Access to medicines in remote and rural areas: a survey of residents in the Scottish Highlands and Western Isles.

Objectives: Sparsely populated areas are potentially predisposed to health inequalities due to limited access to services. This study aimed to explore and describe issues of access to medicines and related advice experienced by residents of the Scottish Highlands and Western Isles. Study design: Cross-sectional cohort study. Methods: Anonymized questionnaires were mailed to a random sample of 6000 residents aged ≥18 years identified from the electoral register. The questionnaire contained items on: access to medicines; interactions with health care services; and perceptions of the services. Results were analysed using descriptive, inferential and spatial statistics. Results: Adjusted response rate was 49.5% (2913/5889). Almost two thirds (63.4%, 1847) were prescribed medicines regularly, 88.5% (1634) of whom considered the source convenient. Pharmacy (73.8%, 1364) or dispensing GP (24.0%, 443) were the most accessed sources. Prescription medicine advice was mainly obtained from the GP (55.7%, 1029). Respondents ≥80 years old were significantly (P0.0001) more likely to live alone (45.3%, 92) compared with those 80 (15.8%, 424). Almost a fifth (16.5%, 31) of those 80 years living alone disagreed that they obtained prescribed medicines from a convenient source. The majority of respondents who felt they did not have a convenient medicines source, regardless of urban/rural classification, lived within five miles of a pharmacy or GP practice. Conclusions: Respondents accessed medicines and advice from a variety of sources. While most considered their access to medicines convenient, there were issues for those over 80 years and living alone. Perceived convenience would not appear to be solely based on geographical proximity to supply source. This requires further exploration given that these individuals are likely to have long-term conditions and be prescribed medicines on a chronic basis

Natural Inflation From Fermion Loops

``Natural'' inflationary theories are a class of models in which inflation is driven by a pseudo-Nambu-Goldstone boson. In this paper we consider two models, one old and one new, in which the potential for inflation is generated by loop effects from a fermion sector which explicitly breaks a global $U(1)$ symmetry. In both models, we retrieve the ``standard'' natural inflation potential, $V\left(\theta\right) = \Lambda^4\left[1 + \cos\left(\theta / \mu\right)\right]$, as a limiting case of the exact one-loop potential, but we carry out a general analysis of the models including the limiting case. Constraints from the COBE DMR observation and from theoretical consistency are used to limit the parameters of the models, and successful inflation occurs without the necessity of fine-tuning the parameters.Comment: (Revised) 15 pages, LaTeX (revTeX), 8 figures in uuencoded PostScript format. Version accepted for publication in Phys. Rev. D 15. Corrected definition of power spectrum and added three reference

Gravitational field around a screwed superconducting cosmic string in scalar-tensor theories

We obtain the solution that corresponds to a screwed superconducting cosmic string (SSCS) in the framework of a general scalar-tensor theory including torsion. We investigate the metric of the SSCS in Brans-Dicke theory with torsion and analyze the case without torsion. We show that in the case with torsion the space-time background presents other properties different from that in which torsion is absent. When the spin vanish, this torsion is a $\phi$-gradient and then it propagates outside of the string. We investigate the effect of torsion on the gravitational force and on the geodesics of a test-particle moving around the SSCS. The accretion of matter by wakes formation when a SSCS moves with speed $v$ is investigated. We compare our results with those obtained for cosmic strings in the framework of scalar-tensor theory.Comment: 22 pages, LaTeX, presented at the "XXII - Encontro Nacional de Fisica de Particulas e Campos", Sao Lourenco, MG, Brazi

Transgenic amplification of glucocorticoid action in adipose tissue causes high blood pressure in mice

