It is possible that this is caused by the binding of ACEA to CB2 receptors at micromolar concentrations (Ki of 3 ± 1 μm; Hillard et al., 1999). There is evidence for the expression of CB2 receptors in neurons and glia throughout Autophagy Compound Library in vitro the CNS (Gong et al., 2006), including

in the spinal cord and primary afferents (Beltramo et al., 2006). ACEA is also a TRPV1 agonist at micromolar concentrations (Price et al., 2004). However, opening of TRPV1 channels by ACEA would further increase substance P release (Marvizon et al., 2003a), so this could not explain the reversal of the increase in NK1R internalization at high concentrations of ACEA. Our results are at variance with those of Lever & Malcangio (2002), who found that capsaicin-induced substance P release from mouse spinal cord slices was considerably increased by the CB1 antagonist rimonabant and inhibited by the endocannabinoid anandamide. learn more However, they used rimonabant at a dose, 5 μm, at which it may activate other receptors such as adenosine A1 receptors (Savinainen et al., 2003). We found that the inhibition of NK1R internalization produced by rimonabant and AM281 disappeared at micromolar doses.

As for anandamide, its inhibition could have been mediated by receptors other than CB1 that also bind anandamide, such as CB2 receptors (Devane et al., 1992; Kano et al., 2009) and TRPV1 (Zygmunt et al., 1999; Starowicz et al., 2007). AM251 is also an agonist of the novel cannabinoid receptor GPR55 (Ryberg et al., 2007;

Kano et al., 2009). However, its inhibition of substance P PR-171 order release cannot be attributed to this receptor for various reasons. First, unlike AM251, the GPR55 agonist O-1640 (Johns et al., 2007; Oka et al., 2007; Waldeck-Weiermair et al., 2008) did not inhibit NK1R internalization evoked by dorsal root stimulation (Fig. 2B). Second, like AM251, rimonabant (which acts as an antagonist of GPR55; Ross, 2009) inhibited NK1R internalization. Third, AM281, which is ineffective at GPR55 (Ross, 2009), also inhibited NK1R internalization. TRPV1 channels are activated by some endocannabinoids (Kano et al., 2009). However, the effects of the synthetic cannabinoids used in this study cannot be attributed to TRVP1 either, because NK1R internalization induced by direct application of capsaicin to the slices was not inhibited by AM251 (Fig. 6B). We have previously shown (Lao et al., 2003) that capsaicin-induced substance P release bypasses the inhibition produced by GABAB receptors and probably other GPCRs. This is because GPCRs inhibit substance P release by inactivating voltage-dependent Ca2+ channels (Strock & Diverse-Pierluissi, 2004; Raingo et al., 2007), whereas TRPV1 channels provide an alternative route for Ca2+ entry into the terminal that bypasses the voltage-dependent Ca2+ channels. The inhibition of substance P release by the CB1 antagonists AM251, AM281and rimonabant is probably caused by blockade of the effect of endocannabinoids released in the dorsal horn.

Barriers to the development of pharmacy: While core activities remain the basis of remuneration – some activities are increasingly being undertaken (albeit under supervision) by dispensing technicians, technically leaving the pharmacists with the capacity to develop their advisory role.

However, regulations prohibit undertaking different roles. The issue was not simply one of wanting payment for service, but more broadly a sense of a lack of acknowledgement of the value of advice offered. Patient registration versus unplanned services: There was a desire to have greater direct involvement with patients by offering advisory and support services, but which was undermined by pharmacists offering unplanned services, e.g. the Health Living Pharmacies initiative promoted unplanned advice services by support staff rather than more MLN8237 nmr valued pharmacist-delivered planned services. Speculation about pharmacy’s future: Future technological innovation was a consideration and pharmacy needs to prepare for such eventuality to protect its continued existence. Securing the future in the face of technological changes requires a policy that quantifies exactly what pharmacists OSI906 do and offer, and provides an element of quality assurance of their services which have demonstrable value. Our findings are based on self-selecting pharmacists, albeit in

a variety of positions – including established employee pharmacists within large corporates, locums, and pharmacists working in management. Community pharmacy’s future was considered to rest on the successful management of a redefined identity away from a core dispensing/supply model to one trading on pharmacists’; expertise and knowledge as medicines advisors. Key to this was the imperative to establish quantifiably and qualitatively the premium such advice carries; Nintedanib (BIBF 1120) establishing among the public and policy makers the value such support for medicines use can offer, such as the forthcoming evaluation of the New Medicines Service. 1. Pharmacy Voice. Community pharmacy. Our prospectus for better health. Pharmacy Voice Ltd, London

