Drug-related problems in cardiovascular patients in primary care.

Coronary Heart Disease and stroke are key priorities for the NHS because they cause morbidity and mortality. Cardiovascular patients take multiple medicines for cardiovascular diseases and co-existing diseases and frequently use health services, and therefore encounter drug-related problems (DRPs). The aim of this research is to identify and characterise medicine-related and service-related problems experienced by cardiovascular patients using a screening tool in GP surgeries and community pharmacies. A screening interview (tool) was developed to identify DRPs and was administered to 259 cardiovascular patients recruited from 5 GP surgeries and 4 community pharmacies in London. Of the 259 participants, 98 consented to a home interview, which validated the DRPs identified using the screening tool and provided more in-depth information and patients' views on their use of medicines and services. Additionally, their records in participating GP surgeries and pharmacies were reviewed providing additional information on their responses. Of the 98 participants, 53 (54%) were assigned to the study group (participants with DRPs) following the screening interviews, compared with 64 (65%) finally being assigned to the study group following home interviews. The number of DRPs doubled from the screening interviews to the home interviews because of the in-depth nature of the home interview; however, the screening tool may be used to identify patients at risk of DRPs. The screening tool should be used routinely in GP surgeries and pharmacies in conjunction with medication review clinics to assess the medicines and services used by patients. DRPs, such as non-compliance, lack of information, problems impinging on the ability of a patient to consult a GP, may be addressed. Patients should be encouraged to voice their opinions and concerns about their medicines and services. This research study supports the involvement of other HCPs, e.g. pharmacists, in reviewing and optimising patients' treatment with medicines

Assessing the Energy-Efficiency Information Gap: Results from a Survey of Home Energy Auditors

Commercial and residential buildings are responsible for 42 percent of all U.S. energy consumption and 41 percent of U.S. CO2 emissions. Engineering studies identify several investments in new enegy-efficiency equipment or building retrofits that would more than pay for themselves in terms of lower future energy costs, but homeowners and businesses generally do not have good information about how to take advantage of these opportunities. Energy auditors make up a growing industry of professionals who evaluate building energy use and provide this information to building owners. This paper reports the results of a survey of nearly 500 home energy auditors and contractors that Resources for the Future conducted in summer 2011. The survey asked about the characteristics of these businesses and the services they provide, the degree to which homeowners follow up on their recommendations, and the respondents’ opinions on barriers to home energy retrofits and the role for government. Findings from the survey suggest that the audit industry only partially is filling the information gap. Not enough homeowners know about or understand audits, and the follow-through on recommendations once they do have audits is incomplete. But the survey findings suggest that low energy prices and the high cost of retrofits may be more responsible for these outcomes than failures of information.energy efficiency, climate change

A Short Wavelength GigaHertz Clocked Fiber-Optic Quantum Key Distribution System

A quantum key distribution system has been developed, using standard telecommunications optical fiber, which is capable of operating at clock rates of greater than 1 GHz. The quantum key distribution system implements a polarization encoded version of the B92 protocol. The system employs vertical-cavity surface-emitting lasers with emission wavelengths of 850 nm as weak coherent light sources, and silicon single photon avalanche diodes as the single photon detectors. A distributed feedback laser of emission wavelength 1.3 micro-metres, and a linear gain germanium avalanche photodiode was used to optically synchronize individual photons over the standard telecommunications fiber. The quantum key distribution system exhibited a quantum bit error rate of 1.4%, and an estimated net bit rate greater than 100,000 bits-per-second for a 4.2 km transmission range. For a 10 km fiber range a quantum bit error rate of 2.1%, and estimated net bit rate of greater than 7,000 bits-per-second was achieved.Comment: Pre-press versio

EuAgxAl11−x with the BaCd11-Type Structure: Phase Width, Coloring, and Electronic Structure

The EuAgxAl11−x (loading composition, x ≈ 3−8) ternary system was experimentally and theoretically investigated. According to powder X-ray diffraction, phases adopting the BaCd11-type structure (space group I41/amd, Z = 4) were obtained for a narrow composition range, i.e., x ≈ 5−6. Single-crystal X-ray crystallography showed that Ag and Al atoms share 4b, 8d, and 32i sites and that 4b site distinctly prefers Ag to Al. Eu is divalent in these phases, which was supported by both magnetometry and unit-cell dimensional analysis. Comparison with other isostructural RE (rare earth)−Ag−Al compounds showed that the BaCd11-type structure is stable specifically at the valence electron concentrations (vec) of 2.1−2.3 e− per atom. A Mulliken population analysis was performed with Extended Hückel calculations, the result of which explained the observed site preferences of the Ag and Al atoms. TB-LMTO-ASA calculations were used to study the relative energies of various models established according to crystallography and the coloring problem was included by maximizing the number of Ag−Al contacts. The calculated density of states (DOS) and crystal orbital Hamiltonian population (COHP) curves explain the stability of the BaCd11-type structure at specifically vec ≈ 2.1−2.3 e− per atom in RE−Ag−Al ternary compounds

