bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the gap: community pharmacists' perceptions of their current role compared with their aspirations
Authors: Rutter P R , Hunt A J , Jones I F
Published: February 2011

Objective

To investigate community pharmacy managers' perceptions of their role in providing health care to patients and to compare these with their aspirations for the future.

Method

Fourteen pharmacist managers from one regional area of a UK national multiple pharmacy chain participated in two focus groups.

Key findings

Participants voiced a shared vision of wanting to play a more integral part in the health care of patients. Strategies put forward to embrace a more participative role included delegation of health screening and minor illness clinics from the prescriber to the pharmacist, having more formalised and open channels of communication with prescribers and moving away from performing technical duties, such as the physical assembly of medicines. Participants in both groups showed awareness that apathy and inaction would result in potential opportunities for pharmacy to be lost or passed over to another profession within the primary health care team (PHCT). Two key external obstacles that currently prevented attainment of desired roles were identified: first, a lack of awareness among other health care professionals and the general public about the pharmacist's skills and attributes and, secondly, current UK legislation that limits the potential for community pharmacists to expand their role away from the pharmacy premises.

Conclusions

Participants believed that they could provide a more comprehensive pharmaceutical service if given the chance. However, they believed that implementation of change would be difficult considering the obstacles that needed to be surmounted for change to occur.
Perceived barriers to participating in continuing education: the views of newly registered community pharmacists
Authors: Ward P R , Seston E M , Wilson P , Bagley L
Published: February 2011

Objective

The main aim of this study was to explore newly registered community pharmacists' attitudes to the current provision of continuing education (CE) and to identify key factors that act as motivators and barriers to participation in CE.

Method

Eight focus groups of newly registered pharmacists were set up. All focus groups were tape-recorded and transcribed verbatim. The results presented in this paper focus specifically on the barriers to participation in CE.

Setting

Four geographical areas of England.

Key findings

The main barrier identified by the pharmacists was competing demands on their time, both in and out of work. Participants felt disillusioned with further study, describing this stage of their lives as a “honeymoon period” in which they sought to make adjustments in both their professional and personal lives. They also felt disillusioned with the reality of community pharmacy and offered this as an explanation for their lack of involvement in CE. In addition, many pharmacists believed themselves to be at the peak of their pharmaceutical knowledge, thus not requiring CE. Rather, it was felt that they needed to develop their skills in other areas such as communication skills or applying pharmaceutical knowledge in practice. It was suggested that this could only be remedied through working with and learning from more experienced pharmacists, rather than undertaking formal CE activities.

Conclusion

Non-participation in CE may be seen to result from a complex web of factors which do not easily map on to policies to increase participation of newly registered pharmacists in CE activities. Nevertheless, if newly registered community pharmacists are to achieve the continuity of learning necessary for continuing professional development, education providers will need to address their specific learning needs in the period following registration.
Personality preferences of lecturers and students at a pharmacy school
Authors: Rothmann Sebastiaan , Basson Willem Diederick , Rothmann Johanna Christina
Published: February 2011

Background

Jung's theory of psychological types and the Myers-Briggs Type Indicator (MBTI) continue to gain popularity in social and behavioural sciences. The MBTI was developed to measure people's personality preferences.

Objectives

To compare the personality preferences of pharmacy students and lecturers at a tertiary education institution and to determine if personality preferences are related to academic performance.

Method

A survey design was used.

Setting

The study population included undergraduate and master's students and lecturers of a pharmacy school at a university.

Key findings

The MBTI instrument was completed by 603 out of 686 undergraduates (87.9 per cent), all master's students and all 35 lecturers. The results showed that pharmacy students and lecturers preferred sensing and judgment. It appeared that students' preferences for extraversion and perception were related to lower academic performance and slower advancement through the pharmacy course.

Conclusion

Pharmaceutical care requires understanding of the preferences of self and others. Pharmacy students and lecturers need to know their own and others' MBTI preferences, and to develop skills in the opposite or “shadow” preferences.
Prescribing new drugs: a survey of hospital consultants in the West Midlands
Authors: Jones Miren I , Greenfield Sheila M , Bradley Colin P , Jowett Sue
Published: February 2011

Objective

To investigate the factors that influence how consultants introduce new drugs into their clinical practice.

Method

A postal questionnaire survey of hospital consultants.

Setting

169 consultants in medical specialties in six hospitals (general or teaching hospitals) in the West Midlands region, United Kingdom.

Key findings

Ninety-two completed questionnaires (54 per cent) were returned. Eighty consultants (87 per cent) reported using a new drug in the previous two years; 60 (65 per cent) had used either one or two new drugs and these were generally in their specialist field. There was no significant difference between hospitals in how easy it was to introduce a new drug. Sixty-one consultants (67 per cent) said that the procedure required an application to the hospital drug and therapeutics committee. Consultants frequently asked patients' general practitioners to prescribe a new drug. Consultants rated independent sources of information more highly than non-independent sources. The most important factors reported to influence prescribing decisions about new drugs were drug characteristics, such as efficacy and safety, and evidence from scientific literature. Sixty-four respondents (70 per cent) saw drug company representatives up to once a week and 57 (62 per cent) had been involved in clinical trials of new drugs in the previous five years.

