Sun exposure and interaction with family history in risk of melanoma, Queensland, Australia

Sun exposure is the main environmental risk factor for melanoma, but the timing of exposure during life that confers increased risk is controversial. Here we provide the first report of the association between lifetime and age-specific cumulative ultraviolet exposure and cutaneous melanoma in Queensland, Australia, an area of high solar radiation, and examine the association separately for families at high, intermediate and low familial melanoma risk. Subjects were a population-based sample of melanoma cases diagnosed and registered in Queensland between 1982 and 1990 and their relatives. The analysis included 1,263 cases and relatives with confirmed cutaneous melanoma and 3,111 first-degree relatives without melanoma as controls. Data an lifetime residence and sun exposure, family history and other melanoma risk factors were collected by a mailed questionnaire. Using conditional multiple logistic regression with stratification by family, cumulative sun exposure in childhood and in adulthood after age 20 was significantly associated with melanoma, with estimated relative risks of 1.15 per 5,000 minimal erythemal doses (MEDs) from age 5 to 12 years, and 1.52 per 5 MEDs/day from age 20. There was no association with sun exposure in families at high familial melanoma risk. History of nonmelanoma skin cancer (relative risk [RR] = 1.26) and multiple sunburns (RR = 1.31) were significant risk factors. These findings indicate that sun exposure in childhood and in adulthood are important determinants of melanoma but not in those rare families with high melanoma susceptibility, in which genetic factors are likely to be more important. (C) 2002 Wiley-Liss, Inc.

Pro re nata medication for psychoses: an audit of practice in two metropolitan hospitals

Objective: To examine the use of pro re nata (PRN) (as needed) medication in hospitalized patients with psychotic disorders. Methods: Retrospective chart reviews were conducted at two large public psychiatry units situated in inner city general hospitals. Pro re nata medication prescription, administration and outcomes were examined during inpatient episodes of care for 184 consecutive admissions of patients diagnosed with a psychotic disorder. Patient demographics, diagnoses, and regularly prescribed medication were also recorded. All admissions were drawn from a three-month period from December 1998-February 1999. Results: The most prevalent diagnoses were schizophrenia related disorders (n = 111) and mania (n = 34). Substance use disorders (n = 49) were the most common comorbid dis-orders. Pro re nata medication was administered during the acute phase of 82% of admissions. Drugs prescribed Pro re nata were mostly typical antipsychotics, benzodiazepines and/or anti-cholinergics. Coprescription of typical antipsychotics PRN with regularly scheduled atypical antipsychotics was common (64%). Pro re nata medications accounted for 31% of the total antipsychotic dose and 28% of the total anxiolytic dose administered during acute treatment. Higher daily doses of PRN medication were given to manic patients, males, younger patients and those with substance use disorders. Pro re nata prescriptions usually specified a maximum daily dose (87%) but rarely gave indications for use (6%). Adminis-tration records frequently lacked a specified reason for use (48%) or a notation of outcome (64%). Unit staff noted medication-related morbidity in 37% of patients receiving PRN medication, compared to 3% of patients receiving only regularly scheduled medication. Extrapyramidal symptoms (EPS) were most frequently associated with administration of PRN haloperidol (Relative Risk vs other PRN medications = 5.61, 95% CI = 2.36-13.73). Conclusions: Pro re nata medications comprised a significant part of the treatment which psychotic patients received. The common practice of coprescribing PRN typical antipsychotics with scheduled atypical antipsychotics is potentially problematical since administration of PRN medication is associated with significant medication related morbidity. Preferential use of benzodiazepines as PRN agents may minimize this morbidity and foster subsequent compliance with regularly prescribed antipsychotics.

The first non-turnover voltammetric response from a molybdenum enzyme: direct electroscopy of dimethylsulfoxide reductase from Rhodobacter capsulatus

The first direct voltammetric response from a molybdenum enzyme under non-turnover conditions is reported. Cyclic voltammetry of dimethylsulfoxide reductase from Rhodobacter capsulatus reveals a reversible Mo-VI/V response at + 161 mV followed by a reversible Mo-V/IV response at -102 mV versus NHE at pH 8. The higher potential couple exhibits a pH dependence consistent with protonation upon reduction to the Mo-V state and we have determined the pK(a) for this semi-reduced species to be 9.0. The lower potential couple is pH independent within the range 5 < pH < 10. The optical spectrum of the Mo chromophore has been investigated with spectroelectrochemistry. At high potential, in its resting state, the enzyme exhibits a spectrum characteristic of the Mo-VI form. This changes significantly following bulk electrolysis (-400 mV versus NHE) at an optically transparent, indium-doped tin oxide working electrode, where a single visible electronic maximum at 632 nm is observed, which is comparable with spectra reported previously for the dithionite-reduced enzyme. This two-electron process is chemically reversible by reoxidizing the enzyme at the electrode in the absence of mediators or promoters. The activity of the enzyme has been established by observation of a catalytic current in the presence of DMSO at pH 8, where a sigmoidal (steady state) voltammogram is seen. Electronic supplementary material to this paper (Fig. S 1) can be obtained by using the Springer Link server located at http://dx.doi.org/10.1007/s00775-002-0374-y.

