Ethical decision-making, passivity and pharmacy

Background: Increasing interest in empirical ethics has enhanced understanding of healthcare professionals' ethical problems and attendant decision-making. A four-stage decision-making model involving ethical attention, reasoning, intention and action offers further insights into how more than reasoning alone may contribute to decision-making. Aims: To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an under-researched professional group. Methods: 23 purposively sampled UK community pharmacists were asked, in semi-structured interviews, to describe ethical problems in their work and how they were resolved. Framework analysis of transcribed interviews utilised the four decision-making stages, together with constant comparative methods and deviant-case analysis. Results: Pharmacists were often inattentive and constructed problems in legal terms. Ethical reasoning was limited, but examples of appeals to consequences, the golden rule, religious faith and common-sense experience emerged. Ethical intention was compromised by frequent concern about legal prosecution. Ethical inaction was common, typified by pharmacists' failure to report healthcare professionals' bad practices, and ethical passivity emerged to describe these negative examples of the four decision-making stages. Pharmacists occasionally described more ethically active decision-making, but this often involved ethical uncertainty. Discussion: The four decision-making stages are a useful tool in considering how healthcare professionals try to resolve ethical problems in practice. They reveal processes often ignored in normative theories, and their recognition and the emergence of ethical passivity indicates the complexity of decision-making in practice. Ethical passivity may be deleterious to patients' welfare, and concerns emerge about improving pharmacists' ethical training and promoting ethical awareness and responsibility

A new prescription for empirical ethics research in pharmacy: a critical review of the literature

Empirical ethics research is increasingly valued in bioethics and healthcare more generally, but there remain as yet under-researched areas such as pharmacy, despite the increasingly visible attempts by the profession to embrace additional roles beyond the supply of medicines. A descriptive and critical review of the extant empirical pharmacy ethics literature is provided here. A chronological change from quantitative to qualitative approaches is highlighted in this review, as well as differing theoretical approaches such as cognitive moral development and the four principles of biomedical ethics. Research with pharmacy student cohorts is common, as is representation from American pharmacists. Many examples of ethical problems are identified, as well as commercial and legal influences on ethical understanding and decision making. In this paper, it is argued that as pharmacy seeks to develop additional roles with concomitant ethical responsibilities, a new prescription is needed for empirical ethics research in pharmacy - one that embraces an agenda of systematic research using a plurality of methodological and theoretical approaches to better explore this under-researched discipline

HIV-1 envelope protein gp41: An NMR study of dodecyl phosphocholine embedded gp41 reveals a dynamic prefusion intermediate conformation.

Human immunodeficiency viral (HIV-1) fusion is mediated by the viral envelope gp120/gp41 complex (ENVelope glycoprotein). After gp120 shedding, gp41 is exposed and elicits membrane fusion via a cascade of conformational changes. In contrast to prefusion and postfusion conformation, little is known about any intermediate conformation. We report on a solution NMR investigation of homotrimeric HIV-1 gp4127–194, comprising the transmembrane region and reconstituted in dodecyl phosphocholine (DPC) micelles. The protein is mainly α-helical, but experiences internal dynamics on the nanosecond and micro to millisecond time scale and transient α-helical behavior for certain residues in the N-terminal heptad repeat (NHR). Strong lipid interactions are observed, in particular for C-terminal residues of the NHR and imunodominant loop region connecting NHR and C-terminal heptad repeat (CHR). Our data indicate an extended conformation with features anticipated for a prefusion intermediate, presumably in exchange with a lowly populated postfusion six-helical bundle conformation

Infection of maize by Fusarium species and contamination with fumonisin in Africa

Fusarium is one of the major fungal genera associated with maize in Africa. This genus comprises several toxigenic species including F. verticillioides and F. proliferatum, which are the most prolific producers of fumonisins. The fumonisins are a group of economically important mycotoxins and very common contaminants of maize-based foods and feeds throughout the world. They have been found to be associated with several animal diseases such as leukoencephalomalacia in horses and pulmonary oedema in pigs. Effects of fumonisins on humans are not yet well understood. However, their occurrence in maize has been associated with high incidences of oesophageal and liver cancer. Infection of maize by Fusarium species and contamination with fumonisins are generally influenced by many factors including environmental conditions (climate, temperature, humidity), insect infestation and pre- and postharvest handling. Attempts to control F. verticillioides and to detoxify or reduce fumonisin levels in maize have been undertaken. However, more research studies are urgently needed in order to understand more about this toxin. Fumonisins are less documented because they are recently discovered mycotoxins compared to aflatoxins. To date in Africa, apart from South Africa, very little information is available on Fusarium infection and fumonisin contamination in maize. It is a matter of great concern that on this continent, millions of people are consuming contaminated maize and maize-based foods daily without being aware of the danger. Key words: Fusarium, fumonisins, maize, Africa. African Journal of Biotechnology Vol. 2 (12), pp. 570-579, December 200

Age and food deprivation affects expression of the glucocorticosteriod stress response in Magellanic penguin (Spheniscus magellanicus) chicks

