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Lower the cost for the patient Brudon, 1990 ; and thus possibly improve utilization of the services Litvack & Bodart, 1991 ; . However, since implementation of the Bamako Initiative, the profit of the health centre depends partly on income through drug selling. This may stimulate nurses to prescribe more drugs than necessary McPake, 1993 ; . Supply gaps in the local depot may also affect prescribing behaviour. During our study, all participating village pharmacies had a complete stock of the drugs listed in the essential drug list for rural pharmacies. As far as the proportion of antibiotics and injections among prescriptions is concerned, the prescribing behaviour is quite good Adikwu & Osondu, 1991 ; . The high proportion of essential drugs, and also the high proportion of drugs prescribed by international non-proprietory name INN ; , could lead to the conclusion that the essential drug system has been well integrated in the daily routine of the prescribers. Of course one must consider that the village pharmacies had a regional monopoly over drug supply. As almost all of the drugs sold in the pharmacies belong to the essential drug list and are listed by their generic INN, prescribers are more or less forced to follow this system. Nevertheless, there are differences between the three districts as far as the proportion of essential drugs and the use of INN prescription are concerned, with the highest proportions found in Solenzo, followed by Nouna and lastly Tougan. Possibly this reflects the fact that the programme was implemented first in Solenzo and last in Tougan, so that HCWs in Tougan might.
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In the area where the nerves transmit altogether, there is a chemical transmitter called neuroepinephrine. The triggering of the sympathetic nervous system causes neuroepinephrine to be released from the synapse and accepted by the receptors on the other side. So this happens in the sympathetic nervous system: a release of neuroepinephrine from the one dendrite across the synapse and activate a nerve impulse. This then turns up the thermogenesis as well as other activities generated by the nervous system. It's important to note that thermogenesis is one of the very important parts that uses up energy as this is happening. It's kind of turning up the thermostat on the body. We all have a basal metabolism which can be measured by a doctor or scientist and tells us how much activity or energy is consumed just by running our body. By using the Power Program, we can turn up the thermostat. I have experienced weight loss on the program, but I've also experienced a sweating. This is because of the thermogenesis. I have talked to quite a few people who say they have experienced an increase in sweating. If we turn up the thermostat, we're causing more of the energy we take in to go into thermogenesis as well as other areas of the sympathetic system, so less of the energy is used in work and less is used for storage and less goes to fat. The brown fat is activated, and it calls into service the white cells, which are the primary storage of fat in the body. Although we have a consistent number of fat cells, the size can vary tremendously. The number remains the same, but the size changes. Interestingly enough, one of the consequences of thermogenesis is a loss of appetite. If I'm not as hungry, I'm not going to eat as much. The same thing for exercise; when the thermostat is turned up, the metabolism is up, and I'll feel more energy. So, when people feel they have more energy, they will be able to do more, which will also help them to utilize fat. The brown fat cell is unique in its mitochondria. The mitochondria are the energy source, or power plant. In the brown fat cell, the unique mitochondria help it create energy. The brown fat cell is a real energy burner and really burns h eat. Part of the problem of human obesity has very little to do with eating habits as much as it does with brown fat cell deterioration. They have and are now conducting studies on human obesity. They are speculating that part of the problem with human obesity lies in the amount of adipose tissue activity. They've done studies with people as far as foods eaten and energy produced in lean and obese people and has found a difference in the amount of brown fat activity. Post-obese people still have a deficiency in the.
