DriveSafe DriveAware: A systematic review

Objectives: Driving is an activity of daily living that significantly affects independence, and driving cessation is associated with poor health, lower quality of life, cognitive decline and early entry into care facilities. There is no consensus regarding the best off-road tool to assess driving safety. Therefore, this review explored the diagnostic accuracy, reliability and clinical utility of DriveSafe DriveAware (DSDA) compared with an on-road driving assessment. Methods: This review adhered to the PRISMA guidelines. Electronic databases for all English language articles published prior to December 2021 were searched. Studies were assessed for methodological quality and results were synthesised using a narrative descriptive approach. Results: Six studies were reviewed, consisting of 1332 participants. Four studies assessed diagnostic accuracy, two studies assessed reliability and three were relevant to clinical utility since they used DSDA as a standalone tool. Some studies demonstrated high levels of diagnostic accuracy, with specificity and sensitivity above 90% for those who fall into the safe and unsafe categories (50% of those assessed). Inter-rater reliability showed substantial agreement, and test–retest reliability was demonstrated for all age groups. DSDA was assessed as having high clinical utility (as a standalone tool) based on time taken to conduct, cost effectiveness and equipment required to complete the assessment. Conclusions: DriveSafe DriveAware appears to be an ideal tool for the subacute setting; however, at present, inadequate evidence exists to support its use as a standalone tool for directing driving decisions. Further research is required

Adrenergic factors regulating cell division in the colonic crypt epithelium during carcinogenesis and in colonic adenoma and adenocarcinoma.

Evidence exists implicating adrenergic factors in the control of intestinal epithelial cell proliferation in both normal and diseased states. In this report, attention is focussed on changes in the amine requirements of proliferating cells during the chemical induction of tumours in the colon of mouse. Cell proliferation rates were measured stathmokinetically. Tumours were induced by s.c. injection of dimethylhydrazine (DMH). Results with a series of adrenoceptor agonists and antagonists suggest that there is an alpha 2-adrenoceptor mediated excitatory effect in normal colon but an alpha 2 adrenoceptor mediated inhibitory effect in adenoma and carcinoma. Alpha 1 adrenoceptors, on the other hand, have an inhibitory effect in normal crypts and in adenomas, and an excitatory effect in carcinomas. Beta adrenoceptors have an inhibitory effect in the normal and DMH-treated crypt, and in adenomas, but not in carcinomas. In the crypt epithelium of DMH-treated mice, two regions on cell proliferation, with differing regulatory factors, could be identified. In the upper region of the carcinogen-exposed crypt is a zone where cell proliferation is stimulated by an alpha 2 adrenergic mechanism, thus resembling the basal region of the normal crypt. By contrast, in the basal region of these crypts, cell proliferation is stimulated by an alpha 1 mechanism, thus resembling a malignant tumour

Parents with psychosis : a pilot study examining self-report measures related to family functioning

The aims of this study were to examine the utility of various self-report instruments related to family functioning in families where a parent has a psychotic disorder, and to explore associations between these instruments and symptoms in the parent. Twenty-one parents with a psychotic disorders participated in the study. All participants were able to complete the questionnaires and the majority of parents reported levels of parental competence in the average range. Most parents (90%) perceived themselves to be effective parents, however 30% reported low levels of satisfaction with the parenting role. There were significant associations between objective measures of negative symptoms and self-report scores related to problems in ways of coping, and problems with parent-child interactions. Many individuals with psychosis were able to report areas of perceived need related to their role as parents and to the functioning of their families, however there are several limitations in the use of these instruments in this setting.<br /

Late Cenozoic diversification of the austral genus Lagenophora (Astereae, Asteraceae)

