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The UN [United Nations Office on Drugs and Crime (UNODC): World Drug Report, 2005, vol. 1: Analysis. UNODC, 2005.], EU [European Monitoring Centre for Drugs and Drug Addiction (EMCDDA): Annual Report, 2005.http://annualreport.emcdda.eu.int/en/home-en.html.] and WHO [World Health Organisation (WHO): Biregional Strategy for Harm Reduction, 2005-2009. HIV and Injecting Drug Use. WHO, 2005.] have consistently highlighted in recent years the ongoing and persistent nature of opiate and particularly heroin use on a global scale. While this is a global phenomenon, authors have emphasised the significant impact such an epidemic has on individual lives and on society. National prevalence studies have indicated the scale of the problem, but the drug-using career, typically consisting of initiation, habitual use, a treatment-relapse cycle and eventual recovery, is not well understood. This paper presents one of the first ODE models of opiate addiction, based on the principles of mathematical epidemiology. The aim of this model is to identify parameters of interest for further study, with a view to informing and assisting policy-makers in targeting prevention and treatment resources for maximum effectiveness. An epidemic threshold value, R(0), is proposed for the drug-using career. Sensitivity analysis is performed on R(0) and it is then used to examine the stability of the system. A condition under which a backward bifurcation may exist is found, as are conditions that permit the existence of one or more endemic equilibria. A key result arising from this model is that prevention is indeed better than cure.

The rate of cardiovascular diseases (CVD) mortality has decreased over the last few years. However, in rural areas, this reduction is less substantial compared to urban areas despite the effort to ...

Emma White profiles a Specsavers Hearing Centre and discusses the company's engagement in audiology with joint venture partner Aekta Patel.

I was halfway through my Ph.D. coursework and struggling to define my nebulous research topic, with deadlines hurtling toward me and the MATLAB error beep propagating through my skull like a cluster bomb, when it all became too much. Smashing the keyboard in frustration and ripping incomprehensible

The discovery of two genes that predispose individuals to breast cancer has led to great excitement in the scientific world, with enormous interest shown by the media and public. This has often led to misunderstandings about the benefits of these discoveries to individuals with a family history of breast cancer. The pathway to the clinic is often difficult and full of inconsistent explanations. This increases the anxiety experienced by patients and may raise their expectations. It is necessary to be cautious when explaining the application of these discoveries to patients in the clinical setting so that they are offered a balanced view of the realities of detecting faulty genes and of the preventative measures available. Ongoing support and access to health professionals are suggested as vital components of a clinical service, and ongoing evaluation of the advantages and disadvantages of cancer genetic counselling is warrented.

Objective: To compare the incidence and severity of local side effects of urinary-derived gonadotropins administered SC and IM. Design: Prospective randomized study of women undergoing IVF treatment. Setting: Tertiary referral center for assisted reproduction. Patient(s): A total of 71 patients were randomized to receive gonadotropins by the SC (n = 41) or IM (n = 30) route. Intervention(s): One cycle of IVF with gonadotropins administered either SC or IM for ovarian stimulation. Main Outcome Measure(s): Incidence and severity of local side effects, such as redness, itching, swelling, pain, and bruising. Result(s): Pain was the most common side effect, with 55.3% and 70.1% of IM and SC injections, respectively, resulting in pain. There were no statistically significant differences in the incidence of itching or bruising after IM and SC injections. Although there was a higher incidence of redness and swelling in the SC group compared with the IM group, most cases were classified as mild. Conclusion(s): There was a significantly higher incidence of some local side effects after SC gonadotropin administration but most of these were mild and well tolerated by patients.

