bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of probe application pressure on in vitro and in vivo capacitance (Corneometer CM 825®) and conductance (Skicon 200 EX®) measurements
Authors: Clarys Peter , Clijsen Ron , Barel André O.
Published: February 2011

Background/purpose: The measuring probe of the electrical hydration instruments is equipped with a spring system to ensure a constant pressure of probe application on the skin surface. However, it is possible to trigger the measurement at, respectively, a low and a high force of probe application. It is the purpose of this paper to compare the in vitro and in vivo hydration values of the capacitance and conductance method at, respectively, low and high values of application pressure on the considered surface.

Methods: In vitro capacitance and conductance hydration measurements were carried out at a low and a high pressure on a calibration filter pad impregnated with different alcohols and in vivo on different skin sites covering a wide range of hydration values.

Results: The in vitro results were pressure dependent and higher hydration values were noticed when the probes were applied with a high pressure compared with a low pressure.

In vivo, the pressure effect was a function of the skin type and it was more pronounced for dry skin (40%), lower for normal skin (20%) and the lowest for hydrated skin (5–8%).

Conclusion: This study confirms the influence of probe pressure application on the skin surface when carrying out capacitance and conductance hydration measurements.
The prevalence of hypertension in children with spina bifida
Authors: Mazur L , Lacy B , Wilsford L
Published: February 2011

Aim:  To determine whether children with spina bifida (SB) have a higher prevalence of hypertension (HTN) than population‐based controls.

Methods:  Charts of all patients (n = 123) seen in the Spina Bifida Clinic at Shriners Hospital in Houston, Texas, were reviewed for age, gender, ethnicity, type and level of neural tube defect, height, weight and blood pressure (BP). HTN was defined as a systolic blood pressure or diastolic blood pressure ≥95th percentile for age, gender and height on ≥3 occasions. Data from the National Health and Nutrition Examination Survey and from a Houston‐based study were used for comparison.

Results:  Fifty‐one (41.5%) patients were hypertensive. This was significantly higher than the 3% prevalence in the national controls, p < 0.001 and the 4.5% prevalence in the Houston controls, p < 0.001. Maximum body mass index increased the risk for HTN [odds ratio, 1.018; 95% confidence interval (1.005, 1.031); and p = 0.005].

Conclusion:  Children with SB have a significantly higher prevalence of HTN than children in the general population. Age‐, gender‐, and height‐based norms are important for the early identification and treatment of HTN in children.
Quality of life in infants with atopic dermatitis and healthy infants: a follow‐up from birth to 24 months
Authors: Alanne S , Nermes M , Söderlund R , Laitinen K
Published: February 2011

Aim:  To evaluate quality of life (QOL) in infants with atopic dermatitis (AD) by comparison with healthy infants to find treatment modalities contributing most to QOL in these patients.

Methods:  The population (N = 134) was recruited in the context of an on‐going prospective mother–infant study. QOL was measured using the Infant Dermatitis Quality of Life Index for the infants with AD and a modification of this for the healthy infants.

Results:  The index scores of infants with AD were 4.15 (SD 2.96), 3.89 (SD 3.62) and 3.23 (SD 2.71) at 6, 12 and 24 months, respectively, the QOL being significantly poorer at 6 (p < 0.001) and 12 (p = 0.01) months compared to healthy infants. The principal impairments were itching, scratching and sleep disturbances at 6 and 12 months and treatment difficulties at 6 months. Problems with getting to sleep were reported at all stages irrespective of AD.

Conclusions:  Simple treatment regimens targeting itching in particular are likely to contribute most to the QOL of infants with AD; however, sleeping problems may remain as an age‐related phenomenon. Early detection of symptoms and effective parent guidance contributed to the well‐being of the child.
The Evolution of United States–Mexico Labor Cooperation (1994‐2009): Achievements and Challenges
Authors: NOLAN GARCÍA KIMBERLY A.
Published: February 2011

This article offers an account of cooperation between Mexico and the United States around labor issues from 1994, when the North American Free Trade Agreement (NAFTA) labor side agreement first made labor issues relevant to United States–Mexico foreign relations, to the present, where that cooperation has broken down substantially. I offer a panorama of the scope and content of labor cooperation between Mexico and the United States, across both formal channels of representation, such as the NAFTA institutions and bilateral meetings, as well as the informal channels, including those forged by civil society and labor unions across borders. I then provide insight into the erosion of labor cooperation in recent years, discuss the wavering commitment to labor issues across successive administrations in both Mexico and the United States, and speculate as to what impact this may have on U.S.–Mexican relations more broadly.

