Identification of Potential Drug Interaction with Complementary and Alternative Medicines Among Chronic Disease Outpatients

Chronic diseases such as congestive heart failure (CHF) and chronic kidney disease (CKD) are related with multiple drug prescription which can lead to drug interaction. The high usage of complementary and alternative medicines (CAM) in Indonesians can also increase the risk for drug interaction. The objective of this study is to describe CAMs use and identify potential drug interaction with CAMs in CHF and CKD outpatients. The study is a cross sectional study. Data of prescribed drugs and CAMs consumed by the patients was collected by using medication reconciliation process. Data of routine CAMs and prescribed medicines were compared to identify potential drug interactions which were then classified based on their mechanism and significance. The result showed that 6,90 % of CHF patients and 25 % of CKD patients consumed CAMs. Potential drug interaction between the CAMs and the prescribed drugs was identified in 2.74% of patients consuming CAMs. Based on the mechanism, interaction was dominated by pharmacodynamics interaction (69.2%) while interaction significancy was various. It can be concluded that CAMs usage was more familiar in CKD patients compared to CHF patients. Potential drug interaction with CAMs was able to be identified through medication reconciliation process and should be taken into awareness by the healthcare team

Long life, low cost ball valve, with lifted seals and cartridge type construction

Ball valve design incorporates modular construction in easy-to-install, easy-to-replace cartridge housing, and a system of cams to lift upstream and downstream seals away from the ball during rotation. Tests conducted on nitrogen tetroxide prove new valve to be more efficient than previous models in preventing leakage

Climate change impacts on water for irrigated horticulture in the Vale of Evesham. Final Report

This project has undertaken a scoping review and assessment of the impacts of climate change on irrigated horticulture in the Vale of Evesham, an area of intense irrigated production located within the Environment Agency’s Warwickshire Avon CAMS Catchment. The research was based on a combination of methodologies including desk-based review of published and grey literature, computer agroclimatic and water balance modelling, GIS mapping, meetings with key informants and a stakeholder workshop. Future climate datasets were derived from the latest UK Climate Impacts Programme (UKICIP02) climatology, using selected emission scenarios for the 2020s, 2050s and 2080s. These scenarios were then used to model and map the future agroclimatic conditions under which agriculture might operate and the consequent impacts on irrigation need (depths of water applied) and volumetric demand. This was complimented by a postal survey to abstractors and a stakeholder workshop, to identify, review and assess farmer adaptation options and responses. The key findings arising from the research, implications for water resource management and recommendations for further work are summarised below. Using a geographical information system (GIS), a series of agroclimate maps have been produced, for the baseline and selected UKCIP02 scenario. The maps show major changes in agroclimate within the catchment over the next 50 years. The driest agroclimate zones are currently located around Worcester, Evesham, Tewkesbury and Gloucester, corresponding to areas where horticultural production and irrigation demand are most concentrated. By the 2020s, all agroclimate zones are predicted to increase in aridity. By the 2050s the entire catchment is predicted to have a drier agroclimate than is currently experienced anywhere in the driest parts of the catchment. This will have major impacts on the pattern of land use and irrigation water demand. Cont/d

Differential alphav integrin-mediated Ras-ERK signaling during two pathways of angiogenesis.

Antagonists of alphavbeta3 and alphavbeta5 disrupt angiogenesis in response to bFGF and VEGF, respectively. Here, we show that these alphav integrins differentially contribute to sustained Ras-extracellular signal-related kinase (Ras-ERK) signaling in blood vessels, a requirement for endothelial cell survival and angiogenesis. Inhibition of FAK or alphavbeta5 disrupted VEGF-mediated Ras and c-Raf activity on the chick chorioallantoic membrane, whereas blockade of FAK or integrin alphavbeta3 had no effect on bFGF-mediated Ras activity, but did suppress c-Raf activation. Furthermore, retroviral delivery of active Ras or c-Raf promoted ERK activity and angiogenesis, which anti-alphavbeta5 blocked upstream of Ras, whereas anti-alphavbeta3 blocked downstream of Ras, but upstream of c-Raf. The activation of c-Raf by bFGF/alphavbeta3 not only depended on FAK, but also required p21-activated kinase-dependent phosphorylation of serine 338 on c-Raf, whereas VEGF-mediated c-Raf phosphorylation/activation depended on Src, but not Pak. Thus, integrins alphavbeta3 and alphavbeta5 differentially regulate the Ras-ERK pathway, accounting for distinct vascular responses during two pathways of angiogenesis