Conclusion

In general, the consultants reported that they used only a small number of new drugs. There is considerable pressure on hospital doctors to control prescribing and costs of new drugs through policies that require approval by the drug and therapeutics committee. Although contact with the pharmaceutical industry was high, consultants reported that independent sources of information were more important. Factors such as clinical trial evidence and improved drug characteristics were said to be the most influential in reaching decisions to prescribe new drugs.
Patient satisfaction with a community pharmacist-managed system of repeat prescribing
Authors: Jones Jan , Matheson Catriona , Bond Christine
Published: February 2011

Background

A randomised controlled trial investigated a community pharmacist-managed system of repeat prescribing. Patients attended their general practitioner for a medication review at intervals of up to 12 months and were monitored on a monthly basis when collecting repeat medicines by a community pharmacist of their choice.

Objective

To establish patient satisfaction with the pharmacist-managed repeat prescribing system, ie, whether they preferred to continue with this new system.

Method

Questionnaires were sent to 2,667 subjects, 1,625 in the group who received their repeat medicines by the intervention method and 1,042 in the control group who continued to receive their medicines by the traditional system.

Key findings

The response rate was 73 per cent. The baseline patient satisfaction with the traditional system of repeat prescribing was 88 per cent. However, the pharmacist-managed repeat prescribing was preferred to the traditional system by 81 per cent of intervention subjects, many of whom felt that the new prescribing system saved time and provided increased convenience. Reduced time and financial costs of obtaining repeat prescriptions influenced satisfaction. Many patients felt reassured by the increased clinical input provided by the community pharmacist. Patients in non-city communities showed greater preference for the new system than their city counterparts.

Conclusion

Results indicate that this or a similar system of pharmacist-managed repeat prescribing may be preferred to the traditional method by many patients who are stabilised on regular medication obtained by repeat prescriptions.
Patients' views of the value of “brown bag” medication reviews
Authors: Nathan Alan , Goodyer Larry , Lovejoy Anne , Savage Imogen
Published: February 2011

Objective

To explore and describe patients' views of the value of brown bag medication reviews.

Method

Semi-structured, tape-recorded interviews were conducted with 20 patients who had participated in a brown bag medication review scheme.

Setting

A health authority area in south-east inner London.

Key findings

Patients perceived the following benefits from brown bag reviews: clinical problems resolved; better understanding of their medications, leading to increased confidence; and appreciation that an interest was being taken in their health care. Reviews had given patients a sense of empowerment, and had made them realise that they had a right to information about their medical treatment and medication. As a result they were likely to be more proactive in seeking information in future. Reviews had made patients realise that pharmacists were knowledgeable about medicines, where previously many had thought that only doctors had sufficient knowledge. Reviews had enhanced relationships between patients and pharmacists. However, some patients still perceived their doctor as the authoritative source of information about medicines. Patients' accounts indicated that much of the information provided by the pharmacist was new, raising the issue of what information was routinely being provided by pharmacists.

Conclusions

Brown bag reviews were regarded by patients as beneficial and they wanted them to be available in the future. Patients' perceptions of pharmacists as health professionals and providers of information on medicines were enhanced by brown bag reviews.
Postal surveys — a view from the other side
Authors: Tully Mary P , Cantrill Judith A
Published: February 2011

Objectives

To explore the reasons why elderly people with arthritis choose to participate in a reliability study conducted by postal survey, and their views of the process of taking part.

Methods

Twenty elderly people suffering from arthritis were interviewed in depth. They were chosen on the basis of how they had completed postal questionnaires about their arthritis, on two separate occasions to assess reliability, two weeks apart. Interviews were taped, with permission, and transcribed verbatim. Content analysis of the interview data, and any telephone calls, comments or letters received from all survey recipients, was conducted using NUD-IST.

Key findings

Many respondents thought that such surveys only involved the worst sufferers and that anyone else was “a fraud”. Part of the motivation for individuals to participate was the desire to help the researcher, others with arthritis or, for some respondents, themselves. The details of the questionnaires were used by the respondents as clues to develop their theories of the survey's purpose. There was commonly a failure to perceive the need to complete the questionnaires twice, regardless of whether there had been a change in their health. Some respondents did not see the point of the second questionnaires, some apologised for their unchanged health, and others actively sought to find further information to put into the second set.

Conclusion

These results have implications for researchers, by identifying the range of detail required by potential survey respondents to reduce response bias. If the purpose of the survey is not clearly communicated, participants will impose their own, probably different, interpretation, with unexpected consequences.
Skin conditions in the pharmacy: consumer satisfaction and economic considerations
Authors: Plunkett Anne , Lau Phyllis , Stewart Kay , Marks Robin
Published: February 2011

Objective

To evaluate whether consumers were satisfied with advice about skin conditions received from community pharmacists in Victoria, Australia, and to estimate costs and potential savings to the consumer and government associated with managing these conditions in the pharmacy.