Este artículo ofrece un recuento de la cooperación entre México y los Estados Unidos acerca de temas laborales desde 1994, cuando el acuerdo paralelo del Tratado de Libre Comercio de América del Norte (TLCAN) hizo relevantes por primera vez temas laborales para las relaciones exteriores de ambos países, hasta el presente, cuando la cooperación ha fracasado substancialmente. Ofrezco un panorama del alcance y contenido de la cooperación laboral entre México y los Estados Unidos, a través de tanto canales formales de representación tales como las instituciones del TLCAN y las reuniones bilaterales, como también de canales informales, incluyendo aquellos creados por la sociedad civil y sindicatos a través de las fronteras. Proveo entonces una visión de la erosión de la cooperación laboral en años recientes, discuto el vacilante compromiso en temas laborales a través de las administraciones tanto en México como en los Estados Unidos, y especulo sobre el impacto más amplio que esto puede tener en las relaciones Estados Unidos‐México.
Migration from Mexico to the United States: Wage Benefits of Crossing the Border and Going to the U.S. Interior
Authors: AGUAYO‐TÉLLEZ ERNESTO , RIVERA‐MENDOZA CRHISTIAN I.
Published: February 2011

Emigrating from Mexico to the United States requires three steps: going to the border, crossing it, and going to the final U.S. destination. This article attempts to measure the earnings benefits of each migration step, focusing particularly on the second step: crossing the border. Using U.S and Mexican microdata of workers living in Mexico and in the United States, this article compares wages of identical individuals on both sides of the border after controlling for unobserved differences between migrants and nonmigrants. On average, Mexican workers increase their wages 1.22 times by moving to the Mexican side of the border, 4.15 times by crossing it, and 1.12 times by moving to an interior location in the United States. Gains are larger for unskilled workers. Also, gains for crossing the border are larger for illegal workers, while gains for going to the U.S. interior are larger for legal workers.

Emigrar de México a los Estados Unidos requiere tres pasos: ir a la frontera, cruzarla e ir al destino final en los Estados Unidos. Este artículo calcula las ganancias salariales en cada paso, enfocándose particularmente en el segundo paso: cruzar la frontera. Utilizando microdatos de México y de los Estados Unidos, este artículo compara los salarios de trabajadores idénticos en ambos países después de controlar por características no observables de los migrantes y los no migrantes. En promedio, los trabajadores mexicanos incrementan su salario 1.22 veces al migrar al lado mexicano de la frontera, 4.15 veces al cruzarla, y 1.12 veces al migrar de la frontera al interior de los Estados Unidos. Las ganancias son mayores para trabajadores no calificados. Las ganancias de cruzar la frontera son mayores para los trabajadores ilegales, mientras que las ganancias de ir al interior de los Estados Unidos son mayores para los trabajadores legales.
El Título en la Mano: The Impact of Titling Programs on Low‐Income Housing in Texas Colonias
Authors: Ward Peter M. , de Souza Flavio , Giusti Cecilia , Larson Jane E.
Published: February 2011

This article analyzes the impact of The Community Resources Group Receivership Program undertaken from 1998 to 2002 that provided clean property titles to residents in several informal housing colonias (subdivisions) in South Texas. Survey data were gathered from 260 low‐income households comprising two populations: those who had secure title from the outset, and those who were beneficiaries of the land titling program. Focus group interviews were conducted to explore how the beneficiaries construct the meaning of ownership before and after title “regularization.” Formal titling consolidates understandings of absolute property relations in comparison with de facto rights born of use (legal or not), which strengthens people's sense of self‐esteem and potential for political involvement. We found that, contrary to conventional wisdom, title provision per se appears to have little direct impact either upon home improvement or upon residents' receiving enhanced access to credit and financial services. We also found evidence that informality and illegality is likely to reemerge as owners die intestate, and as they revert to informal land market property transfers.
Sentimental Frauds
Authors: Stern Simon
Published: February 2011

The 2006 class action against James Frey, concerning his fabrications inA Million Little Pieces, was the first suit of its kind in the United States. There is nothing new about false memoirs, so what can explain the lawsuit? When the book was promoted on “Oprah's Book Club,” viewers were invited to respond emotionally, and saw their responses as a form of testimony. Those responses produced a sense of betrayal and inauthenticity when Frey's falsehoods were revealed. This view finds support in the eighteenth‐century sentimental novel, which similarly linked readers' reactions to the author's emotional authenticity. Fraud was an ongoing concern for sentimental novelists, some of whom used elaborate editorial to ploys to disavow responsibility for the text, while others populated their novels with fraudulent characters, intended as foils for the protagonist. An investigation of these novels helps to reveal the implications of the Frey case for future claims of literary fraud.
Hopi Tradition as Jurisdiction: On the Potentializing Limits of Hopi Sovereignty
Authors: Richland Justin B.
Published: February 2011

In this article I reconsider Hopi tradition as jurisdiction—reflexive moments of Hopi legal discourse that orient to the limits of Hopi sovereignty, even as they presuppose its power. I explore these themes in two significant moments of Hopi political history. First, I consider the uses of tradition in the creation of the contemporary Hopi tribe through the field notes of the US agent charged with drafting the 1936 Hopi Constitution. Then I consider more contemporary uses of tradition in recent Hopi tribal court cases that extended judicial power over matters reserved for local village leadership. Both instances suggest efforts to potentialize tribal power even as they orient explicitly to the limits of that authority. These traditions are thus, ironically, understood not as replaying Euro‐American logics of nationalist totalities, but as indigenous sociopolitical actions that unsettle static representations of Hopi cultural identity and the sovereignty claimed through them.
Sphingosine 1‐phosphate, sphingosine kinase and autocrine calcium signalling in thyroid cells
Authors: Törnquist K.
Published: February 2011

