on the success of in vitro studies of an active packaging, produced by coating the surface of post-consumer recycled polyethylene terephthalate (PCRPET) package with an aqueous silicone solution (2%, v/v) containing an antifungal agent (potassium sorbate, KS). Antifungal efficacy was evaluated, in vivo, during the storage of raspberries, blackberries and blueberries by examining their shelf life extension. The packaging effectively delayed the growth of Botrytis by extending its lag-phase, which, in turn, extended the shelf life of the berries by up to 3d. Among the three berries tested, the packaging proved to be more advantageous in the case of raspberries, due to their physiological characteristics and shorter shelf life. Based on sensory panel evaluations, it was shown that the coating, containing KS, did not influence the packaging appearance and transparency, and the fruit did not suffer from any off-flavor development.
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Cannabis has a long history of anecdotal medicinal use and limited licensed medicinal use. Until recently, alleged clinical effects from anecdotal reports and the use of licensed cannabinoid medicines are most likely mediated by tetrahydrocannabinol by virtue of: 1) this cannabinoid being present in the most significant quantities in these preparations; and b) the proportion:potency relationship between tetrahydrocannabinol and other plant cannabinoids derived from cannabis. However, there has recently been considerable interest in the therapeutic potential for the plant cannabinoid, cannabidiol (CBD), in neurological disorders but the current evidence suggests that CBD does not directly interact with the endocannabinoid system except in vitro at supraphysiological concentrations. Thus, as further evidence for CBD’s beneficial effects in neurological disease emerges, there remains an urgent need to establish the molecular targets through which it exerts its therapeutic effects. Here, we conducted a systematic search of the extant literature for original articles describing the molecular phar- macology of CBD. We critically appraised the results for the validity of the molecular targets proposed. Thereafter, we considered whether the molecular targets of CBD identified hold therapeutic potential in relevant neurological diseases. The molecular targets identified include numerous classical ion channels, receptors, transporters, and enzymes. Some CBD effects at these targets in in vitro assays only manifest at high concentrations, which may be difficult to achieve in vivo, particularly given CBD’s relatively poor bioavailability. Moreover, several targets were asserted through experimental designs that demonstrate only correlation with a given target rather than a causal proof. When the molecular targets of CBD that were physiologically plausible were considered for their potential for exploitation in neurological therapeu- tics, the results were variable. In some cases, the targets identified had little or no established link to the diseases considered. In others, molecular targets of CBD were entirely consistent with those already actively exploited in relevant, clinically used, neurological treatments. Finally, CBD was found to act upon a number of targets that are linked to neurological therapeutics but that its actions were not consistent with modulation of such targets that would derive a therapeutically beneficial outcome. Overall, we find that while >65 discrete molecular targets have been reported in the literature for CBD, a relatively limited number represent plausible targets for the drug’s action in neurological disorders when judged by the criteria we set. We conclude that CBD is very unlikely to exert effects in neurological diseases through modulation of the endocannabinoid system. Moreover, a number of other molecular targets of CBD reported in the literature are unlikely to be of relevance owing to effects only being observed at supraphysiological concentrations. Of interest and after excluding unlikely and implausible targets, the remaining molecular targets of CBD with plausible evidence for involvement in therapeutic effects in neurological disorders (e.g., voltage-dependent anion channel 1, G protein-coupled receptor 55, CaV3.x, etc.) are associated with either the regulation of, or responses to changes in, intracellular calcium levels. While no causal proof yet exists for CBD’s effects at these targets, they represent the most probable for such investigations and should be prioritized in further studies of CBD’s therapeutic mechanism of action.
