bluuebunny/crossref_metadata_2025 huggingface dataset:
Medication compliance devices in primary care: activities of community-based nurses
Authors: Stewart Derek , Ogilvie Elaine , Kennedy Emily , Hansford Denise , Neil Elaine
Published: February 2011

Objective

To investigate the workload, training and views of community-based nurses in relation to medication compliance devices.

Method

Postal questionnaires distributed to all nurse team leaders (n=57) and community-based nurses (n=327) in the Grampian region of Scotland.

Setting

Primary care.

Key findings

Responses were received from 32 team leaders (56 per cent) and 153 nurses (47 per cent). Ninety-six nurses (63 per cent) filled a total of 212 medication compliance devices per week for patients under their care — an activity which accounted for an estimated total of 121 hours per week (mean of 1.25 hours per nurse per week, range 0.5 to 7 hours) and for which they had received no formal training. One hundred devices (47 per cent) were filled to enable carers to administer medicines. Team leaders reported several areas of concern which had been raised by their staff, particularly relating to responsibility and accountability under professional body guidelines.

Conclusion

Many community-based nurses fill medication compliance devices, an activity which clearly causes much concern. There is an urgent need to develop and evaluate multidisciplinary models of care based around the needs of individual patients requiring medication compliance devices.
The training experience of primary care pharmacists
Authors: Jesson Jill K , Wilson Keith A , Blenkinsopp Alison
Published: February 2011

Objectives

To map the tasks, activities and training provision for primary care pharmacists (PCPs) and to identify perceived future training needs.

Methods

Survey undertaken in 1998/1999 using a pre-piloted, postal, self-completion questionnaire to two samples of PCPs.

Setting

PCPs in (a) the West Midlands and (b) England (outside West Midlands).

Key findings

The response rate was 66 per cent. A majority (68 per cent) had worked in the role for less than two years. Eighty per cent had some form of continuing education or training for the role although only 50 per cent had a formal qualification. Over two-thirds had contributed to the funding of their training, with one-third providing all funding. Seventy-four per cent of PCPs agreed that pharmacists should go through a procedure to ensure competence (accreditation) before being allowed to work for a general medical practice or primary care group. Views on the need for formal education/training prior to work differed: 82 per cent of those with formal qualifications, but only 46 per cent of those without, considered that this should be a requirement. There was general agreement that training/education had met training needs. Views on future training closely reflected previous training experiences, with a focus upon pharmaceutical roles rather than upon generic skill development and the acquisition of management skills.

Conclusions

The study provides a snapshot in time of the experience of pioneer PCPs and the training available to them. PCPs will need further training or updating if they are to provide the wider roles required by the developing needs of the National Health Service. Consideration should be given to formal recognition of the training of PCPs in order to assure competence. The expectation that pharmacists should fund their own training is likely to be a barrier to uptake of training and uncertainties over funding will militate against consistency of training.
Public perceptions of community pharmacists in Benin City, Nigeria
Authors: Oparah C A , Iwuagwu M A
Published: February 2011

Objective

To determine public perceptions of community pharmacists and pharmacies in Benin City, Nigeria.

Method

A self-completion questionnaire was distributed to a stratified random sample of 1,500 households. Data were collected using a 22-item, Likert-type scale which was shown to have 0.77 reliability. The neutral point was assumed to be 66 on the scale of 22 to 110. Scores above 66 were interpreted as positive perception.

Results

The response rate was 68.3 per cent (1,025/1500). Almost two-thirds (64 per cent) of respondents perceived the community pharmacist as a health care provider, and 70 per cent agreed that community pharmacists are needed, especially in the area of medicinal product selection (76 per cent). However, 52 per cent believed pharmacists are profit motivated and only 43 per cent said they would be willing to pay for pharmacist consultation. Respondents reported difficulty in differentiating between pharmacists and pharmacy attendants, with only 58 per cent reporting that they could tell the difference. The pharmacists scored 76.37 ± 27.63, with 60 per cent of respondents scoring them above 66.

Conclusion

This study found that community pharmacists received a moderately positive rating from the public. There is a need for community pharmacists to carve out a more distinct professional identity for themselves.
Perceived factors influencing the development of primary care-based pharmaceutical care in Scotland
Authors: Krska J , Veitch G B A
Published: February 2011

Objective

To obtain the views of key pharmacists in Scotland (potential policy-makers and innovative practising pharmacists) on a systematic approach to pharmaceutical care and on the factors important in its development.

Method

Semi-structured interviews, based on factors identified from the literature as resources required for, or barriers to, pharmaceutical care development.

Key findings

All 16 interviewees agreed with the systematic approach and identified community pharmacies as the key locus for the delivery of pharmaceutical care in primary care. Many expressed similar views in relation to remuneration, the need for training, physical resources, relationships with general practitioners to facilitate access to clinical information from medical records, repeat dispensing systems and improvements to existing computer systems to support the necessary documentation. Divergent opinions were expressed on the need for registration of patients with community pharmacies, on the use of dispensing technicians and on what specific literature and information from medical records would be required to support pharmaceutical care. While all agreed that there was insufficient evidence available of the benefits of pharmaceutical care, many felt that its development should nonetheless be progressed.