Methods

In 1997–1998, a consumer survey on costs and satisfaction was carried out in Victoria as part of a statewide education programme with community pharmacists. Pharmacists recorded details of dermatological consultations involving over-the-counter (OTC) products, and recruited pharmacy consumers for follow-up by a member of the research team.

Results

Consumer consultations were recorded at 126 pharmacies. One hundred and five (58.0 per cent) of the 181 consumers who were subsequently interviewed reported being very satisfied with their consultation. One hundred and thirty-two (73.0 per cent) spent up to 10 minutes consulting the pharmacist and 78 (43.1 per cent) spent between $A5 (£1.95) and $A10 on OTC products. A total of 37 consumers (20.4 per cent) consulted a medical practitioner on the advice of their pharmacist. While most of the 37 consumers spent under $A10 in the pharmacy, if the cost of medical consultation and the subsidised nature of items supplied on medical prescription were taken into account, the costs to the consumer and government would have been greater. The direct costs for a pharmacist consultation on the management of skin conditions were lower than the expected direct costs associated with a general practitioner (GP) consultation.

Conclusions

Consumers were satisfied with the advice and treatment they received from the pharmacist on the management of skin conditions. Pharmacists' advice also appeared to be cost-effective for both the consumer and government. Community pharmacists appear to be satisfactory primary providers of advice and treatment for people with minor skin conditions.
Occurrence of potential drug-drug interactions in nursing home residents
Authors: van Dijk K N , de Vries C S , van den Berg P B , Brouwers J R B J , De Van den Berg L T W Jong
Published: February 2011

Objective

It has been suggested that elderly people are at increased risk of drug-related problems such as drug-induced adverse effects, drug-drug interactions and drug-disease interactions. This is particularly the case for nursing home residents because of the often complicated and multiple co-morbidity that occurs in these people. The aim of this study was to develop prescribing indicators to assess systematically the occurrence and nature of potential drug-drug interactions (DDIs) in a cohort of Dutch nursing home residents.

Method

The study was conducted in residents aged 65 years and over in six nursing homes (n=2,355, two-year study period). Computerised medication data for the residents were evaluated with respect to co-prescribing of potentially interacting drugs. All DDIs that were classified as clinically relevant according to the Dutch National Drug Interaction Database were studied. DDIs were classified into three categories according to their pharmacological mechanism: 1 — pharmacokinetic interactions at the level of gastrointestinal (GI) absorption; 2 — pharmacokinetic interactions at the level of metabolism and excretion; and 3 — pharmacodynamic interactions.

Key findings

Thirty-two per cent (n=748) of all residents were exposed to one or more combinations of drugs that could lead to clinically adverse outcomes. The numbers of residents who received drug combinations with a mechanism of interaction from category 1, 2 or 3 were 73 (3 per cent), 164 (7 per cent) and 612 (26 per cent) respectively. The number of medications prescribed was significantly associated with the occurrence of a potential DDI (P<0.05). Drugs most frequently involved were oral anticoagulants, antibiotics and theophylline.

Conclusion

During the two-year study period, about one-third of the residents were exposed to at least one drug interaction considered clinically relevant. Adequate surveillance systems are needed to enable better identification of these interactions with a view to preventing potential clinical problems. Using the prescribing indicators developed in this study, such surveillance could focus on detection and clinical aspects of potential DDIs and possible alternative treatments.
“In the eye of the beholder”: pharmacy students have more positive perceptions of medicines than students of other disciplines
Authors: Horne Robert , Frost Susie , Hankins Matthew , Wright Siobhan
Published: February 2011

Objective

Exploratory study to examine whether pharmacy students differ significantly from students on other courses in their beliefs about medicines.

Method

Questionnaire study assessing beliefs about medicines in general and perceptions of personal sensitivity to the potential adverse effects of medication.

Setting

Undergraduate students sampled from each academic year of five degree courses. Five hundred and seventy completed questionnaires were analysed.

Key findings

The findings indicated significant differences between students on the basis of their chosen course. Pharmacy students were significantly more likely than engineering, accountancy, social policy, and humanities students to believe that medicines in general are beneficial, and were significantly less likely to perceive medicines as potentially harmful. Humanities students were more likely than most other groups to believe that medicines are over-prescribed by doctors. The observed relationship between course and medication beliefs remained statistically significant when controlling for ethnic background, experience of taking prescribed medication, and year of study. A further analysis revealed no significant effect of year of course on medication beliefs, and no significant interaction between course and year of study.

