bluuebunny/crossref_metadata_2025 huggingface dataset:
Four‐Year Clinical Evaluation of Posterior Resin‐Based Composite Restorations Placed Using the Total‐Etch Technique
Authors: BARATIERI LUIZ NARCISO , RITTER ANDRÉ V.
Published: July 2007

Purpose: To report the 4‐year clinical performance of posterior resin‐based composite restorations placed using the total‐etch technique.

Materials and Methods: Over a period of 1 year, 726 restorations (248 molars, 478 premolars; 260 Class I, 466 Class II; 540 replacements, 186 primary decay) were placed on conservative preparations, using the incremental placement technique in a clinical environment. Baseline data were collected, and the restorations were evaluated after 4 years. Z100 and Scotchbond Multipurpose (SBMP) (3M Dental Products, St. Paul, Minnesota) were used as the restorative system. The criteria evaluated were color match, marginal adaptation, anatomic form, cavosurface marginal discoloration, axial contour, interproximal contact, secondary caries, postoperative sensitivity, and tooth vitality.

Results: At baseline, 24% of the teeth restored presented postoperative sensitivity; 86% of the sensitive teeth were from the replacement group. At 4 years, all teeth were vital to cold test. Eighteen restorations (2.5%) presented clinically detectable marginal fracture. The shade was acceptable in all restorations. Cavosurface marginal discoloration was observed in 47 restorations (6.5% bravo scores). Axial contour, interproximal contact, and marginal adaptation received 100% alfa scores. No secondary caries was diagnosed in any of the teeth examined. None of the examined restorations required replacement.

CLINICAL SIGNIFICANCE

Under controlled clinical conditions, posterior resin‐based composite restorations placed with the total‐etch technique and restorative Z1OO/SBMP have the potential to present a high success rate at 4 years. None of the examined restorations required replacement, and there was no clinically detectable wear in any of the restorations. Simultaneous etching of enamel and dentin followed by the application of a resin adhesive can be considered an adequate modality of pulp protection in nonexposed tooth preparations.
Critical Appraisal
Authors: Hilton Thomas J. , Swift Edward J.
Published: July 2007

Several manufacturers have introduced “condensable” or, more accurately, “packable” composites for restoration of posterior teeth. Typically, the differences between these and more traditional composites are an increase in stiffness and a reduction in stickiness. However, some manufacturers have made claims of improved physical properties for their materials. This review evaluates the published laboratory research on packable composites.
Anterior Esthetic Rehabilitation on Teeth and Dental Implants Optimized with Procera® Technology: A Case Report
Authors: BONNARD PASCAL , HERMANS MARC , ADRIAENSSENS PHILIPPE , DAELEMANS PHILIPPE , MALEVEZ CHANTAL
Published: July 2007

With the latest developments of the Procera® system, all‐ceramic crowns have become an attractive solution to provide functional and esthetic rehabilitation on teeth and dental implants. The Procera AllCeram crown and Procera Abutment embrace the concept of computer‐assisted design and computer‐assisted machining (CAD/CAM) and can be used together for optimal esthetic result. The purpose of this case report was to illustrate the advantages of these new components for complex anterior rehabilitation. Three natural teeth and a Procera Abutment were restored using four Procera AllCeram crowns. Treatment planning and esthetic benefits are discussed.

CLINICAL SIGNIFICANCE

For complex anterior rehabilitations, the Procera system fulfills both functional and esthetic objectives, providing a new way in the field of esthetic and restorative dentistry. Nevertheless, planning and preparation stages are decisive for successful treatment.
Periosteal Connective Tissue Grafting or Root Coverage with Enamel Matrix Derivative: A Case Report
Authors: ITO KOICHI , AKUTAGAWA HIDEYASU
Published: July 2007

A 24‐year‐old female patient presented for the resolution of esthetic concerns associated with wide gingival recession facial to the maxillary left central incisor before orthodontic treatment. A periosteal connective tissue graft in conjunction with an enamel matrix derivative was used to achieve root coverage. This technique achieved healthy thick keratinized tissue coverage of the root surfaces and effectively improved the esthetics. These satisfactory clinical results have been maintained for 18 months, even through active orthodontic treatment.