Obesity is closely associated with the metabolic syndrome, a combination of disorders including insulin resistance, diabetes, dyslipidemia, and hypertension. A role for local glucocorticoid reamplification in obesity and the metabolic syndrome has been suggested. The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) regenerates active cortisol from inactive 11-keto forms, and aP2-HSD1 mice with relative transgenic overexpression of this enzyme in fat cells develop visceral obesity with insulin resistance and dyslipidemia. Here we report that aP2-HSD1 mice also have high arterial blood pressure (BP). The mice have increased sensitivity to dietary salt and increased plasma levels of angiotensinogen, angiotensin II, and aldosterone. This hypertension is abolished by selective angiotensin II receptor AT-1 antagonist at a low dose that does not affect BP in non-Tg littermates. These findings suggest that activation of the circulating renin-angiotensin system (RAS) develops in aP2-HSD1 mice. The long-term hypertension is further reflected by an appreciable hypertrophy and hyperplasia of the distal tubule epithelium of the nephron, resembling salt-sensitive or angiotensin II–mediated hypertension. Taken together, our findings suggest that overexpression of 11β-HSD1 in fat is sufficient to cause salt-sensitive hypertension mediated by an activated RAS. The potential role of adipose 11β-HSD1 in mediating critical features of the metabolic syndrome extends beyond obesity and metabolic complications to include the most central cardiovascular feature of this disorder

The genus Aloe L. (Asphodelaceae: Alooideae) in Malawi

Malawi is a landlocked country situated in the eastern section of South Tropical Africa. This relatively small country has a rich mosaic of habitats owing to the varied topography, altitudinal ranges and rainfall found in different areas. Malawi harbours at least 21 different aloes, three of which are endemic to the country. Aloes in Malawi are severely threatened by habitat destruction and many species are in dire need of conservation. A key to the aloes of Malawi is provided, as well as a description, illustration, distribution map and information on habitat, flowering time, and conservation status for each of the species.Malawi ist ein Land ohne Meereszugang im östlichen Teil des südlichen tropischen Afrikas. Das relativ kleine Land hat bedingt durch variable Topographie und Höhenlagen sowie unterschiedliche Regenmengen ein reiches Mosaik verschiedener Habitate. In Malawi sind mindestens 21 Aloe-Arten heimisch, von welchen drei für das Land endemisch sind. Die Aloe-Arten Malawis sind durch Habitatzerstörung stark gefährdet, und zahlreiche Arten bedürfen dringend Schutzmassnahmen. Es wird ein Schlüssel zu den malawischen Arten gegeben, sowie für jede Arte Beschreibung, Abbildung, Verbreitungskarte und Angaben zu Standort, Blütezeit, und Gefährdungsstatus.http://www.bcss.org.uk/journal.htmlam201

Gravitational field around a time-like current-carrying screwed cosmic string in scalar-tensor theories

In this paper we obtain the space-time generated by a time-like current-carrying superconducting screwed cosmic string(TCSCS). This gravitational field is obtained in a modified scalar-tensor theory in the sense that torsion is taken into account. We show that this solution is comptible with a torsion field generated by the scalar field $\phi$. The analysis of gravitational effects of a TCSCS shows up that the torsion effects that appear in the physical frame of Jordan-Fierz can be described in a geometric form given by contorsion term plus a symmetric part which contains the scalar gradient. As an important application of this solution, we consider the linear perturbation method developed by Zel'dovich, investigate the accretion of cold dark matter due to the formation of wakes when a TCSCS moves with speed $v$ and discuss the role played by torsion. Our results are compared with those obtained for cosmic strings in the framework of scalar-tensor theories without taking torsion into account.Comment: 21 pages, no figures, Revised Version, presented at the "XXIV- Encontro Nacional de Fisica de Particulas e Campos ", Caxambu, MG, Brazil, to appear in Phys. Rev.

Oscillations During Inflation and the Cosmological Density Perturbations

Adiabatic (curvature) perturbations are produced during a period of cosmological inflation that is driven by a single scalar field, the inflaton. On particle physics grounds -- though -- it is natural to expect that this scalar field is coupled to other scalar degrees of freedom. This gives rise to oscillations between the perturbation of the inflaton field and the perturbations of the other scalar degrees of freedom, similar to the phenomenon of neutrino oscillations. Since the degree of the mixing is governed by the squared mass matrix of the scalar fields, the oscillations can occur even if the energy density of the extra scalar fields is much smaller than the energy density of the inflaton field. The probability of oscillation is resonantly amplified when perturbations cross the horizon and the perturbations in the inflaton field may disappear at horizon crossing giving rise to perturbations in scalar fields other than the inflaton. Adiabatic and isocurvature perturbations are inevitably correlated at the end of inflation and we provide a simple expression for the cross-correlation in terms of the slow-roll parameters.Comment: 23 pages, uses LaTeX, added few reference

