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We examined non-medical use (NMU) of olanzapine among adults on methadone treatment. Information was collected on patient demographics and NMU of olanzapine. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was administered to assess risk among current users of olanzapine.
Ninety-two clients participated and 30% reported lifetime history of NMU of olanzapine. Nine people reported doses of 30 mg or higher on a typical day of use, with three typically using 100 mg. The most common reasons for use were to relieve anxiety and to aid sleep, but a quarter used it to ‘get stoned’. Eleven participants (12%) reported NMU of olanzapine in the preceding month. Eight completed the ASSIST with four scoring in the high-risk zone.
Self-medication is the dominant motivator for NMU of olanzapine, but hedonic motivations also occur. A small minority show features of dependency. All doctors should be aware of the potential NMU of olanzapine, especially among patients with history of addiction.
Current prescriptions for welfare reform and increased reliance on the voluntary sector often base their appeal on the lessons of history, in particular the apparent successes of Victorian philanthropy in combating ‘pauperism’. This article looks at how this message has become influential in the USA and the UK among the ruling parties of right and left through the particular prism of the neo-conservative appreciation of the work of Thomas Chalmers, the early nineteenth-century Scottish churchman and authority on poverty. The attraction of Chalmers, both to the Charity Organization Society then and neo-conservatives today, lies in the practical application of his idea of the ‘godly commonwealth’ in Glasgow and Edinburgh where voluntary effort, organized through the church, replaced the statutory obligations of the poor law. While Chalmers, and his followers, declared his ‘experiments’ to be great successes, modern Scottish historians have revealed these claims to be false and his efforts failures. Only by completely ignoring the evidence presented by this historiography and continuing to rely on Chalmers's own writings and earlier hagiographies can the neo-conservative approbation of Chalmers be sustained. Such wilful neglect raises questions both about their approach to history and their proposed remedies for tackling poverty today.
This article examines the role played by local councillors in constructing new housing in Scotland during the inter-war period. Rather than view local authorities as simply the objective agency of central government's ambitions to construct council houses, we argue that the self-interest and motivations of councillors have to be recognized as significant factors in this process. It is argued also that the concerns of private landlords were neither ignored nor sacrificed in the rush to build new housing. Rather, given that councils remained dominated by local business men, many of whom were private landlords, councillors acted in ways to protect their own material and class interests. In so doing, they consciously, if implicitly, shaped the social geography of twentieth-century Scotland.
A series of editorials in this Journal have argued that psychiatry is in the midst of a crisis. The various solutions proposed would all involve a strengthening of psychiatry's identity as essentially ‘applied neuroscience’. Although not discounting the importance of the brain sciences and psychopharmacology, we argue that psychiatry needs to move beyond the dominance of the current, technological paradigm. This would be more in keeping with the evidence about how positive outcomes are achieved and could also serve to foster more meaningful collaboration with the growing service user movement.
Malignant mesothelioma is a rare, highly aggressive cancer arising from mesothelial cells that line the pleural cavities. Approximately 80% of mesothelioma cases can be directly attributed to asbestos exposure. Additional suspected causes or co-carcinogens include other mineral fibres, simian virus 40 (SV40) and radiation. A mesothelioma epidemic in Turkey has demonstrated a probable genetic predisposition to mineral fibre carcinogenesis and studies of human tissues and animal models of mesothelioma have demonstrated genetic and epigenetic events that contribute to the multistep process of mineral fibre carcinogenesis. Several growth factors and their receptors have a significant role in the oncogenesis, progression and resistance to therapy of mesothelioma. Epidermal growth factor (EGF), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and insulin-like growth factor (IGF) have been shown as targets for therapy based on promising preclinical data. However, clinical trials of tyrosine kinase inhibitors in mesothelioma have been disappointing. Bcl-XL is an important antiapoptotic member of the Bcl-2 family and is overexpressed in several solid tumours, including mesothelioma. Reduction of Bcl-XL expression in mesothelioma induces apoptosis and engenders sensitisation to cytotoxic chemotherapeutic agents. Pharmacological inhibitors of antiapoptotic Bcl-2 family members continue to undergo refinement and have shown promise in mesothelioma.