CLINICAL SIGNIFICANCE

This case report demonstrates an innovative approach to root coverage that uses an enamel matrix derivative in conjunction with periosteal connective tissue grafting. Although there is no absolute clinical evidence that the enamel matrix derivative contributed to the final outcome, the results are encouraging and should be pursued through case‐controlled clinical trials.
Maximizing Esthetic Results in Posterior Restorations Using Composite Opaquers
Authors: DIAS WALTER R.L. , PEREIRA PATRICIA N.R. , SWIFT EDWARD J.
Published: July 2007

After removal of caries or a faulty existing restoration in a posterior tooth, frequently the pulpal floor is a dark substrate. Composites are translucent by nature, and even the more opaque shades transmit nearly 60% of visible light, meaning that composites require a certain thickness to maintain their intended shade, especially if the underlying substrate is particularly dark. Depending on the intensity of the dark substrate, even relatively thick composite restorations may not be capable of disguising the discolored dentin underneath. The substrate absorbs a significant part of the light that would otherwise reflect toward the occlusal surface, and the restoration has a nonvital monochromatic grayish color. Opaquers and tints (color modifiers) may be extremely useful to overcome this situation. In this study, composite restorations were placed in extracted teeth to demonstrate that the final esthetic results rely upon the optical properties of the background as well as those of the composite material itself. Preparations with simulated dark pulpal floors were restored without the use of opaquers and tint modifiers. After tooth hydration, the final shade was recorded with photographs. The restoration was removed and a new restoration was placed, but this time with a technique involving opaquer and tints. This article compares and discusses the outcomes of these two procedures.

CLINICAL SIGNIFICANCE

This demonstration shows a simple technique that can help dentists obtain predictable esthetic results in their daily practice with posterior composite restorations.
Fabrication of Direct Fiber‐Reinforced Posts: A Structural Design Concept
Authors: TERRY DOUGLAS A. , TRIOLO PETER T. , SWIFT EDWARD J.
Published: July 2007

As the clinician continues the quest for optimal functional and esthetic success of a tooth‐restorative complex, the current selection of restorative materials and techniques may prove overwhelming. Although no single system provides the ideal restorative solution for every clinical circumstance, understanding of general design criteria and the components for the various post and core systems available allow the clinician to appropriately select the method and materials compatible with the existing tooth structure and desired result. This article provides a discussion of the various post and core systems, the methods and materials inherent in these systems, and general design principles. Using that basic information and clinical experience, the authors offer an alternative procedure for the rehabilitation of the intraradicular anatomy of the post‐endodontic channel with a direct composite resin–the fiber‐reinforced post and core system.

CLINICAL SIGNIFICANCE

Using improved restorative materials that simulate the physical properties and other characteristics of natural teeth in combination with the proper design principles, the clinician can develop a tooth‐restorative complex with optimal functional and esthetic results.
Simple Technique to Fabricate Provisional Restorations for Porcelain Veneers
Authors: DAN SNEED W. , KNIGHT JAMES S.
Published: July 2007

Fabrication of provisional restorations for teeth prepared to receive porcelain veneers can be a time‐consuming and difficult task. This article describes a simple, quick, and predictable procedure to make these restorations. A clinical case is presented to illustrate the technique.
Effect of Light Power Density on Development of Elastic Modulus of a Model Light‐Activated Composite during Polymerization
Authors: SAKAGUCHI RONALD L. , FERRACANE JACK L.
Published: July 2007

Purpose: Elastic modulus development during polymerization of a composite is a measure of the polymerization maturity and the restoration's ability to transfer stress to enamel and dentin. The characteristics of elastic modulus development in real time during cure are largely unknown. The purpose of this study was to evaluate the effect of light power density and total energy density on the early development of elastic modulus for a light‐activated composite.

Methods: Cylindrical specimens of a model hybrid composite were tested in flexure in a dynamic mechanical analyzer (DMA). Specimens were light‐activated (Variable Intensity Polymerizer, Bisco, Itasca, Illinois) for 60 seconds. Elastic modulus was measured continuously for 5 minutes from the start of light activation. Development of elastic modulus was assessed for six different light power densities and two reduced power density levels given at longer exposure duration to provide similar energy density values. One‐way analysis of variance with Tukey's post hoc comparison test was used to evaluate significant differences of elastic modulus at p= .05.

Results: The rates of elastic modulus development and final moduli were dependent on the light power density applied. Composite specimens cured by equivalent energy densities using short times and high power density or long times and low power density produced equivalent elastic moduli. Elastic moduli for emitted power densities between 400 and 600 mW/cm2 (160–260 mW/cm2 measured at the specimen surface) were not significantly different (p > .05).

Conclusions: Light power densities greater than 160 mW/cm2 measured at the specimen surface resulted in elastic moduli that were not significantly different. Equivalent energy densities produced comparable elastic moduli.
Nightguard Vital Bleaching and Its Effect on Enamel Surface Morphology
Authors: LEONARD RALPH H. , EAGLE JAMES C. , GARLAND GLENN E. , MATTHEWS KEVIN P. , RUDD ANDY L. , PHILLIPS CEIB
Published: July 2007

Background: The effect that nightguard vital bleaching (NGVB) has on enamel surface morphology is a subject of debate. Previous studies that have evaluated the effect of NGVB on the enamel surface report minimal changes to changes that appear to worsen post‐treatment. The purpose of this in vivo NGVB study was to evaluate by scanning electron microscopy (SEM) the effects that 10% carbamide peroxide has on enamel morphology after 2 weeks of treatment and at 6 months post‐treatment.