In many cell types metabolites of sphingomyelin have a profound role in cellular signalling. One particular field where these derivatives have obtained a crucial role is calcium signalling. This is an interesting aspect on how lipids may wield their physiological role, as calcium is probably one of the most versatile signalling molecules in the cell, and modulation of calcium signalling may have profound effects on cellular physiology. In this review we discuss a novel aspect of sphingolipid signalling, i.e. the autocrine role of sphingosine 1‐phosphate (S1P) in regulating calcium entry in thyroid cells. Although many investigations have highlighted the importance of S1P as a regulator of both calcium release from the endoplasmic reticulum and calcium entry through plasma membrane channels, the autocrine mechanism presented here introduces a new aspect of S1P signalling in thyroid cells. This mechanism may be physiologically relevant in many other cell types, including cancer cells.
Genome‐scale diversity and niche adaptation analysis of Lactococcus lactis by comparative genome hybridization using multi‐strain arrays
Authors: Siezen Roland J. , Bayjanov Jumamurat R. , Felis Giovanna E. , van der Sijde Marijke R. , Starrenburg Marjo , Molenaar Douwe , Wels Michiel , van Hijum Sacha A. F. T. , van Hylckama Vlieg Johan E. T.
Published: February 2011

Lactococcus lactis produces lactic acid and is widely used in the manufacturing of various fermented dairy products. However, the species is also frequently isolated from non‐dairy niches, such as fermented plant material. Recently, these non‐dairy strains have gained increasing interest, as they have been described to possess flavour‐forming activities that are rarely found in dairy isolates and have diverse metabolic properties. We performed an extensive whole‐genome diversity analysis on 39 L. lactis strains, isolated from dairy and plant sources. Comparative genome hybridization analysis with multi‐strain microarrays was used to assess presence or absence of genes and gene clusters in these strains, relative to all L. lactis sequences in public databases, whereby chromosomal and plasmid‐encoded genes were computationally analysed separately. Nearly 3900 chromosomal orthologous groups (chrOGs) were defined on basis of four sequenced chromosomes of L. lactis strains (IL1403, KF147, SK11, MG1363). Of these, 1268 chrOGs are present in at least 35 strains and represent the presently known core genome of L. lactis, and 72 chrOGs appear to be unique for L. lactis. Nearly 600 and 400 chrOGs were found to be specific for either the subspecies lactis or subspecies cremoris respectively. Strain variability was found in presence or absence of gene clusters related to growth on plant substrates, such as genes involved in the consumption of arabinose, xylan, α‐galactosides and galacturonate. Further niche‐specific differences were found in gene clusters for exopolysaccharides biosynthesis, stress response (iron transport, osmotolerance) and bacterial defence mechanisms (nisin biosynthesis). Strain variability of functions encoded on known plasmids included proteolysis, lactose fermentation, citrate uptake, metal ion resistance and exopolysaccharides biosynthesis. The present study supports the view of L. lactis as a species with a very flexible genome.
Do the national survey results reflect the state of drug‐induced liver injury in a single local city in which there is no hospital having Members of the Board of Councilors of the Japan Society of Hepatology? Results of a questionnaire survey conducted in a local city
Authors: Hisamochi Akiko , Kumashiro Ryukichi , Sata Michio
Published: February 2011

Aim:  This survey aims at clarifying if there are common features of drug‐induced liver injury (DILI) in local areas and in the national surveys, and the degree of dissemination of the new diagnostic criteria (JDDW scale) proposed during the Japan Digestive Disease Week (JDDW) in 2004 and Manual for Serious Side‐Effects of DILI (Manual) published in April 2008.

Methods:  An anonymous questionnaire for DILI was conducted for 6 weeks starting on 20 October 2008. The participants were 179 medical doctors. One hundred and fifty‐seven of them belonged to the Medical Association of Nakatsu City (population: 86 000 persons), which is located in northern Kyushu, and 22 physicians working in a core hospital, Nakatsu Municipal Hospital.

Results:  Seventy‐four percent of the responding doctors with 13 various specialties had experienced DILI cases. The three most frequent causative drugs were antibiotics, folk medicines and drugs for the circulatory system. DILI associated with folk medicines was encountered mostly after 2000. The doctors' recognition of the JDDW scale and Manual were as low as 17% and 29%, respectively.