Conclusion

Many of the views expressed are similar to those identified among community pharmacists in similar studies. Planning of future services needs to involve community pharmacists if indeed they are key to pharmaceutical care provision.
Development of a pharmacist-led cholesterol screening and lipid-lowering medication review service in coronary artery bypass graft patients
Authors: Alldred D P , Booth C , Chrystyn H
Published: February 2011

Objective

To assess the effects of pharmacist intervention on lipid management in coronary artery bypass graft (CABG) patients.

Method

Open study in which total cholesterol (TC) levels were measured in 43 elective CABG patients at visit 1 (pre-surgery) and visit 2 (six weeks post-discharge following surgery). Statin therapy was initiated (using atorvastatin) or statin doses were adjusted according to an agreed protocol.

Key findings

Prior to CABG surgery, 19 patients (44 per cent) did not have target TC values. Fourteen (74 per cent) of these patients were already receiving a statin while five patients (26 per cent) were not receiving statin therapy. At visit 2, 33 patients (77 per cent) had achieved target TC. Mean (SD) TC was 5.7 (0.72) mmol/L at visit 1 and 4.8 (0.68) mmol/L at visit 2 in the intervention patients (P<0.01). There was no significant difference between mean TC at visits 1 and 2 in the non-intervention patients (patients who had target TC values at visit 1). From a previous meta-analysis, the decrease in TC of 0.9 mmol/L (16 per cent) in the intervention patients equates to a 24 per cent risk reduction in coronary heart disease (CHD) mortality and an 18 per cent risk reduction in total mortality. The recent National Service Framework for CHD has set standards for improving the care of CHD patients. From this study, it appears that the management of raised TC in this high-risk population is sub-optimal.

Conclusion

This study has shown that the role of the pharmacist can be extended to encompass the management of raised total cholesterol in CABG patients, thereby contributing towards health care benefit.
Analysis of the information and support needs generated by a community pharmacy-based methadone treatment programme
Authors: O'Connor Sile , Sheridan Janie , Corrigan Des
Published: February 2011

Background

Methadone treatment has been provided in Ireland since 1998 under the methadone protocol scheme. Two liaison pharmacists were employed by the Eastern Health Board to interface between pharmacists dispensing methadone in primary and tertiary care.

Objective

To analyse and review the inquiries received and addressed by one liaison pharmacist in the first year of operation of a community pharmacy-based methadone treatment scheme.

Method

Inquiries received were recorded by the pharmacist using a standard data collection form. Using content analysis, key themes were identified and each inquiry was classified. Data were analysed using standard computer software.

Key findings

Two primary categories of liaison inquiry were addressed: “patient-related” inquiries, requiring the organisation of community pharmacy-based methadone dispensing services for patients, and “pharmacy-related” inquiries, which were requests from community pharmacists for information or support. Two thirds of the inquiries were “patient-related.” The primary users of the liaison service were prescribers employed by the addiction services and community pharmacists.

Conclusion

The liaison pharmacy service handled diverse inquiries, with an emphasis on the facilitation of the provision of pharmaceutical care for patients requiring community pharmacy-based methadone dispensing services. The liaison service had a significant secondary role in the provision of support and information for community pharmacists. The study findings are of relevance to those involved in developing and introducing primary care-based services for drug misusers.
Analysis of income from prescription charges
Authors: Walker Roger
Published: February 2011

Focal points
Adherence to national recommendations on antibiotic policies and impact on prescribing in an NHS region
Authors: Seymour H E , Brent S L , Snider K , Hollyoak V A , Smith J M
Published: February 2011

Focal points
Pharmaceutical information exchange between primary and secondary health care professionals and cancer patients
Authors: Scanlan Justine C
Published: February 2011

Focal points
Can automated dispensing decrease prescription turn-around time and alter staff work patterns?
Authors: Rutter P M , Brown D , Portlock J C
Published: February 2011

Focal points
Medianes management and the individual patient
Authors: Morecroft C , Cantrill J , Tully M , Crossley M
Published: February 2011

Focal points
A randomised, controlled study to quantify the benefits of community pharmacist interventions on the prescribing of cardiovascular drugs in general practice
Authors: Fish A , Antonazzo E , Reid J P , Bond C M , Porteous T H , Scott Tony
Published: February 2011

Focal points
Laxative prescribing during pregnancy in primary care
Authors: Offia A , Walker R
Published: February 2011

Focal points
A patient-held medication record and a patient medication profile to support the continuity of acute cancer care
Authors: Kelly J , Forrest F , Hudson S
Published: February 2011

Focal points
Use of health information touchscreens by community pharmacy users in six local community pharmacies
Authors: Bennett E V , Jones I F
Published: February 2011

Focal points
Adverse drug reactions: mothers talk
Authors: Hughes M L , Whittlesea C M C , Luscombe D K
Published: February 2011

Focal points
Responding to red eye
Authors: Seston E M , Nicolson M , Hassell K , Cantrill J A , Noyce P R
Published: February 2011

