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Public Attitudes towards Medicinal Waste and Medicines Reuse in a ‘Free Prescription’ Healthcare System
Get PDFThis study investigates public attitudes towards medicinal waste and medicines reuse within a ‘free prescription’ healthcare system. A quantitative online survey was employed in a sample drawn from the population of Wales, where prescription medicines have been ‘free’ since 2007. Qualitative interviews informed the content of the attitude statements with categorical or ordinal response options assigned. The questionnaire was hosted on the HealthWise Wales platform for 1 year from October 2017. Of the 5584 respondents, 67.2% had at least one medicine on repeat prescription. Overall, 89.1% held strong concerns about medicinal waste. High acceptance for the reuse of prescription medicines which have been returned unused by patients to pharmacies was reported for tablets (78.7%) and capsules (75.1%) if the medicine is checked by a pharmacist first (92.4% rated essential). Concerns identified related to tampering of packs (69.2%) and the need for hygienic storage (65.4%). However, those working in healthcare had less concern about the safety of reusing medicines. The level of public acceptance for the reuse of medication was higher than previously reported. This is the largest survey to capture these views to date, which has implications for the future design of medicines reuse schemes
The influence of anesthesia with and without medetomidine on cardiac structure and function in sanctuary captive chimpanzees (pan troglodytes)
No full textDependent on timing of assessment, anesthetic agents and specifically medetomidinenegatively impact cardiac function in great apes. The aim of this study was todetermine the influence of tiletamine-zolazepam with and without medetomidine oncardiac structure and function in healthy chimpanzees ( Pan troglodytes ) during aperiod of relative blood pressure stability. Twenty-four chimpanzees living in an Africanwildlife sanctuary undergoing routine health assessments were stratified by age, sexand body mass and randomized to be anesthetized using either tiletamine-zolazepam(6 mg/kg; TZ; n=13; seven males and six females) or a combination of tiletamine-zolazepam (2 mg/kg) and medetomidine (0.02 mg/kg; TZM; n= 11; five males and sixfemales). During the health checks, regular heart rate and blood pressure readingswere taken and a standardized echocardiogram was performed 20-30 minutes post-induction. Data were compared between the two anesthetic groups using independentsamples T or Mann Whitney U tests. Whileheart rate (Mean ± S.D; TZ: 76 ± 10 bpm;TZM: 65 ± 14 bpm, P = 0.027), cardiac output (TZ: 3.0 ± 0.7 L/min; TZM: 2.4 ±0.7 L/min, P = 0.032) and mitral A wave velocities (TZ: 0.51 ± 0.16 cm/s; TZM:0.36 ± 0.10 cm/s, P = 0.013) were lower in the TZM group, there were no statisticallysignificant differences in cardiac structure or the remaining functional variablesbetween groups. Furthermore, there were no statistical differences in systolic (TZ114.6 ± 14.9 mmHg; TZM: 123.0 ± 28.1 mmHg; P = 0.289) or diastolic bloodpressure (TZ: 81.8 ± 22.3 mmHg, TZM: 83.8 ± 20.1 mmHg; P = 0.827) between thegroups during the echocardiogram. This study has shown that during a period ofrelative blood pressure stability there are few differences in measures of cardiacstructure and function between protocols using tiletamine-zolazepam with or withoutmedetomidine in healthy chimpanzees
The acute effects of accentuated eccentric loading on drop jump kinetics in adolescent athletes
Get PDFThe purpose of the study was to determine the acute effects of accentuated eccentric loading (AEL) on drop jump kinetics in adolescent athletes. Fifteen male rugby players (mean sd: age = 16.2 ± 1.01, weight = 73.38 ± 9.94 and height = 178.91 ± 6.74) completed three trials of a drop jump with and without an accentuated eccentric load using a dumbbell release technique that equated to 15% body mass. The addition of the AEL stimulus resulted in significant, moderate increases in jump height (p < 0.05; Wilcoxon r = 0.47) and braking and propulsive impulse (p < 0.05, Hedges’ g = 0.43; p < 0.05, g = 0.61 respectively) but did not significantly influence reactive strength index. Concurrently, there were significant, moderate increases in ground contact times (p < 0.05; r = 0.45) and reductions in spring-like correlations (p < 0.05; g = 0.94). Neither the magnitude or timing of peak landing force were significantly altered in the AEL protocol (p < 0.05, g = 0.38; p < 0.05, r = 0.10 respectively). Cumulatively, these data