Large Scale Structure Formation with Global Topological Defects. A new Formalism and its implementation by numerical simulations

We investigate cosmological structure formation seeded by topological defects which may form during a phase transition in the early universe. First we derive a partially new, local and gauge invariant system of perturbation equations to treat microwave background and dark matter fluctuations induced by topological defects or any other type of seeds. We then show that this system is well suited for numerical analysis of structure formation by applying it to seeds induced by fluctuations of a global scalar field. Our numerical results are complementary to previous investigations since we use substantially different methods. The resulting microwave background fluctuations are compatible with older simulations. We also obtain a scale invariant spectrum of fluctuations with about the same amplitude. However, our dark matter results yield a smaller bias parameter compatible with $b\sim 2$ on a scale of $20 Mpc$ in contrast to previous work which yielded to large bias factors. Our conclusions are thus more positive. According to the aspects analyzed in this work, global topological defect induced fluctuations yield viable scenarios of structure formation and do better than standard CDM on large scales.Comment: uuencoded, compressed tar-file containing the text in LaTeX and 12 Postscript Figures, 41 page

Primeval Corrections to the CMB Anisotropies

We show that deviations of the quantum state of the inflaton from the thermal vacuum of inflation may leave an imprint in the CMB anisotropies. The quantum dynamics of the inflaton in such a state produces corrections to the inflationary fluctuations, which may be observable. Because these effects originate from IR physics below the Planck scale, they will dominate over any trans-Planckian imprints in any theory which obeys decoupling. Inflation sweeps away these initial deviations and forces its quantum state closer to the thermal vacuum. We view this as the quantum version of the cosmic no-hair theorem. Such imprints in the CMB may be a useful, independent test of the duration of inflation, or of significant features in the inflaton potential about 60 e-folds before inflation ended, instead of an unlikely discovery of the signatures of quantum gravity. The absence of any such substructure would suggest that inflation lasted uninterrupted much longer than ${\cal O}(100)$ e-folds.Comment: 17 pages, latex, no figures; v3: added references and comments, final version to appear in Phys. Rev.

Phenotypic dissection of the mouse Ren-1(d) knockout by complementation with human renin

Normal renin synthesis and secretion is important for the maintenance of juxtaglomerular apparatus architecture. Mice lacking a functional Ren-1d gene are devoid of renal juxtaglomerular cell granules and exhibit an altered macula densa morphology. Due to the species-specificity of renin activity, transgenic mice are ideal models for experimentally investigating and manipulating expression patterns of the human renin gene in a native cellular environment without confounding Renin-angiotensin-system interactions. A 55 kb transgene encompassing the human renin locus was crossed onto the mouse Ren-1d-null background, restoring granulation in juxtaglomerular cells.  Correct processing of human renin in dense core granules was confirmed by immunogold labelling. After stimulation of the renin-angiotensin system, juxtaglomerular cells contained rhomboid protogranules with paracrystalline contents, dilated rough endoplasmic reticulum and electron-lucent granular structures. However, complementation of Ren-1d-/- mice with human renin was unable to rescue the abnormality seen in macula densa structure. The juxtaglomerular apparatus was still able to respond to tubuloglomerular feedback in isolated perfused juxtaglomerular apparatus preparations, although minor differences in glomerular tuft contractility and macula densa cell calcium handling were observed. This study reveals that the human renin protein is able to complement the mouse Ren-1d-/- non-granulated defect and suggests that granulopoiesis requires a structural motif that is conserved between the mouse Ren-1d and human renin proteins. It also suggests that the altered macula densa phenotype is related to the activity of the renin-1d enzyme in a local juxtaglomerular renin-angiotensin system