Conclusion

The findings suggest that students' attitudes were formed before they arrived at university, rather than being “shaped” by the course over a three-year period. The implications of these findings for patient-pharmacist communication are discussed.
Older persons' opinions about, and sources of, prescription drug information
Authors: Thompson Sally , Stewart Kay
Published: February 2011

Objectives

(1) To explore older persons' opinions about their receipt of prescription drug information from general practitioners (GPs) and pharmacists, (2) to determine the information older persons wish to know about their prescription medication and the information sources they use, (3) to determine the opinions of older persons about prescription medication labels and patient information leaflets, and (4) to determine any significant differences between those aged 65–74 years and those aged 75 years and over.

Method

Data were gathered via 204 detailed in-home interviews completed between March,1993, and November, 1995. Respondents were identified through GPs.

Setting

The study was conducted in Melbourne, Australia.

Key findings

The vast majority of respondents liked to receive verbal counselling from GPs and pharmacists about their prescription medication and the majority were willing to share responsibility for receiving that information. However, a small minority of patients seemed to receive little information from GPs and pharmacists about their prescription medication and had no real perception of a need for information. As might be expected, the item of information most desired by respondents was when and how to use the medication (89 per cent). This was followed by the condition for which the medication was prescribed (76 per cent) and side effects (72 per cent). For 90 per cent of respondents GPs were their greatest prescription drug information source; pharmacists featured highly as a secondary source (57 per cent of respondents). Almost all respondents (92 per cent) thought that the information pharmacists printed on prescription medication labels was adequate although numerous suggestions were advanced for label improvement. Seventy-six per cent of respondents were of the opinion that, when receiving a prescription medication that was new to them, an information leaflet written for the consumer about that medication would be helpful. The 75 and over age group were less enthusiastic about receiving such leaflets than the 65–74 age group (P=0.015).

Conclusion

Education programmes aimed at improving the quality use of medicines in Australia still need to encourage older persons to actively seek, and health professionals to volunteer, prescription drug information. Patient information leaflets are well accepted by older persons; however, it is important that the information be adequately explained.
European barriers to the implementation of pharmaceutical care
Authors: van Mil J W F , de Boer W O , Tromp T H F J
Published: February 2011

Objective

To establish the perceived barriers to the implementation of pharmaceutical care into community pharmacy practice in different European countries and the relative importance of these barriers.

Method

Structured interviews with representatives from national pharmacists' organisations or pharmaceutical care researchers from 11 European countries known to be actively attempting to implement pharmaceutical care. Respondents were asked to consider a list of 25 potential barriers to pharmaceutical care and to score the relative importance of each for their own country. Data were analysed to produce a European overview of barriers as well as inter-country comparisons.

Key findings

Lack of time and lack of money are major barriers for the implementation of pharmaceutical care in European countries. Many other barriers were identified, but their impact on the implementation of pharmaceutical care seems to differ markedly over Europe. No correlation was found between money and time as barriers. Some clusters of countries were identified with similar barrier patterns.

Conclusion

Time and money are perceived to be major both in absolute and relative rankings. The European pharmaceutical associations need to pay attention to remuneration issues before attempting to implement pharmaceutical care in their countries. The results also show that pharmaceutical organisations need to work continuously to change attitudes among pharmacists. Important barriers have also been identified in the educational domain and changes in the European curriculae for pharmacy are therefore needed. Co-operation between some countries on these issues would appear to be useful.
Haemodialysis patients' beliefs about treatment: implications for adherence to medication and fluid-diet restrictions
Authors: Horne Robert , Sumner Sian , Jubraj Barry , Weinman John , Frost Susie
Published: February 2011

Objectives

To assess haemodialysis patients' beliefs about treatment and to investigate which beliefs correlate with adherence to medication and fluid-diet restrictions.

Methods

Forty-seven haemodialysis patients receiving intermittent hospital haemodialysis completed questionnaires assessing their beliefs about medication and fluid-diet restrictions.

Key findings

Adherence rates varied between and within patients, and were related to specific treatment beliefs in a logically consistent way. Reported intentional non-adherence to medication correlated with concerns about the potential adverse effects of renal medication. Low adherence to fluid-diet restrictions (assessed by inter-dialysis weight gain) was associated with the personal belief that the restrictions were too strict. Most patients (90 per cent) agreed that medicines prescribed for their renal condition were necessary for maintaining health. However, 32 per cent harboured concerns about their medication, arising from beliefs about the potential for dependence, long-term effects, or disruption of life. Concerns about renal medication correlated with more general beliefs that medicines as a whole are harmful, addictive poisons which are overused by doctors. Although specific treatment beliefs (medication or fluid-diet restrictions) were related to specific adherence behaviours, these two areas of beliefs and behaviours were unrelated.

Conclusions

Patients' perceptions of treatment merit further study. Eliciting and addressing patients' perceptions of treatment may be a target for pharmaceutical care and a foundation for partnership in medicine-taking.
Shared care in the UK: failings of the past and lessons for the future
Authors: Duggan C , Beavon N , Bates I , Patel S
Published: February 2011

Aims

To explore and evaluate the implementation of shared care in the UK, to identify failings and to make recommendations for successful implementation of shared care in the future.