Focal points
A pilot project on the impact of a community pharmacy programme providing advice to women initiating HRT therapy
Authors: Scott E M , McElnay J C , Shirley A B , Steele K
Published: February 2011

Focal points
Developing an R&D agenda for pharmacy workforce research
Authors: Hassell Karen , Seston Liz
Published: February 2011

Focal points
Supplying emergency hormonal contraception through patient group direction: a qualitative study of the views of pharmacists
Authors: Bissell Paul , Anderson Claire , Savage Imogen , Goodyear Larry
Published: February 2011

Focal points
Attitudes of community pharmacists towards medication error reporting
Authors: Cavell Gillian F , Burgess Vanessa , Oborne C Alice , Williams Roma , Colwill Soma
Published: February 2011

Focal points
The views of general practitioners on the reuse of patients' own drugs
Authors: Salmon Kimberley , Whittam Janet , Freeborn Stephen
Published: February 2011

Focal points
Training needs analysis for pharmacy technicians in Northern Ireland
Authors: Fleming G F , Maguire T A
Published: February 2011

Focal points
Cost implications of the use of troponin I (cTnI) measurement to diagnose heart conditions
Authors: Scullin C , McElnay J C , Scott M G , Ryan M , Trouton T G , Baird S
Published: February 2011

Focal points
Do increasing levels of income deprivation have an effect on the prescribing of OTC medication?
Authors: Evans David
Published: February 2011

Focal points
Implementing a system for tackling under-eporting of adverse drug reactions within a district general hospital
Authors: Andrew Inga , Baker Sonia , Chalmers Anita
Published: February 2011

Focal points
Does social environment affect arthritis patients' ability to remain on methotrexate treatment?
Authors: Bayraktar A , Hudson S , Watson A , Fraser S , Hunter J
Published: February 2011

Focal points
Preliminary investigation of the problems associated with supply of palliative care medicines in primary care
Authors: Lacey Fiona , Jesson Jill
Published: February 2011

Focal points
Validation of a “desire for information” scale
Authors: DUGGAN C , BATES I , STURMAN S , ANDERSSON E , ÅSTRÖM K , CARLSSON J
Published: February 2011

Objective

To validate a scale to measure patients' desires for information about their prescribed drugs.

Methods

Both quantitative and qualitative methods were used. Standardised bedside interviews were conducted with general medical patients in three hospitals over an eight-month period. The validity of the scale was explored by interfacing qualitative data from patients' perspectives and their scores to the scale.

Setting

General medical wards at three teaching hospitals in London.

Key findings

A total of 630 patients were recruited for interview; 50.2 per cent were male and 49.8 per cent female. The mean age for the population was 60 years. More than half (54 per cent) of the study population was retired, and the majority (82 per cent) described their cultural background as white. Through a factor analytic approach, the primary 12-item scale was refined to six items (designated F1), measuring “extent of information desired”. A second extracted factor (designated F2) measured “inhibited desire for information”, but was not considered reliable. The responses to semi-structured interviews gave valuable insights into the types of information sought: low-scorers declared no need for detailed information as this would sometimes even worry or frighten them, while high-scorers worried about not receiving enough information and requested specific details that would help them in their self care.

Conclusion

Interfacing qualitative responses to semi-structured and open questions and the quantitative scores contributed to the validation of a new six-item scale and gave insights into the types of information patients seek. By developing a tool to identify patients' desires for information, pharmacists will be able to identify and meet the drug information needs of patients in an appropriate and timely way.
A randomised controlled trial of a pharmaceutical care programme in high-risk diabetic patients in an outpatient clinic
Authors: Clifford Rhonda M , Batty Kevin T , Davis Timothy M E , Davis Wendy , Stein Gary , Stewart Graeme , Plumridge Richard J
Published: February 2011

Objective

To determine the impact of a pharmaceutical care programme (PCP) in diabetic patients.

Design

Randomised controlled study of high-risk diabetic patients.

Setting

Outpatient clinic at Fremantle hospital (FH), Western Australia.

Method

Patients over 18 years of age who could communicate freely in English and fulfilled pre-determined criteria for being high-risk for the development of diabetic complications, were randomly assigned to the PCP or control groups in a ratio of 2:1. In the PCP arm, a clinical pharmacist reviewed and monitored all aspects of the patients' drug therapy in collaboration with other health care professionals at six-weekly intervals for six months. The control patients received usual outpatient care.

Main outcome measures

Glycosylated haemoglobin (HbA1c), quality of life (QOL), patient satisfaction with health care providers and changes in drug therapy during the PCP.

Results

Seventy-three patients were recruited into the study, of whom 48 (66 per cent) were randomised to the PCP. There were no significant differences between the PCP (cases) and the control groups for demographic variables. The mean (±SD) HbA1c for the cases was 8.4±1.4 per cent at the beginning and 8.2±1.5 per cent at the end of the study period (P>0.05). There was similarly no change in the control group (8.5±1.6 per cent to 8.1±1.6 % P>0.05). There were no significant changes in QOL for cases or controls over the period of the study. During the PCP, there was a significant increase in patient satisfaction with the care provided by the clinical pharmacist (P=0.007) and the provision of drug information (P=0.036). The clinical pharmacist facilitated 39 drug interventions in the 48 cases. A high level of complementary medicine usage was found in the PCP group (16.7 per cent).