New meteor showers identified in the CAMS and SonotaCo meteoroid orbit surveys

A cluster analysis was applied to the combined meteoroid orbit database derived from low-light level video observations by the SonotaCo consortium in Japan (64,650 meteors observed between 2007 and 2009) and by the Cameras for All-sky Meteor Surveillance (CAMS) project in California, during its first year of operation (40,744 meteors from Oct. 21, 2010 to Dec. 31, 2011). The objective was to identify known and potentially new meteoroid streams and identify their parent bodies. The database was examined by a single-linking algorithm using the Southworth and Hawkins D-criterion to identify similar orbits, with a low criterion threshold of D < 0.05. A minimum member threshold of 6 produced a total of 88 meteoroid streams. 43 are established streams and 45 are newly identified streams. The newly identified streams were included as numbers 448-502 in the IAU Meteor Shower Working List. Potential parent bodies are proposed.Comment: Accepted in Proceedings of the Meteoroids 2013 Conference Aug. 26-30, 2013, A.M. University, Poznan, Polan

The use of complementary and alternative medications by menopausal women living in South East Queensland

Complementary and alternative medication (CAM) use during menopause is a growing public and women's health issue. The use of CAMs is increasing and evidence of CAM use in the general population suggests that women in the menopausal age range are more likely to use CAMs. In the context of menopause, preliminary research has indicated that women are using a number of CAMs to address symptoms. In a study of American women aged 45 to 65 years, 22% of women used CAMs during menopause, specifically herbal or naturopathic remedies (13%), relaxation techniques (9%) and dietary soy supplements (7%). Fourteen percent (14%) of women strongly agreed with the proposition that approaches such as nutrition and vitamins were better than hormones (Newton et al., 2002). The term 'menopause' is a concept of varying perceptions and perspectives. From the biological perspective, menopause is constant, however from the individual perspective, menopause is a unique experience shaped by cultural, emotional, psychological and physical characteristics. Symptoms commonly cited during menopause include hot flushes, night sweats palpitations, irregular menses and muscle and bone pain. The use of CAMs during menopause has the potential to address current symptoms and promote long term health and wellness. The reviewed literature indicated that while a preliminary understanding of CAM use during menopause is evident, further research is needed to clarify and contextualise current prevalence rates and types used. In addition, an understanding of the reasons and factors that influence women to use CAMs during this transition is crucial to understanding women's menopausal experience. This project aimed to explore the prevalence of CAM use during menopause and to identify the reasons that influence women to use these therapies during the transition. To address this question, a two phase study was designed to incorporate both quantitative and qualitative research methods. For Phase 1, a secondary data analysis was undertaken on a dataset that explored women's menopausal experiences and therapies used to address symptoms and for phase 2, focus groups were used to explore women's personal experiences and perceptions of CAM use during menopause. The secondary data analysis was undertaken on a population based sample of 886 women aged 47-67 years. Women were randomly selected from the electoral roll on the basis of gender, age and postcode, which were selected to ensure representation of urban and rural and varying socioeconomic status. From this analysis, the findings indicated that 80% of women used at least one type of CAM with therapeutic techniques (activities such as walking and swimming) the most commonly used (83.0%), followed by nutrition (66.8%), phytoestrogens (55.8%), herbal therapies (41.3%) and CAM medications (25.1%). Women who used CAMs were more likely to experience anxiety and vasomotor (hot flushes and night sweats) symptoms, have higher education levels, be low to middle income earners, be aged under 55 years, be previous users of hormone therapy (HT) and have participated in self breast examinations. CAM users were 40 to 90% less likely to be currently using HT or to smoke more than 20 cigarettes per day. The results of the secondary data analysis indicated the