Methods

The study utilised a triangulation approach, employing three different methods to explore the production and format of shared care protocols (SCPs) and the perceived use and future trends of shared care. A postal survey of hospital pharmacists and pharmaceutical and medical advisers in health authorities and interviews with health care professionals provided insight into perceptions of shared care and recommendations for the future. A content analysis of a sample of SCPs in current use assessed the utility of SCPs in practice.

Results

A total of 321 SCPs were identified that described 99 different drugs and treatments. The protocols varied considerably with no apparent standard either within or between regions, but there was a correlation between the patient-related information available, information across the health care interface (r=0.355, P=0.05) and pharmaceutical information (r=0.401, P=0.05). There were expressions of uncertainty about the benefit of such protocols to patients. Health authority staff in particular expressed predominantly negative attitudes in the questionnaire whereas the pharmacists were more positive. The transfer of prescribing and associated costs from hospital to community (described as “cost shifting”) was repeatedly identified as a barrier, together with competing professional interests and reluctance to change with the times. General practitioners (GPs) were most commonly excluded from the production of SCPs, which may enforce negative feelings around implementation of SCPs across the health care interface. Improved information technology and better use of evidence-based guidelines and protocols were seen as ways forward in developing shared care.

Conclusions

Since 1991, a large number of SCPs have been produced in the UK but the benefits to patients are not clear. There is a general perception of cynicism about their use; “cost-shifting” is perceived as their main purpose. There appears to have been no formal evaluation of their use or mechanisms for their implementation, and distribution has been erratic. This study highlights that, with greater involvement of health care professionals, better communication systems and the removal of identified barriers, shared care is a concept essential in the evolving NHS.
Understanding of pharmacy-related terms among three ethnic groups in New Zealand
Authors: Norris Pauline , Simpson Tamika , Bird Kiri , Kirifi Jack
Published: February 2011

Objective

To investigate understanding of nine pharmacy-related terms among members of three ethnic groups in New Zealand (Pakeha, Maori and Tokelauan).

Method

In total, 244 people (approximately 80 from each ethnic group) were included. Potential participants were approached in the street, or at venues where the target ethnic groups were likely to be found. All respondents had visited a pharmacy for one or more prescriptions in the past 12 months. Demographic details were collected. The pharmacy-related terms included in the study and their definitions were obtained from a similar study in the US. Respondents were asked to define the terms in their own words. Responses were recorded on paper by the interviewers and coded as a group by the research team.

Setting

The study was carried out in Wellington, New Zealand, by researchers from the three ethnic groups.

Key findings

There was a low overall level of understanding, and this varied significantly by ethnicity, gender, age and level of education. Only 37.1 per cent of answers were correct. The average number of correct answers (out of nine) was 5.30 for Pakeha, 3.06 for Maori, and 1.69 for Tokelauans. Overall, 23.2 per cent of words were defined incorrectly.

Conclusion

Pharmacists and other health professionals cannot assume knowledge of medicine-related terms by consumers. Even when consumers themselves believe that they understand a term their understanding of it may differ from that of health professionals.
Using community pharmacies to evaluate the safety of a prescription only medicine in an OTC environment: a unique method in Europe
Authors: Gibb I A , Miller K , Veltri J C , Page B A , Charlesworth A , Kellett N
Published: February 2011

Focal points
Continuation of treatment of drug misusers between primary and secondary care in the South West
Authors: Bolton C , Gamble K , Heer K , Kalher D , Mehta R , Scott J
Published: February 2011

Focal points
Effect of pharmaceutical pre-assessment on post-operative interventions
Authors: Harris L , Walters P A , Costello C
Published: February 2011

Focal points
Patient self-eports of potential adverse drug reactions
Authors: Krska J , Jarernsiripornkul N , Capps P A G , Richards R M E
Published: February 2011

Focal points
Obtaining accurate patient-specific perioperative anaesthetic costs in orthopaedic anaesthesia
Authors: Al-Ageel Sinaa , Elliott Rachel , Noyce Peter
Published: February 2011

Focal points
Patient knowledge and acceptability of topical corticosteroid preparations: the role of the pharmacist in patient education
Authors: Woodford R , Woodford E M , Langley C A , Marriott J F , Wilson K A
Published: February 2011

Focal points
Clinical medication review by a pharmacist of patients on repeat prescriptions in general practice
Authors: Petty D R , Zermansky A G , Raynor D K , Lowe C J , Vail A , Freemantle N
Published: February 2011

Focal points
Supplying emergency hormonal contraception in the pharmacy: the perspectives of service users
Authors: Anderson Claire , Bissell Paul , Sharma Sangeeta , Sharma Ritu
Published: February 2011