Conclusions

PCPs provide patients with important medication information and result in changes to drug therapy. However, in diabetic patients under specialist care, a six-month PCP did not lead to an improvement in glycaemic control. The role for pharmacist intervention in primary care now needs to be evaluated.
A classification system for issues identified in pharmaceutical care practice
Authors: Krska Janet , Jamieson Debbie , Arris Fiona , McGuire Andrew , Abbott Sorrel , Hansford Denise , Cromarty John
Published: February 2011

Objective

To investigate the usefulness of a system for classifying pharmaceutical care issues (PCIs), defined in Scottish practice guidelines as “an element of a pharmaceutical need which is addressed by the pharmacist,” which were identified during the delivery of pharmaceutical care in a primary care setting.

Method

The classification system had 12 categories, each with a definition and examples reflecting the primary care setting to assist in assigning categories to individual PCIs. There was no category of “other” or “miscellaneous”. The system was used by two clinical pharmacists in a study involving 332 patients aged 65 years or over collecting four or more medicines regularly. The point at which PCIs were identified and resolved, the drugs involved and the actions required to resolve them were analysed for each type of PCI.

Setting

Six randomly selected medical practices in the Grampian region of Scotland.

Key findings

All 2,586 PCIs identified were successfully assigned one category within this classification system. The most commonly occurring types of PCI were “potential adverse drug reaction”, “need for monitoring”, “potentially ineffective therapy” and “need for education.” Most PCIs classed as “potential adverse drug reaction” and “need for monitoring” were identified from the prescription record. A third of “potentially ineffective therapy” PCIs, plus most PCIs classed as “drug use — no indication” and “indication — no treatment” were identified from medical records. Patient interview identified most of the PCIs categorised as “need for education,” “suspected adverse drug reaction” and “actual compliance issue.” Resolving the “need for education,” “suspected/actual compliance issue” and “out of date medicines” PCIs mostly involved the patient, whereas those involving changes to prescribed therapy or monitoring required contact with a health care professional.

Conclusion

The classification system was comprehensive in its coverage of PCIs arising from clinical pharmacists' direct patient care activities in a primary care setting. While the system requires further development and testing, it would appear to be a useful tool for researchers and practitioners to use in describing and comparing PCIs in different studies and using different practices.
Consumer opinions on medicines information and factors affecting its use — an Australian experience
Authors: Koo Michelle , Krass Ines , Aslani Parisa
Published: February 2011

Background

Consumer Medicine Information (CMI) is brand-specific, written drug information produced by pharmaceutical companies and intended for consumers in Australia. The content of CMI is defined in legal regulations.

Objectives

This exploratory study investigated: (a) consumers' awareness, perceptions and modes of CMI use, (b) the impact of CMI on consumers, and (c) possible factors affecting CMI use.

Methods

Six focus groups (n=57 consumers) were conducted. Discussions were tape-recorded, transcribed verbatim and thematically analysed.

Setting

Metropolitan Sydney, New South Wales, Australia.

Key findings

Most participants were aware of written information about prescription medications but were unfamiliar with the term “CMI”. Few had experienced a health care professional providing or discussing CMI but most had read it and found it useful. There were many suggestions for improvements to the format and content of CMI to increase its “user-friendliness”. CMI had caused anxiety in some participants but increased awareness of their medications in others. Several factors appeared to increase the likelihood of CMI use: information-oriented coping mechanism, severe disease, internal locus of control, appropriate timing of information provision, and care-giver role. Conversely, difficulty in reading and understanding CMI, confidence in health care professionals and perceived “problem-free” therapies appeared to reduce CMI use.

Conclusions

Although consumers were aware of and read written drug information, there was limited interaction with a health professional when written information was provided.
Surveillance of adverse drug reactions at two multidisciplinary hospitals and an outpatient specialty clinic in India
Authors: Samuel S A , Rajendran S D , Ebenezzar S , Jayaharan S , Azir P
Published: February 2011

Context

Adverse drug reaction (ADR) reporting is under-developed in India, with only two of six national reporting centres currently functioning.

Objective

To introduce an ADR monitoring programme at two hospitals and an outpatient skin specialty clinic in South India and to evaluate the programme.

Design

An ADR monitoring programme was introduced in three participating centres and ADRs were documented and analysed over a period of six months. All unplanned admissions, all inpatients of the two participating hospitals and all outpatients of the skin specialty clinic were included in the study. A clinical pharmacist (the investigator) interviewed all patients on admission to identify suspected ADRs. For inpatients and clinic outpatients, suspected ADRs were documented by the treating doctor. A panel of four judges, including the investigator and the physician treating the patient with the suspected ADR, assessed the cases. Confirmed ADRs were then classified and categorised.