Materials and Methods: Ten patients participated in the study. Each participant wore a guard filled with an active whitening solution for 8 to 10 hours per day for 14 treatment days. An impression of the study teeth (maxillary incisors) was taken at baseline, after 14 days of treatment, and at 6 months post‐treatment, and an epoxy cast made. The epoxy casts were prepared for viewing under the SEM and photographs were taken at 200 times and 2000 times magnification. Six examiners evaluated changes in enamel surface morphology by comparing the SEM photographs taken at baseline, on treatment day 14, and at 6 months post‐treatment. Still masked, the examiners also compared each patient's baseline: treatment day 14 and baseline: 6 months post‐treatment photographs with photographs of a known standard.

Results: This in vivo study demonstrated that a 14‐day regimen of NGVB using a 10% carbamide peroxide solution had minimal effect on the surface morphology of enamel and that the effects did not worsen over time.
Critical Appraisal
Authors: Georges Annie J. St. , Miguez Patricia A. , Swift Edward J.
Published: July 2007

The topic of visible light‐curing has become controversial in recent years. Strong interest from dentists and manufacturers as well as from researchers and scientists has brought about the publication of numerous articles on the topic. In view of the great quantity of frequently conflicting information, it is important to accurately analyze and interpret the results and the conclusions of these studies. Because multiple factors can influence the resulting polymerization process, it might still be too soon to favor one of the “new” curing techniques rather than the conventional one that has been used for many years. By trying to understand the complex phenomenon of composite polymerization, dentists will be able to make decisions based on scientific proofs rather than on momentary trends. To fulfill this goal, this first of two critical appraisals is devoted to the effect of different curing techniques on the properties and characteristics of the cured composite. The second appraisal, to appear in a subsequent issue of the Journal of Esthetic and Restorative Dentistry, will address the issue of polymerization contraction stress effects on the adhesive bond between enamel or dentin and the composite restoration.
INFLUENCE OF LIGHT INTENSITY ON TWO RESTORATIVE SYSTEMS
Authors: Unterbrink G.L. , Muessner R.
Published: July 2007

Objective: This in vitro study examined the effect of light intensity variations on several properties of two restorative systems.

Materials and Methods: Two resin composite systems (Tetric, Ivoclar Vivadent, Schaan, Liechtenstein; 2100, 3M Dental Products Division, St. Paul, Minnesota) and two dentin bonding agents (Syntac, Ivoclar Vivadent; Scotchbond Multi‐Purpose, 3M Dental) were used. To evaluate marginal gap formation in dentin cavities (with a C factor of 2.5), 48 bovine incisors were embedded in epoxy resin. The labial enamel was removed, and the dentin surface was polished to 600‐grit. Preparations were made in dentin and restored using one of four combinations of bonding system and composite. The composite was polymerized with either a high‐intensity lamp (450 mW/cm2) or a low‐intensity lamp (250 mW/cm2). After storage in water for approximately 60 minutes, the surfaces of the samples were prepared for electron microscopy analysis. Also, the flexural strength and modulus of each composite were determined at 30 minutes and 24 hours after polymerization with either the high‐ or low‐intensity light. Volumetric shrinkage was measured using the density method at four time periods for both light intensities and for wet versus dry storage. Finally, Vickers hardness profiles were evaluated to determine depth of cure.

Results: Marginal analysis showed that 2100, when used with either Scotch‐bond Multi‐Purpose or Syntac, had an increased incidence of gap formation when polymerized with the high‐intensity light. Tetric had better marginal adaptation than 2100, when used with either dentin bonding agent, and with both light intensities. The flexural strength and modulus of both composites were lower with low‐intensity light‐curing. There were no differences in volumetric shrinkage or depth of cure related to curing method for either composite.

Conclusions: The results of this study suggest that marginal quality may be reduced when a high‐intensity light is used to cure composite. Also, the light intensity influences development of the elastic modulus and, therefore, affects shrinkage stress in the composite. The two composites tested in this study responded differently to the different methods of light‐curing. In general, Z100 showed inferior properties than Tetric when cured with either high‐ or low‐intensity light, for both marginal integrity and the flexural modulus and strength. Finally, with a polymerization time of 40 seconds, the composites were equally well cured to a depth of 4.5 mm, regardless of the light intensity used.
PHYSICAL PROPERTIES OF COMPOSITES CURED WITH CONVENTIONAL LIGHT OR ARGON LASER
Authors: Cobb D.S. , Vargas M.A. , Rundle T.
Published: July 2007

Objective: This study evaluated various physical properties of two resin composites polymerized by either an argon laser or a conventional visible light.