Focal points
A postal survey to assess the views of community pharmacists on the deregulation of emergency hormonal contraception
Authors: Wearn A , Gray M , Gill P , Ewan M A , Sandhu P , Rajaei-Dehkordi Z
Published: February 2011

Focal points
Identification of the need for pharmaceutical care within the prevention strategy of CHD: a study in acute MI patients
Authors: Chinwong S , Reid F , McGlynn S , Hudson S A , Flapan A D
Published: February 2011

Focal points
The role of community pharmacists and medicines counter assistants in health promotion: reflections from a folic acid campaign
Authors: ANDERSON CLAIRE , RAJYAGURU RASHMI
Published: February 2011

Context

In the UK in 1996, the National Pharmaceutical Association collaborated with the Health Education Authority to pilot a resource pack that would enable community pharmacists and their medicines counter assistants to contribute to the promotion of the use of folic acid in planned pregnancy.

Objective

To determine the views of pharmacists and medicines counter assistants about the use of the resource pack.

Method

Depth interviews were carried out to elicit views, underlying feelings, experiences and attitudes towards staging and managing the project. The data were analysed using the constant comparison as outlined in grounded theory. Themes were identified and quotes from interviewees used to illustrate the themes.

Setting

14 pharmacists and 14 medicines counter assistants in a West London health authority.

Key findings

Most pharmacists and medicines counter assistants reported feeling more comfortable when advising regular customers rather than unknown customers. Leaflets, posters and displays were thought to be better ways to target passing trade. The majority of the minority ethnic pharmacists and medicines counter assistants considered that they had an important role in communicating information about folic acid to customers from minority ethnic groups, provided they both spoke the same language.

Conclusions

Most pharmacists will only raise sensitive issues, such as the importance of taking folic acid to prevent neural tube defects, with customers with whom they already have a relationship. Stimulating inquiries from passing trade by targeting with leaflets, displays and other health education resources offers an additional benefit. Pharmacies are an important setting for disseminating health messages to people from minority ethnic groups in their own languages.
The use of serial point-prevalence studies to investigate hospital anti-infective prescribing
Authors: Dean Bryony , Lawson Wendy , Jacklin Ann , Rogers Tom , Azadian Berge , Holmes Alison
Published: February 2011

Objectives

To develop and test an efficient, reproducible method for the surveillance of hospital anti-infective use; to use this method to investigate patterns of anti-infective prescribing.

Method

A series of three standardised point-prevalence studies were carried out in which pharmacists recorded details of all inpatients prescribed systemic anti-infectives. Time taken to collect, enter and analyse these data was documented. Parameters examined included: percentage of patients prescribed anti-infectives, percentage of anti-infectives that were for “reserved” use, percentage of these with appropriate approval, percentage of anti-infectives administered intravenously, duration of therapy, and combinations of anti-infectives used.

Setting

All hospital inpatients in a large National Health Service (NHS) Trust comprising four sites.

Key findings

For each study, an estimated 35 additional hours of pharmacists' time was required for data collection, cleaning and analysis, and 15 hours for data entry. The method developed was easily reproducible and results from the three studies were very similar. Overall, 33 per cent of 2,656 inpatients were prescribed at least one anti-infective (mean 1.7 per patient); 48 per cent of anti-infectives were given intravenously (IV), of which 34 per cent could have been given orally. Of the anti-infectives used, 21 per cent were for “reserved” use. Of these, 65 per cent were used for an approved indication, and 11 per cent were not. The remaining 24 per cent had no indication documented in the medical notes.

Conclusion

This is a practical method for studying hospital anti-infective use in the absence of computerised prescribing. The database produced provides a wealth of information and various targets for intervention have been identified; these can now be evaluated against the baseline data collected. The methods developed could be used in other hospitals to provide benchmarking data.
An assessment of the level of moral development of American and Canadian pharmacy students
Authors: Latif David A
Published: February 2011

Context

Moral reasoning assessment is an assessment of conceptual adequacy of moral thinking. It attempts to tap the basic conceptual frameworks that individuals use to analyse social-moral problems and to judge the proper course of action. It is a significant construct because of its pragmatic and positive relationship to clinical performance in health professionals. Thus, pharmacy students at higher levels of moral reasoning can be expected to perform at higher levels on clinical performance measurements.

Objective

To examine the moral reasoning of pharmacy students at schools of pharmacy in the United States and Canada.

Method

Rest's Defining Issues Test (DIT) was used as a surrogate measure of pharmacy students' moral reasoning and was completed by all first-year pharmacy students at one school of pharmacy in the US and one in Canada.

Results

The results indicated that significant differences existed between the Canadian and American pharmacy students. The Canadian students scored significantly higher than their American counterparts. The mean moral reasoning score of both classes was lower than previous empirical research results from other first-year health professional students. The results are discussed along with potential educational interventions and suggestions for selecting pharmacy students to schools of pharmacy.