Bacterial receiver domains modulate intracellular responses to external stimuli in two-component systems. Sma0114 is the first structurally characterized representative from the family of receiver domains that are substrates for histidine-tryptophan-glutamate (HWE) kinases. We report the NMR structure of Sma0114 bound by Ca(2+) and BeF3(-), a phosphate analogue that stabilizes the activated state. Differences between the NMR structures of the inactive and activated states occur in helix α1, the active site loop that connects strand β3 and helix α3, and in the segment from strand β5 to helix α5 of the 455 (α4-β5-α5) face. Structural rearrangements of the 455 face typically make receiver domains competent for binding downstream target molecules. In Sma0114 the structural changes accompanying activation result in a more negatively charged surface for the 455 face. Coupling between the 455 face and active site phosphorylation is usually mediated through the rearrangement of a threonine and tyrosine residue, in a mechanism called Y-T coupling. The NMR structure indicates that Sma0114 lacks Y-T coupling and that communication between the active site and the 455 face is achieved through a conserved lysine residue that stabilizes the acyl phosphate in receiver domains. (15)N-NMR relaxation experiments were used to investigate the backbone dynamics of the Sma0114 apoprotein, the binary Sma0114·Ca(2+) complex, and the ternary Sma0114·Ca(2+)·BeF3(-) complex. The loss of entropy due to ligand binding at the active site is compensated by increased flexibility in the 455 face. The dynamic character of the 455 face in Sma0114, which results in part from the replacement of helix α4 by a flexible loop, may facilitate induced-fit recognition of target molecules.

There is evidence that creative writing forms an important part of the recovery experience of people affected by severe mental illness. In this paper, we consider theoretical models that explain how creative writing might contribute to recovery, and we discuss the potential for creative writing in psychosocial rehabilitation. We argue that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than content, and that consequently, the involvement of professional writers might be important. We describe a pilot workshop that deployed these principles and was well-received by participants. Finally, we make recommendations regarding the role of creative writing in psychosocial rehabilitation for people recovering from severe mental illness and suggest that the development of an evidence base regarding the effectiveness of creative writing is a priority.

Receiver domains control intracellular responses triggered by signal transduction in bacterial two-component systems. Here, we report the solution nuclear magnetic resonance structure and dynamics of Sma0114 from the bacterium Sinorhizobium meliloti, the first such characterization of a receiver domain from the HWE-kinase family of two-component systems. The structure of Sma0114 adopts a prototypical α(5)/β(5) Rossman fold but has features that set it apart from other receiver domains. The fourth β-strand of Sma0114 houses a PFxFATGY sequence motif, common to many HWE-kinase-associated receiver domains. This sequence motif in Sma0114 may substitute for the conserved Y-T coupling mechanism, which propagates conformational transitions in the 455 (α4-β5-α5) faces of receiver domains, to prime them for binding downstream effectors once they become activated by phosphorylation. In addition, the fourth α-helix of the consensus 455 face in Sma0114 is replaced with a segment that shows high flexibility on the pico- to nanosecond time scale by (15)N relaxation data. Secondary structure prediction analysis suggests that the absence of helix α4 may be a conserved property of the HWE-kinase-associated family of receiver domains to which Sma0114 belongs. In spite of these differences, Sma0114 has a conserved active site, binds divalent metal ions such as Mg(2+) and Ca(2+) that are required for phosphorylation, and exhibits micro- to millisecond active-site dynamics similar to those of other receiver domains. Taken together, our results suggest that Sma0114 has a conserved active site but differs from typical receiver domains in the structure of the 455 face that is used to effect signal transduction following activation.

Members of the orderHalobacterialesare obligate extreme halophiles that belong to the domainArchaea. The classification of theHalobacterialescurrently relies on a polyphasic approach, which integrates phenotypic, genotypic and chemotaxonomic characterization. However, the most utilized genetic marker for phylogeny, the 16S rRNA gene, has multiple drawbacks for use with theHalobacteriales: the species of many genera exhibit large intragenic differences between multiple ribosomal RNA operons, the gene is too conserved to discriminate reliably at the species level and it appears to be the most frequently recombined gene between closely related species. Moreover, theHalobacterialesis a rapidly expanding group due to recent successes at cultivating novel strains from a diverse set of hypersaline environments; a fast, reliable, inexpensive, portable molecular method for discriminating species is required for their investigation. Recently, multilocus sequence analysis (MLSA) has been shown to be an effective tool for strain identification and taxonomic designation, even for those taxa that experience frequent lateral gene transfer and homologous recombination. In this study, MLSA was utilized for evolutionary and taxonomic investigation of theHalobacteriales. Efficacy of the MLSA approach was tested across a hierarchical gradient using 52 halobacterial strains, representing 33 species (including names without standing in nomenclature) and 14 genera. A subset of 21 strains from the genusHaloarculawas analysed separately to test the sensitivity and relevance of the MLSA approach among closely related strains and species. The results demonstrated that MLSA differentiated individual strains, reliably grouped strains into species and species into genera and identified potential novel species and also family-like relationships. This study demonstrates that MLSA is a rapid and informative molecular method that will probably accommodate strain analysis at any taxonomic level within theHalobacteriales.