Materials and Methods: A hybrid composite, Herculite XRV (Kerr Corp., Orange, California), and a microfill composite, Durafill VS (Kulzer, Wehrheim, Germany), were used in this study. Three physical properties, diametral tensile strength, compressive strength, and flexural strength, were tested. Five specimens of each composite resin were made for each set of physical properties tested, for a total of 18 groups and 90 specimens. Specimens were fabricated according to the American National Standards Institute and American Dental Association Specification No. 27 for each property tested. The composite was polymerized with either an argon laser (power density of 1000 mW/cm2) for 10 or 20 seconds or a conventional visible light (power density of 354 mW/cm2) for 40 seconds. Specimens were stored in water in light‐proof containers at 37°C for 7 days before testing with a Zwick (Atlanta, Georgia) universal testing machine.

Results: The physical properties of Herculite XRV were not affected by the light source or exposure time. For Durafill VS, no significant differences were observed for the diametral tensile strength whether the argon laser or conventional light was used. However, the flexural strength of the microfill was significantly lower when polymerized with the argon laser a t 10 seconds compared with the two other curing methods (20‐second laser cure, 40‐second conventional cure). Also, the compressive strength of Durafill VS polymerized with the argon laser a t 10 seconds was significantly lower than when it was cured with the conventional light for 40 seconds.

Conclusions: Hybrid and microfill resin composites cured with an argon laser for 20 seconds had physical properties comparable to composites polymerized with a conventional visible light unit for 40 seconds. Therefore, with adequate exposure time, the argon laser is a potential alternative to conventional visible light‐curing.
Is hospital admission a sufficiently sensitive outcome measure for evaluating medication review services? A descriptive analysis of admissions within a randomised controlled trial
Authors: Krska Janet , Hansford Denise , Seymour D Gwyn , Farquharson Judy
Published: July 2007

Objective

The aims of the study were: to describe and assess hospital admissions occurring during a randomised controlled trial (RCT) of a pharmacist-led medication review service; to describe the admissions in terms of emergency status and main cause; to estimate the potential contribution of pharmaceutical care issues (PCIs) to admission; and to assess the proportion of admissions that could be influenced by a pharmacist intervention.

Setting

Within the context of a RCT of pharmacists providing medication review for 332 elderly patients living at home, taking at least four repeat medicines, carried out in one region of Scotland. Method Hospital data were obtained for all admissions occurring during the 9-month period studied, summarised and evaluated by two independent medical reviewers for the contribution of PCIs to admission. Two pharmacists assessed the extent to which PCIs were preventable by pharmacist intervention.

Key findings

Approximately two-thirds of the 77 admissions were unplanned, and two-thirds were to medical wards. Only 17 (22%) of all admissions were considered to be related to PCIs and 10 (13%) possibly preventable by pharmacist intervention. Although the majority of surgical admissions were considered to be unrelated to PCIs (26/29), both unplanned and planned medical admissions were related to PCIs. One of these occurred as a direct result of the pharmacist's recommendation.

Conclusion

The overall numbers of hospital admissions, medical admissions and unplanned admissions may not be sufficiently sensitive outcome measures for evaluating the impact of pharmacist interventions. Consideration could be given to developing categories of admission that are related to medicines or are likely to be preventable as more relevant measures. Including more details of hospital admissions in future studies may be useful.
Supplementary pharmacist prescribers' views about communication skills teaching and learning, and applying these new skills in practice
Authors: Cleland Jennifer , Bailey Karen , McLachlan Seonaid , McVey Lisa , Edwards Ruth
Published: July 2007

Objective

To explore supplementary pharmacist prescribers' (SPPs') views of communication skills teaching and learning, and its impact on their practice.

Method

Semi-structured in-depth telephone interviews.

Key findings

A total of 66/143 (46%) pharmacists consented to take part. Of these 66, nine SPPs were purposively selected to represent three different sectors of pharmacy: primary care, hospital and community. Questions for a semi-structured interview schedule were derived from themes identified from SPP self-reflective essays submitted earlier in the course. Framework analysis was used to interpret the data. SPPs' views of communication skills teaching and learning were positive. Topics raised as particularly useful were how to structure the consultation, eliciting a patient-centred history, including the patient's perspective on their situation and/or illness, and working in partnership with the patient. However, interviewees highlighted some practical difficulties with putting these new skills into practice.

Conclusions

The results indicate that SPPs view communication skills training as changing aspects of their consultation practice. The communication skills identified for further development tended to be those not usually required in traditional pharmacy consultations. The results emphasise the importance of providing communication skills training for extended roles.
Medication errors in community pharmacy: an investigation into the types and potential causes
Authors: Lynskey D , Haigh S J , Patel N , Macadam A B
Published: July 2007

Objectives

To establish the nature of medication errors occurring within community pharmacy and analyse common error patterns. To identify factors which influence the occurrence of medication errors and near misses, with the intention of designing systems or strategies to reduce the occurrence of these events.

