177,693 research outputs found
Risk management and outcomes of adverse events to pioglitazone in primary care in the UK: an observational study
No full textBackground: Pioglitazone is an antidiabetic drug that belongs to the thiazolidinedione (TZD) class of insulin-sensitizing agents. Adverse events to pioglitazone of potential severity are listed in the `special warnings and special precautions for use' section of the pioglitazone summary of product characteristics (SPC), with recommendations for monitoring and management. Objective: To describe the risk management and outcomes of recognized TZD class effects in patients prescribed pioglitazone. Methods: An observational study of risk management and event outcomes for the adverse events of cardiac failure, fluid retention/oedema, weight gain, anaemia and abnormal liver function tests (LFTs) was performed. Patients were identified from within a prescription-event monitoring (PEM) postmarketing cohort of first-users of pioglitazone. Patients with pre-existing events or alternative causes, or with no possibility of collecting further information, were excluded. Outcomes included (i) the method of detection of the adverse event, i.e. whether the patient or the prescriber identified the problem; (ii) whether responsibility for risk management was taken at a primary- or secondary-care level; (iii) interventions taken to manage the event, including discontinuation of treatment; (iv) resolution and/or other outcomes of the event; and (v) general practitioner (GP) opinion of relatedness of the event to pioglitazone. Results: Acute events such as cardiac failure and oedema were more likely to be detected by the patient presenting with the event rather than at regular follow-up. GPs were more likely to take responsibility for management of abnormal LFTs, anaemia and oedema events, whereas hospital admissions occurred mainly in patients with cardiac failure (45.3%). Pioglitazone was stopped in more than 50% of each type of event, apart from anaemia. Oedema events were the most likely to resolve (87.6%) and anaemia the least likely (42.9%). Oedema events were the most likely to be attributed to the drug by GPs, whereas cardiac failure was the event least attributed to pioglitazone. Conclusions: Timely drug withdrawal and/or interventions such as corrective treatment or referral to a specialist can lead to successful resolution of class-effect adverse events of pioglitazone. Regular follow-up of patients on antidiabetic agents is essential to detect certain events, but more acute events are more likely to be reported spontaneously. Treatment options for patients with diabetes mellitus and cardiovascular risk factors are limited, requiring careful benefit-risk assessment of pioglitazone use in these patients and careful monitoring for signs of worsening cardiac function
Safety profile of oxcarbazepine: results from a prescription-event monitoring study
No full textPurpose: To monitor safety of oxcarbazepine, prescribed in primary care in England, using prescription-event monitoring (PEM). Methods: Postmarketing surveillance using observational cohort technique of PEM. Exposure data were obtained from dispensed British National Health Service prescriptions issued by general practitioners (GPs) March 2000–July 2003. Demographic, drug utilization, and clinical event data were collected from questionnaires posted to GPs at least 6 months after first prescription date for each patient. Incidence densities (IDs) (number of first reports per 1,000 patient-months of treatment) were calculated and differences for events reported in month 1 (ID1) and months 2–6 (ID2–6) (99% confidence intervals) were examined for changes in event rates. Follow-up and causality assessment of medically significant events were undertaken. Results: The cohort comprised 2,243 patients [mean age 40.4 years; range 2–99 years; standard deviation (SD) 18.8; 46.3% (n = 1,038) male]. Most frequently reported primary indications were epilepsy, convulsion (n = 1,111; 49.5%, n = 209; 9.3%, respectively). GPs recorded 932 reasons for stopping medication in 698 (31.1%) patients; most frequent clinical reason “drowsiness/sedation” (n = 57; 2.5% of cohort). Clinical events (excluding indication) associated with starting treatment (lower 99% CI > 0) included: “drowsiness/sedation” (ID1-ID2–6 = 14.2), “nausea/vomiting” (ID1-ID2–6 = 13.0), and dizziness (ID1-ID2–6 = 11.6). Events followed up and assessed as probably related to oxcarbazepine use included rash (7 of 11) and hyponatremia (15 of 38). Discussion: There were no serious adverse drug reactions reported during this study. Results of the study should be taken in context with other epidemiologic studies
Appropriate Similarity Measures for Author Cocitation Analysis
No full textWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Competizione tra Territori ed Economia Circolare
No full textIl presente lavoro intende offrire alcuni spunti di riflessione su come “paradigmi circolari” nei food systems del pianeta possano consentire di offrire risposte concrete nella ricerca di sentieri sostenibili dentro la globalizzazione. In tale ottica, esso mira a sollecitare i policy maker sulle strategie più appropriate da adottare per sostenere uno sviluppo territoriale che sia in linea con i più recenti orientamenti di Agenda 2030 e con le relative nuove responsabilità per la costruzione del benessere individuale e collettivo
Ecological Human Imprint: Global Agro Ecosystem, Balance of Human Race with Nature and Economic Sustainability
No full text"Closing the R&D Gap, Evaluating the Sources of R&D Spending"
No full textBoth spending and tax policies have been implemented in the United States with the goal of stimulating private sector research and development (R&D). Karier questions whether current R&D policy, especially the research and experimentation tax credit, can contribute to closing the gap between nondefense expenditures on R&D in the United States and such expenditures in other countries, such as Japan and Germany. He also explores possible changes to our current R&D policy to make it more effective.
