Global concern around over the counter availability of codeine containing products and risk of misuse, dependence and related harms are evident. A phenomenological study of lived experiences of ...codeine misuse and dependence was undertaken in Ireland, following the Pharmaceutical Society of Ireland's 2010 guidelines for restricted supply of non-prescription codeine containing products.
In-depth interviews were conducted with a purposive sample of adult codeine misusers and dependents (n=21), both actively using, in treatment and in recovery. The narratives were analysed using the Empirical Phenomenological Psychological five-step method (Karlsson, 1995). A total of 10 themes with 82 categories were identified. Two concepts at a higher level of abstraction above the theme-level emerged during the final stage of analysis. The concepts identified were 'emotional pain and user self-legitimization of use' and 'entrapment into habit-forming and invisible dependent use'. These concepts were reported in different ways by a majority of participants.
Findings are presented under the following themes: (1) profile and product preferences; (2) awareness of habit forming use and harm; (3) negotiating pharmacy sales; (4) alternative sourcing routes; (5) the codeine feeling; (6) the daily routine; (7) acute and chronic side effects; (8) social isolation; (9) withdrawal and dependence and (10) help-seeking and treatment experiences.
There is a public health and regulatory imperative to develop proactive responses tackling public availability of codeine containing medicines, risk minimisation in consumer self-treatment for pain, enhanced patient awareness of potential for habit forming use and its consequences and continued health professional pharmacovigilence.
In order to understand the possible influence of aerosols on the environment in the agricultural Yangtze delta region of China, a one-month field sampling campaign was carried out during November ...1999 in Linan, China. Measurements included the aerosol light scattering coefficient at 530
nm,
σ
sp, measured at both dry relative humidity (RH<40%) and under ambient conditions (sample RH=63±19%), and the absorption coefficient at 565
nm,
σ
ap, for aerosol particles having diameters <2.5
μm (PM
2.5). At the same time, daily filter samples of PM
2.5 as well as aerosol particles having diameters <10
μm (PM
10) were collected and analyzed for mass, major ion, organic compound (OC), and elemental carbon (EC) concentrations in order to determine which anthropogenic chemical species were primarily responsible for aerosol light extinction. The aerosol loading in the rural Yangtze delta region was comparable to highly polluted urban areas, with mean and standard deviation (S.D.) values for
σ
sp,
σ
ap and PM
2.5 of 353
Mm
−1 (202
Mm
−1), 23
Mm
−1 (14
Mm
−1) and 90
μg
m
−3 (47
μg
m
−3), respectively. A clear diurnal pattern was observed in
σ
sp and
σ
ap with minimum values occurring in the middle of the day, most likely associated with the maximum midday mixing height. The ratio of the change in light scattering coefficient at ambient RH to that at controlled RH (RH<40%),
F
σ
sp
(RH), indicates that condensed water typically contributed ∼40% to the light scattering budget in this region. The mass scattering efficiency of the dry aerosol, E
scat_2.5, and mass absorption efficiency of EC, E
abs_2.5, have mean and S.D. values of 4.0
m
2
g
−1 (0.4
m
2
g
−1) and 8.6
m
2
g
−1 (7.0
m
2
g
−1), respectively. PM
2.5 concentrations in Linan and two other locations in the Yangtze delta, Sheshan and Changshu (which have monthly mean values ranging from ∼80 to 110
μg
m
−3), are all significantly higher than the proposed 24-h average US PM
2.5 NAAQS of 65
μg
m
−3. Organic compounds are the dominant chemical species accounting for ∼50% of the PM
2.5 mass at all three sites. The results indicate that aerosol loadings in the agricultural Yangtze delta region of China are relatively high, and suggest that aerosols have a significant impact on visibility, climate, crop production, and human health in this region.