Setting

Fifteen community pharmacies situated within Brighton and Hove City Primary Care Trust, East Sussex, between January and March 2004.

Method

A self-reporting form was designed, piloted and administered to pharmacists, which gathered information on the detection of an error or near miss in the dispensing process.

Key findings

One-hundred and thirteen near misses and thirty-two medication errors were reported. The majority of near misses were detected by the pharmacist at the final check, and the majority of medication errors were detected by the patient or patient's representative. Selection errors were most common, with similar drug names and packaging cited as the main contributory factors. ‘Business’ was frequently cited as the circumstance surrounding the error.

Conclusion

This study demonstrates that pharmacists do have an important part to play and the positive impact of community pharmacists in preventing, detecting and correcting errors and thus preventing harm to patients in the primary care setting. However, medication errors do occur, and therefore a multifactorial approach by manufacturers, marketing and packaging personnel, in addition to input from pharmacists, may be an effective permanent solution in reducing the errors made.
An evaluation of a rural community pharmacy-based smoking-cessation counselling and nicotine replacement therapy initiative
Authors: Cramp Geoffrey J , Mitchell Caroline , Steer Cathy , Pfleger Sharon
Published: July 2007

Objective

To evaluate the efficiency and the effectiveness of a rural community pharmacy-based smoking-cessation counselling and nicotine replacement therapy (NRT) initiative.

Setting

Community pharmacies in NHS Highland in the north of Scotland.

Key findings

Most clients (77%) smoked cigarettes for an average of 34 pack-years ranging from 1 to 174 pack-years. Almost three-quarters (73%) of the NRT prescribed was in the form of patches. Most respondents (91%) claimed pharmacists' advice was useful, and most (65%) thought that the pharmacist was their preferred healthcare professional for smoking-cessation advice because of ease of access. At the end of week four, 45% of clients reported that they had stopped smoking, this fell to 35% at the end of week 12, and at 44 weeks the point prevalent abstinence rate was 15.8%. Of those that did not stop, 19% reduced their smoking level. This initiative cost £525 for each quitter. Thirteen quality criteria were defined in the assessment framework of which six were achieved.

Conclusions

There are no established criteria for evaluating community pharmacy-based smoking-cessation initiatives currently available, neither are reductions in smoking levels reported. Enhancing the role of the community pharmacist to include health improvement improves the interface between healthcare and the consumer, and helps to meet the national recommendations. Community pharmacy-based smoking-cessation initiatives impact on smoking-cessation targets, allow for the variety of services relevant to the needs of the population and are part of the key to making a difference.

Methods

A review of the literature on community pharmacy-based smoking-cessation initiatives informed a performance assessment framework. Data for evaluation were collected through client records, questionnaires and semi-structured interviews of the stakeholders, and a cost-effectiveness analysis was undertaken.
Extemporaneous compounding in New Zealand hospitals
Authors: Kairuz Therése , Myftiu Joana , Svirskis Darren , Hasan Fhazeel , Lal Aarti , Patel Roshni , Kumar Karishma , Chhim Srey , Singh Ranjani , Garg Sanjay
Published: July 2007

Objective

The skill to compound non-sterile products is one of the seven competencies required of entry-level pharmacists for registration with the New Zealand Pharmacy Council. The need for extemporaneous compounding skills has been questioned in other countries, as it is argued that the skill is not often required in modern pharmacy settings. The aim of the current study was to determine the scope and frequency of extemporaneous compounding in New Zealand hospitals

Method

Retrospective data were collected from eight large hospitals where extemporaneous compounded is regularly undertaken, for the period June 1, 2004 to December 31, 2004. Data were retrieved from compounding logbooks and batch sheets in hospital dispensaries. Data were collected from the north and south islands of the country. There are 32 hospitals of various sizes in New Zealand but extemporaneous compounding is not undertaken at all of them due to staff shortages or lack of demand.

Key findings

There were 2015 products compounded over the seven-month period, with an average of 251.9 per month. Suspensions were the most frequently compounded oral dosage form. Omeprazole suspension was the most frequently compounded extemporaneous product. Nearly one-third of the compounded products were for beta-blockers. Creams, ointments and non-oral solutions were the most common topical compounded products.

Conclusion

Pharmacists perform a broad range of extemporaneous compounding, and the skill of compounding is thus an essential competency for all hospital pharmacists.
The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist's time and activities
Authors: Franklin Bryony Dean , O'Grady Kara , Donyai Parastou , Jacklin Ann , Barber Nick
Published: July 2007

Objective

To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out.