indicate that implementation of AEL resulted in meaningful improvements in jump height, driven by significant increases in braking and propulsive impulse. Despite extensions in ground contact times and reductions in spring-like behavior, neither peak landing force or time to peak force were negatively altered by the AEL. These results indicate that adolescent athletes can realize superior vertical jump heights during drop jumps using AEL, without displaying marked changes in the magnitude or timing of peak landing forc
Hemolysis of PM10 on RBCs in vitro: An indoor air study in a coal-burning lung cancer epidemic area
Get PDFEpidemiological studies have suggested that inhalation exposure to indoor ambient air from coal-burning environments is causally associated with respiratory health risks. In order to explore the toxicological mechanisms behind the adverse health effects, the hemolytic activity of PM10 (particulate matter with an aerodynamic diameter of 10um or less) samples collected from homes burning coal in the recognized China “cancer village” Xuanwei were evaluated and matched against their trace elemental contents. The results demonstrated that the hemolytic activity of indoor PM10 in coal-burning environments ranged from 4.28% to 5.24%, with a clear positive dose-response relationship. Although low dose samples exhibited a reduced hemolytic activity, PM10 could have a toxic effect upon people in a coal-burning indoor environment for extended time periods. The concentrations of analyzed trace elements in PM10 samples ranged from 6966 to 12,958 ppm. Among the analyzed elements, Zn, Ti, Ni, Cu, Pb, Ba, Mn, Cr and V were found at higher concentrations and accounted for over 95% of the total elements. The concentrations of total analyzed elements in the PM10 samples revealed a significant positive correlation with PM10 hemolytic activity. Of the analyzed elements, Zn, Pb and Cs positively correlated with hemolysis, while Li, U and V negatively correlated with the hemolysis of human red blood cells (RBCs). Therefore, the heavy metal elements could be one of the main factors responsible for the hemolytic capacity of indoor PM10 in coal-burning environments
Exploring Listeria monocytogenes perceptions in small and medium sized food manufacturers: technical leaders' perceptions of risk, control and responsibility
Get PDFDue to its ability to colonise, grow and form in niches in food manufacturing environments, the management of Listeria monocytogenes can be complex, particularly for food manufacturing small and medium sized enterprises (SMEs). In addition to an effective food safety management system, the perceptions of risk, control and responsibility within a food manufacturing business are important influential factors associated with the management of L. monocytogenes. Research exploring managerial perspectives of L. monocytogenes in food manufacturer SMEs is lacking. Consequently, this study conducted in-depth interviews (n=10) with technical leaders from food manufacturing SMEs to ascertain factors that may influence listeria management, such as factors associated with cultural dimensions. Perceived risks associated with L. monocytogenes were related to business reputation and consumer health impacts, but such events were perceived to be unlikely. Technical leaders reported having clearly defined and well executed processes to ensure food safety; but for some, L. monocytogenes, as a single pathogen was seldom considered. Despite acknowledging that “everyone” had responsibility for ensuring control of the pathogen, technical leaders indicated that the ‘people’ attributes associated with organisational culture were difficult factors to control and manage. Trust in staff ability to assure food safety was widely discussed, with technical leaders acknowledging that food handlers may not necessarily have specific knowledge regarding L. monocytogenes. Some technical leaders perceived themselves as having the greatest levels of responsibility for L. monocytogenes. Overall, technical leaders perceived a medium level of risk, with high levels of control and high levels of responsibility for L. monocytogenes. Optimistic bias, illusion of invulnerability, illusion of control, and perceived attribution of responsibility are discussed, which may hinder implementation of effective listeria management in SME food manufacturing businesses. Consideration of specific pathogen risks in food manufacture in relation to food safety cultural dimensions may assist development of highly targeted and effective interventions
