N-type calcium channel blockers: Novel therapeutics for the treatment of pain

Highly selective Cav2.2 voltage-gated calcium channel (VGCC) inhibitors have emerged as a new class of therapeutics for the treatment of chronic and neuropathic pain. Cone snail venoms provided the first drug in class with FDA approval granted in 2005 to Prialt (ω-conotoxin MVIIA, Elan) for the treatment of neuropathic pain. Since this pioneering work, major efforts underway to develop alternative small molecule inhibitors of Cav2.2 calcium channel have met with varied success. This review focuses on the properties of the Cav2.2 calcium channel in different pain states, the action of ω-conotoxins GVIA, MVIIA and CVID, describing their structure-activity relationships and potential as leads for the design of improved Cav2.2 calcium channel therapeutics, and finally the development of small molecules for the treatment of chronic pain.

A paralysis in public health policy: water fluoridation in Queensland (1996-2006)

By focusing on developments between 1996 and 2006, this paper explains the reasons for one of Australia’s public health inconsistencies, the comparatively low adoption of adjusted water fluoridation in Queensland. As such, this work involved literature review and traditional historical method. In Queensland, parliamentary support for water fluoridation is conditional on community approval. Political ambivalence and the constraints of the “Fluoridation of Public Water Supplies Act (1963)” Qld have hindered the advocacy of water fluoridation. The political circumstance surrounding the “Lord Mayor’s Taskforce on Fluoridation Report” (1997) influenced its findings and confirms that Australia’s biggest local authority, the Brisbane City Council, failed to authoritatively analyse water fluoridation. In 2004, a private member’s bill to mandate fluoridation failed in a spectacular fashion. In 2005, an official systems review of Queensland Health recommended public debate about water fluoridation. Our principal conclusion is that without mandatory legislation, widespread implementationof water fluoridation in Queensland is most unlikely.

Use of routine data for determination of the population pharmacokinetics and enteral biovailability of phenytoin in neonates and infants with seizures

Objective: To investigate the population pharmacokinetics and the enteral bioavailability of phenytoin in neonates and infants with seizures. Methods: Data (5 mg kg-1 day-1) from 83 patients were obtained retrospectively from the medical records following written ethical approval. A one-compartment model was fitted to the data using NONMEM with FOCE-interaction. Between-subject variability (BSV) and interoccasion variability (IOV) were modelled exponentially together with a log transform-both-sides exponential residual unexplained variance (RUV) model. Covariates in nested models were screened for significance (X2, 1, 0.01). Model validity was determined by bootstrapping with replacement (N=500 samples) from the dataset. Results: The parameters of final pharmacokinetic were: Clearance (L h-1) = 0.826.(current Weight [kg]/70)0.75.(1+0.0692.(Postnatal age [days]-11)); Volume of distribution (L) = 74.2.(current Weight [kg]/70); Enteral bioavailability = 0.76; Absorption rate constant (h-1) = 0.167. BSV for clearance and volume of distribution were 74.2% and 65.6%, respectively. The IOV in clearance was 54.4%. The RUV was 51.1%. Final model parameters deviated from mean bootstrap estimates by

O método de tradução de João Ferreira de Almeida: O caso do Evangelho de Mateus

Entre as traduções da Bíblia utilizadas nos países lusófonos, a clássica versão de João Ferreira de Almeida é a mais popular, mesmo quando o conceito de equivalência dinâmica é o impulsionador principal na produção de novas versões bíblicas. O texto da tradução original, tal como Almeida escreveu, jamais foi publicado e até agora não se conhece a localização de algum presumido manuscrito dela. As primeiras edições foram impressas com a revisão e aprovação do clero da Igreja Reformada Holandesa. Partindo do que se conhece da vida e da história da tradução de João Ferreira de Almeida, das seis primeiras edições do seu Novo Testamento e das edições do século XVIII do seu Antigo Testamento, esta pesquisa desenvolve um método para obtenção de uma edição crítica da obra de João Ferreira de Almeida, e o testa, produzindo uma versão crítica do Evangelho de Mateus.

A Comunicação Mediada por Interfaces Digitais: a interação humana com os jogos digitais em celulares.