Setting

Surgical ward, London teaching hospital.

Method

All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made.

Key findings

Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with ‘self’. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P < 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P < 0.0001; chi-square test).

Conclusion

The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.
The effect of training and service provision on the self-assessed competence of community pharmacists
Authors: Laaksonen Raisa , Mills Elizabeth R , Duggan Catherine , Davies J Graham , Bates Ian , Mackie Clare A
Published: July 2007

Objective

The purpose of this study was to explore self-assessed competence of community pharmacists who had completed additional clinical pharmacy training at certificate level and were accredited to provide a clinical medication review service to primary care patients (the ‘trained’ group). The self-assessed competence of these pharmacists was compared with others who had not undertaken the training (the ‘untrained’ group).

Method

A postal questionnaire was sent to 179 community pharmacists in both groups across four primary care trusts in the east of London. The questionnaire comprised two parts: characteristics of the respondents; and 81 behavioural statements divided into four competency clusters.

Key findings

The response rate was 50% (n = 90). While pharmacists who possessed a postgraduate qualification were more likely to assess themselves to be more competent in the ‘Delivery of patient care’ competency cluster, there was no difference in self-assessed competence between ‘trained’ and ‘untrained’ groups.

Conclusion

Training and experience in providing clinical medication reviews did not seem to influence the self-assessed competence of community pharmacists: indeed, the ‘trained’ pharmacists seemed to have become more aware of their competence gaps. As the roles of community pharmacists expand, pharmacists need greater targeted support to face new challenges and to deliver the new services in chronic medicines management.
Exploring pharmacists' views about the contribution that reflective learning can make to the development of professional practice
Authors: Black Patricia E , Plowright David
Published: July 2007

Objective

Postgraduate courses for pharmacists are increasingly incorporating reflection on learning and on professional practice as the theory of learning in use. This paper provides an insight into the views of pharmacists, who participated in a prescribing course, about using reflection to contribute to the development of their learning and professional practice.

Method

The research was exploratory in nature and employed an inductive, grounded theory strategy. Qualitative data were collected from focus groups and individual interviewees. Twenty-six individuals, who had been registered on Keele University's Supplementary Prescribing (SP) course, participated in total.

Key findings and conclusions

Two key themes are discussed in this paper that appear to the authors to provide an insight into how reflective learning contributes to the development of professional practice. The structured reflective activities included in participants' reflective portfolios were a catalyst to making them aware of the reflective learning process that they instinctively or intuitively used in their professional practice to some degree. Participants also appeared to be aware of different levels or depths of reflection. They articulated these in a more pragmatic way than the theoretical presentations of levels that appear in published literature. Overall, they saw reflection as being of benefit to their professional development, patient care and their interactions with other health professionals. They perceived it as a way of building the healthcare team through helping them integrate with other health professionals by developing a community of practice.
Electronically transferred prescriptions: picked up faster than paper prescriptions
Authors: Nilsson J Lars G , Bäckström Sara , Sundström Johanna
Published: July 2007

The pick-up rate of 2149 e-prescriptions and 414 paper prescriptions for short-term treatments was determined at a middle-sized Swedish pharmacy. We found a high pick-up rate of 90% within 5 days from the date of issue. The number of patients with a pick-up delay of more than 5 days was significantly higher among those with paper prescriptions (15%) compared to those with e-prescriptions (10%).
Effect of a Filter Cover on Temperature and Humidity in a Mouse Cage
Authors: Simmons M. L. , Robie D. M. , Jones J. B. , Serrano L. J.
Published: July 2007

To determine how a filter cap affects the heat and moisture build-up in a mouse cage, and how that build-up is affected by ambient conditions of temperature and relative humidity, 50 adult female mice were housed 10 per cage in polycarbonate cages, which were covered with a fibrous filter and sealed with a neoprene gasket and hold-down rod. The cages were placed in a chamber which controlled ambient temperature and humidity. Observations were made at 1°F intervals of temperature (68–74°F, 19.9–23.3°C) and at three different relative humidities (40, 55, and 70 per cent). Every 24 hours the chamber conditions were changed, and cages, bedding, water, filter caps, and food were replaced. Three sensors suspended just under the filter cover measured temperature and humidity and transmitted the data to a recorder. The first reading was taken after a 3-hour equilibraiion period, then every 3 hours until the next day's change. By measuring the average temperature and humidity, it was possible to study the differences between cage and ambient conditions. At 68°F (19.9°C) and 40 per cent relative humidity, the mean conditions in the cages were 72°F (22.2°C) and 50 per cent; at the upper limit of 74°F (23.3 °C) and 70 per cent, the mean cage conditions were 78°F (25.5°C) and 75 per cent.
Factors Influencing Dietary Vitamin K Requirements of Rats and Mice
Authors: Hacking M. R. , Lane-Petter W.
Published: July 2007