Key findings

In total, 152 ADRs were documented. The percentage of patients with a reported ADR at each of the three centres was 3.5, 3.7 and 2.3. The gender of patients with reported ADRs was 53.9 per cent male and 46.1 per cent female. Most of the patients had a type “A” reaction (110, 72.4 per cent). Using Naranjo's probability scale, 25.7 per cent of ADRs were categorised as “probable” and 74.3 per cent as “possible.” Of the ADRs reported in the two hospitals, 31.1 per cent related to unplanned medication-related hospital admissions and 68.9 per cent occurred during the hospital stay. Antibiotics (32.2 per cent), psychotropic drugs, steroids and non-steroidal anti-inflammatory drugs (11.8 per cent each) were the most common drugs that caused ADRs. General medicine (37.5 per cent) and dermatology (35.5 per cent) departments accounted for the highest number of ADRs. Pruritic rash (36.7 per cent) was the most common ADR reported at the skin clinic while pruritic rash, gastritis and diarrhoea (10.7 per cent each) and akathisia and hypoglycaemia (7.8 per cent) were the most common ADRs reported in the hospitals.

Conclusion

This is the first study to evaluate an ADR reporting programme in India. Introduction of the ADR monitoring programme improved health care practitioners' awareness of the importance of pharmacovigilance. Occurrence of ADRs seemed to be similar to those reported in the developed world, with the exception of the proportion of severe ADRs (25 per cent), which was higher than reported elsewhere in published studies.
SOCIOLOGICAL THEORY AND PHARMACY PRACTICE RESEARCH: (3) How relevant is Marxist sociology for pharmacy practice research?
Authors: Bissell Paul , Traulsen Janine Morgall , Haugbølle Lotte Stig
Published: February 2011

In our previous paper on the relevance of sociology to pharmacy practice research, we discussed the ideas of Talcott Parsons and his work on the sick role.1 We explained that his consensual depiction of how health care relationships functioned within society came under sustained attack during the 1960s and beyond. Much of this criticism emanated from scholars influenced by the work of Karl Marx. The sociological perspective most heavily influenced by Marx's ideas has come to be known as the political economy critique (although for simplicity we refer in this paper to the ideas of Marx rather than the political economy critique). No sociological textbook would be complete without a major section devoted to Marx. The same applies to this series on the relevance of sociology to pharmacy practice research. What we will show in this paper is that sociologists influenced by Marx have produced a compelling critique of the relationship between capitalism and health in Western societies and this critique continues to be germane to understanding contemporary health care systems, health issues and the role of pharmacy within society.
Is 15 per cent very common? Informing people about the risks of medication side effects
Authors: Berry Dianne C , Knapp Peter R , Raynor Theo
Published: February 2011

Objectives

To assess the general public's interpretation of the verbal descriptors for side effect frequency recommended for use in medicine information leaflets by a European Union (EU) guideline, and to examine the extent to which differences in interpretation affect people's perception of risk and their judgments of intention to comply with the prescribed treatment.

Method

Two studies used a controlled empirical methodology in which people were presented with a hypothetical, but realistic, scenario about visiting their general practitioner and being prescribed medication. They were given an explanation that focused on the side effects of the medicine, together with information about the probability of occurrence using either numerical percentages or the corresponding EU verbal descriptors. Interpretation of the descriptors was assessed. In study 2, participants were also required to make various judgments, including risk to health and intention to comply.

Key findings

In both studies, use of the EU recommended descriptors led to significant overestimations of the likelihood of particular side effects occurring. Study 2 further showed that the “overestimation” resulted in significantly increased ratings of perceived severity of side effects and risk to health, as well as significantly reduced ratings of intention to comply, compared with those for people who received the probability information in numerical form.

Conclusion

While it is recognised that the current findings require replication in a clinical setting, the European and national authorities should suspend the use of the EU recommended terms until further research is available to allow the use of an evidence-based approach.
An evaluation of the process-related medication risks for elective surgery patients from pre-operative assessment to discharge
Authors: Sagripanti Marisa , Dean Bryony , Barber Nick
Published: February 2011

Aim

To investigate where the process-related medication risks occur in an elective surgery service with a pre-operative assessment clinic (PAC) and make recommendations for how pharmacy services should best be provided.

Method

The study involved identification of discrepancies in medication history taking, changes that occurred in patients' medication between PAC and admission, and changes that occurred between admission and discharge. Prescribing errors were identified and classified according to whether they occurred on admission, during the inpatient stay or on discharge, and whether they were identified and rectified by the existing pharmacy service.

Setting

Seventy-six patients recruited from the nurse-led PAC of a 580-bed London teaching hospital between May 2 and June 30, 2000.

Key findings

The PAC nurse omitted 27 per cent of medications from the medication history; the admitting doctor omitted 37 per cent from the medication history documented in the medical notes and 47 per cent from the inpatient medication chart; the majority of the omissions were complementary and over-the-counter preparations. Twenty-six per cent of patients had changes made to their medication between PAC and admission, and 85 per cent had changes made between admission and discharge. A total of 177 prescribing errors were identified (median of 1 error per patient; interquartile range 0–3), of which 38 per cent occurred on admission, 14 per cent during the inpatient stay and 48 per cent at discharge. Pharmacists made interventions to rectify 59 per cent of the errors.

