481 research outputs found
Focusing in on use of pharmacokinetic profiles in routine hemophilia care
No full textEmergence of population pharmacokinetic models for prediction of individual pharmacokinetic (PK) profiles facilitates individualization of prescribed prophylactic therapy for patients with hemophilia A and B and may have a favorable impact on clinical outcomes and annual factor utilization. How providers approach the integration and application of these data into routine clinical practice is not clear.
To explore the potential application of and barriers to incorporating PK profiles into current hemophilia prophylaxis decision making.
A facilitated group discussion of hematologists practicing within the federally-supported United States Hemophilia Treatment Center Network was conducted. Separately, a group of parents of patients with severe hemophilia less than 18 years of age participated in a focus group on individualizing prophylactic factor regimens with the use of PK data.
Physician participants constructed a conceptual model for factors that determined their selection of hemophilia prophylaxis. These factors clustered in five groupings. When charged with creating a prophylaxis regimen for a specific clinical case including PK data, eight of nine providers generated a unique regimen. Parent focus group supported PK data use as they preferred data driven treatment decisions.
Clinician application of PK data for prophylaxis decision making is heterogeneous. Prospective evaluation of the use of PK-tailored prophylaxis in routine care and its impact on patient outcomes is needed. Parents perceived that, while obtaining blood draws could be challenging, images of factor activity decay informed their decisions about physical activity timing and provided an opportunity for partnership and shared decision making with their provider
The campaign for democratic socialism 1960-1964.
No full textPhDIn early 1960 it seemed likely that the official Labour
Party defence policy would be defeated by a unilateralist
resolution at the Scarborough Conference. In response to
this possibility the Campaign for Democratic Socialism,
or CDS, was established.
The CDS projected the image of a grass-roots movement
inspired by Gaitskell's "fight and fight again" speech.
But it was run by a Campaign Committee which included
leading members of the Party like Tony Crosland, Roy
Jenkins and Patrick Gordon Walker, as well as less well
known members like Bill Rodgers, Dick Taverne, Philip
Williams, Brian Walden, Denis Howell and David Marquand.
This highly talented group launched an elaborate and
successful lobbying, publicity and briefing operation
which was influential in overturning the unilateralist
vote at the Blackpool Conference of 1961. After Blackpool
the Campaign helped many of its leading members find
seats in the House of Commons while continuing to put the
"revisionist" case through its newspaper Campaign.
The importance of the CDS in the history of the Labour
Party is, primarily, as the first internal pressure group
organised by the right of the Party. It was also the
first internal Party group to use such sophisticated
lobbying techniques. Moreover, the subsequent careers of
the leading members of the Campaign influenced the
development of the Labour Party. The CDS was an important
formative political action for many of them. Finally many
of the CDS supporters set-up or joined the SDP when it
was launched
Plasma drug concentrations and physiological measures in 'dance party' participants
No full textThe increasing use of (7) 3,4-methylenedioxymethamphetamine (MDMA) in the setting of large dance parties (‘raves’) and clubs has been the source of some concern, because of potential acute adverse events, and because animal studies suggest that MDMA has the potential to damage brain serotonin (5-HT) neurons. However, it is not yet known whether MDMA, as used in the setting of dance parties, leads to plasma levels of MDMA that are associated with toxicity to 5-HT neurons in animals. The present study sought to address this question. Plasma MDMA concentrations, vital signs, and a variety of blood and urine measures were obtained prior to, and hours after, individuals attended a dance party. After the dance party, subjects were without clinical complaints, had measurable amounts of residual MDMA in plasma, and nearly half of the subjects also tested positive for methamphetamine, another amphetamine analog that has been shown to have 5-HT neurotoxic potential in animals. Plasma concentrations of MDMA did not correlate with self-reported use of ‘ecstasy’ and, in some subjects, overlapped with those that have been associated with 5-HT neurotoxicity in non-human primates. Additional subjects were likely to have had similar concentrations while at the dance party, when one considers the reported time of drug ingestion and the plasma half-life of MDMA in humans. Hematological and biochemical analyses were generally unremarkable. Moderate increases in blood pressure, heart rate and body temperature were observed in the subjects with the highest MDMA plasma concentrations. These findings are consistent with epidemiological findings that most people who use MDMA at dance parties do not develop serious clinical complications, and suggest that some of these individuals may be at risk for developing MDMA-induced toxicity to brain serotonin neurons.Rodney J Irvine, Michael Keane, Peter Felgate, Una D McCann, Paul D Callaghan and Jason M Whit