Conclusion:  This survey revealed that the results of the national investigations conducted by the Japan Society of Hepatology (JSH) reflect the current state of DILI in local areas in which there is no hospital with Members of the Board of Councilors of the JSH. Widespread utilization of the Manual and JDDW scale by local doctors must be facilitated for early diagnosis of DILI and the prevention of severe conditions.
Moyamoya disease as a possible cause of neurological impairment following liver transplantation for Wilson's disease
Authors: Desideri Federico , Marignani Massimo , Vanovermeire Olivier , Colle Isabelle , Fave Gianfranco Delle , Hemelsoet Dimitri , Geerts Anja , Van Vlierberghe Hans
Published: February 2011

In Wilson's disease, liver transplantation can constitute the only option for patients presenting with fulminant hepatic failure or decompensated liver disease unresponsive to drug therapy. We report the case of a 29‐year‐old woman receiving a liver transplant for end‐stage Wilson's disease who developed neurological complications after transplantation. After an accurate evaluation of possible differential causes of neurological complications developing as the result of liver transplantation, moyamoya disease was diagnosed. Moyamoya disease is a rare cerebrovascular disease of unknown etiology. However, data exist supporting a possible role for some immunosuppressive regimens in determining the peculiar vascular alterations observed in moyamoya disease. To the best of our knowledge, the association with post‐transplantation state for Wilson's disease has not been previously described.
Pharmacological therapy of nonalcoholic steatohepatitis
Authors: Hojo Mariko , Watanabe Sumio
Published: February 2011

Nonalcoholic steatohepatitis (NASH), unlike simple steatosis, is a potentially progressive disease. Various types of drugs have been explored for the treatment of NASH. We reviewed the various therapies available, with particular emphasis on their efficacy for the improvement of hepatic fibrosis. Treatments for NASH included lipase‐inhibiting agents, drugs that target components of metabolic syndrome, antioxidants, liver cytoprotectants, and suppressors of inflammatory cytokines. Alanine transaminase levels were significantly decreased and the grade of histologic features other than fibrosis was significantly improved in more than 75% of treatment arms across studies, yet the stage of liver fibrosis was significantly improved in less than 30% of treatment arms. Recently, drugs such as peroxisome proliferator‐activated receptor‐γ agonists have received attention for their anti‐fibrotic effect. However, due to a lack of large‐scale, high quality, long‐term clinical trials, the utility of any particular treatment for NASH is not yet clear. Further clinical studies are needed to evaluate the efficacy and safety of individual drugs.
Millennium Development Goals: A New Source for Open Innovation
Authors: Guiney Pat , Flanigan Laura , Guth Julia
Published: February 2011

In 2010, the United Nations concluded its summit with the adoption of a global action plan to achieve eight anti‐poverty goals by a target date of 2015. Imagine what design and an attitude of open innovation could do for the most impoverished among us—as well as to the triple bottom line.
Porphyromonas gingivalis mutY is involved in the repair of oxidative stress‐induced DNA mispairing
Authors: Robles A.G. , Reid K. , Roy F. , Fletcher H.M.
Published: February 2011

The ability for DNA mismatch repair, after oxidative stress‐induced DNA damage, is critical for the persistence of Porphyromonas gingivalis in the inflammatory environment of the periodontal pocket. Our previous report demonstrated that, in contrast to other organisms, the repair of oxidative stress‐induced DNA damage involving 8‐oxo‐7,8‐dihydroguanine (8‐oxoG) may occur by a yet‐to‐be described mechanism in P. gingivalis. 8‐oxoG does not block DNA replication; rather, it mispairs with adenine, which can be repaired by the MutY glycosylase. To determine the function of the P. gingivalis MutY homologue in DNA repair, it was insertionally inactivated using the ermF‐ermAM antibiotic cassette and used to create a mutY‐deficient mutant (FLL147) by allelic exchange mutagenesis. FLL147 had an increased rate of spontaneous mutation and was more sensitive to hydrogen peroxide compared with the wild‐type W83 strain. DNA oligomers containing a site‐specific 8‐oxoG:A mispair was repaired similarly in both the P. gingivalis mutY‐defective mutant and wild‐type strains. The P. gingivalis mutY homologue was shown to complement the mutY mutation in Escherichia coli. In a gel mobility shift assay, the purified recombinant MutY is able to bind an oligo containing an 8‐oxoG:A mispair. Taken together, MutY may play the expected role in oxidative stress resistance in P. gingivalis. However, there may exist other redundant mechanism(s) for the removal of 8‐oxoG:A mismatch in this organism.
Formulation and stability of cefuroxime eye-drops
Authors: Oldham G B
Published: February 2011

The recent clinical demand for cefuroxime eye-drops has given rise to practical difficulties because of the short shelf life recommended by the manufacturer of Zinacef injection, the product used to prepare the eye-drops. The purpose of this investigation was to determine the stability of various formulations of cefuroxime sodium eye-drops by high pressure liquid chromatography.

The results showed that buffering the solution in the pH range 6.0 to 7.3 has little effect on the shelf life when compared with a simple aqueous solution of 5 per cent cefuroxime, which retains satisfactory potency for 21 days in a refrigerator at 2°C during simulated patient usage. Although stable for only 24 hours at room temperature, negligible loss of potency is observed after storing the eye-drops for 12 months at -30°C. Frozen solutions should be defrosted at room temperature and shaken thoroughly to redisperse the cefuroxime evenly throughout the solution. Thawed solutions are stable in the refrigerator for a further 21 days at 2°C or for 14 days at 8°C.