Conclusion

This is the first study to have assessed moral reasoning in pharmacy students. The reasons for differences between US and Canadian students are unknown. The lower scores of pharmacy students compared with other student health professionals indicate that further research is needed.
Using discrete choice experiments to evaluate alternative electronic prescribing systems
Authors: Ubach Cristina , Bate Angela , Ryan Mandy , Porteous Terry , Bond Christine , Robertson Roma
Published: February 2011

Objective

To assess the relative importance to pharmacists and general practitioners (GPs) of different characteristics of electronic prescribing systems.

Methods

A discrete choice experiment (DCE) was used to obtain preferences for the following attributes of an electronic prescribing scheme: “typical response time”, “frequency of slow responses”, “frequency of unscheduled downtime”, “length of unscheduled downtime”, “frequency of scheduled downtime”, and “frequency of lost/corrupted data”. Preferences of GPs and pharmacists were compared using the Likelihood ratio test and the Wald statistic. The rate at which respondents were willing to trade between attributes and benefit scores for different systems were estimated. Rationality of responses and theoretical validity of responses to the DCE were also assessed.

Subjects and setting

199 pharmacists and 197 GPs in Scotland.

Key findings

The usable response rate for the DCE was 42.4 per cent. Preferences of pharmacists and GPs were significantly different. Given the units of measurement, the most important attribute for pharmacists was “length of unscheduled downtime” whereas for GPs it was “typical response time”. Evidence was found of rationality of responses and theoretical validity.

Conclusions

All technical attributes of an electronic prescribing system assessed in this study were considered by the respondents to be important. Discrete choice experiments provide useful information on the relative importance and trade-offs between attributes as well as benefit scores for different systems. The preferences of pharmacists and GPs are significantly different. Future research should investigate the nature of the benefit function, the assumption of trading across attributes and the external validity of the technique.
The pharmacy labour market 1991 to 2001
Authors: Hassell Karen , Shann Phillip , Fisher Richard
Published: February 2011

Focal points
Prescriptions with potentially hazardous/contraindicated drug combinations presented to community pharmacies
Authors: Chen Y -F , Neil K E , Avery A J , Dewey M E
Published: February 2011

Focal points
Warfarin toxicity: do discharge ICD-10 codes and yellow cards accurately identify serious adverse drug reactions?
Authors: Dent S N , Cox A R , Marriott J F , Langley C A , Wilson K A
Published: February 2011

Focal points
Pharmacist work patterns: are they affected by staffing levels and prescription numbers?
Authors: Rutter P M
Published: February 2011

Focal points
Adolescents' perceptions of the internet as a health information source
Authors: Gray N J , Klein J D , Cantrill J A , Noyce P R
Published: February 2011

Focal points
How much do recent users know about emergency hormonal contraception?
Authors: Day Maria , Knapp Peter , Dye Louise , Sowter Julie , Raynor D K
Published: February 2011

Focal points
Patients' understanding and perceptions of treatment as determinants of adherence to warfarin treatment
Authors: Engova Dita , Duggan Catherine , MacCallum Peter , Bates Ian
Published: February 2011

Focal points
Clinical medication review in general practice: what is the benefit of a second review?
Authors: Petty D R , Knapp P , Raynor D K , Zermansky A Z , Freemantle N
Published: February 2011

Focal points
Non-prescription medicine supply: protocols and practice
Authors: Kelly F , Sare A T , Williams K A , Benrimoj S I
Published: February 2011

Focal points
An evaluation of the impact of NICE guidelines regarding COX-2 selective inhibitors on GP prescribing
Authors: Shemilt K , Airley R , Clareburt C
Published: February 2011

Focal points
Quality improvement in community pharmacy practice
Authors: McGovern E M , Campbell A , Lindsay H , Thomson D A M , Bryson S M
Published: February 2011

Focal points
An audit of the supply of emergency hormonal contraception through patient group direction
Authors: Bissell Paul , Anderson Claire
Published: February 2011

Focal points
Medication review: whose job it is?
Authors: Krska Janet , Ross Susan
Published: February 2011

Focal points
Developing a research agenda for teaching ethics to pharmacy students
Authors: Wingfield Joy , Bissell Paul , Anderson Claire , Sadler Stacey
Published: February 2011

Focal points
Striated muscle activator of Rho signalling (STARS) is a PGC‐1α/oestrogen‐related receptor‐α target gene and is upregulated in human skeletal muscle after endurance exercise
Authors: Wallace Marita A. , Hock M. Benjamin , Hazen Bethany C. , Kralli Anastasia , Snow Rod J. , Russell Aaron P.
Published: February 2011

