A detailed analysis of online pharmacy characteristics to inform safe usage by patients

Background: Evidence suggests that consumers potentially put themselves at risk when purchasing medicines on-line. Whilst logos provided by regulators may provide some level of reassurance there may be other indicators which could be used by consumers to identify those websites which may be safely used. Objectives: Identify characteristics of on-line pharmacies which are related to whether websites are regulated or non-regulated and those characteristics which could be used by patients to increase the likelihood of accessing regulated sites. Setting: Online pharmacies which supply diazepam, fluoxetine and simvastatin. Methods: Using piloted search terms via Google and Yahoo search engines, identified websites were screened for regulatory status, adherence to regulatory standards, administrative requirements, clinical assessment requirements and additional details deemed to be of relevance to a user. Characteristics of regulated and non-regulated (defined as those with an absence of a correctly linked regulatory logo) websites were compared to identify differences which could be used to improve patient safety. Main outcome measure: Regulatory status, adherence to regulatory standards, quality of information provision, barriers to medicines access. Results: 113 websites sold diazepam, fluoxetine and simvastatin; were identified within the first 100 results. Less than quarter were found to be regulated online pharmacies. 80 websites were willing to sell the medication without a prescription. The unregulated internet pharmacy websites (defined as those with an absence of a correctly linked regulatory logo) were found to adhere more closely to the clinical criteria, were less significantly likely to disclose a contact name and address, telephone number of the pharmacy or demand a prescription prior to sale (P\0.05, Fisher’s Exact). Conclusions: The three prescription-only medicines which are liable to abuse, have potentially serious interactions and require counselling to ensure patient safety are readily available via the internet. When purchasing medicines via this route UK consumers should be made aware of the importance of regulatory logos and additionally should ensure that the seller can be meaningfully contacted by the contact details provided. The provision of clinical information should not be used alone as an indication of the seller’s provenance

Effectiveness of State and Federal Government Agreements with Major Credit Card and Shipping Companies to Block Illegal Internet Cigarette Sales

Most Internet vendors offer tax-free cigarettes making them cheaper than those sold at stores. This undermines the impact that higher prices have upon reducing consumption. Most Internet tobacco sales have violated taxation and youth access laws, which led to landmark voluntary agreements in 2005 with the major credit card companies and major private shippers to ban payment transactions and shipments for all Internet cigarette sales

FUS-ALS mutants alter FMRP phase separation equilibrium and impair protein translation

FUsed in Sarcoma (FUS) is a multifunctional RNA binding protein (RBP). FUS mutations lead to its cytoplasmic mislocalization and cause the neurodegenerative disease amyotrophic lateral sclerosis (ALS). Here, we use mouse and human models with endogenous ALS-associated mutations to study the early consequences of increased cytoplasmic FUS. We show that in axons, mutant FUS condensates sequester and promote the phase separation of fragile X mental retardation protein (FMRP), another RBP associated with neurodegeneration. This leads to repression of translation in mouse and human FUS-ALS motor neurons and is corroborated in vitro, where FUS and FMRP copartition and repress translation. Last, we show that translation of FMRP-bound RNAs is reduced in vivo in FUS-ALS motor neurons. Our results unravel new pathomechanisms of FUS-ALS and identify a novel paradigm by which mutations in one RBP favor the formation of condensates sequestering other RBPs, affecting crucial biological functions, such as protein translation

Gender specific factors associated with having stopped smoking among in-school adolescents in Ukraine: results from the Global Youth Tobacco Survey 2005