2012. 2. Smith J, Picton C, Dayan M. Now or never: shaping pharmacy for the future: The report of the Commission on future models of care delivered through pharmacy. Royal Pharmaceutical Society, London, November 2013. M. Twigg1, M. Craskeb, P. Nightingaleb, S. Howardb, D. Wrighta aUniversity of East Anglia, Norwich, UK, bCelesio, Coventry, UK Encouraging patients to identify their medication information needs and self-present for medicines use reviews may improve service uptake, satisfaction with the service itself and enhance patient outcomes. A card designed to enable patients to identify their information needs and thereby self-present for a medicines use review (MUR) was piloted in one locality within one pharmacy chain.

Incidence of adverse drug reactions in paediatric/out patients: a systematic review and meta-analysis of prospective studies British Journal of Clinical Pharmacology 2001; 52: 77–83 Tania Hardy-Osborne, Kamala Ramatar, Rachel Airley University of Huddersfield, Huddersfield, UK Pharmacists may be described as scientists, clinicians, or both. How do pharmacists and those they work with perceive the importance of scientific

knowledge and skills to pharmacy practice? In a ‘Draw a pharmacist test’, students often depicted their scientific background, whereas qualified pharmacists of all sectors rarely did, instead representing features of clinical roles. Science students and non-pharmacist academics, meanwhile, tended to project ‘shop’ stereotypes. The drawings showed increasing complexity as pharmacy students progressed SAHA HDAC clinical trial through their MPharm. As the extemporaneous dispensing and manufacturing role of pharmacists has largely disappeared, the role of the

pharmacist has had to adapt to survive in the progressive health care environment. The evolution of clinical pharmacy and pharmaceutical care has meant that pharmacists have needed to acquire GSK458 cost clinical skills. With this, however, there has arguably been a decreased emphasis on the importance of applying core scientific skills to pharmacy practice outside of the academic and industrial sectors. Recent reports suggest that pharmacists need to become reacquainted with their scientific heritage to develop their

roles and progress the profession1. This study aimed to examine pharmacists and pharmacy students’ perceptions Demeclocycline of the personality, skills and knowledge attributes held by scientists and clinical professionals, and how far this fits with the role of pharmacists within different sectors of practice. Based on Chambers’ (1983) Draw – A – Scientist test2 as a template a ‘Draw – A – Pharmacist test’ was designed and pharmacists, pharmacy students and a control group of pharmaceutical science students were asked to complete caricatures representing their perceptions of pharmacists. School research ethical approval was obtained prior to the study. Themes appearing most frequently in the drawings included smart dress, drugs, resources (BNF, MEP etc.) and a friendly demeanour (smile). Although some pharmacy students recognised the dichotomy between the scientific and clinical role of pharmacists (figure 1), this was not reflected in drawings submitted by qualified pharmacists, pharmaceutical science students or non-pharmacist academics, who tended to depict ‘shop’ stereotypes.

The severity of PD symptoms was evaluated using the Hoehn–Yahr Scale (Hoehn & Yahr, 1967) and the Unified Parkinson’s Disease Rating Scale (UPDRS; Lang & Fahn, 1989). For the diagnosis of possible mental disorders, we used the Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (First et al., 1996). Depressive symptoms, impulse control disorders and pathological gambling were screened with the Hamilton Depression Rating Scale (HAM-D; Hamilton, 1960), Minnesota

Impulsive Disorders Interview (MIDI; Christenson et al., 1994) and South Oaks selleck screening library Gambling Screen (SOGS; Lesieur & Blume, 1987), respectively. We also administered the Barratt Impulsiveness Scale-11 (BIS-11) evaluating three dimensions of impulsivity (motor impulsivity, attentional impulsivity and non-planning; Patton et al., 1995). Beyond the total BIS-11 score, we focused on attentional impulsivity because this dimension is the most definitive measure of impulsivity in PD (Antonini et al., 2011), and this dimension of the BIS-11 is the most relevant in relation to attentional functions.