John A Costello : The Forgotten Taioseach
No full textEThOS - Electronic Theses Online ServiceGBUnited Kingdo
The impact of politics and personalities on Conservative education policies, 1976-1997
No full textThis thesis offers a detailed examination of aspects of Conservative education policies between 1976 and 1997. While developments during this period generated considerable amounts of contemporary discussion and analysis, this is the first historical study to cover the period as a whole. Drawing on a series of interviews with many of the participants, particular attention is paid to the two major developments that affected schools during the period - the introduction of a national curriculum and Grant Maintained schools.\ud
After an introduction that includes a discussion of the methodology, the typology used within the thesis, and a related literature review, the thesis follows a narrative structure in analysing the course of Conservative education policies between 1976 and 1997. Both the origins and the context of how the various policies emerged are discussed and analysed, as well as how and why there was a radical break with the previous pattern of educational policy making and discussion.\ud
The two issues that characterise the period are the politicisation of the policy-making process, and the consequences of that politicisation on implementing the actual policies. Attention is drawn to the increasing encroachment of politics and ideology into the field of education during the 1970s and 1980s, and how this encroachment created a new `space' between policy proposals and practice. While this development was responsible for the political triumph of the 1988 Education Reform Act, it proved less successful in translating that triumph into a sustainable and coherent set of policies during the implementation stage.\ud
The process of politicisation had introduced a degree of interference by individual politicians and their advisers that was a new development in the field of education policy, and it is argued that the conflicts generated by this overdependence and over-reliance on individuals to make decisions about education policy, rather than ideological incoherence or bureaucratic or professional opposition, was the primary factor that adversely affected the course of Conservative education reforms. \u
The labour party, Europe and consensus politics 1960. 1975
No full textThis thesis concerns the Labour Party and British European Policy. While Labour, historically, has had a pluralistic structure and has been prone to internal division, in Government the Party felt compelled by the external environment within which it was operating, to maintain the 'consensus’ view. It was able to do this because the post- war consensus was strong enough to cement it into the governmental process.(^1) Out of office, however. Labour opposed the same policies it had proposed in Government. By doing so the Party performed its constitutional role of opposition and was, more importantly, also able to maintain a semblance of Party unity. So before elections and while the Party is in power, the tendency is usually towards an ideological compromise around which the Party can unite, if only temporarily. In opposition, however, the ideological differences become more acute, there is more ideological debate and those on the extreme ends of either wing of the Party stand a better chance of influencing policy. Compromises made while in government may heighten ideological disputes once the Party loses an election, since a genuine compromise is almost impossible.(^2) Applying these insights to the seemingly perennial issue of Britain's relationship with Europe, our story is fundamentally about how Labour simultaneously dealt with the emerging consensus about Common Market membership in the 1960's and early 1970's, whilst also dealing with the abiding problem of party unity. In this thesis we examine how unity in the Labour Party was so difficult to achieve for the Party leadership during a period in which British governments were persistently confronted with the need to accommodate significant changes in Britain's global role
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No full textBivalirudin during thrombolysis with catheter‐directed tPA in a heparin‐refractory patient: A case report
No full textVenous thromboembolism has increasing significance in hospitalized pediatric patients. Patients who have life‐threatening or limb‐threatening thrombotic events require thrombolysis in addition to anticoagulation. In patients who show signs of heparin resistance or heparin‐induced thrombocytopenia, it is imperative to identify alternative therapeutic options. We present a child in whom bivalirudin was used for systemic anticoagulation during catheter‐directed thrombolysis along with tissue plasminogen activator (Alteplase®) for the treatment of a near‐occlusive organ‐threatening thrombus. We also review the currently available literature on the use of combination therapy of an intravenous direct thrombin inhibitor with alteplase.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152619/1/pbc28094_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152619/2/pbc28094.pd
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