<p>Abstract</p> <p>Background</p> <p>The prevalence of cigarette smoking in Ukraine is different between genders and is among the highest in the world. There is need to identify gender-specific factors that are associated with having stopped smoking among adolescents.</p> <p>Findings</p> <p>We used data from the Ukraine Global Youth Tobacco Survey 2005. We carried out a backward stepwise logistic regression analysis with having stopped smoking as the outcome.</p> <p>Altogether, 2800 adolescents reported having ever smoked cigarettes. Overall 64.1% (63.4% male, and 65.5% female) adolescents reported having stopped smoking. Male adolescents who stated that smoking decreases body weight were 25% more likely, while female adolescents were 9% less likely to stop smoking. While male adolescents who received support on how to stop smoking from a family member were 7% less likely, female adolescents were 60% more likely to stop smoking. Furthermore, while male adolescents who received a lecture on the harmful effects of smoking were 10% less likely, female adolescents were 9% more likely to stop smoking. Finally both male and female adolescents who were sure or most probably that they would not smoke a cigarette offered to them by their best friends were more likely, and those adolescents who were sure that smoking is harmful to health were less likely to stop smoking.</p> <p>Conclusions</p> <p>Our study has identified some factors that are associated with having quit smoking that are gender-specific. We believe public health programs targeting adolescent smoking should consider these factors in their design and implementation of gender sensitive interventions.</p

Roadless and Low-Traffic Areas as Conservation Targets in Europe

With increasing road encroachment, habitat fragmentation by transport infrastructures has been a serious threat for European biodiversity. Areas with no roads or little traffic (“roadless and low-traffic areas”) represent relatively undisturbed natural habitats and functioning ecosystems. They provide many benefits for biodiversity and human societies (e.g., landscape connectivity, barrier against pests and invasions, ecosystem services). Roadless and low-traffic areas, with a lower level of anthropogenic disturbances, are of special relevance in Europe because of their rarity and, in the context of climate change, because of their contribution to higher resilience and buffering capacity within landscape ecosystems. An analysis of European legal instruments illustrates that, although most laws aimed at protecting targets which are inherent to fragmentation, like connectivity, ecosystem processes or integrity, roadless areas are widely neglected as a legal target. A case study in Germany underlines this finding. Although the Natura 2000 network covers a significant proportion of the country (16%), Natura 2000 sites are highly fragmented and most low-traffic areas (75%) lie unprotected outside this network. This proportion is even higher for the old Federal States (western Germany), where only 20% of the low-traffic areas are protected. We propose that the few remaining roadless and low-traffic areas in Europe should be an important focus of conservation efforts; they should be urgently inventoried, included more explicitly in the law and accounted for in transport and urban planning. Considering them as complementary conservation targets would represent a concrete step towards the strengthening and adaptation of the Natura 2000 network to climate change

Do images of a personalised future body shape help with weight loss? A randomised controlled study

Background: This randomised controlled study evaluated a computer-generated future self-image as a personalised, visual motivational tool for weight loss in adults. Methods: One hundred and forty-five people (age 18–79 years) with a Body Mass Index (BMI) of at least 25 kg/m2 were randomised to receive a hard copy future self-image at recruitment (early image) or after 8 weeks (delayed image). Participants received general healthy lifestyle information at recruitment and were weighed at 4-weekly intervals for 24 weeks. The image was created using an iPad app called ‘Future Me’. A second randomisation at 16 weeks allocated either an additional future self-image or no additional image. Results: Seventy-four participants were allocated to receive their image at commencement, and 71 to the delayed-image group. Regarding to weight loss, the delayed-image group did consistently better in all analyses. Twenty-four recruits were deemed non-starters, comprising 15 (21%) in the delayed-image group and 9 (12%) in the early-image group (χ2(1) = 2.1, p = 0.15). At 24 weeks there was a significant change in weight overall (p \u3c 0.0001), and a difference in rate of change between groups (delayed-image group: −0.60 kg, early-image group: −0.42 kg, p = 0.01). Men lost weight faster than women. The group into which participants were allocated at week 16 (second image or not) appeared not to influence the outcome (p = 0.31). Analysis of all completers and withdrawals showed a strong trend over time (p \u3c 0.0001), and a difference in rate of change between groups (delayed-image: −0.50 kg, early-image: −0. 27 kg, p = 0.0008). Conclusion: One in five participants in the delayed-image group completing the 24-week intervention achieved a clinically significant weight loss, having received only future self-images and general lifestyle advice. Timing the provision of future self-images appears to be significant, and promising for future research to clarify their efficacy. Trial Registration: Australian Clinical Trials Registry, identifier: ACTRN12613000883718. Registered on 8 August 2013