As temperatures up to 8°C are often recorded with domestic refrigerators, a 14 day shelf life is recommended in the refrigerator.
Long-term stability of teicoplanin in dialysis fluid: Implications for the home-treatment of CAPD peritonitis
Authors: Mawhinney W M , Adair C G , Gorman S P , Mcclurg B
Published: February 2011

The long-term stability of teicoplanin in dialysis solution was determined at various storage temperatures. The investigation was undertaken using dialysis solution (1.36 per cent glucose) containing 25mg/L teicoplanin. Stability under refrigerated conditions (4°C), room temperature (representing typical home storage conditions of 20°C) and body temperature (37°C) was determined in triplicate over a 42 day period. Samples (5ml) from each dialysis bag were taken at 0, 1, 2, 5, 7, 10, 14, 21, 28 and 42 days. Measurement of teicoplanin was by stability-indicating bioassay involving a standard plate technique using spore suspensions of Bacillus subtilis. All bioanalyses were performed in triplicate. Loss of teicoplanin activity of more than 10 per cent was indicative of instability. At 4°C, the mean concentration (±SD) of teicoplanin over the 42-day period was 24.05±1.53mg/L with a coefficient of variation of 6.36 per cent. However, loss in antibiotic activity was observed at the higher temperature storage conditions. At 20°C, a 10 per cent reduction in activity occurred after 25 days' storage; at 37°C it occurred after seven days. Therefore, teicoplanin is stable in dialysis fluid but the storage conditions have a marked effect on shelf-life.
Survey of use of the Pharmacy Information and News Service (PINS) among community pharmacists
Authors: Boakes R M , Strickland-Hodge B , Jepson M H
Published: February 2011

A postal survey was sent to all users of the Pharmacy Information and News Service (PINS) in May, 1990. Of 356 questionnaires (72 per cent) returned, 179 were from community pharmacists currently using PINS, and these were analysed. The PINS option which the greatest number of those respondents found “useful” or “very useful” was the news section, followed by the malaria prophylaxis and register inquiries sections. Some 59 per cent accessed PINS less than once a week, most claiming to use it less than they had envisaged when they became subscribers. Sixty-seven per cent indicated that the type and quality of information on PINS was what they had expected, but 58 per cent did not think the system was user-friendly.
Undeclared drugs in traditional Chinese antirheumatoid medicine
Authors: Karunanithy R , Sumita K P
Published: February 2011

Thirty samples of traditional antirheumatoid drugs freely available in Chinese drug stores in Singapore and West Malaysia were analysed for undeclared synthetic drugs using thin layer chromatography, high performance liquid chromatography, micro-colour test and infra-red spectroscopy. Four of the samples were found to contain undisclosed synthetic drugs, two contained paracetamol and two prednisolone.
Customers' recall of information given in community pharmacies
Authors: Wilson M , Robinson E J , Blenkinsopp A , Panton R
Published: February 2011

Three studies are reported in which the giving of information to customers, orally, in community pharmacies was tape recorded, and the customers were interviewed the following day. Customers' recall of information, including instructions considered to be essential, was low. In study 1, involving 44 customers in two pharmacies, a mean of 11 items of information was given to customers, but on average only three were recalled. Customers who took a more active part in discussion with the pharmacist (who were more likely to purchase self-medication than to be prescription customers) tended to be given more new information and more repeated information, to recall more but also to forget more than passive customers. In study 2, 42 customers of three pharmacists were interviewed to determine the influence of a number of variables on recall. Whether customers reported feeling ill or in a hurry, or reported having received the information already from their general practitioner, or having had prior experience of the medication, were all unrelated to the amount of information recalled. The few customers who reported that the information provided by the pharmacist was not welcome were particularly poor at recalling it. In Study 3, the amount of information given or recalled was found to be unaffected by whether customers talked to a pharmacist in the busy sales area (n=25) or in a quiet counselling area (n=27). If pharmacists are to be effective providers of information about health and illness, attention must be paid to ways of improving customers' retention of information given.
Difficulties in the use of medicine packaging
Authors: Rees J A , Forbes A J , Ross A J
Published: February 2011

A postal questionnaire sent to a large group of the general public asked about difficulties encountered in the use of liquid medicine bottles, eye-drop containers, ointment/cream tubes and inhalers. Liquid medicine bottles and ointment/cream tubes were the most widely used, with eye-drop bottles having been used by approximately half of the respondents. Only 16 per cent had used inhalers. The use of eye-drop bottles and ointment/cream tubes caused the greatest number of difficulties for the majority of users. Other than with inhalers, those aged under 40 years reported the greatest number of difficulties with medicine containers. It is suggested that new medicine containers be designed to overcome the large number of difficulties reported by the general public.
The case for qualitative research
Authors: Strong Philip
Published: February 2011

Qualitative as well as quantitative methods are needed in pharmacy practice research
Time taken to produce dispensing labels in hospital pharmacies, and factors affecting it
Authors: Ngo S , Barber N , Jacklin A , Clark P
Published: February 2011