Abiraterone cell line Socioeconomic status was described with the Hollingshead Four-Factor Index (Hollingshead, 1975), and general cognitive functions were assessed with the revised version of the Wechsler Adult Intelligence Scale (Wechsler, 1981). Stimuli were presented on a VP2765-LED-27″ monitor (ViewSonic, Walnut, CA, USA; refresh rate: 60 Hz, resolution: 1920 ×1080 pixel; viewing distance: (-)-p-Bromotetramisole Oxalate 50 cm; output luminance: 65 cd/m2) controlled by a personal computer (Dell XPS workstation). We used photographs of natural and urban scenes (size: 28º of visual angle), as described previously (Levy-Gigi & Kéri, 2012; Szamosi et al., 2013). The experimental trials included rapid serial presentations of scenes (exposure time: 133 ms/scene; inter-stimulus interval: 367 ms). Participants were presented with 16 scenes. Four of the 16 scenes contained superimposed letters in their center (two white target letters; two black distractor letters; Fig. 1). Twelve scenes in the sequence contained no letters. The task was to remember the target letters. Participants were

explicitly instructed to ignore and forget the distractor letters. Following each trial (presentation of 16 scenes: two scenes with target; two scenes with distractor; and 12 scenes alone in a pseudorandom order), participants were first asked to type the target letter, which was followed by immediate feedback (‘Good answer!’ with a smiling cartoon face and a symbolic monetary reward of 100 Hungarian Forints; wrong answers were not followed by feedback). Following the response, we asked the participants to type the distractor letter if they remembered that. Immediately after the letter recall task, two scenes (‘A’ and ‘B’) were exposed for 3000 ms. One of these scenes was from the sequence (serial position: 6–14). The other scene was not presented in the sequence.

Grading: 1D In the absence of randomized trial data for women with HIV infection who undertake VBAC, evidence to support benefit of VBAC and vaginal birth over elective CS is limited to expert judgement that is subject to inherent biases. The probability of a successful vaginal delivery remains dependent on current and past obstetric factors. In general, provided that the woman is being cared for in a consultant-led maternity unit and the labour properly monitored with rapid recourse to CS in the face of any difficulty, the outcome of trial of labour for mother and neonate is good,

even if scar dehiscence occurs [33]. In the non-HIV population, 70% of VBACs manage a vaginal delivery with a uterine rupture rate of about 0.3%. Therefore, where a vaginal birth has been recommended based on ART and VL, maternal FK228 cost management JQ1 nmr of the delivery, including a decision regarding VBAC, should be as for an uninfected woman. 7.2.4 Delivery by PLCS is recommended for women taking zidovudine monotherapy irrespective of plasma VL at the time of delivery (Grading: 1A) and for women with VL >400 HIV RNA copies/mL regardless of ART (see Recommendation 7.2.1) with the exception of elite controllers (see Section 5.5:

Elite controllers). Grading: 1D Zidovudine monotherapy with a planned pre-labour pre-ROMs CS is a proven option for women not requiring treatment for themselves, with a pretreatment VL <10 000 HIV RNA copies/mL plasma. Observational studies BCKDHA conducted in the early 1990s, before the use of HAART, found a reduction in MTCT with PLCS. In 1999, a large international meta-analysis (n = 8533) [34] and an RCT of mode of delivery

in Europe (n = 436) [9] both demonstrated a protective effect of PLCS, with reductions in MTCT of 50% and 70% respectively. In the latter study, the risk of transmission in women who were taking zidovudine monotherapy and who were delivered by PLCS was <1%. Cohort data from the UK and Ireland between 2000 and 2006 have shown that the MTCT rate in women on zidovudine monotherapy combined with PLCS was 0% (0 of 467 patients; 95% upper CI 0.8%) [1]. This was not significantly different from the 0.7% transmission rate with HAART plus PLCS (17 of 2337 patients; 95% CI 0.4–1.2%) or the 0.7% rate with HAART plus planned vaginal delivery (four of 565 patients; 95% CI 0.2–1.8%). These findings support the option of zidovudine monotherapy in women not requiring treatment for themselves with low VLs who either have an obstetric indication for, or are prepared to be delivered by, PLCS. There is no evidence that women on HAART with a low VL have increased surgical morbidity compared with the HIV-negative population A Cochrane review evaluating the risk of postpartum morbidity according to mode of delivery included five studies: the European randomized mode of delivery trial and five observational studies from North America and Europe [35].