Conclusion

Given the large number of changes to patients' medication that occurred between PAC and admission, we would not support the writing of inpatient medication charts or the supply of medication at this stage. For this group of patients in the study hospital, the greatest process-related medication risks occurred on admission and discharge, and pharmacy services should be provided accordingly.
Contribution of a ward-based technician service to delivering effective patient health care and reducing dispensary workload
Authors: Conroy Clare , Cattell Richard , Nicholls Mary
Published: February 2011

Objective

To determine whether introduction of a ward-based technician service reduces medication administration errors and decreases pharmacy workload.

Method

Information on the incidence of unavailable medication administration errors (U-MAEs), number of calls to pharmacy, volume of weekend medicine supply and workload of the non-stock supply (NSS) pharmacist was compared during a two-week period prior to the implementation of a ward-based technician service (control period) and a two-week period after the introduction of the service (study period).

Setting

Five wards (two acute admission wards and three care of the elderly medical wards) at Bristol Royal Infirmary with a perceived high workload.

Key findings

When a ward-based technician service was implemented the number of U-MAEs was almost halved (46 per cent reduction), and there was a 60 per cent reduction in the number of telephone calls from the five pilot wards to the dispensary. Overall, there was a decrease in the number of item requests during the weekend; however, the number of items requested from the non stock supply pharmacist increased from 51 to 58 (14 per cent).

Conclusion

Following the introduction of the ward-based technician service, patient care has improved as medicines are available more reliably, and the work life of the pharmacy team has benefited.
Influences on prescribing: the perceptions of general practitioners in two primary care trusts
Authors: Åström K , Duggan C , Bates I
Published: February 2011

Focal points
UK survey of discharge prescriptions, transcribing and development of the hospital pharmacist-prescribing role
Authors: Hobson R J , Sewell G J
Published: February 2011

Focal points
How professionals define medicines management: a preliminary qualitative investigation
Authors: Prentis S Simpson , Atkin K , Raynor D K , Closs S J
Published: February 2011

Focal points
Pharmaceutical care across the health care interface: an evidence-based approach to developing and evaluating documentation in practice
Authors: Bateson C , Duggan C , Bates I
Published: February 2011

Focal points
The impact of the deregulation of emergency hormonal contraception on a patient group direction scheme in the north-west of England
Authors: Seston E M , Smith I , Cantrill J A , O'Brien K
Published: February 2011

Focal points
The sale of emergency hormonal contraception in community pharmacies in the UK: the views of users
Authors: Bissell Paul , Harness Rachael , Anderson Claire
Published: February 2011

Focal points
Investigating the potential contribution of community pharmacists in identifying, understanding and meeting the bone health needs of patients in collaboration with GPs
Authors: Gray Mike , Rajaei-Dehkordi Ziba , Ewan Marilyn , Wysocki Richard
Published: February 2011

Focal points
Proton pump inhibitor prescribing following endoscopic diagnosis in a district general hospital
Authors: Curtis C E , Ford N , Marriott J F , Wilson K A , Langley C A
Published: February 2011

Focal points
Set-up and maintenance of syringe drivers for subcutaneous drug administration in palliative care
Authors: Hirsch C M , Marriott J F , Langley C A , Wilson K A , Faull C
Published: February 2011

Focal points
Are community pharmacists prepared to work extended opening hours?
Authors: Saini S , Langley C A , Marriott J F , Wilson K A
Published: February 2011

Focal points
Observed structured clinical examinations: the views of preregistration trainees six months after graduating from Portsmouth University
Authors: Rutter P M , Brown D
Published: February 2011

Focal Point

Undergraduate OSCE based assessments appear to be directly relevant in contributing to the tasks and skills needed through the pharmacy preregistration year
The power of the “medicine”: adolescents define the term
Authors: Gray Nicola J , Sesselberg Tracy S , Klein Jonathan D
Published: February 2011

Focal points
Pharmaceutical care for older people: recording and review of medication following admission to hospital
Authors: Tulip Sarah C , Cheung Philip , Campbell David , Walters P
Published: February 2011

Focal points
Factors influencing provision of pharmacist discharge prescription transcription services and authorisation requirements of pharmacist-written prescriptions
Authors: Hobson R J , Sewell G J
Published: February 2011

Focal points
Incongruity: patients' experiences of hypertension and their general practitioners' perception of their treatment and care
Authors: Morecroft C , Cantrill J , Tully M P , Crossley M
Published: February 2011

Focal points
Children's outcomes and parents' preferences for the induction and maintenance of anaesthesia for day-case surgery
Authors: Elliott R A , Payne K , Davies L M , Moore J K , Moore E W
Published: February 2011

Focal points
Current paediatric parenteral nutrition practice in Europe
Authors: Kluettgens B U , Sewell G J , Nunn A J
Published: February 2011

Focal points
Quality of life in patients receiving treatment for gastro-oesophageal reflux disease
Authors: Inglott Anthony Serracino , Azzopardi Lilian M , Adami Maurice Zarb
Published: February 2011

Focal points
Smoking cessation programme in a young offenders institution
Authors: Shearin Pamela , Hepburn Kirstie , Hands Sandra , McAteer James , Braddick Lyndon
Published: February 2011