O trabalho é um estudo exploratório sobre o processamento de mensagens de entretenimento. O objetivo do trabalho foi propor e testar um modelo de processamento de mensagens dedicado à compreensão de jogos digitais. Para realizar tal tarefa realizou-se um extenso levantamento de técnicas de observação de usuários diante de softwares e mídias, para conhecer as qualidades e limitações de cada uma dessas técnicas, bem como de sua abordagem do problema. Também foi realizado um levantamento dos modelos de processamento de mensagens nas mídias tradicionais e nas novas mídias. Com isso foi possível propor um novo modelo de análise de processamento de mensagens de entretenimento. Uma vez criado o modelo teórico, fez-se preciso testar se os elementos propostos como participantes desse processo estavam corretos e se seriam capazes de capturar adequadamente as semelhanças e diferenças entre a interação entre jogadores e as diferentes mídias. Por essa razão, estruturou-se uma ferramenta de coleta de dados, que foi validada junto a designers de jogos digitais, uma vez que esses profissionais conhecem o processo de criação de um jogo, seus elementos e objetivos. Posteriormente, foi feito um primeiro teste, junto a praticantes de jogos digitais de diversas idades em computadores pessoais e TV digital interativa, a fim e verificar como os elementos do modelo relacionavam-se entre si. O teste seguinte fez a coleta de dados de praticantes de jogos digitais em aparelhos celulares, tendo como objetivo capturar como se dá a formação de uma experiência através do processamento da mensagem de entretenimento num meio cujas limitações são inúmeras: tamanho de tela e teclas, para citar algumas delas. Como resultado, verificou-se, por meio de testes estatísticos, que jogos praticados em meios como computadores pessoais atraem mais por seus aspectos estéticos, enquanto a apreciação de um jogo em aparelhos celulares depende muito mais de sua habilidade de manter a interação que um jogo praticado em PC. Com isso conclui-se que o processamento das mensagens de entretenimento depende da capacidade dos seus criadores em entender os limites de cada meio e usar adequadamente os elementos que compõe o ambiente de um jogo, para conseguir levar à apreciação do mesmo.(AU)

DEPRESSÃO, ANSIEDADE, ESTRESSE E QUALIDADE DE VIDA DE ESTUDANTES DE UNIVERSIDADES PÚBLICA E PRIVADA

Variáveis como depressão, ansiedade, estresse e qualidade de vida, oferecem indicativos de saúde e doença de jovens, estudantes em fase de formação profissional; é importante detectar sinais e sintomas leves ou graves, uma vez que representam quatro das dez principais causas de incapacidade no mundo. Assim, o presente estudo apresentou como objetivos: a) Caracterizar o perfil sócio demográfico dos estudantes universitários das duas instituições em estudo estudadas; b) Avaliar sintomas de depressão dos estudantes; c) Avaliar sinais de ansiedade e estresse dos estudantes; d) Avaliar a qualidade de vida geral dos estudantes; e) correlacionar as variáveis qualidade de vida, sinais e sintomas de ansiedade, depressão e estresse dos discentes d) correlacionar as variáveis qualidade de vida geral, sinais e sintomas de ansiedade, depressão dos discentes. Participaram da pesquisa 570 Universitários, 344 eram estudantes da Universidade Metodista de São Paulo e 226 da Universidade Federal do Amazonas, dos gêneros feminino e masculino, entre 16 e 55 anos, estudantes de diferentes cursos universitários da área da saúde e humanas. Para coleta de dados foram utilizados os seguintes Instrumentos: questionário de dados socioeconômicos e culturais; WHOQOL Breve Avaliação da Qualidade de Vida composta por 26 questões e EADS Escala de Depressão, Ansiedade e Estresse composta por 21 itens; .Os instrumentos, autoaplicáveis, foram feitos aplicados em ambiente acadêmico de sala de aula, com a devida autorização do professor e direção, informo que o projeto foi e aprovação pelo do Comitê de Ética (Plataforma Brasil) das respectivas universidades em questão. Os dados foram avaliados estatisticamente com auxílio do Programa SPSS versão 2.0 para Windows. Os resultados mostraram que a maioria da amostra é do curso de Psicologia, Gestão em Recursos Humanos e Pedagogia (39%), sendo do 1º e 4º(32%) anos, a escolha do curso foi 1ºopção (66%), mora com familiar (76,9%) e não mudou de residência para estudar na Universidade (83,3%). Os resultados revelaram que o melhor nível de QV encontra-se nos domínios Psicológico e Social da Instituição UFAM localizada no Estado do Amazonas. Os domínios mais afetados, ou seja, aquele, em que os universitários encontram mais prejuízo é no que se referem ao domínio Físico e Meio Ambiente de ambas as Instituições estudadas. Com relação ao EADS, pode se observar que a maior média apresentada refere-se ao fator estresse das duas Instituições estudadas, sendo representado pelo resultado de 15.00 (UMESP) e 12.70 (UFAM) e a média menor foi no fator ansiedade UMESP (7,51). Assim sendo, observa-se que os estudantes obtiveram um grau leve de estresse, depressão e ansiedade em ambas instituições estudadas. Analisando e ao correlacionar os domínios de qualidade de vida e as variáveis ansiedade, depressão e estresse, observou-se uma correlação significativa negativa em todas as variáveis, sendo maior entre depressão e domínios psicológico e ambiental,.Isso significa que quanto maior a depressão, menor a qualidade de vida nos domínios psicológico e ambiental. A partir dos resultados, sugerem-se estudos mais aprofundados.