15), LGN excitatory to L4 inhibitory (P = 0.0619), and TRN inhibitory to LGN excitatory (P = 0.3). The number of neurons in each area is shown in Table 2. The model contained a total of 46 926 neurons and approximately 43 million synapses. Simple and extended versions of the Izhikevich model were used to govern the dynamics of the spiking neurons in this simulation. GS 1101 The computational efficiency of these point neurons (single compartment) makes them ideal for large-scale simulations. Izhikevich neurons are also highly realistic and are able to reproduce at least 20 different firing modes seen in the brain, which

include: spiking, bursting, rebound spikes and bursts, subthreshold oscillations, resonance, spike frequency adaptation, spike threshold variability, and bistability of resting and spiking states (Izhikevich, 2004). Inhibitory and excitatory neurons in the cortex were modeled using the simple Izhikevich model, which are described by the following equations PLX-4720 manufacturer (Izhikevich, 2003): (2) where v is the membrane potential, u is the recovery variable, I is the input current, and a, b, c and d are parameters chosen based on the neuron type. For regular spiking, excitatory neurons, we set a = 0.01, b = 0.2, c = −65.0 and d = 8.0 (see Fig. 4). For fast-spiking, inhibitory neurons, we set a = 0.1, b = 0.2, c = −65.0 and d = 2.0 (Fig. 4). GABAergic and cholinergic neurons in the BF were modeled as simple

Izhikevich inhibitory and excitatory neurons, respectively. LGN and TRN neurons were modeled using the extended version of the Izhikevich neuron model to account for the bursting and tonic modes of activity, which these neurons have been shown to exhibit (Izhikevich & Edelman, 2008). The equations governing these neurons are given as: (5) The equations for this extended model are similar to the previous model, except they include additional parameters, such as: membrane capacitance (C), resting potential (vr) and instantaneous

threshold potential (vt). For LGN neurons, parameters were set to: a = 0.1, c = −60, d = 10, C = 200, vr = −60 and vt = −50. For TRN neurons, parameters were set to: a = 0.015, c = −55, d = 50, C = 40, vr = −65 and vt = −45 (Izhikevich & Edelman, 2008). To simulate Carnitine palmitoyltransferase II the switch between bursting and tonic mode, the b parameter, which is related to the excitability of the cell, was changed depending upon membrane potential, v. Specifically, if v < −65, b was set to 70 and the neuron would be in bursting mode (Fig. 4; bottom, right). If v > −65, b was set to 0 and the neuron would be in tonic mode (Fig. 4; bottom, left). The synaptic input, I, driving each neuron was dictated by simulated AMPA, NMDA, GABAA and GABAB conductances (Izhikevich & Edelman, 2008; Richert et al., 2011). The conductance equations used are well established and have been described in Dayan & Abbott (2001) and Izhikevich et al. (2004). The total synaptic input seen by each neuron was given by: (7) where v is the membrane potential and g is the conductance.

Tobacco plants inoculated at their roots with RK5050 showed wilt symptoms sooner than the tomato plants (Fig. 2c). Although tobacco plants inoculated with RK5204 (ΔprhK) and RK5208 (ΔprhL) started to wilt at 4 dpi, they died later than the tobacco plants inoculated with RK5050, i.e. at 21 and 18 dpi, Selleck Dactolisib respectively. Tobacco plants inoculated with RK5253 (ΔprhM) showed wilt at 7 dpi, and

died at 21 dpi (Fig. 2c). The three mutants displayed different levels of pathogenesis on the two host plants – tomato and tobacco. They were severely impaired in the colonization of tomato xylem vessels (Fig. S1), but proliferated in tobacco leaves only slightly slower compared with the wild type (data not shown). Different host plants displayed different symptoms, depending upon the infecting strain (Lin et al., 2008). When a pUC7169 plasmid containing the three genes was transferred into each of the mutant strains, all three of the recombinant strains recovered pathogenicity to the wild-type level (Fig. 2d). Cell suspensions