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ANNEX 1: SPEAKER BIOGRAPHIES Conor Barry, UN Framework Convention on Climate Change Secretariat Conor Barry is a Programme Officer in the Clean Development Mechanism Registration and Issuance Unit at the UN Framework Convention on Climate Change Secretariat. Pierre Boileau, Canadian Standards Association Pierre Boileau is the Manager for Climate Change for the Canadian Standards Association CSA ; , a not-for-profit standards development organization. His role is to raise awareness of new international standards for GHG monitoring and reporting and new GHG registries products that are offered by CSA. Mr. Boileau has worked for the Canadian government on GHG inventories and project-level quantification. He has also participated on UNFCCC inventory expert review teams and managed a program on GHG verification. Derik Broekhoff, World Resources Institute Derik Broekhoff is a senior member of the Greenhouse Gas Protocol team at the World Resources Institute WRI ; , and manages WRI work on carbon offset project accounting, emissions trading, and carbon market policy development. He is a primary author of the GHG Protocol for Project Accounting and currently leads a multi-stakeholder workgroup developing GHG accounting guidelines for projects in the electricity sector. Prior to joining WRI he worked for ten years in the fields of energy and climate change consulting, where he developed financial and economic analytical tools for GHG market forecasting, risk management, project evaluation, and business strategy development for a wide range of private and public sector clients. Mr. Broekhoff has a B.A. in International Relations from Stanford University and a Masters degree in Public Policy from the University of California at Berkeley. Frank Convery, University College Dublin Professor Frank Convery is Chairman of Sustainable Energy Ireland, Ireland's energy agency, and is Heritage Trust Professor of Environmental Studies at University College Dublin. He was formerly Research Professor at the Economic and Social Research Institute, and has also worked in the USA. Frank is active on a number of EU-wide investigations and bodies, and is a member of the Science Committee of the European Environment Agency. He has written extensively on resource and environmental issues and his current research relates to European Union environmental policy. Chris Dekkers, The Netherlands Ministry of Housing, Spatial Planning and the Environment Chris Dekkers is the Coordinator of the NOx Emission Trading Programme within the Directorate General for the Environment at The Netherlands Ministry of Housing, Spatial Planning and the Environment VROM ; . Mr. Dekkers has a University Degree in Mathematical Economics at the Erasmus University of Rotterdam. Mr. Dekkers' professional career includes corporate planning in industry, development work in Africa for the United Nations, and policy development for the oil industry in the Ministry of Economics. Mr. Dekkers joined the Ministry of Environment in 1990 as environmental coordinator for the refining industry and became responsible for the Development of Strategy and Policy Decisions.
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Drawing.64 breathing problems e dyspnea Becky case study .59, 144 Mirapex.506 Mirtazapine.524 Permax .499 Zoe case study .29 breathing unevenly .206 breathing, rapid Artane .515 bromocriptine . 191, 478, 502 adverse effects .502 recommended dosages .502 Bromocriptine mesylate .485 bronchitis Tasmar .520 bruising Comtan.518 buffer. 201, 532, 583 Build up . 234, 254 burning mouth Rose . See Sinemet adverse effects BuSpar .410 buttocks twitching or spasm .206 Buzz . 409, 533 C Cabergoline. 191, 485, 509 Carbex. 193, 485 carbidopa . 525, 583 ratio to levodopa.410 carotid sinus. 403, 497 cell loss footnote ; .569 chaos theory.557 Charcot.19 charts. See graphs chest pain Eldepryl .522 Mirapex.506 Tasmar .520 chin tremor. See tremor description .87 choreiform Sinemet .527 cigarettes.44, 50, 124, 158, clinical practice lagging . 591, 605 clonazepam e Klonopin Clozaril .11 CNS depressants.518 Coach . 228, 347 cocaine . 18, 160, 196 crack.161 cocaine analog .596 cocaine research smaller doses vs. fewer doses .395.