Estimating the value of victory:English football

Professional English football combines publicly traded ownership shares with an active and observable wagering market. This article utilizes the information from these markets, presenting a model that may be used to estimate the impact of matches on club values. Such information is potentially useful as clubs assess the values of players and coaches based on their anticipated contributions to team performance. The article also illustrates the modelling of ‘binomial events,’ such as win/lose, hire/do not hire or approval/disapproval, and how market-determined price responses illuminate expectations.

Risk management in oil and gas construction projects in Vietnam

Purpose - The purpose of the paper is to the identify risk factors, which affect oil and gas construction projects in Vietnam and derive risk responses. Design/methodology/approach - Questionnaire survey was conducted with the involvement of project executives of PetroVietnam and statistical analysis was carried out in order to identify the major project risks. Subsequently, mitigating measures were derived using informal interviews with the various levels of management of PetroVietnam. Findings - Bureaucratic government system and long project approval procedures, poor design, incompetence of project team, inadequate tendering practices, and late internal approval processes from the owner were identified as major risks. The executives suggested various strategies to mitigate the identified risks. Reforming the government system, effective partnership with foreign collaborators, training project executives, implementing contractor evaluation using multiple criteria decision-making technique, and enhancing authorities of project people were suggested as viable approaches. Practical implications - The improvement measures as derived in this study would improve chances of project success in the oil and gas industry in Vietnam. Originality/value - There are several risk management studies on managing projects in developing countries. However, as risk factors vary considerably across industry and countries, the study of risk management for successful projects in the oil and gas industry in Vietnam is unique and has tremendous importance for effective project management.

Documentation of antibiotic prescribing controls in UK NHS hospitals

Objectives: To identify the types, prevalence and nature of antibiotic prescribing control documents within NHS hospitals in the UK. Methods: A self-completion postal questionnaire was sent to each Chief Pharmacist at 465 NHS hospitals in 2001/2002. This contained questions covering hospital demographics, and hospital antibiotic prescribing control documentation, including format, dissemination, approval and review processes. Results: In total, 253 (54%) completed questionnaires were returned. Of these, 168 respondents' hospitals had an antibiotic formulary, 107 had a policy for antibiotic prescribing and 216 had guidelines on antibiotic use. All three types of antibiotic prescribing documents were used by 82 hospitals but 18 did not have any documents; 44% of formularies, 45% of policies and 35% of guidelines were available electronically. The Drug and Therapeutics Committee was the most frequently cited body for document approval and approximately one-third of documents had been approved during the current year of the questionnaire. Only about one-half of responding hospitals had an annual review of documents. Conclusions: Despite publication of high-profile national guidance in response to growing concerns regarding antimicrobial resistance, there has been little increase in the use of antibiotic prescribing control documents in NHS hospitals over the past decade. It is clear that appropriate controls for antibiotic prescribing are not yet universally applied in the UK and recommendations for action have been proposed. © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved.