with high cell density of the popA-lacZYA reporter strain and the derived prhKLM mutants were infiltrated into tomato leaves, and the in planta popA expression was monitored up to 24 h postinoculation (hpi). Cell numbers did not change during this period, and gene expression was normalized to cell number. In the leaves, popA expression in the wild type increased until 18 hpi, and then fell slightly until 24 hpi (Fig. 3). Throughout the experiments, expression levels were substantially repressed in the prhK, prhL, and prhM mutants NVP-BGJ398 datasheet (Fig. 3). All three genes (prhK, prhL, and prhM) of the prhK operon are well conserved among Betaproteobacteria. It is likely that in the genus Ralstonia, the operon contains three genes plus an additional two genes (RSc2168 and RSc2169) (Fig. 4). Except for Burkholderia glumae, the other three bacteria shown in Fig. 4 are not plant pathogens. This indicates that these three genes are quite common and are not specific to bacterial plant pathogens. Moreover, orthologs

of these three genes have been detected in a wide range of bacteria, including E. coli. RSc2171 and RSc2170, which are annotated as allophanate hydrolase Isotretinoin subunit 1 and 2, respectively (Salanoubat et al., 2002), are related to the urea amidolyase of Saccharomyces cerevisiae (Wang et al., 1997). In addition, KipI and KipA in Bacillus subtilis, which modulate the phosphorylation level of the two-component response regulator Spo0F, are homologs of RSc2171 and RSc2170, respectively (Wang et al., 1997). PrhK is 55% similar to the KipI C-terminal domain, which binds to the KinA histidine kinase (Jacques et al., 2008). RSc2169 is annotated as a LamB/YcsF family protein. In fungi, LamB seems to be required for the utilization of lactam rings as a nitrogen source (Wang et al., 1997).

For example, in a population survey in Wales, 8% of people self-reporting stomach disorder with diarrhea due to food reported contracting the disease while outside the UK.9 Follow-up of laboratory confirmed cases of campylobacteriosis in the UK showed that 20% of the cases had traveled abroad in 2 weeks prior to symptom onset.10 The proportion of human salmonellosis cases in Denmark attributed to travel was 46% in 2007 and 23% in 2008.11,12 In Sweden, 77% of the shigellosis and 78% of the salmonellosis cases between

1997 and 2003 were travel-related.13 In Canada, a review of the public health surveillance for TRC concluded that travel information was not systematically collected and reported by any surveillance system for gastrointestinal illness.14 A targeted study in 2000 reported that among 625 Canadians surveyed, Selleck Sorafenib 55 reported having suffered from an acute gastrointestinal illness and 6 (11%)

of those had traveled abroad (eg, outside Canada) within 4 weeks prior to symptom onset.15 On an individual basis, several factors contribute to the risk of contracting a disease abroad, such as age, gender, vaccination see more and chemoprophylaxis, travel duration, reason for travel, and conditions of travel (eg, type of accommodation).3,16,17 With regard to the reason for travel, several studies highlighted greater risk among those visiting friends and relatives, compared to travelers for tourism or leisure whereas other studies focused on new immigrants.18,19 Therefore, both the increase in Canadians traveling abroad20 and the continuing immigration from various parts of the world21 are expected to contribute significantly to the burden of illness due to enteropathogens in Canada,

the extent of which has not been precisely or recently estimated. This study aimed to describe TRC of illness caused by enteropathogens in a Canadian community, and more specifically Etomidate to estimate the burden of such TRC compared to the burden of DC, and to describe the characteristics of the travelers who contracted such illness while abroad. An underlying hypothesis was that subgroups of travelers exist in terms of risk of contracting infectious diseases outside Canada, namely new immigrants, short-term travelers, and long-term travelers. Data were obtained from the National Integrated Enteric Pathogen Surveillance program (C-EnterNet), a sentinel site surveillance system facilitated by the Public Health Agency of Canada operating in the Region of Waterloo (ROW), Ontario. Approximately 500,000 people reside in three cities and four rural townships in this area (http://maps.region.waterloo.on.ca/locator/locator.htm). The study period spanned from June 2005 to May 2009, inclusive.