The time taken in hospital pharmacies to produce labels for individual patients' medication was measured, and factors affecting the labelling process investigated. Labelling time was measured by direct observation using a stopclock at randomly chosen semi-stratified time periods. Four combinations of major London hospitals and computer systems were studied. The time to produce 2,167 labels was measured and 59 operators were observed. There were significant differences in average labelling time between the studied hospitals/systems (16.6 to 39.3 seconds per label). Operators' experience with their system and the occurrence of interruptions were found to affect labelling significantly (P<0.0001 in both cases). There was an overall trend for labelling time to decrease with increasing experience (P<0.0001), and interruptions added 11 to 12 seconds on average. Operator experience also affected the rate and duration of interruptions, which subsequently affected labelling time. Fewer interruptions occurred with more experienced staff (P=0.0015) and when interrupted, they took less time than inexperienced staff to complete the labelling process. A performance indicator of person-days per 100,000 labels varied from 62.3 to 147.6. Pharmacy managers should be aware that there are significant differences in performance using different labelling systems and that staff training and systems of work may have a marked effect on labelling time.
The effect of buffering on the stability of reconstituted benzylpenicillin injection
Authors: Allwood M C , Brown P W
Published: February 2011

The stability of benzylpenicillin sodium injection after reconstitution was investigated using a stability-indicating high pressure liquid chromatography (HPLC) method. Benzylpenicillin reconstituted in water for injections, diluted in 0.9 per cent sodium chloride infusion in Minibags and stored at 5C was stable for two days (based on t/90 per cent calculations). The effect of reconstituting benzylpenicillin in citrate buffer at pHs between 6 and 8 was investigated. Maximum stability was found to occur in the pH range 6.5-7.5. The stability of buffer-reconstituted benzylpenicillin diluted in 0.9 per cent sodium chloride infusion was then investigated. Results indicated that benzylpenicillin injection 600mg reconstituted in 3.6ml citrate buffer within the pH range 6.5 to 7.5, diluted in 50ml 0.9 per cent sodium chloride in Minibags and stored at 5C, may be assigned a shelf life of at least 28 days.
Specialisation — the future of pharmacy?
Authors: Holland Ross
Published: February 2011

Specialist pharmacy services could benefit the public, the funding agencies and the profession
Wound care and the pharmacist
Authors: Morgan David A
Published: February 2011

Wound care is coming of age and the pharmacist has an important role to play in the next stage of its development
Factors affecting the physical and chemical stability of morphine sulphate solutions stored in syringes
Authors: Grassby P F , Hutchings L
Published: February 2011

The stability of morphine sulphate solution (2mg/ml in 0.9 per cent w/v saline) was determined after storage in two brands and two sizes of polypropylene syringes, with or without 0.1 per cent w/v sodium metabisulphite. The suitability of plastic syringes for the long term storage of morphine solutions was further investigated by an assessment of sorption onto or into the syringe, vapour loss and oxygen permeability. A comparison was also made with storage in glass syringes. Measurement of morphine sulphate was by a stability-indicating high performance liquid chromatographic assay. After six weeks, a small loss (<5 per cent) in potency was detected due to oxidation in polypropylene syringes without antioxidant. Polypropylene syringes showed little resistance to oxygen permeation. Oxidation was greater in glass syringes compared with polypropylene syringes, possibly due to release of caustic material. Although inclusion of sodium metabisulphite 0.1 per cent w/v offered protection against oxidation, and the breakdown product pseudomorphine was not detected, the antioxidant was incompatible with morphine under these conditions, resulting in the formation of an unknown substance or complex. To summarise, an acceptable level of stability was observed after storage of morphine solutions in 30ml or 50ml three-piece polypropylene syringes in the dark, at room temperature, for six weeks. While such syringes are not protected from oxygen permeation and are susceptible to oxidation over the longer term, all attempts at using glass syringes or an antioxidant were unsuccessful due to a number of factors.
Reasons for community pharmacists establishing patient medication records
Authors: Rogers P J , Fletcher G , Rees J E
Published: February 2011

A survey was conducted among a sample of those pharmacists in Britain who installed a patient medication record (PMR) system during 1990 to gauge the importance of various factors that might have influenced the pharmacist's decision to acquire the system. The responses indicate that government funding influenced the developing utilisation of PMRs, but to a lesser extent than anticipated. PMRs have been installed primarily for clinical and professional reasons. Of the reasons for installing a PMR system, competition from other pharmacies was more likely to be considered important by female pharmacists, and by pharmacists working for large multiple companies, than by their male counterparts or independent contractors. The need to upgrade equipment at the end of its life span was cited as a reason for purchasing a PMR system. Future progress is likely to be very dependent on such upgrades at periodic intervals to introduce new technology into pharmacy practice.
Salivary potential
Authors: Zuidema J , Höld K M , De Boer D , Maes R
Published: February 2011

There is renewed interest in saliva as a “non-invasive” specimen for therapeutic drug monitoring, diagnosis and doping control
Survival of neonatal intravenous infusion sites
Authors: Hecker John F
Published: February 2011