The literature concerning the dietary requirements of rats and mice for vitamin K has been reviewed and some relevant observations on the breeding colony of rats at Carworth Europe are reported. From the literature cited it is concluded that the true vitamin K requirement, that is, the amount that must be absorbed to prevent prolongation of prothrombin time, is influenced by many factors; the most important are strain, age, sex and environmental temperature. In determining the amount of a particular form of vitamin K that must be included in the diet of a given strain of rat or mouse in a given environment, the principal factors to be considered are the degree of coprophagy, the level of vitamin A and the amount and types of fats and proteins present in the diet.
A Method for Calculating the Area of Breeding and Growing Accommodation Required for a Given Output of Small Laboratory Animals
Authors: Festing Michael , Bleby John
Published: July 2007

A method is given for the calculation of the area of animal accommodation needed to produce a given output of small laboratory animals. This method depends on determining the number of cages needed according to productivity, the age of animals at time of use, the proportion of animals not suitable for use, and the stocking density of the growing stock for the output needed. The area needed to hold this number of cages can then be calculated according to the shelf length taken by the cages, working space required, numbers of tiers of cages, and the proportion of animals that will be wasted due to fluctuations in supply and demand. An example is given and compared with actual results, and the effects of errors in the estimation of some of the variables are discussed.
Factor VII Deficiency in the Beagle Dog
Authors: Capel-Edwards K. , Hall O. E.
Published: July 2007

Two cases are described of factor VII deficiency in the blood of healthy female beagles. The diagnosis was established on the basis of: (i) prolonged Quick's one-stage prothrombin and ‘Thrombotest’ times, both corrected by the addition of 10 per cent by volume of normal canine serum; (ii) normal Russell's viper venom time and thromboplastin generation test; and (iii) reduced factor VII activity compared with plasma from a normal dog. Attention is drawn to some implications of inherited blood-coagulation disorders not associated with physical evidence of bleeding.
Changes in macrophage metabolism in mice heavily infected with Hexamita muris
Authors: Keast D. , Chesterman F. C.
Published: July 2007

The rate of 3H-RNA synthesis is increased in macrophages cultured from mice with severe, and often fatal, infestation with the intestinal flagellate Hexamita muris. The response of the cultured macrophages to foreign antigen is also impaired at such times. The macrophages behave normally when the flagellate is present as a commensal.

The pathology of the heavily infested mice is described and the results are discussed with reference to present concepts of the role of the macrophage in immunity.
Incidence and metastatic pattern of lymphoreticular neoplasms in untreated NZO/B1 mice
Authors: Goodall C. M. , Bielschowsky Marianne , Forster D. R.
Published: July 2007

Data on the occurrence of lymphoreticular neoplasms in untreated mice of the NZO/B1 strain with hyperglycaemic obesity, are presented. 51% of the lymphomas were primary in Peyer's plaques, an uncommon lesion in most strains of mice. The incidence of lymphomas in males, virgin and breeder females, together with the age distributions and age-dependent cumulative probability curves, are given as background data for other laboratories working with NZO/B1 mice.
Pentobarbitone sodium anaesthesia for oral and immunological procedures in the guinea-pig
Authors: Cannell H.
Published: July 2007

250 Hartley strain guinea-pigs were anaesthetised using 37.5 mg pentobarbitone per kg bodyweight. This dosage level differs considerably from those levels previously recorded in the literature. Average hypnotic ('sleeping') time was 120 minutes. Deep surgical anaesthesia was more difficult to achieve, as large animals gave irregular results at their weight-adjusted dosage level.
Repeated general anaesthesia in macaques by intramuscular methohexitone sodium
Authors: Wallace J. , Johnson N. W. , Kenney E. B.
Published: July 2007

Intramuscular methohexitone sodium as a short-acting general anaesthetic for oral procedures in macaques resulted in no significant weight loss or detectable systemic side effect in any animal during a period of 52 days continuous daily use. Histological examination of injection sites revealed no significant tissue damage.
Myocardial tuberculoma in a chacma baboon (Papio ursinus Kerr, 1792)
Authors: Bartsch R. C. , Wessels B. C. , McConnell E. E.
Published: July 2007

A case of myocardial tuberculosis in a chacma baboon ( Papio ursinus Kerr, 1792) is described. Lesions were confined to the heart and adjacent tissues, apparently without lung involvement. Microscopically, the lesion consisted of a diffuse granulomatous reaction with many giant cells and a few acid-fast bacilli. It was postulated that the infection was caused by Mycobacterium tuberculosis var. hominis contracted after capture.
Mortality from birth to weaning in the mongolian gerbil, Meriones unguiculatus
Authors: Norris M. L. , Adams C. E.
Published: July 2007