Whys and What Ifs: Writing and Anxiety Reduction in Individuals Bereaved by Addiction
Get PDFResearch has shown that writing can help reduce anxiety in individuals who have experienced trauma or complicated grief. This small case study asked if writing could also reduce anxiety in those bereaved by addiction. For this study, thirteen individuals who experienced increased anxiety as a result of bereavement by addiction completed two semi-structured interviews and responded to ten writing prompts over four weeks. Thematic analysis was used to analyze interview transcripts and narrative analysis was used to analyze participants’ writing. Findings from this study suggest that writing decreased anxiety for six participants by helping them to identify intrusive ruminations and by demonstrating the progress they had made since the death of their loved one. However, more research is needed to understand why writing reduced anxiety for only half of these participants and to understand how writing might be more effectively used as a therapeutic intervention for individuals bereaved by addiction
Influence of iron manipulation on hypoxic pulmonary vasoconstriction and pulmonary reactivity during ascent and acclimatization to 5050 m
Get PDFTo examine the adaptational role of iron bioavailability on the pulmonary vascular responses to acute and chronic hypobaric hypoxia, the hematological and cardiopulmonary profile of lowlanders and Sherpa were determined during: 1) a nine-day ascent to 5050m (20 lowlanders; 12 Sherpa), and 2) following partial acclimatization (11±4 days) to 5050m (18 lowlanders; 20 Sherpa), where both groups received either an i.v. infusion of iron (iron (III)-hydroxide sucrose) or an iron chelator (desferrioxamine). During ascent, there were reductions in iron status in both lowlanders and Sherpa; however, Sherpa appeared to demonstrate a more efficient capacity to mobilize stored iron, compared to lowlanders, when expressed as a hepcidin per unit change in either body iron or the soluble transferrin receptor index, between 3400-5050m (p=0.016 and p=0.029 respectively). The rise in pulmonary artery systolic pressure (PASP) was blunted in Sherpa, compared to lowlanders during ascent; however, PASP was comparable in both groups upon arrival to 5050m. Following partial acclimatization, despite Sherpa demonstrating a blunted hypoxic ventilatory response and greater resting hypoxemia, they had similar hypoxic pulmonary vasoconstriction when compared to lowlanders at rest. Iron-infusion attenuated PASP in both groups at rest (p=0.005), while chelation did not exaggerate PASP in either group at rest or during exaggerated hypoxemia (PIO2=67 mmHg). During exercise at 25% peak wattage, PASP was only consistently elevated in Sherpa, which persisted following both iron infusion or chelation. These findings provide new evidence on the complex interplay of iron regulation on pulmonary vascular regulation during acclimatization and adaptation to high altitude
The Imperative to Address Sustainability Skills Gaps in Tourism in Wales
Get PDFTourism is fundamental to the economy of Wales, and the government tourism plan 2020–2025 centres on sustainable development. This paper presents a quantitative analysis of research undertaken by the Next Tourism Generation Alliance (NTGA) project in Wales evidencing sustainability skills gaps. Survey data collected from five tourism sectors, accommodation, food and beverage, destination management, visitor attractions, travel agents and tour operators, show that the highest green and social skills gaps were identified in food and beverage businesses, whilst accommodation reported the lowest skills gaps. The effect of the type of tourism sector, business size and job level on green skills gaps perceptions was found to be insignificant, which indicates that training in sustainability skills is considered important regardless of these variables. The effect of type of tourism activity on perceptions of social skills gaps including personal and communication was significant. Addressing skills gaps is crucial given the significance of the industry in the national economy and the need for recovery from COVID-19. Tourism is one of the worst affected industries in the pandemic, and global market research and policy guidance highlight the importance of sustainable tourism development to ensure a resilient recovery