Focal points
Reactive interventions by pharmacists to prescribing decisions by house officers: an audit with support implications
Authors: Higgins M P , Scanlan J C , Milligan D
Published: February 2011

Focal points
A qualitative assessment of the treatment approach to managing uncomplicated, lower urinary tract infections in nursing home residents
Authors: Schweizer A K , O'Neill C , Hughes C M , Macauley D
Published: February 2011

Focal points
Community pharmacists and continuing professional development: a study of perceptions and current involvement
Authors: Attewell J M , Blenkinsopp A , Black P
Published: February 2011

Focal points
Workforce mobility in the pharmacy profession
Authors: Mullen R , Hassell K , Noyce P R
Published: February 2011

Focal points
The implementation of a harm-minimisation model for the identification and treatment of over-the-counter drug misuse and abuse in community pharmacies
Authors: Wazaify M , McElnay J C , Hughes C M
Published: February 2011

Focal points
Pharmaceutical care: cultural, practice and professional perspectives
Authors: Tulip Sarah C , Cheung Philip , Campbell David , Walters P
Published: February 2011

Focal points
Factors affecting self-care activities, postprandial plasma glucose and HbA1c in patients with type 2 diabetes
Authors: Aburuz S M , McElnay J C , Millership J S , Andrews W J , Smyth S
Published: February 2011

Focal points
GABAergic control of micturition within the periaqueductal grey matter of the male rat
Authors: Stone E. , Coote J. H. , Allard J. , Lovick T. A.
Published: February 2011

Non‐technical summary  Even when the bladder is full, emptying can be deferred voluntarily until individuals find themselves in a socially appropriate environment. This indicates that the brain is important in the control of bladder function. This study used drugs that either mimic or block the effects of the neurotransmitter chemicals involved in communication between nerve cells to investigate the brain nerve circuits that govern the control of the bladder. A small region in the midbrain was shown to be critical for normal bladder emptying to occur. Normally the excitability of the nerve circuits in this region was controlled by the action of an inhibitory neurotransmitter chemical called GABA. However, if GABA's effect was removed, bladder emptying became abnormally frequent. These results advance our understanding of the normal control of bladder function, and have implications for the development of new treatments for some forms of incontinence.
Brain circuits mediating baroreflex bradycardia inhibition in rats: an anatomical and functional link between the cuneiform nucleus and the periaqueductal grey
Authors: Netzer Florence , Bernard Jean‐François , Verberne Anthony J. M. , Hamon Michel , Camus Françoise , Benoliel Jean‐Jacques , Sévoz‐Couche Caroline
Published: February 2011

Non‐technical summary  Defence reactions are physiological responses to imminent danger. They include increased blood pressure and heart rate, and a reduction in the reflex cardiac response to changes in blood pressure. Two regions in the brain, the hypothalamus and the periaqueductal grey area, known to be involved in pathological conditions such as anxiety, are involved in the production of these responses. However, there is no direct connection between those regions. In this study we report that the midbrain cuneiform nucleus links the hypothalamus and periaqueductal grey area. Our findings may explain how anxiety is related to cardiovascular pathologies.
Smearing technique for vibration analysis of simply supported cross-stiffened and doubly curved thin rectangular shells
Authors: Luan Yu , Ohlrich Mogens , Jacobsen Finn
Published: February 2011

Plates stiffened with ribs can be modeled as equivalent homogeneous isotropic or orthotropic plates. Modeling such an equivalent smeared plate numerically, say, with the finite element method requires far less computer resources than modeling the complete stiffened plate. This may be important when a number of stiffened plates are combined in a complicated assembly composed of many plate panels. However, whereas the equivalent smeared plate technique is well established and recently improved for flat panels, there is no similar established technique for doubly curved stiffened shells. In this paper the improved smeared plate technique is combined with the equation of motion for a doubly curved thin rectangular shell, and a solution is offered for using the smearing technique for stiffened shell structures. The developed prediction technique is validated by comparing natural frequencies and mode shapes as well as forced responses from simulations based on the smeared theory with results from experiments with a doubly curved cross-stiffened shell. Moreover, natural frequencies of cross-stiffened panels determined by finite element simulations that include the exact cross-sectional geometries of panels with cross-stiffeners are compared with predictions based on the smeared theory for a range of different panel curvatures. Good agreement is found.
Guided wave propagation in single and double layer hollow cylinders embedded in infinite media
Authors: Jia Hua , Jing Mu , Joseph L. Rose
Published: February 2011

Millions of miles of pipes are being used for the transportation, distribution, and local use of petroleum products, gas, water, and chemicals. Most of the pipes are buried in soil, leading to the significance of the study on the subject of guided wave propagation in pipes with soil influence. Previous investigations of ultrasonic guided wave propagation in an elastic hollow cylinder and in an elastic hollow cylinder coated with a viscoelastic material have led to the development of inspection techniques for bare and coated pipes. However, the lack of investigation on guided wave propagation in hollow cylinders embedded in infinite media like soil has hindered the development of pipe inspection methods. Therefore the influence of infinite media on wave propagation is explored in this paper. Dispersion curves and wave structures of both axisymmetric and nonaxisymmetric wave modes are developed. Due to the importance of the convergence of numerical calculations, the requirements of thickness and element number of the finite soil layer between hollow cylinder and infinite element layer are discussed, and an optimal combination is obtained in this paper. Wave structures are used for the mode identification in the non-monotonic region caused by the viscoelastic properties of coating and infinite media.
Distortion-product otoacoustic emission suppression tuning curves in humans
Authors: Gorga Michael P. , Neely Stephen T. , Kopun Judy , Tan Hongyang
Published: February 2011