Lagenophora (Astereae, Asteraceae) has 14 species in New Zealand, Australia, Asia, southern South America, Gough Island and Tristan da Cunha. Phylogenetic relationships in Lagenophora were inferred using nuclear and plastid DNA regions. Reconstruction of spatio-temporal evolution was estimated using parsimony, Bayesian inference and likelihood methods, a Bayesian relaxed molecular clock and ancestral area and habitat reconstructions. Our results support a narrow taxonomic concept of Lagenophora including only a core group of species with one clade diversifying in New Zealand and another in South America. The split between the New Zealand and South American Lagenophora dates from 11.2 Mya [6.1–17.4 95% highest posterior density (HPD)]. The inferred ancestral habitats were openings in beech forest and subalpine tussockland. The biogeographical analyses infer a complex ancestral area for Lagenophora involving New Zealand and southern South America. Thus, the estimated divergence times and biogeographical reconstructions provide circumstantial evidence that Antarctica may have served as a corridor for migration until the expansion of the continental ice during the late Cenozoic. The extant distribution of Lagenophora reflects a complex history that could also have involved direct long-distance dispersal across southern oceans.Fil: Sancho, Gisela. Universidad Nacional de la Plata. Facultad de Cs.naturales y Museo. Departamento Científico de Plantas Vasculares; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: De Lange, Peter. Ecosystems And Species Unit. Department of Conservation; Nueva ZelandaFil: Donato, Mariano Humberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Limnología "Dr. Raúl A. Ringuelet". Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Instituto de Limnología; ArgentinaFil: Barkla, John. Otago Conservancy; Nueva ZelandaFil: Wagstaff, Steve J.. Allan Herbarium; Nueva Zeland

TINGKAT KEPUASAN PASIEN TERHADAP PERAN APOTEKER DALAM PELAYANAN SWAMEDIKASI DI APOTEK R3 FARMA 2 BULULAWANG KABUPATEN MALANG

Apoteker memiliki peran penting terhadap seluruh pekerjaan kefarmasian di apotek salah satunya memberikan informasi obat yang tepat kepada pasien dalam swamedikasi. Salah satu indikator yang digunakan untuk mengetahui peran apoteker terhadap kualitas pelayanan swamedikasi adalah dengan mengukur tingkat kepuasan. Penelitian ini bertujuan untuk mengetahui tingkat kepuasan pasien terhadap peran apoteker dalam pelayanan swamedikasi di Apotek R3 Farma 2 Bululawang. Penelitian ini bersifat deskriptif dengan jumlah responden yaitu 87 responden. Hasil dari penelitian ini menunjukkan bahwa tingkat kepuasan pasien terhadap peran apoteker dalam pelayanan swamedikasi di Apotek R3 Farma 2 Bululawang sebagian besar puas yaitu sebanyak 54 responden (62%), kategori sangat puas 21 responden (24%), cukup puas 10 responden (12%), dan kurang puas 2 responden (2%). Berdasarkan hasil penelitian dapat disimpulkan bahwa pelayanan swamedikasi oleh apoteker di apotek R3 Farma 2 Bululawang dalam kategori puas dengan persentase 77,6%. Kata Kunci : Apoteker, Apotek, Swamedikasi, Tingkat Kepuasa

Late Cenozoic diversification of the austral genus <i>Lagenophora</i> (Astereae, Asteraceae)

Lagenophora (Astereae, Asteraceae) has 14 species in New Zealand, Australia, Asia, southern South America, Gough Island and Tristan da Cunha. Phylogenetic relationships in Lagenophora were inferred using nuclear and plastid DNA regions. Reconstruction of spatio-temporal evolution was estimated using parsimony, Bayesian inference and likelihood methods, a Bayesian relaxed molecular clock and ancestral area and habitat reconstructions. Our results support a narrow taxonomic concept of Lagenophora including only a core group of species with one clade diversifying in New Zealand and another in South America. The split between the New Zealand and South American Lagenophora dates from 11.2Mya [6.1-17.4 95% highest posterior density (HPD)]. The inferred ancestral habitats were openings in beech forest and subalpine tussockland. The biogeographical analyses infer a complex ancestral area for Lagenophora involving New Zealand and southern South America. Thus, the estimated divergence times and biogeographical reconstructions provide circumstantial evidence that Antarctica may have served as a corridor for migration until the expansion of the continental ice during the late Cenozoic. The extant distribution of Lagenophora reflects a complex history that could also have involved direct long-distance dispersal across southern oceans.Facultad de Ciencias Naturales y MuseoInstituto de Limnología "Dr. Raúl A. Ringuelet