The influence of training status on right ventricular morphology and segmental strain in elite pre-adolescent soccer players
Get PDFPurpose: Cardiac modifications to training are a product of the, genetic pre-disposition for adaptation and the repetitive haemodynamic loads that are placed on the myocardium. Elite pre-adolescent athletes are exposed to high intensity training at a young age with little understanding of the physiological and clinical consequences. It is unclear how right ventricular (RV) structure and function may respond to this type of stimulus. The aim of this study was to compare RV structure and strain across the cardiac cycle and within individual segments in elite soccer players (SP) and controls (CON). Methods: Twenty-two highly trained, male pre-adolescent SP and 22 age-and sex-matched recreationally active individuals CON were investigated using 2D echocardiography, including myocardial speckle tracking to assess basal, mid-wall, apical and global longitudinal strain and strain rate during systole (SRS) and diastole (SRE and SRA). Results: Greater RV cavity size was identified in the SP compared to CON (RVD 1 SP: 32.3 ± 3.1 vs. CON: 29.6±2.8 (mm/m 2 ) 0.5 ; p=0.005). No inter-group differences were noted for peak global RV strain (SP: -28.6 ± 4.9 vs CON: -30.3 ± 4.0 %, p=0.11). Lower mid-wall strain was demonstrated in the SP compared to CON (SP: -27.9 ± 5.8 vs CON: -32.2 ± 4.4 %, p=0.007). Conclusion: Soccer training has the potential to increase RV size in pre-adolescent players. The unique segmental analyses used in this study has identified inter-group differences that were masked by global strain evaluations. The clinical and physiological implications of these findings warrant further investigation
A robust machine learning framework to identify signatures for frailty: a nested case-control study in four aging European cohorts
Get PDFPhenotype-specific omic expression patterns in people with frailty could provide invaluable insight into the underlying multi-systemic pathological processes and targets for intervention. Classical approaches to frailty have not considered the potential for different frailty phenotypes. We characterized associations between frailty (with/without disability) and sets of omic factors (genomic, proteomic, and metabolomic) plus markers measured in routine geriatric care. This study was a prevalent case control using stored biospecimens (urine, whole blood, cells, plasma, and serum) from 1522 individuals (identified as robust (R), pre-frail (P), or frail (F)] from the Toledo Study of Healthy Aging (R=178/P=184/F=109), 3 City Bordeaux (111/269/100), Aging Multidisciplinary Investigation (157/79/54) and InCHIANTI (106/98/77) cohorts. The analysis included over 35,000 omic and routine laboratory variables from robust and frail or pre-frail (with/without disability) individuals using a machine learning framework. We identified three protective biomarkers, vitamin D3 (OR: 0.81 [95% CI: 0.68–0.98]), lutein zeaxanthin (OR: 0.82 [95% CI: 0.70–0.97]), and miRNA125b-5p (OR: 0.73, [95% CI: 0.56–0.97]) and one risk biomarker, cardiac troponin T (OR: 1.25 [95% CI: 1.23–1.27]). Excluding individuals with a disability, one protective biomarker was identified, miR125b-5p (OR: 0.85, [95% CI: 0.81–0.88]). Three risks of frailty biomarkers were detected: pro-BNP (OR: 1.47 [95% CI: 1.27–1.7]), cardiac troponin T (OR: 1.29 [95% CI: 1.21–1.38]), and sRAGE (OR: 1.26 [95% CI: 1.01–1.57]). Three key frailty biomarkers demonstrated a statistical association with frailty (oxidative stress, vitamin D, and cardiovascular system) with relationship patterns differing depending on the presence or absence of a disability