The Distribution of Dust and Gas in Elliptical Galaxies

Results from IRAS and recent optical CCD surveys are examined to discuss the distribution and origin of dust and ionized gas in elliptical galaxies. In strong contrast with the situation among spiral galaxies, masses of dust in elliptical galaxies as derived from optical extinction are an order of magnitude LOWER than those derived from IRAS data. I find that this dilemma can be resolved by assuming the presence of a diffusely distributed component of dust which is not detectable in optical data. The morphology of dust lanes and their association with ionized gas in elliptical galaxies argues for an external origin of BOTH components of the ISM.Comment: Invited talk given at conference on "NEW EXTRAGALACTIC PERSPECTIVES IN THE NEW SOUTH AFRICA: Changing Perceptions of the Morphology, Dust Content and Dust-Gas Ratios in Galaxies", Held in Johannesburg, South Africa, during January 22-26, 1996. Proceedings will be edited by D.L. Block and published by Kluwer, Dordrecht, The Netherlands. uuencoded, gzipped LaTeX file of 8 pages; figures included as PostScript files (enclosed). Uses crckapb.sty (enclosed) and psfig.st

Abundance, movements and biodiversity of flying predatory insects in crop and non-crop agroecosystems

[EN] Predatory insects are key natural enemies that can highly reduce crops pest damage. However, there is a lack of knowledge about the movements of flying predatory insects in agroecosystems throughout the year. In particular, it is still unclear how these predators move from crop to non-crop habitats, which are the preferred habitats to overwinter and to spread during the spring and if these predators leave or stay after chemical treatments. Here, the Neuroptera, a generalist, highly mobile, flying predator order of insects, was selected as model. We studied the effects of farming management and the efficiency of edge shelterbelts, ground cover vegetation, and fruit trees canopy on holding flying predatory insects in Mediterranean traditional agroecosystems. Seasonal movements and winter effects were also assessed. We evaluated monthly nine fruit agroecosystems, six organic, and three pesticides sprayed, of 0.5-1 ha in eastern Spain during 3 years using two complementary methods, yellow sticky traps and aspirator. Results show surprisingly that the insect abundance was highest in pesticide sprayed systems, with 3.40 insects/sample versus 2.32 insects/sample in organic systems. The biodiversity indices were highest in agroecosystems conducted under organic management, with S of 4.68 and D of 2.34. Shelterbelts showed highest biodiversity indices, S of 3.27 and D of 1.93, among insect habitats. Insect species whose adults were active during the winter preferred fruit trees to spend all year round. However, numerous species moved from fruit trees to shelterbelts to overwinter and dispersed into the orchard during the following spring. The ground cover vegetation showed statistically much lower attractiveness for flying predatory insects than other habitats. Shelterbelts should therefore be the first option in terms of investment in ecological infrastructures enhancing flying predators.Sorribas Mellado, JJ.; González Cavero, S.; Domínguez Gento, A.; Vercher Aznar, R. (2016). Abundance, movements and biodiversity of flying predatory insects in crop and non-crop agroecosystems. Agronomy for Sustainable Development. 36(2). doi:10.1007/s13593-016-0360-3S362Altieri MA, Letourneau DK (1982) Vegetation management and biological control in agroecosystems. Crop Prot 1:405–430. doi: 10.1016/0261-2194(82)90023-0Altieri MA, Schmidt LL (1986) The dynamics of colonizing arthropod communities at the interface of abandoned, organic and commercial apple orchards and adjacent woodland habitats. Agric Ecosyst Environ 16:29–43. doi: 10.1016/0167-8809(86)90073-3Bengtsson J, Ahnström J, Weibull A (2005) The effects of organic agriculture on biodiversity and abundance: a meta-analysis. J App Ecol 42:261–269. doi: 10.1111/j.1365-2664.2005.01005.xBianchi F, Booij CJH, Tscharntke T (2006) Sustainable pest regulation in agricultural landscapes: a review on landscape composition, biodiversity and natural pest control. Proc R Soc B 273:1715–1727. doi: 10.1098/rspb.2006.3530Chaplin-Kramer RM, Rourke E, Blitzer EJ, Kremen C (2011) A meta-analysis of crop pest and natural enemy response to landscape