ETHNICITY AND RISK: THE CHARACTERISTICS OF POPULATIONS IN CENSUS WARDS CONTAINING MAJOR ACCIDENT HAZARDS IN ENGLAND AND WALES

Recent geographical and sociological research has focused on analysing the environmental equity and justice dimensions of the distribution of pollution and risk. In the US, where most of this research has taken place, studies have shown that ethnic minority and poor communities bear a disproportionate burden of environmental risk, leading to accusations of environmental racism and deliberate targeting of marginal communities in siting decisions. Little attention has been given to these issues in the UK. This paper reports on a preliminary study examining the ethnic characteristics of census wards containing a particular category of technological risk known as 'major accident hazards'. The ethnic characteristics of wards with and without major accident hazard sites are analysed at national and regional scales. This reveals some evidence of a disproportionate siting of major accident hazard sites in wards with higher Asian populations. However it is stressed that these results provide no more than a preliminary indication of a pattern of distribution to be investigated further and that there are a number of significant limitations with the analysis undertaken including the size of spatial unit utilised, the lack of differentiation between major accident hazard sites and the need to examine the relationship between ethnicity and other socio-economic variables. No definitive conclusions can be drawn at this stage as to the validity, significance or cause of the apparent bias in site locations

Bringing Eyes of Faith to Film: Using Popular Movies to Cultivate a Sacramental Imagination and Improve Media Literacy in Adolescents

Adolescents are bombarded during most of their waking hours by images on various screens: computer, television, and film. As so-called digital natives, they are aware that these images are manufactured and manipulated to elicit certain responses. But while they acknowledge the artificiality of those images, they allow the same mediated messages virtually unfettered access to their hearts and minds with sad or even chilling results. Catholic educators and pastoral workers are charged with helping young people navigate the terrain created by popular media for at least two reasons: to nurture a more sophisticated approach to reading media, and to leverage Catholicism’s long history of employing art to illuminate aspects of God and the transcendent. The endeavor described in this article posits that the Great Commandment (Matthew 12:28-31), to love God and love one’s neighbor as oneself, provides an intellectual and pastoral framework for using recent popular films to sharpen media literacy skills on the one hand and to cultivate a sacramental imagination on the other, using tools that are portable to multiple disciplines and to most new films

Aspergillus fumigatus enhances elastase production in pseudomonas aeruginosaco-cultures

In the cystic fibrosis (CF) lung the presence of bacteria and fungi in the airways promotes an inflammatory response causing progressive lung damage, ultimately leading to high rates of morbidity and mortality. We hypothesized that polymicrobial interactions play an important role in promoting airway pathogenesis. We therefore examined the interplay between the most commonly isolated bacterial CF pathogen, Pseudomonas aeruginosa, and the most prevalent filamentous fungi, Aspergillus fumigatus, to test this. Co-culture experiments showed that in the presence of A. fumigatus the production of P. aeruginosa elastase was enhanced. This was confirmed by the presence of zones of clearance on Elastin-Congo Red (ECR) agar, which was identified as elastase by mass spectrometry. When P. aeruginosa were grown in a co-culture model with mature A. fumigatus biofilms, 60% of isolates produced significantly more elastase in the presence of the filamentous fungi than in its absence (P < .05). The expression of lasB also increased when P. aeruginosa isolates PA01 and PA14 were grown in co-culture with A. fumigatus. Supernatants from co-culture experiments were also significantly toxic to a human lung epithelial cell line (19–38% cell cytotoxicity) in comparison to supernatants from P. aeruginosa only cultures (P < .0001). Here we report that P. aeruginosa cytotoxic elastase is enhanced in the presence of the filamentous fungi A. fumigatus, suggesting that this may have a role to play in the damaging pathology associated with the lung tissue in this disease. This indicates that patients who have a co-colonisation with these two organisms may have a poorer prognosis