The release of nicotine from chewing gum formulations

The first clinically proven nicotine replacement product to obtain regulatory approval was Nicorette® gum. It provides a convenient way of delivering nicotine directly to the buccal cavity, thus, circumventing 'first-pass' elimination following gastrointestinal absorption. Since launch, Nicorette® gum has been investigated in numerous studies (clinical) which are often difficult to compare due to large variations in study design and degree of sophistication. In order to standardise testing, in 2000 the European Pharmacopoeia introduced an apparatus to investigate the in vitro release of drug substances from medical chewing gum. With use of the chewing machine, the main aims of this project were to determine factors that could affect release from Nicorette® gum, to develop an in vitro in vivo correlation and to investigate formulation variables on release of nicotine from gums. A standard in vitro test method was developed. The gum was placed in the chewing chamber with 40 mL of artificial saliva at 37'C and chewed at 60 chews per minute. The chew rate, the type of dissolution medium used, pH, volume, temperature and the ionic strength of the dissolution medium were altered to investigate the effects on release in vitro. It was found that increasing the temperature of the dissolution media and the rate at which the gums were chewed resulted in a greater release of nicotine, whilst increasing the ionic strength of the dissolution medium to 80 mM resulted in a lower release. The addition of 0.1 % sodium Jauryl sulphate to the artificial saliva was found to double the release of nicotine compared to the use of artificial saliva and water alone. Although altering the dissolution volume and the starting pH did not affect the release. The increase in pH may be insufficient to provide optimal conditions for nicotine absorption (since the rate at which nicotine is transported through the buccal membrane was found to be higher at pH values greater than 8.6 where nicotine is predominately unionised). Using a time mapping function, it was also possible to establish a level A in vitro in vivo correlation. 4 mg Nicorette® gum was chewed at various chew rates in vitro and correlated to an in vivo chew-out study. All chew rates used in vitro could be successfully used for IVIVC purposes, however statistically, chew rates of 10 and 20 chews per minute performed better than all other chew rates. Finally a series of nicotine gums was made to investigate the effect of formulation variables on release of nicotine from the gum. Using a directly compressible gum base, in comparison to Nicorette® the gums crumbled when chewed in vitro, resulting in a faster release of nicotine. To investigate the effect of altering the gum base, the concentration of sodium salts, sugar syrup, the form of the active drug, the addition sequence and the incorporation of surfactant into the gum, the traditional manufacturing method was used to make a series of gum formulations. Results showed that the time of addition of the active drug, the incorporation of surfactants and using different gum base all increased the release of nicotine from the gum. In contrast, reducing the concentration of sodium carbonate resulted in a lower release. Using a stronger nicotine ion-exchange resin delayed the release of nicotine from the gum, whilst altering the concentration of sugar syrup had little effect on the release but altered the texture of the gum.

Community pharmacists' engagement with public health in Great Britain

Objective - The objective of the research was to examine to what extent community pharmacists in Great Britain believed that their job was concerned with local public health issues. Methods - The project (Pharmacy and Public Health)received ethical approval from the Research Ethics Committee of the School of Life and Health Sciences at Aston University. After piloting, in August 2006 a self-completion postal questionnaire was sent to practicing community pharmacists in Great Britain (n=1998), with a follow-up to non-responders 4 weeks later. A final response rate of 51% (n=1023/1998) was achieved. Results - Respondents were asked to indicate their answer to the question “to what extent is your present job concerned with local public health issues?” on a three-point scale – “highly”, “slightly” or “not at all” concerned with public health. They were also asked to indicate whether they were pharmacy owners, employee pharmacists or self-employed locum pharmacists. Less than half (43%,n=384/898) of respondents answering both questions believed that their job was highly concerned with public health. A relationship was observed between employment status and the level to which a respondent believed that their job was concerned with public health (chi-square test with P=0.001). Over half of pharmacy owners (51%, n=68/134) considered that their job was highly concerned with public health compared to44% (n=193/443) of employee pharmacists and38% (n=123/321) of locum pharmacists. Conclusion - This research suggests that community pharmacists in Great Britain are not ‘fully engaged’ with public health. Pharmacy owners may feel more enfranchised in the public health movement than their employees and locums. Indeed, one-in-ten locums reported that their job was not at all concerned with public health which, as locum pharmacists constitute over a third of actively employed community pharmacists, could be limiting factor in any drive to strengthen the public health function of community pharmacists.