A survey was performed on the survival of 446 peripheral intravenous infusion sites in 82 babies in a neonatal intensive care unit. Median survival was 31 hours. Factors identified by multivariate survival analysis as significantly decreasing site survival were faster infusion rates, total parenteral nutrition rather than dextrose, decreased gestational age, and co-infusion of phosphate, ceftazidime and metronidazole. Pancuronium, aminophylline and, possibly, saline and ampicillin increased survival. These data indicate that, while neonatal infusions fail more rapidly than infusions in adults, there appear to be relatively few factors that have marked effects of the rate of failure.
Comparison of dissolution rates of ibuprofen tablets
Authors: Bosanquet Andrew G , Betteridge Richard F
Published: February 2011

The dissolution profiles of 600mg ibuprofen tablets from four manufacturers have been compared with those of Boots's Brufen. The latter showed rapid dissolution in phosphate buffer pH 7.2 (the USP method) such that 50 per cent was dissolved in 3.9 ± 0.9 min and 90 per cent in 7.7 ± 1.9 min. Tablets from one manufacturer showed similar dissolution characteristics to those of Boots while the other manufacturers' products dissolved more slowly. Five out of 48 tablets from one manufacturer did not achieve the USP specification of 70 per cent dissolved by 30 min. Differences in dissolution rates have been shown to affect speed of action in some products. A study is required to determine the analgesic properties of ibuprofen tablets that dissolve at different rates.
Development of a computerised system to provide audit of pharmaceutical activity
Authors: Lea John , Morgan Simon
Published: February 2011

This article describes the development of a computer software system designed to provide full clinical audit and quality assurance of clinical services at the Royal Shrewsbury hospital, Shropshire.
Shelf life of cefuroxime eye-drops when dispensed in artificial tear preparations
Authors: Hebron Brian , Scott Hilary
Published: February 2011

There has recently been a clinical demand for cefuroxime formulated as an eyedrop. Cefuroxime exhibits a broad spectrum of activity against most common ocular infections and is considered to be less toxic to the compromised epithelium than some other topical antibiotics. A formulation in an artificial tear solution would be expected to enhance drug penetration by prolonging pre-corneal drug retention, and the presence of a preservative might enable a suitable formulation to be given a shelf life of more than 24 hours.

This paper reports studies on the stability of cefuroxime 50mg/ml (5 per cent) in artificial tear solutions, sodium chloride eye-drops and in solutions of benzalkonium chloride, hypromellose or water for injections. Cefuroxime was assayed by high performance liquid chromatography. The method had a coefficient of variation of 0.23 per cent at the concentration investigated and recovery of added cefuroxime was 100 per cent. The preparation of cefuroxime in artificial tear solutions which were preservative free or contained benzalkonium chloride less than 0.002 per cent appeared to be physically stable. Preparation of cefuroxime in Sno Tears also produced a stable solution. This preparation can be given a shelf life of 28 days at 4C, 24 hours at 25C and 14 days if stored in a domestic refrigerator, enabling a full course of treatment to be given on a single visit to the pharmacy.
The quality of written inpatient prescriptions
Authors: Jenkins Duncan , Cairns Christopher , Barber Nicholas
Published: February 2011

The aim of this study was to determine the quality of inpatient prescription writing. Prescriptions from a teaching hospital and a district general hospital were assessed against prescription writing standards drawn from the British National Formulary and local procedures. The prescription charts were from a stratified sample of inpatients discharged between July, 1989, and July, 1990. Over 400 inpatients' charts, containing 4,536 prescriptions, were examined. Depending on the type of prescription, between 12 per cent and 32 per cent failed to use the approved name of the drug and 4 to 10 per cent were illegible or ambiguous. The dose was written incorrectly in 11 to 26 per cent of cases. Failures were particularly common in “as required” prescriptions, with 21 per cent potentially allowing an overdose of a drug to be given and 5 per cent indicating more than one route of administration. Three per cent of fluid additive prescriptions had not had the type of fluid defined. The standard of inpatient prescription writing needs to be improved. This paper offers objective standards which could be used to start a regular audit process.
Pharmacy practice research in the hospitals of South East Thames regional health authority, England
Authors: Davies G , Dodds L , Fleet E , Horne R , Joshua A
Published: February 2011

Pharmacy practice research is a relatively new discipline which is vital to the development of the pharmacist's professional role, both in the hospital service and in community practice. In 1991, a pharmacy practice research group was set up in South East Thames regional health authority, England, and its members set as a priority the need to develop a regional database of previous and ongoing pharmacy practice research that would be easily accessible to pharmacists within the region and elsewhere. At the same time, the opportunity was taken to survey the perceived barriers to practice research within the region.