“
“Serotonin (5-HT) PARP inhibitor signaling in the central nervous system (CNS) helps to regulate a variety of important cognitive and behavioral processes and it is a common therapeutic target for mood disorders. Because sleep abnormalities are frequently associated

with mood disorders, there has been substantial interest in the regulatory abilities of 5-HT signaling on the sleep/wake cycle. However, to date there have been few practical and reliable ways to reversibly manipulate brain 5-HT levels without disrupting other monoaminergic signaling pathways that may be important for sleep. In this issue of European Journal of Neuroscience, Nakamaru-Ogiso and colleagues reveal a new method for reducing brain 5-HT levels in rats, a well-established Ferroptosis tumor rodent model of sleep–wake architecture. Intraperitoneal injections of the hemoprotein enzyme tryptophan side chain oxidase I (TSOI) transiently reduce brain and peripheral 5-HT concentrations by reversibly depleting the rats of tryptophan, while preserving catecholeaminergic

signaling. The authors report that this transient reduction of brain 5-HT abolishes the sleep/wake rhythm but has no meaningful influences on daily sleep amount. Moreover, the circadian rhythm in brain temperature is preserved in TSOI-injected rats, providing evidence that the effects of the manipulation are specific to sleep and are not caused by global effects on circadian timing. These findings suggest that in addition to its well-established Cediranib (AZD2171) regulatory influences

on central circadian timing, brain 5-HT also plays a more direct role in the specific regulation of the sleep/wake rhythm. The lack of practical methods to rapidly and reversibly manipulate brain 5-HT in mammals has been an obstacle in our understanding of the role of 5-HT signaling in sleep. Tryptophan-hydroxylase 2 (TPH2), the rate-limiting enzyme in 5-HT synthesis in the brain, has been a dependable target for brain 5-HT reduction; however, a lack of specificity of TPH2 inhibitors results in the collateral reduction of catecholamines such as the sleep/wake regulator norepinephrine, making these types of agents impractical for sleep studies. Serotonergic neurotoxins and TPH2 molecular deletions in mice have also been valuable to uncover the specific roles of 5-HT signaling, but neither manipulation is reversible, giving them limited usefulness in in vivo sleep experiments. Nakamaru-Ogiso and colleagues report that TSOI eliminates tryptophan and reduces brain 5-HT levels to 30% of controls within 12 h of treatment, with no collateral reductions in catecholeamines, other amino acids or protein synthesis. These influences of TSOI injection are no longer observed 96 h after injection.

”1 In the UK, there was an average of 1,965 laboratory-confirmed reports of imported NVP-BGJ398 in vitro malaria infections between 1987 and 2006,2 and this country, together with France, Germany, and Italy, accounts for about three-quarters of the 10,000 to 12,000 annual cases imported into the World Health Organization European region.3 The majority of imported malaria infections reported in European countries

are caused by Plasmodium falciparum,3 the Plasmodium species associated with the most severe disease and mortality. Data from TropNetEurop,4,5 a European sentinel surveillance system, describe how most cases originate from West Africa and affect travelers of African ethnicity. The most commonly reported reason for travel is to visit

friends and relatives (VFRs), with 64.5% of all travelers citing this as a reason for travel in malaria reports between 1987 and 2006 to the UK’s Malaria Reference Laboratory and 76.4% in reports to TropNetEurop in 2007.5 Those VFRs who were born and lived for some time in malaria-endemic countries before moving to Europe will have acquired partial immunity from exposure to malaria during childhood. Without repeated exposure, immunity appears to wane with time, although the time period during which this occurs is unknown. Bouchaud and colleagues6 have demonstrated that levels of parasitemia and severe disease were lower in African migrants who were YAP-TEAD Inhibitor 1 chemical structure resident outside malarious areas for more than 4

years but acquired falciparum malaria on a short visit to a malaria-endemic area, when compared to patients who had always lived outside these areas. However, a recent study of African migrants in Italy7 suggests that living for Non-specific serine/threonine protein kinase more than 12 years outside a malarious area could result in a more serious clinical presentation with malaria. This highlights the importance for ex-residents of malarious countries to maintain the same malaria preventative measures as other travelers. National and international malaria prevention policies recommend awareness of the risk of malaria, bite avoidance, the use of appropriate chemoprophylaxis, and early diagnosis of malaria-type symptoms when traveling to a malarious country. A number of studies confirm that the use of chemoprophylaxis is low among VFRs. In a study of 302 malaria cases presenting at a hospital in Italy, Castelli and colleagues8 found only 11% of “immigrants” compared to 55% of “non-immunes” had used chemoprophylaxis on their last trip to an endemic area, whereas Driessen and colleagues9 in a Dutch study reported that statistically fewer children of immigrants had used chemoprophylaxis compared to those children in the indigenous Dutch population (not all study authors use the term “VFR” although it is clear from the context that they are referring to those who are going to visit friends or relatives).