prevalence and factors associated with CAM use, however the factors that influence women to use CAMs during the menopause were unclear. A series of three focus groups and two telephone interviews were undertaken with a group of 15 women, who were current users of CAMs, aged 47-67 years and fluent in English. Women were recruited through an advertisement placed in a newsletter distributed by a large metropolitan hospital; a flyer displayed on noticeboards of libraries and shopping centres; and a media release through the local community newspaper and on a state wide radio station. Analysis of the transcripts indicated that a number of factors interact to influence a woman's decision to use CAMs. Influences included relationships with family, friends and health practitioners, effects of symptoms, information on CAMs and menopause, current menopause research, personal perceptions of health, wellness and effectiveness of CAM therapies to alleviate symptoms. Taken together, the results of the Phase 1 and 2 combined with the literature indicated that women were using multiple forms of CAMs. A post hoc analysis was undertaken and the CAM questions analysed in Phase 1 were critiqued within this new knowledge of CAM use. As a consequence, CAMs were redefined into four groups to enhance current understandings. After reclassification, the use of at least one CAM was 71.6%, with the most commonly used dietary phytoestrogens (60.0%), followed by dietary supplements (47.0%), herbal therapies (35.9%) and phytoestrogen supplements (33.0%). Sociodemographic, health and symptom characteristics were further profiled against the redefined categories of dietary phytoestrogens, dietary supplements, herbal therapies, phytoestrogen supplements and users of multiple CAMs. The consistency of associations varied according to the CAM category with no significant association present across all four CAM categories. This post hoc analysis clarified CAM categorisation and highlighted the high prevalence of women who were using multiple forms of CAMs. Additionally, multivariable analysis validated and confirmed the results of Phase 1 as similar profiles of a CAM user were found. This research has identified the prevalence of CAM use during menopause in Queensland women and has begun to elucidate the reasons that influence women to use these therapies during this transition. The utilisation of both quantitative and qualitative methods has provided a comprehensive and holistic depiction of women's use of CAMs during menopause. The results and conclusions drawn from this research have highlighted areas that need addressing within the research and health service domain. For future research, development of a comprehensive CAM survey instrument is required and clarification of the definition of CAMs is also needed. Multiple definitions are currently used to describe CAM use, creating confusion in classifying types of CAMs and comparing prevalence rates between studies. With regard to health service recommendations, there is a need for increased access to information on menopause and alternative therapies for women. Open, active and participatory relationships between health practitioners and menopausal women are essential and health practitioners need to be aware women are using a variety of CAMs during the menopause and are likely to continue to do so even if health practitioner support is not apparent

Ozone profile observations in Houston, Texas (1994 - 2010) from aircraft, balloons, and satellites

Houston, Texas has long been an urban area plagued with high levels of surface ozone, particularly in spring and late summer. The combination of a large commuter population and one of the largest concentrations of petrochemical plants in the world results in abundant and nearly co-located sources of NOx and hydrocarbons. The location of Houston on the South Coast of the United States in a subtropical climate results in meteorological conditions that favor ozone production. Using MOZAIC (1994 - 2004), ozonesonde (2000, 2004 - 2010), and TES (2005 – 2010) data, we examine the evolution of ozone profiles over Houston during a period in which various strategies have been implemented to alleviate the ozone pollution problem. Using meteorological data from associated soundings and analyses, we identify and evaluate influences on the ozone profiles from natural and anthropogenic sources, as well as local and remote sources. We further investigate how these various influences have changed with time