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Acute inflammatory demyelinating polyneuropathy and a unilateral babinski/plantar reflex.
No full textFatwa repositioning: the hidden struggle for Shari’a compliance within Islamic financial institutions
No full textIslamic Financial Institutions (IFIs) have recently witnessed remarkable growth triggered by an increasing Islamic awareness, rising oil revenues in the Gulf and IFIs’ holistic business model. The key selling factor, however, is their Shari’a-based business proposition which often requires some financial sacrifices e.g. being ethical, responsible and philanthropic. It also requires them to refrain from investments in tobacco, alcohol, pornography or earning interest. On the other hand, for IFIs’ sponsors and managers, the key motivational factor of entrance into the Islamic financial market is not their desire for achieving Shari’a objectives through the holistic business model but rather the desire to tap this highly profitable market where customers are inclined to pay a premium for Shari’a compliance. In order for IFIs to be accepted by the market, they need to be certified by Shari’a scholars, known for their integrity and expertise in Shari’a. One can, therefore, expect potential tensions between IFIs’ managers and Shari’a scholars. The purpose of this research is, thus, to probe the struggle for achieving a high level of Shari’a compliance in the presence of a desire for business objectives within Islamic banking.The research explores the following questions. Firstly, who determines and defines Shari'a compliance? In other words, is it the Shari’a scholars who dictate Shari’a compliance ormanagers or an alliance between the two? Secondly, what are the various levels of Shari’a compliance within IFIs? Thirdly, what causal and intervening factors determine the level of Shari’a compliance within IFIs? Fourthly, what strategies are adopted by Shari’a scholars and managers to tackle this phenomenon? Lastly, what is the prevailing level of Shari’a compliance in IFIs in the present scenario? The study explores these questions using Grounded Theory (GT) as a methodological framework. The choice of GT for this research was triggered by two factors; i) non-availability of sufficient literature in this area and ii) the entwinement of the related hidden phenomena with deep social intricacies. Data, which was steered by theoretical sampling, consists mainly of in-depth interviews with a number of key stakeholders from three significant cases and a regulatory body. The findings reveal that Shari’a compliance is a complex process and is determined by a combination of religious, social, ideological, structural, regulatory and self-interest forces. Though Shari’a scholars can apparently be seen as the supreme authority in defining, dictating and implementing Shari’a compliance, the practical phenomenon is opaque because of the managers’ substantial ‘invisible hand’ in the whole process. While many Shari’a scholars employ considerable efforts in making their respective institutions genuinely Shari’a-compliant, managers, on the other hand, try to tap the market with the tag of Shari’a certification obtained from Shari’a scholars. This involves the exercise of a number of strategies e.g. avoidance, controlling, coercion, compromising, confrontation and separation on the part of the two parties.As a result, the study illustrates that Shari’a compliance is not an absolute term. Rather it is constantly being positioned and repositioned- termed as fatwa repositioning in this study- by the combination and intensity of the above-mentioned forces and strategies. It varies from ‘superficial’ to ‘reasonable’ levels on a continuum with two extremes; ‘deep’ and ‘no’ Shari’a compliance. The research has three main implications: theoretical, methodological and practical. On the theoretical side, the research contributes to the Islamic finance literature in particular and organizational control literature in general. The study claims that organizational control is much more complex in IFIs because of the struggle for achieving divergent objectives (pursued by different authorities) through the same institution. There is a latent struggle between the two parties to control each other. Interestingly, Shari’a scholars are generally not in control of what they are supposed to be controlling i.e. Shari’a compliance. On the methodological front, the study suggests some new analytical techniques e.g. a snapshot view of the coding framework and a combination of manual and computer-assisted analysis. From a practical standpoint, the study suggests that Islamic banking is currently in a critical stage. It can either become a viable alternative to the conventional banking system by genuinely incorporating Shari’a objectives into its business model or pave its way to collapse by its existing struggle to achieve business objectives through Shari’a certification from Shari’a scholars
Letter from R. R. Zellick, Assistant Trust Officer, Anglo California National Bank of San Francisco, to Joseph R. Goodman, October 2, 1942
No full textLetter from R. R. Zellick, Assistant Trust Officer at The Anglo California National Bank of San Francisco, to Joseph R. Goodman, regarding property owned by Dave Tatsuno. Zellick mentions a dispute between current tenants and Tatsuno, and that Tatsuno has asked Goodman to help locate trustworthy tenants.Personal correspondence, organizational records, government documents, publications, and other papers created or collected by Joseph R. Goodman documenting the forced removal and incarceration of Japanese Americans during World War II, as well as organized resistance to incarceration. Included in the collection are records of the Japanese Young Men's Christian Association and the Japanese American Citizens' League in San Francisco, including papers of the Japanese YMCA's executive secretary Lincoln Kanai; Sakai family papers; Goodman's correspondence to and from Japanese American incarcerees, organizations opposing forced removal and incarceration of Japanese Americans, the War Relocation Authority, and others; publications, photographs, and ephemera from the Topaz Relocation Center, where Goodman taught high school; War Relocation Authority records and publications; and newspaper clippings, pamphlets, and reports about forced removal and incarceration created by various government, religious, and civic organizations, in California and nationwide
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