Accurate orientation relationship between ferrite and austenite in low carbon martensite and granular bainite

Convergent beam Kikuchi diffraction was used to accurately determine the orientation relationships (ORs) between austenite and martensite, and between austenite and granular bainite in two Fe-Ni-Mn-C alloys. Both martensite and granular bainite have the same crystallographic characteristics with the OR: (111)(A)parallel to(101)(F), [1 (1) over bar0](A) 2.5degrees +/- 2degrees from [1 (1) over bar(1) over bar](B).

U-Series dating of Liujiang hominid site in Guangxi, Southern China

It has been established that modern humans were living in the Levant and Africa ca. 100 ka ago. Hitherto, this has contrasted with the situation in China where no unequivocal specimens of this species have been securely dated to more than 30 ka. Here we present the results of stratigraphic studies and U-series dating of the Tongtianyan Cave, the discovery site of the Liujiang hominid, which represents one of the few well-preserved fossils of modern Homo sapiens in China. The human fossils are inferred to come from either a refilling breccia or a primarily deposited gravel-bearing sandy clay layer. In the former case, which is better supported, the fossils would date to at least similar to 68 ka, but more likely to similar to 111-139 ka. Alternatively, they would be older than, similar to 153 ka. Both scenarios would make the Liujiang hominid one of the earliest modem humans in East Asia, possibly contemporaneous with the earliest known representatives from the Levant and Africa. Parallel studies on other Chinese localities have provided supporting evidence for the redating of Liujiang, which may have important implications for, the origin of modem humans. (C) 2002 Elsevier Science Ltd. All rights reserved.

Porphyrin profiles in blood and urine as a biomarker for exposure to various arsenic species

A sensitive method using HPLC with fluorescence detection has been established for the measurement of porphyrins in biological materials. The assay recoveries were 88.0 +/- 1.8% for protoporphyrin IX in the blood, and ranged from 98.3 +/- 2.7% to 111.1 +/- 7.4% for various porphyrins in the urine. This method was employed to investigate the altered porphyrin profiles in rats after a single dose of various arsenicals including soluble sodium arsenate and sodium arsenite, and the relatively insoluble calcium arsenite, calcium arsenate and arsenic-contaminated soils at dose rates of 5 mg/kg or 0.5 mg/kg body weight. Porphyrin concentrations increased within 24-48hr after the arsenic treatment in blood and urine. Protoporphyrin IX is the predominant porphyrin in the blood. In rats administered 5 mg As(III)/kg body weight, protoporphyrin IX concentration elevated to 123% of them control values in rats, 24 hr after the treatment. Higher increases were recorded in the urinary protoporphyrin IX (253% at 24 hr; 397% on day 2), uroporphyrin (121% at 24 hr; 208% on day 2) and coproporphyrin 111 (391% at 24 hr; 304% on day 2), while there was no significant increase (109% on day 3) observed in the urinary coproporphyrin I excretion. In rats administered 5 mg As(V)/kg, urinary excretion of protoporphyrin IX, uroporphyrin, coproporphyrin Ill and coproporphyrin I elevated to the maximum levels by 48 hr with the corresponding percentage values compared to the control being 177%, 158%, 224% and 143%, respectively. In rats dosed with 5 mg As(III)/kg, the increases (expressed as % of the control values) of protoporphyrin IX in the blood were in the order: sodium arsenite (144%) > sodium arsenate (125%) greater than or equal to calcium arsenite (123%) > calcium arsenate. In contrast, there was no significant increase of protoporphyrin K when the six arsenic-contaminated cattlei dip soils and nine copper chrome arsenate (CCA-contaminated) soils were administered to the rats. Probable explanations are discussed.

Production of mosquitoes in rainwater tanks and wells on Yorke Island, Torres Strait: Preliminary study

The Torres Strait in northernmost Queensland, Australia, is subject to periodic outbreaks of dengue. A large outbreak of dengue 2 in 1996-97 affected five islands, resulting in 200 confirmed cases. On most of the affected islands, rainwater tanks were a common breeding site for vector mosquitoes. Rainwater tanks, wells and household containers filled with water are the most common breeding sites for dengue mosquitoes (Aedes aegypti), the primary vector of dengue in Queensland. We report on surveys conducted in February 2002 to measure the productivity of rainwater tanks and wells on Yorke Is. (Torres Strait), the first time the productivity of rainwater tanks has been measured in Australia. Of 60 rainwater tanks sampled, 10 had broken screens. Using a sticky emergence trap, 179 adult mosquitoes were collected, consisting of 63 Aedes scutellaris and 116 Culex quinquefasciatus. One unscreened tank produced 177 (99%) of the adults. A plankton net was used to sample 16 wells; 12 positive wells yielded 111 immature (larvae and pupae) mosquitoes, consisting of 57% and 43% Ae. scutellaris and Cx. quinquefasciatus, respectively. The apparent displacement of Ae. aegypti by Ae. scutellaris is discussed. Measures to reduce the likelihood of future dengue outbreaks are recommended.