Non‐technical summary  Exercise improves the ability of skeletal muscle to metabolise fats and sugars. For these improvements to occur the muscle detects a signal caused by exercise, resulting in changes in genes and proteins that control metabolism. We show that endurance exercise increases the amount of a protein called striated muscle activator of Rho signalling (STARS) as well as several other proteins influenced by STARS. We also show that the amount of STARS can be increased by signals directed from proteins called peroxisome proliferator‐activated receptor gamma co‐activator 1‐α (PGC‐1α) and oestrogen‐related receptor‐α (ERRα). We also observed that when we reduce the amount of STARS in muscle cells, we block the ability of PGC‐1α/ERRα to increase a gene called carnitine palmitoyltransferase‐1β (CPT‐1β), which is important for fat metabolism. Our study has shown that the STARS pathway is regulated by endurance exercise. STARS may also play a role in fat metabolism in muscle.
Loss of olfactory cell adhesion molecule reduces the synchrony of mitral cell activity in olfactory glomeruli
Authors: Borisovska Maria , McGinley Matthew J. , Bensen AeSoon , Westbrook Gary L.
Published: February 2011

Non‐technical summary  In olfactory bulb glomeruli, incoming sensory input from the nose (axodendritic synapses) is segregated from local intraglomerular interactions (dendrodendritic synapses). We examined the synchrony of neural activity within glomeruli using knockout mice in which loss of olfactory cell adhesion molecule disrupts clustering of synaptic compartments. Using paired whole‐cell recording of mitral cells within a single glomerulus in brain slices, synchrony of fast and slow neural activity was reduced. However, incoming afferent activity and dendrodendritic inhibition were unaffected. We suggest that compartmentalization of synapses in the glomerulus is important for processing of olfactory sensory information.
Factors Affecting the Formation of Carbon Film on the Stainless Steels for the Bipolar Plate of Polymer Electrolyte Fuel Cells
Authors: Matsuo Yoshiaki , Miyano Shin-ich , Sugie Yosohiro , Fukutsuka Tomokazu
Published: February 2011

Factors affecting the formation of carbon film by plasma-assisted chemical vapor deposition on stainless steels were investigated in detail. When the carbon coating time increased, the morphology and crystallinity of the formed carbon changed. The depth profile of the resulting carbon coated sample indicated that it was consisted of top carbon layer without metal species and interfacial layer mainly containing chromium oxide and carbon of lower crystallinity. The top carbon layer with the morphology similar to that of carbon nanowall effectively covered the surface of the metal substrate, providing the high electrochemical stability in an acidic solution. As the cold working rate of the stainless steel substrate increases, the time needed for the complete coverage of the metal surface became shorter. Based on the scanning electron microscopy observation and X-ray diffraction, this was mainly ascribed to the increase in defects where the nucleus formation of carbon can occur and the increased density of carbon on the surface of the metal. The resulting carbon coated stainless steels showed low interfacial resistance and high corrosion resistance in acidic solution even at 80°C, and is promising for the bipolar plate of polymer electrolyte fuel cells.
A Robust Approach to Dynamic Feedback Linearization for a Steerable Nips Mechanism
Authors: Ergueta Edgar I. , Seifried Robert , Horowitz Roberto
Published: February 2011

This paper presents two different control strategies for paper position control in printing devices. The first strategy is based on standard feedback linearization plus dynamic extension (dynamic feedback linearization). Even though this controller is very simple to design, we show that it is not able to handle actuator multiplicative uncertainties, and therefore, it fails when it is implemented on the experimental setup. The second strategy we present uses similar concepts, but it is more robust since feedback linearization is used only to linearize the kinematics of the system and internal loops are used to locally control the actuator’s positions and velocities. In this paper, not only do we formally prove the robustness of the second control strategy but we also show its successful implementation.
Synthesis of the Pitch Cones of N-Lobed Elliptical Bevel Gears
Authors: Figliolini Giorgio , Angeles Jorge
Published: February 2011

A general formulation of the synthesis of the pitch cones of a pair of N-lobed elliptical bevel gears and the pitch surface of its conjugate crown-rack is proposed. In particular, two pitch cones and the pitch surface of their crown-rack are obtained for any number and combination of lobes and in any configuration during their pure-rolling motion. This formulation is implemented in MATLAB; several significant examples are included, with circular bevel gears becoming a particular case thereof.
Polymer molded templates for nanostructured amorphous silicon photovoltaics
Authors: Pei Lei , Balls Amy , Tippets Cary , Abbott Jonathan , Linford Matthew R. , Hu Jian , Madan Arun , Allred David D. , Vanfleet Richard R. , Davis Robert C.
Published: February 2011

Here, the authors report the fabrication of transparent polymer templates for nanostructured amorphous silicon photovoltaics using low-cost nanoimprint lithography of polydimethylsiloxane. The template contains a square two-dimensional array of high-aspect-ratio nanoholes (300 nm diameter by 1 μm deep holes) on a 500×500 nm2 pitch. A 100 nm thick layer of a-Si:H was deposited on the template surface resulting in a periodically nanostructured film. The optical characterization of the nanopatterned film showed lower light transmission at 600–850 nm wavelengths and lower light reflection at 400–650 nm wavelengths, resulting in 20% higher optical absorbance at AM 1.5 spectral irradiance versus a nonpatterned film.