Scales triple beam, handheld, digital varieties ; .indicate drug dealing is probably occurring. Cutting agents, Inositol, mannitol, lidocaine, laxatives, local anesthetics in powdered form are popular substances added to, or "cut" with pure cocaine to increase the drug dealer's product and increase profits. They are legally sold and will usually be labeled. These items have some legitimate use, but a large amount on hand would be inconsistent with personal use. Mirrors are used for doing "lines" of powder cocaine, and can also withstand a heat source being applied if necessary freebasing ; Strainers are used to get the lumps out of powder cocaine and any cutting agent that a drug dealer is adding. Spoons a "coke" spoon ; holds a small dose of powder cocaine. Also, the spoon can withstand a heat source and may be used by those who are injecting cocaine. Burnt foil could be used either as a way to smoke crack cocaine or to heat up powder cocaine for injecting or smoking. Crack pipes are used to smoke crack cocaine. Crack pipes are homemade pipes, often fashioned out of mini liquor bottles or soda cans. Look for a hole punched in the center of the soda can or bottle. A crack pipe assembly may include the pipe, copper mesh scouring pads known as "Brillo" pads ; , metal rods, and pieces of rubber. The copper mesh is used as a filter and to hold the crack cocaine rock in place. The rod is used to position the crack cocaine rock, and the rubber or other material is used to plug any opening in the pipe. This blocks the flow of air out of the pipe. Usually large openings in the pipe are blocked and a very small hole is punched in the makeshift crack pipe. The smoke from the burning crack cocaine rock is inhaled through the small hole. Disposable cigarette lighters from which part of the metal assembly has fallen off indicate that the lighter was lit for a long period of time, consistent with what happens when a crack cocaine smoker uses a lighter as a heat source and aspirin.
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Thanks to our employees We would like to personally thank our employees for their hard work, involvement and commitment. In the past year, we have achieved a great deal: Apart from the excellent performance in Eastern Europe, we have also reached the turnaround in our business in Germany after the restructuring measures of recent years. We ask all Dyckerhoff employees to continue to do everything possible in the coming year to help Dyckerhoff continue with its success. We wish to express our particular thanks to the works council representatives for their businesslike and constructive cooperation.
Materials. All solvents were of HPLC grade obtained from BDH Poole, UK ; and Rathburn Chemicals, Ltd. Walkerburn, Scotland ; and were vacuum filtered through 45 m filters Millipore, Ireland ; before use. Testosterone, -mercaptoethanol, glycerol, Pyronin Y, sodium dodecyl sulfate, and dexamethasone were purchased from Sigma Chemical Co. Poole, Dorset, UK ; . RU 486 and SR-12813 were gifts from Roussel Uclaf Paris ; and Symphar Pharmaceuticals, respectively. Hydroxytestosterone metabolites were purchased from Steraloids Inc. Wilton, NH ; . Polyclonal anti-CYP3A antibodies for Western immunoblotting were gifts donated by Dr. Colin Henderson, University of Dundee. Animals. Female Sprague-Dawley rats 250 300 g ; were housed under conditions of 12 hr light-12 hr darkness cycle for at least 1 week before use and fed CRM diet Special Diet Services, Witham, Essex, UK ; . Administration of drugs. RU 486 50mg kg 1 day 1 for 4 days ; and SR-12813 150mg kg 1 day 1 for 4 days ; were dissolved in olive oil 1ml kg 1 ; before ip administration. Dexamethasone was dissolved in 0.9% w v ; saline and administered at 150mg kg 1 day 1 for 4 days. After overnight fasting, animals were killed on the fifth day and liver microsomes prepared immediately. Preparation of liver microsomes. After cervical dislocation, livers were placed in washing buffer. After removal of nonhepatic tissue, the liver was placed in homogenization buffer 4 weight of the washing buffer ; . The liver was scissor-minced and homogenized with 7 strokes of a motor driven plastic pestle in a