Heritability of adult body height: A comparative study of twin cohorts in eight countries

A major component of variation in body height is due to genetic differences, but environmental factors have a substantial contributory effect. In this study we aimed to analyse whether the genetic architecture of body height varies between affluent western societies. We analysed twin data from eight countries comprising 30,111 complete twin pairs by using the univariate genetic model of the Mx statistical package. Body height and zygosity were self-reported in seven populations and measured directly in one population. We found that there was substantial variation in mean body height between countries; body height was least in Italy (177 cm in men and 163 cm in women) and greatest in the Netherlands (184 cm and 171 cm, respectively). In men there was no corresponding variation in heritability of body height, heritability estimates ranging from 0.87 to 0.93 in populations under an additive genes/unique environment (AE) model. Among women the heritability estimates were generally lower than among men with greater variation between countries, ranging from 0.68 to 0.84 when an additive genes/shared environment/unique environment (ACE) model was used. In four populations where an AE model fit equally well or better, heritability ranged from 0.89 to 0.93. This difference between the sexes was mainly due to the effect of the shared environmental component of variance, which appears to be more important among women than among men in our study populations. Our results indicate that, in general, there are only minor differences in the genetic architecture of height between affluent Caucasian populations, especially among men.

Development of a quality use of medicines coding system to rate clinical pharmacists' medication review recommendations

Objective: To develop a 'quality use of medicines' coding system for the assessment of pharmacists' medication reviews and to apply it to an appropriate cohort. Method: A 'quality use of medicines' coding system was developed based on findings in the literature. These codes were then applied to 216 (111 intervention, 105 control) veterans' medication profiles by an independent clinical pharmacist who was supported by a clinical pharmacologist with the aim to assess the appropriateness of pharmacy interventions. The profiles were provided for veterans participating in a randomised, controlled trial in private hospitals evaluating the effect of medication review and discharge counselling. The reliability of the coding was tested by two independent clinical pharmacists in a random sample of 23 veterans from the study population. Main outcome measure: Interrater reliability was assessed by applying Cohen's kappa score on aggregated codes. Results: The coding system based on the literature consisted of 19 codes. The results from the three clinical pharmacists suggested that the original coding system had two major problems: (a) a lack of discrimination for certain recommendations e. g. adverse drug reactions, toxicity and mortality may be seen as variations in degree of a single effect and (b) certain codes e. g. essential therapy were in low prevalence. The interrater reliability for an aggregation of all codes into positive, negative and clinically non-significant codes ranged from 0.49-0.58 (good to fair). The interrater reliability increased to 0.72-0.79 (excellent) when all negative codes were excluded. Analysis of the sample of 216 profiles showed that the most prevalent recommendations from the clinical pharmacists were a positive impact in reducing adverse responses (31.9%), an improvement in good clinical pharmacy practice (25.5%) and a positive impact in reducing drug toxicity (11.1%). Most medications were assigned the clinically non-significant code (96.6%). In fact, the interventions led to a statistically significant difference in pharmacist recommendations in the categories; adverse response, toxicity and good clinical pharmacy practice measured by the quality use of medicine coding system. Conclusion: It was possible to use the quality use of medicine coding system to rate the quality and potential health impact of pharmacists' medication reviews, and the system did pick up differences between intervention and control patients. The interrater reliability for the summarised coding system was fair, but a larger sample of medication regimens is needed to assess the non-summarised quality use of medicines coding system.

Genotype and environment effects on dynamics of harvest index during grain filling in sorghum

An approach based on a linear rate of increase in harvest index (141) with time after anthesis has been used as a simple means-to predict grain growth and yield in many crop simulation models. When applied to diverse situations, however, this approach has been found to introduce significant error in grain yield predictions. Accordingly, this study was undertaken to examine the stability of the HI approach for yield prediction in sorghum [Sorghum bicolor (L.) Moench]. Four field experiments were conducted under nonlimiting water. and N conditions. The experiments were sown at times that ensured a broad range in temperature and radiation conditions. Treatments consisted of two population densities and three genotypes varying in maturity. Frequent sequential harvests were used to monitor crop growth, yield, and the dynamics of 111. Experiments varied greatly in yield and final HI. There was also a tendency for lower HI with later maturity. Harvest index dynamics also varied among experiments and, to a lesser extent, among treatments within experiments. The variation was associated mostly with the linear rate of increase in HI and timing of cessation of that increase. The average rate of HI increase was 0.0198 d(-1), but this was reduced considerably (0.0147) in one experiment that matured in cool conditions. The variations found in IN dynamics could be largely explained by differences in assimilation during grain filling and remobilization of preanthesis assimilate. We concluded that this level of variation in HI dynamics limited the general applicability of the HI approach in yield prediction and suggested a potential alternative for testing.