complexity. Ecol Lett 14:922–932. doi: 10.1111/j.1461-0248.2011.01642.xCrowder DW, Northfield TD, Strand MR, Snyder WE (2010) Organic agriculture promotes evenness and natural pest control. Nature 466:109–112. doi: 10.1038/nature09183Dogramaci M, DeBano SJ, Kimoto C, Wooster DE (2011) A backpack-mounted suction apparatus for collecting arthropods from various habitats and vegetation. Entomol Exp et Appl 139:86–90. doi: 10.1111/j.1570-7458.2011.01099.xDuelli P, Studer M, Marchland I, Jakob S (1990) Population movements of arthropods between natural and cultivated areas. Biol Conserv 54:193–207. doi: 10.1016/0006-3207(90)90051-PEilenberg J, Hajek A, Lomer C (2001) Suggestions for unifying the terminology in biological control. BioControl 46:387–400. doi: 10.1023/A:1014193329979Forman RTT, Baudry J (1984) Hedgerows and hedgerow networks in landscape ecology. Environ Manage 8:495–510. doi: 10.1007/BF01871575Gurr GM, Wratten SD, Luna JM (2003) Multi-function agricultural biodiversity: pest management and other benefits. Basic Appl Ecol 4:107–116. doi: 10.1078/1439-1791-00122Hole DG, Perkins AJ et al (2005) Does organic farming benefit biodiversity? Biol Conserv 122:113–130. doi: 10.1016/j.biocon.2004.07.018Landis DA, Wratten SD, Gurr GM (2000) Habitat management to conserve natural enemies of arthropod pests in agriculture. Annu Rev Entomol 45:175–201. doi: 10.1146/annurev.ento.45.1.175Long RF, Corbett A, Lamb C, Reberg-Horton C, Chandler J, Stimmann M (1998) Beneficial insects move from flowering plants to nearby crops. Calif Agr 52:23–26. doi: 10.3733/ca.v052n05p23Östman Ö, Ekbom B, Bengtsson J (2001) Landscape heterogeneity and farming practice influence biological control. Basic App Ecol 2:365–371. doi: 10.1078/1439-1791-00072Pantaleoni RA, Ticchiati V (1988) I Neurotteri delle colture agrarie: osservazioni sulle fluttuazioni stagionali di populazione in frutteti. Boll dell’Ist di Entomol 43:43–57Panzer R, Schwartz MW (1998) Effectiveness of a vegetation-based approach to insect conservation. Conserv Biol 12:693–702. doi: 10.1111/j.1523-1739.1998.97051.xParedes D, Cayuela L, Gurr G, Campos M (2013) Effect of non-crop vegetation types on conservation biological control of pests in olive groves. PeerJ 1:1–16. doi: 10.7717/peerj.116Pekar S, Michalko R, Loverre P, Líznarová E, Cernecká L (2015) Biological control in winter: novel evidence for the importance of generalist predators. J Appl Ecol 52:270–279. doi: 10.1111/1365-2664.12363Pollard KA, Holland JM (2006) Arthropods within the woody element of hedgerows and their distribution pattern. Agric Forest Entomol 8:203–211. doi: 10.1111/j.1461-9563.2006.00297.xRand TA, Tylianakis JM, Tscharntke T (2006) Spillover edge effects: the dispersal of agriculturally subsidized insect natural enemies into adjacent natural habitats. Ecol Lett 9:603–614. doi: 10.1111/j.1461-0248.2006.00911.xSilva EB, Franco JC, Vasconcelos T, Branco M (2010) Effect of ground cover vegetation on the abundance and diversity of beneficial arthropods in citrus orchards. Bull Entomol Res 100:489–499. doi: 10.1017/S0007485309990526Smukler SM, Sánchez-Moreno S et al (2010) Biodiversity and multiple ecosystem functions in an organic farmscape. Agric Ecosyst Environ 139:80–97. doi: 10.1016/j.agee.2010.07.004Stelzl M, Devetak D (1999) Neuroptera in agricultural ecosystems. Agric Ecosyst Environ 74:305–321. doi: 10.1016/S0167-8809(99)00040-7Straub CS, Finke DL, Snyder WE (2008) Are the conservation of natural enemy biodiversity and biological control compatible goals? Biol Control 45:225–237. doi: 10.1016/j.biocontrol.2007.05.013Thierry D, Deutsch B, Paulian M, Villenave J, Canard M (2005) Typifying ecosystems by using green lacewing assemblages. Agron Sustain Dev 25:473–479. doi: 10.1051/agro:2005047Thomas CFG, Parkinson L, Griffiths GJK, García AF, Marshall EJP (2001) Aggregation and temporal stability of carabid beetle distributions in field and hedgerow habitats. J App Ecol 38:100–116. doi: 10.1046/j.1365-2664.2001.00574.xVillenave J, Thierry D, Mamun A, Lode T, Rat-Morris E (2005) The pollens consumed by common green lacewings Chrysoperla spp. in cabbage crop environment in western France. Eur J Entomol 02:547–552, 10.14411/eje.2005.078You M, Hou Y, Liu Y, Yang G, Li Z, Cai H (2004) Non-crop habitat manipulation and integrated pest management in agroecosystems. Acta Entomol Sinica 47:260–268 (http://www.insect.org.cn/EN/Y2004/V47/I2/260