We examined how the glucocortical stress response in free‐living Magellanic penguin (Spheniscus magellanicus) chicks changes with age and whether adrenocortical function of chicks within a brood varies in relation to food provisioned by adults. Chicks showed little corticosterone response to capture stress shortly after hatching, an intermediate response around 45‐d posthatch, and a robust stress response near fledging. However, in response to an adrenocorticotropic hormone (ACTH) challenge, hatchlings were capable of secreting corticosterone at adult‐like levels. The larger sibling in broods of two showed a similar gradual stress‐response development pattern. In contrast, by day 45, when differences in body condition were well established between siblings, the smaller, food‐deprived chicks significantly increased baseline levels of corticosterone but showed normal stress‐induced levels. Near fledging, baseline levels had returned to normal, but stress‐induced levels were lower than expected. Similar to altricial species, normally developing semialtricial Magellanic penguin chicks do not express a robust corticosterone stress response until near fledging. Chronic stressors such as food deprivation cause corticosterone use to be up‐regulated earlier than expected. However, in cases of extended chronic stress, down‐regulation may ensue, thus avoiding the negative effects of chronically elevated levels of corticosterone

Physiological condition in Magellanic Penguins: Does it matter if you have to walk a long way to your nest?

Colony edges, as opposed to interiors, are often considered less advantageous nesting places in colonial species. For temperate-breeding penguins, inland colony edges should be less desirable than other edges, as there are added costs of walking farther inland, and ambient temperatures are higher. During settlement and incubation, we compared body condition and baseline and stress-induced levels of the hormone corticosterone in male Magellanic Penguins (Spheniscus magellanicus) nesting on the sea edge of a colony with those nesting on the inland edge, \u3e800 m from shore. Body condition in both groups was significantly lower during settlement than during incubation, but was similar in both groups within breeding stages. Corticosterone levels were similar between breeding stages and for groups within each breeding stage. While body condition can vary over time, penguins appear to be well buffered to physiological extremes, as they do not show modification of corticosterone levels with variations in nesting conditions

The thermal characteristics of roofs: policy, installation and performance

This paper investigates the in-situ performance of UK cold pitched roof structures through a case study dwelling of typical construction using site survey, and estimation of U-values through simple calculation and from measured heat flow data. Significant increases of U-values resulted from under- and un-insulated areas due to installation issues, whilst a higher than expected estimated thermal resistance of the roof space and structure was also noted, potentially associated with heat gains. Both issues are expected to be observed more widely in the stock and contribute to a performance gap for roof insulation

Analysis and design of the twisted loop antenna topology for mobile communications

The handset product has been styled in successive years to reach more compact sizes and there has as a result been a reduction in volume available to house antennas; therefore size/performance trade-offs have had to become accommodated. Some of the issues antenna engineers are currently confronted with include; frequency shifting due to the antenna not being isolated from the handset, far field pattern deformation due to close proximity effects from the energy absorbing human tissues, distortion caused by noise from electronic components that share the handheld platform. What is required is antenna technology, which maintains a high enough performance despite the escalating restrictions imposed by the demands of the market. Research is performed on a twisted loop antenna topology that possesses an integral balun as part of its structure. Two rudimentary designs are utilised in the research, a simple bifilar structure that can be adapted for GSM, peN, Bluetooth and W-LAN applications, and a quadrifilar helix structure for use in GPS. Both structures are based on existing industrial dielectricloaded antenna structures but are modelled as novel air-loaded structures using a commercially available Method of Moments (MoM) electromagnetic simulator. In this fashion, the antennas could be generated quickly with low computational requirements. A parametric study is performed on the bifilar antenna structure to gain an enhanced understanding of the twisted loop topology. Once this understanding is achieved proposed modifications to the structure are implemented to improve the performance of the antenna. The main subject of improvement is the broadening of bandwidth as normally dielectric-loaded antennas have inherent narrow bandwidth. Any improvements made on the air-loaded structures could be tested on dielectric structures in future research. The most successful novel approach attempted to increase the bandwidth in the twisted loop structure was the insertion of parasitic helices to create a coupled multi-pole filter response. In conjunction with the work performed on the bifilar, an air-loaded GPS quadrifilar helix antenna was also modelled. A method for inducing circular polarisation is proposed and then by the insertion of parasitics into the quadrifilar helix design a novel dual-band dual-polarised antenna is presented. Finally measurements are made to demonstrate the advantageous properties the dielectric-loaded GPS antenna has over conventional GPS antennas.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Impact of indigenous storage systems and insect infestation on the contamination of maize with fumonisins

Four storage systems of maize commonly used by farmers in Benin, West Africa, were tested to determine their impact on infection of maize by Fusarium and subsequent contamination with fumonisins. The study showed that Fusarium incidence was significantly higher when maize was stored on a cemented floor in a house, a non ventilated facility (40.3 ± 17.4%), than in the other tested systems (p < 0.05). The lowest Fusarium incidence was recorded when maize was stored in a bamboo granary that is a ventilated facility (25.5 ± 13.5%) (p < 0.05). All maize samples from the tested storage systems were found to be fumonisin positive, with levels ranging from 0.6 to 2.4 mg/kg. Fumonisin level, overall, was found to decrease over the storage period, but not significantly in all the tested storage systems. Damage by lepidopterous pests was significantly and positively correlated with both infection of maize with Fusarium and contamination by fumonisin. In contrary, damage by coleopterous insects was significantly and negatively correlated with infection of maize with Fusarium and contamination by fumonisin. Avoiding the use of non-ventilated systems to store maize and reducing insect infestation in field and during storage are very important recommendations for farmers.Keywords: Maize, storage systems, Fusarium, fumonisins, insect infestatio