Diabetes is one of the greatest public health challenges to face Australia. It is already Australia's leading cause of kidney failure, blindness (in those under 60 years) and lower limb amputation, ...and causes significant cardiovascular disease. Australia's diabetes amputation rate is one of the worst in the developed world, and appears to have significantly increased in the last decade, whereas some other diabetes complication rates appear to have decreased. This paper aims to compare the national burden of disease for the four major diabetes‐related complications and the availability of government funding to combat these complications, in order to determine where diabetes foot disease ranks in Australia. Our review of relevant national literature indicates foot disease ranks second overall in burden of disease and last in evidenced‐based government funding to combat these diabetes complications. This suggests public funding to address foot disease in Australia is disproportionately low when compared to funding dedicated to other diabetes complications. There is ample evidence that appropriate government funding of evidence‐based care improves all diabetes complication outcomes and reduces overall costs. Numerous diverse Australian peak bodies have now recommended similar diabetes foot evidence‐based strategies that have reduced diabetes amputation rates and associated costs in other developed nations. It would seem intuitive that “it's time” to fund these evidence‐based strategies for diabetes foot disease in Australia as well.
Copper nanowires grow from spherical copper seeds in an aqueous solution. Conductive films of copper nanowires have a transmittance of 65% (∼15% more than the best values reported for carbon ...nanotubes), and remain conductive after 1000 bending cycles or one month in air.
The attenuation of solar radiation by atmospheric aerosols simultaneously decreases the amount of radiation reaching the surface and increases the fraction of radiation which is diffuse. Decreasing ...the total amount of photosynthetically active radiation (PAR, 400–700
nm) tends to decrease the amount of photosynthesis occurring in plant leaves. Increasing the fraction of PAR which is diffuse allows more PAR to reach shaded leaves and can thus increase the total amount of photosynthesis occurring in a plant canopy. In an attempt to quantify these two radiative influences of aerosols, the CERES crop model Cereal growth, development and yield. In: Tsuji, G.Y., Hoogenboom, G., Thornton, P.K. (Eds.), Understanding Options for Agricultural Production. Kluwer Academic Publishers, Dordrecht, Netherlands. was modified to estimate the impact on yield for maize, wheat, and rice under varying atmospheric conditions. The influence of aerosols on total and diffuse PAR was modeled using the National Center for Atmospheric Research (NCAR) Tropospheric Ultraviolet Visible (TUV) radiation model UV radiation in the natural and perturbed atmosphere. In: Tevini, M. (Ed.), Environmental Effects of UV (Ultraviolet) Radiation. Lewis Publisher, Boca Raton, Florida. under both clear skies and overcast skies and again when cloudiness conditions were allowed to vary to reflect actual meteorological conditions. The PAR intensity and diffuse fraction results from the radiation model were applied to existing meteorological data sets. These data sets were then used as input for the CERES model. The CERES model was modified so that plant radiation use efficiency (RUE) fluctuated as a function of the diffuse fraction calculated by the TUV model. Model simulations were performed using many years of meteorological data and different amounts of atmospheric aerosol loading for several different locations around the world. The change in crop yield due to the influence of aerosols was found to be extremely dependent on the magnitude of the increase in radiation use efficiency (RUE) incurred by increasing the diffuse fraction. The influence of aerosols on simulated crop yield was found to be more negative on overcast days since the diffuse fraction is already quite high even in a clean atmosphere. Consequently, the more overcast days there are in a growing season, the more negative is the influence of aerosols. For the most realistic set of model results based on location-specific aerosol loadings and crop-specific assumptions of RUE change, the influence of aerosols is estimated to be −10% on maize yield, ±5% on wheat yield, and ±10% on rice yield except for when grown under exceptionally sunny conditions as found in California’s central valley, in which case, yields are predicted to increase by up to 30%. Aerosols also tend to decrease plant water stress by reducing soil evaporation and transpiration. When crops are grown under rainfed conditions, this reduction in water loss from evapotranspiration may offset the decrease in the photosynthetic rate and cause aerosols to have a positive influence on final grain yields.