The survey demonstrated a steady increase in practice research projects undertaken within the region over the past decade, although this partly reflected an increase in the number of research projects imposed by preregistration training requirements or postgraduate qualifications. The most common reason for initiating research was to support a local service development; only 19 per cent had been initiated as a result of “personal interest”. Collaborative research with other professions, but not between pharmacists, was reported. A disappointingly low rate of publication of project results was noted. The main barriers to research were identified as lack of time and lack of funding. The survey results have enabled measures that might encourage practice research within the region to be identified and implemented.
Complaints to family health services authorities about pharmacy services
Authors: Smith F J , Weidner D
Published: February 2011

The public in Britain is being encouraged to expect health care of a high standard. A consequence of this may be that people are more prepared to make complaints. Pharmacists will know that channels exist through which clients can complain about their services. However, few will have experience of these procedures, or be aware of the frequency with which clients resort to this action, for what reasons and with what outcomes. The objective of the study was to investigate the complaints made to family health services authorities (FHSAs) about pharmacy services.

The study involved all complaints made in a three and a half year period to six FHSAs in one health region. The number, nature and outcomes of these cases are presented. A total of 113 complaints was made. These included a wide range of different issues, 92 per cent of which related to dispensing activities. Forty-one per cent of complaints did not constitute a breach of contract by the practitioner. The formal procedure, for investigating complaints, resulting in a hearing was pursued in 25 per cent of cases.

There was considerable variation in the outcome of complaints that included an allegation of breach of contract. The diversity in the nature of complaints indicates that clients' perceptions and expectations of pharmacy services extend beyond the supply of the correct medication.
Stability and bioavailability of a flucytosine suspension
Authors: McPhail D C , Johnson J R , Pryce-Jones R H
Published: February 2011

The stability and bioavailability of a suspension of flucytosine was evaluated. There was found to be no change in the flucytosine content of the suspension over a three month period. A shelf life of at least three months could be given to suspensions made by large scale dispensing.

The bioavailability of the suspension was compared with that of commercially available tablets in eight healthy male volunteers. A single dose (2g) of tablets was administered to each volunteer and urine samples were collected over a 24 hour period. After a washout period of one week, the procedure was repeated using the suspension (2g/20ml). The bioavailability of the suspension relative to commercially available tablets was 80.7 per cent. The high performance liquid chromatography (HPLC) method used was found to give consistent results for tablet and suspension assays and for urine analysis (relative standard deviation 1.8 per cent, correlation coefficient r = 0.996).

Where patients have impaired swallowing reflexes or few accessible sites for venepuncture, flucytosine suspension may have several advantages when large doses (10–15g/day) need to be administered.
Development and acceptability of structured work based learning in a community pharmacy vacation training programme
Authors: Rees J A , Collett J H , Mylrea S , Crowther I
Published: February 2011

The development of structured work based learning (WBL) for use by pharmacy students in a standardised summer vacation work placement is outlined. Assessment methods were developed for measuring the acceptability of the WBL activities and work placement from both the students' and employers' viewpoint. Overall, both were acceptable, and students suggested that the WBL activities should become an integral part of the undergraduate degree course.
Clinical interventions by community pharmacists using patient medication records
Authors: Rogers Philip J , Fletcher George , Rees John E
Published: February 2011

The use of patient medication records (PMRs) in clinical interventions made by community pharmacists has been studied over an 18-month period. Participating pharmacists recorded clinical intervention events by noting the nature of the intervention, the product(s) involved, any at-risk grouping of the patient, and outcome or action taken.

In total, 1,862 clinical interventions were reported, of which 1,234 were associated with the use of a PMR system. PMRs were of particular benefit in interventions associated with patients suffering from cardiovascular disease (231 events), asthma (129 events) and diabetes (55 events). Over 50 per cent of the reported events related to the wrong drug, strength or dose being written on a prescription form, frequently due to errors being made in the use of a general practice computer system at the time the prescription form was generated.

The study illustrates the important benefits to community pharmacists of keeping patient records which enable the exercise of clinical judgement in the provision of pharmaceutical care. Pharmacists using a computerised PMR system were more likely to intervene than those using a manual card-index system. PMRs were shown to be especially useful in alerting the pharmacist to potential drug interactions between previously-dispensed and newly-prescribed medication.
Hospital discharge correspondence — how effective is it?
Authors: Mottram D R , Slater S , West P
Published: February 2011

Continuity of patient care after discharge from hospital relies on effective discharge communication between the hospital doctors and the patient's general practitioner. The aim of this study was to investigate the effectiveness of discharge communication, in terms of its content and timing. The study involved analysing all discharge correspondence received by two city-based group practice medical centres over a period of one month. Three hundred and one pieces of discharge correspondence were scrutinised. These comprised 164 initial discharge summaries and 137 follow-up discharge letters. In general, information was more thoroughly and more accurately recorded in the follow-up letters than in the discharge summaries; however, there were significant delays in the receipt of the letters by the GPs. Results showed that there are many aspects of the correspondence between secondary and primary care which need improving. These include: improvement in the design of discharge correspondence forms; improvement in completing the forms; and improvement to the administrative systems for dispatching discharge correspondence. Although not specifically looked at in this study, we also believe that it would be useful for a mechanism to be set up for hospital pharmacists to establish links with their community colleagues in advance of a patient's discharge in order that the patient's pharmaceutical needs may be readily met in the community.