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We present a data-driven mathematical model of a key initiating step in platelet activation, a central process in the prevention of bleeding following Injury. In vascular disease, this process is activated inappropriately and causes thrombosis, heart attacks and stroke. The collagen receptor GPVI is the primary trigger for platelet activation at sites of injury. Understanding the complex molecular mechanisms initiated by this receptor is important for development of more effective antithrombotic medicines. In this work we developed a series of nonlinear ordinary differential equation models that are direct representations of biological hypotheses surrounding the initial steps in GPVI-stimulated signal transduction. At each stage model simulations were compared to our own quantitative, high-temporal experimental data that guides further experimental design, data collection and model refinement. Much is known about the linear forward reactions within platelet signalling pathways but knowledge of the roles of putative reverse reactions are poorly understood. An initial model, that includes a simple constitutively active phosphatase, was unable to explain experimental data. Model revisions, incorporating a complex pathway of interactions (and specifically the phosphatase TULA-2), provided a good description of the experimental data both based on observations of phosphorylation in samples from one donor and in those of a wider population. Our model was used to investigate the levels of proteins involved in regulating the pathway and the effect of low GPVI levels that have been associated with disease. Results indicate a clear separation in healthy and GPVI deficient states in respect of the signalling cascade dynamics associated with Syk tyrosine phosphorylation and activation. Our approach reveals the central importance of this negative feedback pathway that results in the temporal regulation of a specific class of protein tyrosine phosphatases in controlling the rate, and therefore extent, of GPVI-stimulated platelet activation.
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In this work, the Cloud Feedback Model Intercomparison (CFMIP) Observation Simulation Package (COSP) is expanded to include scattering and emission effects of clouds and precipitation at passive microwave frequencies. This represents an advancement over the official version of COSP (version 1.4.0) in which only clear-sky brightness temperatures are simulated. To highlight the potential utility of this new microwave simulator, COSP results generated using the climate model EC-Earth's version 3 atmosphere as input are compared with Microwave Humidity Sounder (MHS) channel (190.311 GHz) observations. Specifically, simulated seasonal brightness temperatures (TB) are contrasted with MHS observations for the period December 2005 to November 2006 to identify possible biases in EC-Earth's cloud and atmosphere fields. The EC-Earth's atmosphere closely reproduces the microwave signature of many of the major large-scale and regional scale features of the atmosphere and surface. Moreover, greater than 60 % of the simulated TB are within 3 K of the NOAA-18 observations. However, COSP is unable to simulate sufficiently low TB in areas of frequent deep convection. Within the Tropics, the model's atmosphere can yield an underestimation of TB by nearly 30 K for cloudy areas in the ITCZ. Possible reasons for this discrepancy include both incorrect amount of cloud ice water in the model simulations and incorrect ice particle scattering assumptions used in the COSP microwave forward model. These multiple sources of error highlight the non-unique nature of the simulated satellite measurements, a problem exacerbated by the fact that EC-Earth lacks detailed micro-physical parameters necessary for accurate forward model calculations. Such issues limit the robustness of our evaluation and suggest a general note of caution when making COSP-satellite observation evaluations.
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Approximate Bayesian computation (ABC) is a popular family of algorithms which perform approximate parameter inference when numerical evaluation of the likelihood function is not possible but data can be simulated from the model. They return a sample of parameter values which produce simulations close to the observed dataset. A standard approach is to reduce the simulated and observed datasets to vectors of summary statistics and accept when the difference between these is below a specified threshold. ABC can also be adapted to perform model choice. In this article, we present a new software package for R, abctools which provides methods for tuning ABC algorithms. This includes recent dimension reduction algorithms to tune the choice of summary statistics, and coverage methods to tune the choice of threshold. We provide several illustrations of these routines on applications taken from the ABC literature.
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In light of various reforms in recent years, this article provides a (re)assessment of the broad package of family-friendly employment rights and relevant dispute resolution procedure now available to pregnant workers and working carers. It exposes how the realities of working life for many pregnant workers and carers and the long standing desire to promote gender equality in informal care-work remain at odds with the legal framework. An argument is presented in favour of an approach that, based upon the concept of care ethics, better engages with the impact of the provisions upon crucial interdependent care relationships.
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Medicines and other Resources Utilized in Order to Cope Infants Diseases in the Family Daily Life: a qualitative study. The study proposes to investigate the use of medications, medicinal plants and other therapeutic resources to cope infants diseases in the domestic realm in an urban area. The ethnographic research method was utilized as referential, guiding the study for 10 months with 20 fortnight meetings in the domicile of 15 families. The study followed up 180 episodes of disease, 74,5% were treated, in a first instance, at home, resulting in the use of 212 therapeutic resources. The main type of therapeutic resource utilized was industrialized medicines, differing considerably from its clinic recommendations. The realm of the health services was more mobilized as a second treatment option. In the community realm, treatment of diseases known from the popular culture was performed via blessings and prayers. The families use medicines as cultural practices and the acceptance of some type of treatment depends on the expectations and experiences of the family.