Aim: Inheritance and genetic factors are supposed to influence susceptibility to asthma and allergy. We tested if single nucleotide polymorphisms (SNPs) in the IL4R gene were associated with ...susceptibility to such diseases, or if they were related to the phenotypic presentation of asthma and allergic rhinoconjunctivitis (ARC).
Methods: Three hundred and nine 12‐ to 13‐year‐old children were included. Six SNPs in the IL4R were analysed in response to current allergic disease, and to presentation of specific asthma and ARC phenotypes. Questionnaires were used to determine allergic disease status, and skin prick tests to evaluate sensitization to common airborne allergens.
Results: Less eczema was seen in individuals with the AA‐genotype of rs2057768, and less ARC among those with the AA‐genotype of rs2107356, especially ARC associated with sensitization to pollen. The AA‐genotype of rs2057768 and the TT genotype of rs3024632 were associated with a specific asthma phenotype.
Conclusion: Variations within the IL4R gene are associated with allergic diseases in children, preferably with eczema and disease phenotypes of ARC and asthma.
Abstract Valproic acid (VPA) is widely used for the treatment of mood disorders and epilepsy, but its mechanism of action is unclear. In vivo and in vitro studies using rodent models have ...demonstrated that VPA has both neuroprotective and neurotrophic effects. These beneficial effects are, in part, through modulation of glial cell function. Recently, we and others have shown that VPA selectively induces caspase-3 mediated apoptosis in rodent microglial cells. However, the effect of VPA on human microglia has not been tested. In this study, using microglia derived from adult human brains, we demonstrate that VPA does not induce microglial apoptosis as determined by the absence of caspase-3 cleavage. However, VPA does partially decrease the expression of the microglial markers PU.1 and CD45, as well as dramatically reducing microglial phagocytosis. Due to the many roles of microglia in the brain, these VPA-induced alterations in microglial phenotype could potentially have major effects on physiological and pathological actions of these cells.
Abstract Acetabular inclination angles have been suggested as a principal determinant of circulating metal ion levels in metal-on-metal hip arthroplasties. We aimed to determine whether inclination ...angle correlates with ion levels in arthroplasties using the Articular Surface Replacement (ASR) system. Patients undergoing ASR arthroplasties had blood metal ion levels and radiograph analysis performed a mean of 3.2 years after surgery. Inclination angle showed only a weak correlation with cobalt ( r = 0.21) and chromium ( r = 0.15) levels. The correlation between inclination angle and cobalt levels was significant only with small femoral components, although it was still weak. Multiple regression showed a complex interaction of factors influencing ion levels but inclination angle accounted for little of this variation. We conclude that the acetabular inclination angle is not a meaningful determinant of metal ion levels in ASR arthroplasties.
The effect of atmospheric aerosols and regional haze from air pollution on the yields of rice and winter wheat grown in China is assessed. The assessment is based on estimates of aerosol optical ...depths over China, the effect of these optical depths on the solar irradiance reaching the earth's surface, and the response of rice and winter wheat grown in Nanjing to the change in solar irradiance. Two sets of aerosol optical depths are presented: one based on a coupled, regional climate/air quality model simulation and the other inferred from solar radiation measurements made over a 12-year period at meteorological stations in China. The model-estimated optical depths are significantly smaller than those derived from observations, perhaps because of errors in one or both sets of optical depths or because the data from the meteorological stations has been affected by local pollution. Radiative transfer calculations using the smaller, model-estimated aerosol optical depths indicate that the so-called "direct effect" of regional haze results in an ≈ 5-30% reduction in the solar irradiance reaching some of China's most productive agricultural regions. Crop-response model simulations suggest an ≈ 1: 1 relationship between a percentage increase (decrease) in total surface solar irradiance and a percentage increase (decrease) in the yields of rice and wheat. Collectively, these calculations suggest that regional haze in China is currently depressing optimal yields of ≈ 70% of the crops grown in China by at least 5-30%. Reducing the severity of regional haze in China through air pollution control could potentially result in a significant increase in crop yields and help the nation meet its growing food demands in the coming decades.
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