A????es premiadas no 16?? Concurso Inova????o na Gest??o P??blica Federal 2011

Este livro re??ne as dez iniciativas premiadas no 16?? Concurso Inova????o na Gest??o P??blica Federal. Nesta 16?? edi????o, o Concurso conta com os apoios da Embaixada da Fran??a, da Embaixada da Noruega, da Ag??ncia de Coopera????o Internacional Alem?? (GIZ) e da Ag??ncia Brasileira de Coopera????o (ABC), que premiam os primeiros colocados com visitas t??cnicas. A ENAP tamb??m premia os vencedores com vagas nos cursos de Especializa????o em Gest??o P??blica e Desenvolvimento Gerencial , publica????es da Escola, livro contendo os relatos das iniciativas, certificado, divulga????o no Banco de Solu????es do s??tio do Concurso, assinatura de um ano da Revista do Servi??o P??blico (RSP) e Selo Inova????o

A????es premiadas no 14?? Concurso Inova????o na Gest??o P??blica Federal 2009

Nesta publica????o, referente ao 14?? Concurso Inova????o na Gest??o P??blica Federal, o leitor encontrar?? iniciativas inovadoras nas seguintes ??reas: Arranjos institucionais para coordena????o e/ou implementa????o de pol??ticas p??blicas (intra e inter-governamental); avalia????o e monitoramento de pol??ticas p??blicas; gest??o da informa????o; gest??o e desenvolvimento de pessoas; melhoria de processos de trabalho; planejamento, gest??o e desempenho institucional

Programa dinheiro direto na escola: PDDE

Trata-se de experi??ncia pioneira na modalidade de descentraliza????o, envolvendo numeroso grupo de cidad??os que n??o tinham experi??ncia com a gest??o dos recursos p??blicos. Este fato vem tendo importante influ??ncia na mudan??a de cultura, dentre outros, na motiva????o participativa da comunidade e no aprendizado dos procedimentos para lidar com dinheiro p??blico. Refor??ou, em alguns estados e munic??pios, seus pr??prios projetos e iniciativas de descentraliza????o de recursos e autonomia das escolas, acelerando tend??ncias em curso nas redes de ensino. A participa????o social na escola, segundo pesquisas, tem se mostrado como importante mecanismo de eleva????o da qualidade do ensino e o PDDE refor??a tal participa????o. A ader??ncia, o engajamento e a aprova????o do PDDE pela comunidade escolar converteram o Programa de governo em uma a????o da sociedade

Curso: redes de pol??ticas p??blicas: o desafio da governan??a

O curso tem como objetivo apresentar as principais pol??ticas p??blicas implementadas pelos sistemas pol??ticos contempor??neos decorrentes de uma complexa e cont??nua intera????o entre diversos atores, tanto dentro quanto fora do governo.Nesse sentido, busca-se compreender a estrutura subjacente a essa intera????o, denominada rede de pol??ticas p??blicas. Assim, o curso discute as principais caracter??sticas destas redes, suas possibilidades e limita????es

Alinhando o modelo, o m??todo de implementa????o e a pr??tica de gest??o do conhecimento (GC): o caso do Reposit??rio do Conhecimento do Instituto de Pesquisa Econ??mica Aplicada (RCIpea)

Entre as decis??es mais importantes para o ??xito da implementa????o da gest??o do conhecimento (GC) nas organiza????es, encontram-se as escolhas do modelo, do m??todo de implementa????o e das pr??ticas mais adequadas para alcan??ar os resultados esperados com a iniciativa. Organiza????es p??blicas brasileiras v??m adotando modelos distintos no momento de implementar GC (BARBOSA, 2011 e ALVARENGA NETO e VIEIRA, 2011). O objetivo deste artigo ?? analisar como o Instituto de Pesquisa Econ??mica Aplicada (Ipea) implementou de forma alinhada um modelo, um m??todo e uma pr??tica de gest??o do conhecimento (GC). O referencial te??rico utilizado ?? o Modelo de Gest??o do Conhecimento para a Administra????o P??blica Brasileira, constru??do por um dos autores deste trabalho ap??s a realiza????o de uma revis??o sistem??tica da literatura sobre modelos de GC na administra????o p??blica (BATISTA, 2012)