Barriers to obesity management: a pilot study of primary care clinicians

BACKGROUND: Obesity is an increasing epidemic in both the US and veteran populations, yet it remains largely understudied in the Veteran's Health Administration (VHA) setting. The purpose of our study was to identify barriers to the effective management of obesity in VHA primary care settings. METHODS: Three focus groups of clinicians from a Veteran's Affairs Medical Center (VAMC) and an affiliated Community Based Outpatient Center (CBOC) were conducted to identify potential barriers to obesity management. The focus groups and previously published studies then informed the creation of a 47-item survey that was then disseminated and completed by 55 primary care clinicians. RESULTS: The focus groups identified provider, system, and patient barriers to obesity care. Lack of obesity training during medical school and residency was associated with lower rates of discussing diet and exercise with obese patients (p < 0.05). Clinicians who watched their own diets vigorously were more likely to calculate BMI for obese patients than other clinicians (42% vs. 13%, p < 0.05). Many barriers identified in previous studies (e.g., attitudes toward obese patients, lack of insurance payments for obesity care) were not prevalent barriers in the current study. CONCLUSION: Many VHA clinicians do not routinely provide weight management services for obese patients. The most prevalent barriers to obesity care were poor education during medical school and residency and the lack of information provided by the VHA to both clinicians and patients about available weight management services

Physicians' attitudes about obesity and their associations with competency and specialty: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Physicians frequently report negative attitudes about obesity which is thought to affect patient care. However, little is known about how attitudes toward treating obese patients are formed. We conducted a cross-sectional survey of physicians in order to better characterize their attitudes and explore the relationships among attitudes, perceived competency in obesity care, including report of weight loss in patients, and other key physician, training, and practice characteristics.</p> <p>Methods</p> <p>We surveyed all 399 physicians from internal medicine, pediatrics, and psychiatry specialties at one institution regarding obesity care attitudes, competency, including physician report of percent of their patients who lose weight. We performed a factor analysis on the attitude items and used hierarchical regression analysis to explore the degree to which competency, reported weight loss, physician, training and practice characteristics explained the variance in each attitude factor.</p> <p>Results</p> <p>The overall response rate was 63%. More than 40% of physicians had a negative reaction towards obese patients, 56% felt qualified to treat obesity, and 46% felt successful in this realm. The factor analysis revealed 4 factors–<it>Physician Discomfort/Bias, Physician Success/Self Efficacy, Positive Outcome Expectancy</it>, and <it>Negative Outcome Expectancy</it>. Competency and reported percent of patients who lose weight were most strongly associated with the <it>Physician Success/Self Efficacy </it>attitude factor. Greater skill in patient assessment was associated with less <it>Physician Discomfort/Bias</it>. Training characteristics were associated with outcome expectancies with newer physicians reporting more positive treatment expectancies. Pediatric faculty was more positive and psychiatry faculty less negative in their treatment expectancies than internal medicine faculty.</p> <p>Conclusion</p> <p>Physician attitudes towards obesity are associated with competency, specialty, and years since postgraduate training. Further study is necessary to determine the direction of influence and to explore the impact of these attitudes on patient care.</p