glass vessel Elvehejm-Potter ; . The homogenate was then centrifuged at 15, 000g for 20 min. The supernatant was decanted and centrifuged at 180, 000g for 60 min. The pellet was washed in homogenizing buffer and centrifuged at 180, 000g 30 min. ; . The washed pellet was resuspended in storage buffer at a concentration of 20 60mg ml 1 and was stored at 135C. Protein content was determined according to the method of Lowry et al. 12 ; . JAW is in receipt of an MRC-CASE Ph.D studentship in collaboration with Testosterone hydroxylation in liver microsomes. The assay methodology SmithKline Beecham Pharmaceuticals. was based on that described by Sonderfan 10 ; . Microsomal incubations were 1 Present address : MRC EETU, St. George's Hospital Medical School, Cranperformed in 10-ml screw-top, round bottomed glass tubes BDH Ltd., Poole, mer Terrace, London. SW17 ORE UK ; . All glassware was silanised using Repelcote BDH ; . Testosterone 25 l 2 Abbreviations used are HRP, horseradish peroxidase; DAB, diaminobenziof a 10 mM solution in methanol ; was added in the test tube and was followed dine; HMG-CoA, 3-hydroxy-3-methylglutarate-CoA, ns not significant by testosterone metabolism buffer TMB, 50 mM phosphate buffer, pH 7.4 containing 5 mM MgCl2 ; and microsomal protein 1 mg ; to make a final Send reprint requests to: Dr. J. Andrew Williams, Section of Molecular volume of 750 l. The tubes were than shaken in a water bath 37C ; for 5 min Carcinogenesis, Haddow Laboratories, Institute of Cancer Research, Cotswold before the reaction volume was made up to a total of 1ml by addition of freshly Road, Sutton SM2 5NG, UK. prepared NADPH generating system 0.8 mg NADP, 1.6 mg isocitric acid, 1 757 and astemizole.
Address correspondence to: Dr. Hanns Mohler, Institute of Pharmacology and Toxicology, University of Zurich and Swiss Federal Institute of Technology, Winterthurerstr. 190, 8057 Zurich, Switzerland. E-mail: mohler pharma. unizh.ch.
Salvat, B. 1981 ; Preservation of coral reefs: scientific whim or economic necessity? Past, present and future. Proc. Fourth Int. Coral Reef Symp., Manila, 1, 225-229 and atovaquone.
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Anism: Cuticular hydrocarbons of a termitophile and its host. Science 210: 431-433. Howard, R. W., C. A. McDaniel, and G. J. Blomquist. 1982a. Chemical mimicry as an integrating mechanism for three termitophiles associated with Reticulitermes virginicus Banks ; . Psyche 89: 157167. Howard, R. W., D. W. Stanley-Samuelson, and R. D. Akre. 1990. Biosynthesis and chemical mimicry of cuticular hydrocarbons from the obligate predator, Microdon albicomatus Novak Diptera: Syrphidae ; and its ant prey, Mymica incomplete! Provancher Hymenoptera: Formicidae ; . J. Kans. Entomol. Soc. 63: 437-443. Howard, R. W., C. A. McDaniel, D. R. Nelson, G. J. Blomquist, L. T. Gelbaum, and L. H. Zalkow. 1982b. Cuticular hydrocarbons of Reticulilerm virginicus Banks ; and their role as potential species- and caste-recognition cues. J. Chem. Ecol. 8: 1227-1239. Howard, R. W., B. L. Thorne, S. C. Levings, and C. A. McDaniel. 1988. Cuticular hydrocarbons as chemotaxic characters for Nasutitermes corniger Motschulsky ; and N. ephrate Holmegren ; Isoptera: Termitidae ; . Ann. Entomol. Soc. Am. 81: 395-399. Huyton, P. M., P. A. Langley, D. A. Carlson, and M. Schwartz. 1980. Specificity of contact sex pheromones in the tsetse flies, Glossina spp. Physiol. Entomol. 5: 253-264. Jallon, J.-M. and J. R. David. 1987. Variations in cuticular hydrocarbons among the eight species of the Drosophilia melanogaster subgroup. Evolution 41: 294-302. Klahn, J. 1988. Intraspecific comb usurpation in the social wasp Polistes fuscatus. Behav. Ecol. Sociobiol. 23: 1-8. La-France, D., A. Shani, and J. Margalit. 1989. Biological activity of synthetic hydrocarbon mixtures of cuticular components of the female housefly Musca domestica L. ; . J. Chem. Ecol. 15: 14751490. Layton, J. M. and K. E. Espelie. 1995. Effects of nest paper hydrocarbons on nest and nestmate recognition in colonies of Polistes metricus Say. J. Insect Behav. 8: 103-113. Layton, J. M., M. A. Camann, and K. E. Espelie. 