Association between antibiotic prescribing and deprivation in Wales: A multilevel analysis

Introduction The most recent Welsh Antimicrobial Resistance Programme (WARP) report on antibiotic use in primary care found significant variations between Health Boards and hospitals in gross antibiotic use in 2014. The aim of this study was to evaluate the association between socioeconomic deprivation and antibiotic prescribing volumes. Objectives and Approach Welsh General Practitioner (GP) antibiotic prescribing data for years 2013 to 2016 for patients’ resident in Wales were extracted from the Secure Anonymised Information Linkage GP tables. Deprivation was assessed by linking prescribing events to the Welsh Index of Multiple Deprivation (WIMD) score for the patient’s neighbourhood area. The association between deprivation area and antibiotic prescribed (items per 1000 persons per day) was stratified according to the patient’s age, sex, prescription year and antibiotic class. A three-level multilevel Poisson regression model of 1.58 million patients nested within 349 GP practices, nested with 67 GP clusters, was specified to assess the associations Results Just over 7.97 million antibiotic items were prescribed between 2013 and 2016. Patients in the most deprived WIMD quintile had an overall prescription rate that was 25.2% higher than those in the least deprived WIMD quintile. The final model revealed that residing in the most deprived WIMD quintile (incidence rate ratio [IRR] = 1.1769, 95% confidence interval [CI] 1.1768 to 1.1770, being female (IRR = 1,2699, 95% CI 1.2698 to 1.2700), being aged $\geq$90 (IRR = 2.0687, 95% CI 2.0683 to 2.0690), and prescription year being 2013 were associated with significantly higher rate of antibiotics prescription. There were significant primary cares clustering of antibiotics prescription in Wales. Conclusion/Implications This study provides evidence that patients in areas of higher socioeconomic deprivation are more likely to be prescribed antibiotics in primary care in Wales. Population health prevention strategies aimed at reducing high antibiotic prescription rates should consider targeting areas of high deprivation

Fusion 1 : science 11-14

Proporciona una serie de recursos sobre el funcionamiento integrado del trabajo científico a los alumnos de la etapa 3 de secundaria (key stage 3). Está escrito para cumplir con los requisitos del programa de estudios de 2008, ayuda a desarrollar los conocimientos y habilidades científicos e incluye además actividades e investigaciones prácticas en cada una de las lecciones. Se acompaña del recurso para el profesor.SCBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]

Fusion 2 : science 11-14

Proporciona una serie de recursos sobre el funcionamiento integrado del trabajo científico a los alumnos de la etapa 3 de secundaria (key stage 3). Está escrito para cumplir con los requisitos del programa de estudios de 2008, ayuda a desarrollar los conocimientos y habilidades científicos e incluye además actividades e investigaciones prácticas en cada una de las lecciones. Se acompaña del recurso para el profesor.SCBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]

Fusion 3 : science 11-14

Proporciona una serie de recursos sobre el funcionamiento integrado del trabajo científico a los alumnos de la etapa 3 de secundaria (key stage 3). Está escrito para cumplir con los requisitos del programa de estudios de 2008, ayuda a desarrollar los conocimientos y habilidades científicos e incluye además actividades e investigaciones prácticas en cada una de las lecciones. Se acompaña del recurso para el profesor.SCBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]

Edexcel 360 Science. Teacher pack : for GCSE biology, chemistry and physics

Prepara a los estudiantes para la obtención del título General Certificate Secondary Education (GCSE) otorgado por el organismo Edexcel. Este recurso proporciona al profesor las respuestas a las preguntas del libro del alumno, apoyo adicional con cuadernos de trabajo y actividades prácticas para las clases. Al texto impreso le acompaña un CD-ROM con material didáctico en formato Word y PDF. Tiene como material de apoyo el libro del alumno.SCBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]

Pharmacological actions of a novel, high-affinity, and selective human dopamine D3 receptor antagonist, SB277011-A.

ABSTRACT SB-277011-A {trans-N-[4-[2-(6-cyano-1,2,3,4-tetrahydroisoquinolin-2-yl)ethyl]cyclohexyl]-4-quinolininecarboxamide}, is a brain-penetrant, high-affinity, and selective dopamine D 3 receptor antagonist. Radioligand-binding experiments in Chinese hamster ovary (CHO) cells transfected with human dopamine D 3 or D 2 long (hD 3 , hD 2 ) receptors showed SB-277011-A to have high affinity for the hD 3 receptor (pK i ϭ 7.95) with 100-fold selectivity over the hD 2 receptor and over 66 other receptors, enzymes, and ion channels. Similar radioligand-binding data for SB-277011-A were obtained from CHO cells transfected with rat dopamine D 3 or D 2 . In the microphysiometer functional assay, SB-277011-A antagonized quinpirole-induced increases in acidification in CHO cells overexpressing the hD 3 receptor (pK b ϭ 8.3) and was 80-fold selective over hD 2 receptors. Central nervous system penetration studies showed that SB-277011-A readily entered the brain. In in vivo microdialysis studies, SB-277011-A (2.8 mg/kg p.o.) reversed the quinelorane-induced reduction of dopamine efflux in the nucleus accumbens but not striatum, a regional selectivity consistent with the distribution of the dopamine D 3 receptor in rat brain. SB-277011-A (2-42.3 mg/kg p.o.) did not affect spontaneous locomotion, or stimulant-induced hyperlocomotion. SB-277011-A (4.1-42.2 mg/kg p.o.) did not reverse prepulse inhibition deficits in apomorphine-or quinpirole-treated rats, but did significantly reverse the prepulse inhibition deficit in isolation-reared rats at a dose of 3 mg/kg p.o. SB-277011-A (2.5-78.8 mg/kg p.o.) was noncataleptogenic and did not raise plasma prolactin levels. Thus, dopamine D 3 receptor blockade produces few of the behavioral effects characteristic of nonselective dopamine receptor antagonists. The effect of SB-277011-A on isolation-induced prepulse inhibition deficit suggests that blockade of dopamine D 3 receptors may benefit the treatment of schizophrenia