Provision of primary care to patients with chronic cough in the community pharmacy setting

BACKGROUND: Community pharmacies are at the forefront of primary care providers and have an important role in the referral of patients to a medical practitioner for review when necessary. Chronic cough is a common disorder in the community and requires medical assessment. The proficiency of community pharmacy staff to refer patients with chronic cough is currently unknown. OBJECTIVE: To assess the ability of community pharmacy staff to recognize and medically refer patients with a chronic nonproductive cough. METHODS: Following ethics approval, a simulated patient study of 156 community pharmacies in Perth, Western Australia, was conducted over a 3-month period. Simulated patients presented to the pharmacy requesting treatment for a cough. The simulated patient required a referral based on a designated scenario. Demographic details, assessment questions, and advice provided were recorded by the simulated patient immediately postvisit. A logistic regression analysis was performed, with referral for medical assessment as the dependent variable. RESULTS: Of the 155 community pharmacies included in the analysis, 38% provided appropriate medical referral. Cough suppressants were provided as therapy in 72% of all visits. Predictors of medical referral were assessment of symptom duration, medical history, current medications being taken, frequency of reliever use, and the position of the pharmacy staff member conducting the consultation. A third of community pharmacies provided appropriate primary care by recommending medical referral advice to patients with chronic cough. The majority of pharmacy staff members acquired information from the patient that suggested a need for medical referral, yet did not provide referral advice. CONCLUSIONS: Appropriate medical referral is more likely when adequate assessment is undertaken and when a pharmacist is directly involved in the consultation. This highlights the need for pharmacies to ensure that processes are in place for patients to access the pharmacist.

Developing critical understanding in HRM students:using innovative teaching methods to encourage deep approaches to study

Purpose – This paper aims to focus on developing critical understanding in human resource management (HRM) students in Aston Business School, UK. The paper reveals that innovative teaching methods encourage deep approaches to study, an indicator of students reaching their own understanding of material and ideas. This improves student employability and satisfies employer need. Design/methodology/approach – Student response to two second year business modules, matched for high student approval rating, was collected through focus group discussion. One module was taught using EBL and the story method, whilst the other used traditional teaching methods. Transcripts were analysed and compared using the structure of the ASSIST measure. Findings – Critical understanding and transformative learning can be developed through the innovative teaching methods of enquiry-based learning (EBL) and the story method. Research limitations/implications – The limitation is that this is a single case study comparing and contrasting two business modules. The implication is that the study should be replicated and developed in different learning settings, so that there are multiple data sets to confirm the research finding. Practical implications – Future curriculum development, especially in terms of HE, still needs to encourage students and lecturers to understand more about the nature of knowledge and how to learn. The application of EBL and the story method is described in a module case study – “Strategy for Future Leaders”. Originality/value – This is a systematic and comparative study to improve understanding of how students and lecturers learn and of the context in which the learning takes place.

Double-voicing at work : power, gender and linguistic expertise

'Double-voicing' means that when a person speaks, they have a heightened awareness of the concerns and agendas of others, which is reflected in the ways they adjust their language in response to interlocutors. The Russian philosopher Mikhail Bakhtin famously applied the concept of 'double-voiced discourse' to the world of literature, but just touched upon its relevance to everyday language. This book reveals how 'double-voicing' is an inherent and routine part of spoken interactions within educational and professional contexts. Double-voicing is closely related to the ways in which power relations are constructed between speakers, as it is often used by less powerful speakers to negotiate perceived threats from more powerful others. The book explores how women leaders use double-voicing more than men as a means of gaining acceptance and approval in the workplace. While double-voicing at times indexes a speaker's linguistic insecurity, the book argues that it can be harnessed to demonstrate linguistic expertise.

Double-voicing at work:power, gender and linguistic expertise

'Double-voicing' means that when a person speaks, they have a heightened awareness of the concerns and agendas of others, which is reflected in the ways they adjust their language in response to interlocutors. The Russian philosopher Mikhail Bakhtin famously applied the concept of 'double-voiced discourse' to the world of literature, but just touched upon its relevance to everyday language. This book reveals how 'double-voicing' is an inherent and routine part of spoken interactions within educational and professional contexts. Double-voicing is closely related to the ways in which power relations are constructed between speakers, as it is often used by less powerful speakers to negotiate perceived threats from more powerful others. The book explores how women leaders use double-voicing more than men as a means of gaining acceptance and approval in the workplace. While double-voicing at times indexes a speaker's linguistic insecurity, the book argues that it can be harnessed to demonstrate linguistic expertise.