1994. Cuticular lipid profiles of queens, workers, and males of social wasp Polistes metricus Say are colony-specific. J. Chem. Ecol. 20: 2307-2321. Lockey, K. H. 1988. Lipids of the insect cuticle: Origin, composition and function. Comp. Biochem. Physiol. 89B: 595-645. Lockey, K. H. 1991. Insect hydrocarbon classes: Implications for chemotaxonomy. Insect Biochem. 21: 91-97. Lorenzi, M. C. 1992. Epicuticular hydrocarbons of Polistes biglumis bimaculatus Hymenoptera Vespidae ; : Preliminary results. Ethol. Ecol. Evol. 2: 61-63. McRobert, S. P. and L. L. Jackson. 1989. Description of sexual behaviors of Drosophilia rajasekari: The role of Z, Z ; -7, 11-heptacosadiene. J. Chem. Ecol. 15: 1423-1432 and atropine.
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In her initial advice to me, Ms Lennox, midwifery advisor, stated that Ms D appears to have interpreted centimetres of fundal height as being exactly equivalent to weeks of gestation. She stated that if that was the case, Ms D's practice did not accord with good professional standards and that Ms D appeared to have a significant knowledge and skill deficit. My advisor informed me that measurements of fundal height in centimetres do not correspond to weeks of gestation and that interpretation is needed with reference to expected height at different gestation, in order to convert from centimetres to weeks of gestation. My advisor further commented that using an ordinary tape measure is appropriate if the measurements are interpreted correctly. Further information was sought from Ms D to clarify how she calculated her fundal height measurements. Ms D informed me that she expected the measurement in centimetres to equal the gestation in weeks and she understood that there was an accepted variance of 2cms above and below the figure expected of the gestation. Ms D also informed me she learnt her technique of calculating fundal heights from midwifery textbooks, tutors at an institute of technology where she did her midwifery training, midwives at the public hospital antenatal clinic, and midwives with whom she was placed for practical experience during her midwifery training. Ms D also referred to the practice of obstetricians she had observed during antenatal consultations. This information was provided to my midwifery advisor for comment. My advisor informed me that she did not consider Ms D's calculation of fundal height to be appropriate. She said that this way of measuring is only a very rough guide and must be supported by how big the baby feels to the practitioner's hands and in comparison with other "pregnant bellies". With regard to where Ms D obtained her knowledge for calculating fundal heights, my advisor informed me that she had made enquiries at the teaching school in the city and had reviewed the textbooks used by student midwives concerning the measuring of height in centimetres. She informed me that she was surprised to find student midwives are taught that measuring the height in centimetres from the pubic bone to the fundus is equivalent to weeks of gestation give or take 2cms. Based on the further information provided to her concerning Ms D's technique, my advisor acknowledged that Ms D provided services with reasonable care and skill and in line with her teaching. However, my advisor qualified her comments by noting that several of Ms D's measurements were large even by her own interpretation. She stated that given the large measurements she was surprised Ms D did not pay more attention to the comments by the other midwife and by the practice nurse that the baby was large for dates. Ms D informed me that she did take note of the "big baby" comments in Mrs B's antenatal record. She checked Mrs B's size by palpation and measured the fundal height. However, she did not consider the baby to be big. Given her measurements of Mrs B, she did not believe that Mrs B was carrying a big baby. In earlier advice to me Ms informed me that she had the benefit of being able to refer to antenatal records from Mrs B's previous pregnancies. With her second pregnancy a note had been made that the baby was a "good size" at 34 weeks, with the fundal height two weeks greater than the date. This pregnancy and artane.
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