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in ICES Journal of Marine Science following peer review. The definitive publisher-authenticated version “White, E., Minto, C., Nolan, C. P., King, E., Mullins, E., and Clarke, M. 2011. First estimates of age, growth, and maturity of boarfish (Capros aper): a species newly exploited in the Northeast Atlantic. – ICES Journal of Marine Science, 68: 61–66” is available online at: http://icesjms.oxfordjournals.org/content/68/1/61, peer-reviewed, Boarfish in the Northeast Atlantic have recently been exploited commercially for fishmeal. It is a sexually dimorphic species with an estimated maximum age of 26 years, late age at maturity (A50 = 5.25 years), relatively fast rate of growth (K = 0.186 year−1), and a small asymptotic length (L∞ = 128.9 mm).

The migration of doctors and nurses from low- to high-income countries has left many countries relying on mid-level cadres as the mainstay of their health delivery system, Malawi being an example. Although an extremely important resource, little attention has been paid to the management and further development of these cadres. In this paper we use the concept of organisational justice – fairness of treatment, procedures and communication on the part of managers – to explore through a questionnaire how mid-level cadres in jobs traditionally done by higher-level cadres self-assessed their level of job satisfaction. All mid-level health workers present on the day of data collection in 34 health facilities in three health districts of Malawi, one district each from the three geographical regions, were invited to participate; 126 agreed. Perceptions of justice correlated strongly with level of job satisfaction, and in particular perceptions of how well they were treated by their managers and the extent to which they were informed about decisions and changes. Pay was not the only important element in job satisfaction; promotion opportunities and satisfaction with current work assignments were also significant. These findings highlight the important role that managers can play in the motivation, career development and performance of mid-level health workers.

INTRODUCTION: In April 2004 British General Practitioners started to work under a “new contract”, known as GMS2. This encouraged more formal review of many conditions including asthma. AIMS & OBJECTIVES: The questionnaires would enable us to identify patients willing to have telephone reviews of their asthma, those well controlled, and those with poor control. The questionnaires have allowed us to audit our asthma care over a 10 month period. SUBJECT & METHODS: The patients were identified using our clinical software, and were those who had not attended asthma review in the preceding 12 months. The questionnaires asked about smoking status, telephone reviews, and asthma control. The first cohort was posted in February 2005, and in October 2005 we sent out the same questionnaires to another cohort of “non-attenders”. RESULTS: 199 questionnaires received in February, 120 in October. Overall asthma control was good. From the first set of questionnaires (n= 199, all figure relate to 3 or more times per week), 7.5% were woken; 8.5% had their normal activities disturbed; 28% had their normal asthma symptoms; 22% used their reliever inhaler; 84% were non smokers. October 2005 n= 120, these figures were similar, again all figures relate to >3 times in the previous week; woken at night 7.5%; activities disturbed 10%; asthma symptoms 25%; use of blue inhaler 24%; 80% were non smokers. CONCLUSIONS: The questionnaires provided a snapshot of asthma control in the practice population and were easy and inexpensive to perform. It is rewarding that we have less people who have not had a review, but overall asthma control has not changed. In the future those with poor control should probably be chased more actively, perhaps by their doctor, rather than simply by the administrative staff. Conflict of interest and funding No conflict of interest was declared. Postage for the first (February 2005) questionnaires was kindly supported by AstraZeneca.