We present a general construction of Salem numbers via rational functions whose zeros and poles mostly lie on the unit circle and satisfy an interlacing condition. This extends and unifies earlier work. We then consider the “obvious” limit points of the set of Salem numbers produced by our theorems and show that these are all Pisot numbers, in support of a conjecture of Boyd. We then show that all Pisot numbers arise in this way. Combining this with a theorem of Boyd, we produce all Salem numbers via an interlacing construction.
To report a large outbreak of Clostridium difficile infection (CDI; ribotype 027) between June 2007 and August 2008, describe infection control measures, and evaluate the impact of restricting the use of fluoroquinolones in controlling the outbreak.
Outbreak investigation in 3 acute care hospitals of the Northern Health and Social Care Trust in Northern Ireland.
Implementation of a series of CDI control measures that targeted high-risk antibiotic agents (ie, restriction of fluoroquinolones), infection control practices, and environmental hygiene.
A total of 318 cases of CDI were identified during the outbreak, which was the result of the interaction between C. difficile ribotype 027 being introduced into the affected hospitals for the first time and other predisposing risk factors (ranging from host factors to suboptimal compliance with antibiotic guidelines and infection control policies). The 30-day all-cause mortality rate was 24.5%; however, CDI was the attributable cause of death for only 2.5% of the infected patients. Time series analysis showed that restricting the use of fluoroquinolones was associated with a significant reduction in the incidence of CDI (coefficient, —0.054; lag time, 4 months; P = .003).
These findings provide additional evidence to support the value of antimicrobial stewardship as an essential element of multifaceted interventions to control CDI outbreaks. The present CDI outbreak was ended following the implementation of an action plan improving communication, antibiotic stewardship, infection control practices, environmental hygiene, and surveillance.
Employers of business graduates require them to be effective communicators and team members in twenty-first century work environments. As a means of developing these skills, we believe group work is important to an undergraduate business teaching pedagogy preparing graduates for the challenges of modern workplaces. Student responses to a series of qualitative and quantitative focus group activities highlighted the ‘big issues’ encountered in group activities involving an increasingly internationalised and diverse cohort of students. These issues related mainly to communication within the group and the fear of social-loafers. These insights established the basis on which proactive strategies were introduced in a subsequent teaching period to nurture and advance the quality of the learning experience within a tertiary undergraduate business education setting. Given that reduced Government funding to Australian universities has prompted the management of institutions to look to full-fee paying international students to offset shortfalls in their operating budgets, this paper explores the particular impact of increasing numbers of English as a Second Language (ESL) students on the quality of, and student receptiveness to, group based study activities.
Many areas of active research within the broad field of number theory relate to properties of polynomials, and this volume displays the most recent and most interesting work on this theme. The 2006 Number Theory and Polynomials workshop in Bristol drew together international researchers with a variety of number-theoretic interests, and the book's contents reflect the quality of the meeting. Topics covered include recent work on the Schur-Siegel-Smyth trace problem, Mahler measure and its generalisations, the merit factor problem, Barker sequences, K3-surfaces, self-inversive polynomials, Newman's inequality, algorithms for sparse polynomials, the integer transfinite diameter, divisors of polynomials, non-linear recurrence sequences, polynomial ergodic averages, and the Hansen-Mullen primitivity conjecture. With surveys and expository articles presenting the latest research, this volume is essential for graduates and researchers looking for a snapshot of current progress in polynomials and number theory.
This volume is the proceedings of a workshop on ‘Number Theory and Polynomials’ held at Bristol University, 3–7 April 2006, with about fifty participants. The workshop was the first in a series of workshops sponsored by the Heilbronn Institute for Mathematical Research. During the meeting, the participants exchanged lectures, had informal discussions, and posed problems in the broad subject area defined by the theme of the workshop. Some of the articles in these proceedings are, in whole or in part, the direct outcome of questions posed and ideas raised during the workshop.
The meeting and the proceedings shared the aim of bringing together number-theorists with varied backgrounds having a common interest in problems concerning polynomials. Many of the overseas participants were supported by the Heilbronn Institute for Mathematical Research. The articles in the proceedings are not intended to be a record of the lectures at the meeting: some of the papers are more extensive than the corresponding talks, some of the talks are not represented by papers, and non-speakers were also invited to submit papers on the theme of the workshop. Expository papers and surveys were encouraged, and many of the submissions are of this form. It is hoped that this collection of papers will form a useful resource for new and old researchers in the field.