Distortion-product otoacoustic emission (DPOAE) suppression data as a function of suppressor level (L3) for f2 frequencies from 0.5 to 8 kHz and L2 levels from 10 to 60 dB sensation level were used to construct suppression tuning curves (STCs). DPOAE levels in the presence of suppressors were converted into decrement versus L3 functions, and the L3 levels resulting in 3 dB decrements were derived by transformed linear regression. These L3 levels were plotted as a function of f3 to construct STCs. When f3 is represented on an octave scale, STCs were similar in shape across f2 frequency. These STCs were analyzed to provide estimates of gain (tip-to-tail difference) and tuning (QERB). Both gain and tuning decreased as L2 increased, regardless of f2, but the trend with f2 was not monotonic. A roughly linear relation was observed between gain and tuning at each frequency, such that gain increased by 4–16 dB (mean ≈ 5 dB) for every unit increase in QERB, although the pattern varied with frequency. These findings suggest consistent nonlinear processing across a wide frequency range in humans, although the nonlinear operation range is frequency dependent.
Multi-domain active sound control and noise shielding
Authors: Lim H. , Utyuzhnikov S. V. , Lam Y. W. , Turan A.
Published: February 2011

This paper describes an active sound control methodology based on difference potentials. The main feature of this methodology is its ability to automatically preserve “wanted” sound within a domain while canceling “unwanted” noise from outside the domain. This method of preservation of the wanted sounds by active shielding control is demonstrated with various broadband and realistic sound sources such as human voice and music in multiple domains in a one-dimensional enclosure. Unlike many other conventional active control methods, the proposed approach does not require the explicit characterization of the wanted sound to be preserved. The controls are designed based on the measurements of the total field on the boundaries of the shielded domain only, which is allowed to be multiply connected. The method is tested in a variety of experimental cases. The typical attenuation of the unwanted noise is found to be about 20 dB over a large area of the shielded domain and the original wanted sound field is preserved with errors of around 1 dB and below through a broad frequency range up to 1 kHz.
Effects of poroelastic coefficients on normal vibration modes in vocal-fold tissues
Authors: Tao Chao , Liu Xiaojun
Published: February 2011

The vocal-fold tissue is treated as a transversally isotropic fluid-saturated porous material. Effects of poroelastic coefficients on eigenfrequencies and eigenmodes of the vocal-fold vibration are investigated using the Ritz method. The study demonstrates that the often-used elastic model is only a particular case of the poroelastic model with an infinite fluid–solid mass coupling parameter. The elastic model may be considered appropriate for the vocal-fold tissue when the absolute value of the fluid–solid mass coupling parameter is larger than 105 kg/m3. Otherwise, the poroelastic model may be more accurate. The degree of compressibility of the vocal tissue can also been described by the poroelastic coefficients. Finally, it is revealed that the liquid and solid components in a poroelastic model could have different modal shapes when the coupling between them is weak. The mode decoupling could cause desynchronization and irregular vibration of the folds.
The Response of Vegetation on the Andean Flank in Western Amazonia to Pleistocene Climate Change
Authors: Cárdenas Macarena L. , Gosling William D. , Sherlock Sarah C. , Poole Imogen , Pennington R. Toby , Mothes Patricia
Published: February 2011

Pleistocene climate fluctuations caused major shifts in the altitudinal distribution of forest plant species.
Global Invasion History of the Fire Ant
Solenopsis invicta
Authors: Ascunce Marina S. , Yang Chin-Cheng , Oakey Jane , Calcaterra Luis , Wu Wen-Jer , Shih Cheng-Jen , Goudet Jérôme , Ross Kenneth G. , Shoemaker DeWayne
Published: February 2011

Argentine fire ants have spread around the world from a population that was first established a century ago in North America.
Differentiation of
cfiA
-Negative and
cfiA
-Positive Bacteroides fragilis Isolates by Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry
Authors: Wybo Ingrid , De Bel Annelies , Soetens Oriane , Echahidi Fedoua , Vandoorslaer Kristof , Van Cauwenbergh Marina , Piérard Denis
Published: February 2011

Carbapenem resistance in
Bacteroides fragilis
is associated with
cfiA
-encoded class B metallo-beta-lactamase.
cfiA
-negative and
cfiA
-positive isolates belong to genotypically distinct groups. Of a total of 248
B. fragilis
isolates included in this study, 214 were susceptible, 10 were intermediate, and 24 were resistant to meropenem. We show that matrix-assisted laser desorption ionization–time of flight mass spectrometry is able to differentiate between
cfiA
-negative and
cfiA
-positive isolates and predict carbapenem resistance in a routine laboratory setting.