Observations are presented on the incidence of mortality between birth and weaning at 30 days of age in the Mongolian gerbil, Meriones unguiculatus. The proportion of young weaned was approximately 80%; it was little affected by litter size or whether or not adjustment had taken place. A slightly higher proportion of males was lost than females. The heaviest mortality occurred within the first 5 days of birth, apparently due largely to neglect. No case of cannibalism was recorded.
Spontaneous mammary tumours in SPF C3H/Avy mice: formation of virus structures
Authors: Tan W. C. , Sebesteny A.
Published: July 2007

Spontaneous mammary tumours developed in specific-pathogen-free C3H/Avy female mice. Virus particles in the tumour cells were predominantly intracytoplasmic A-type particles, presumably the result of vertical transmission. Structural interactions between A particles and some diffuse bodies were observed. The emergence of a new type of particle with a composite structure was noted. No B-type virus particles were detected.
Causes of death in mated female mice
Authors: Munro Kathleen M. H.
Published: July 2007

Of 341 mated female mice observed during a 2-year period, 29 died. 12 of these were examined in detail: 1 had leukaemia; 2 had renal lesions; 6 had intussusception of colon; 5 had liver necrosis. Of the 6 with intussusception, 5 had an infestation of a nematode, Aspiculuris tetraptera, in the colon: 2 mice with no intussusception were also infested.
Controlled environment systems for experimental animals. I. A unidirectional air flow brooder for chicks
Authors: Egan B. J. , Butler E. J.
Published: July 2007

A hot-air, 2-tier brooder has been designed for rearing and experimental work with 100 pathogen-free chicks up to the age of 3 weeks. It provides a high degree of protection against infection without having to resort to the inconvenience of isolator techniques. Filtered air is supplied horizontally at a constant velocity of 0.51 m/sec (100 ft/min). Temperature can be varied from ambient to 35°C (95°F) and can be controlled to within 0.5°C (1°F). In it chicks grew faster and more uniformly than in a conventional hot-panel brooder.
Serum iron and iron-binding capacity in normal and tumour-bearing golden hamsters
Authors: Bannon P. D. , Friedell G. H.
Published: July 2007

In contrast to other plasma constituents, serum iron levels in hamsters were notably different (higher) from those in man. There were no significant differences in serum iron levels or iron-binding capacity between tumour-bearing and normal hamsters, or between the sexes.
A simple and inexpensive methodology for the care and maintenance of experimental laboratory frogs
Authors: Bardsley J. E. , Harmsen R.
Published: July 2007

The construction of a flow-through system of compartmentalized cages for frogs is described. These cages utilize readily accessible and relatively inexpensive materials, and can be built with ease. They are suitable for use in any laboratory with a table top abutting on a sink, and are adaptable. Also described are techniques for the year-round retention of large numbers of frogs using large holding tanks. Methods for feeding adult and larval Amphibia, and techniques for marking and blood sampling, are also given. Mortality is extremely low.
Incidence of natural virus infections of laboratory animals 1976-1977
Authors: Carthew P. , Sparrow S. , Verstraete A. P.
Published: July 2007

The incidence of clinical viral disease in mice, hamsters, rats, guinea-pigs and rabbits in the United Kingdom in 1976-1977 is recorded. The significance of these diseases is discussed and recommendations for their control are made.
The incidence, pathogenesis and treatment of helminth infections in rhesus monkeys (Macaca mulatta)
Authors: Remfry Jenny
Published: July 2007

In a survey of 259 newly-imported rhesus monkeys, 5 species of nematode parasites were commonly found. Of these 5 species, Oesophagostomum spp. and Strongyloides fulleborni were implicated in the deaths of 3 monkeys. 5 other nematode species, 2 cestode species and 1 trematode species were also found; their pathogenicity is discussed. The results of treatment of parasitic infections with 6 different drugs is reported. Thiabendazole at an initial dose of 100 or 133 mg/kg and repeated at 50 mg/kg was found to be the most effective treatment against Oesophagostomum spp.
Cytology of the bone marrow in the Mongolian gerbil
Authors: Weeks Angela M. , Glomski Chester A.
Published: July 2007

Heterophils were the most numerous cells (39%), followed by the normoblasts (27%) and lymphocytes (8%). Significant differences between males and females were observed in the total number of heterophils (42 and 35% respectively, P < 0·002), heterophil myelocytes (12 and 10%, P < 0·01) and the myeloid:erythroid ratio (1·9:1 and 1·4:1, P < 0·03). Heterophils presented both annular and polymorphous nuclei, which appeared to develop along separate lines. The ring series began with a small nuclear 'vacuole' which increased in size with maturation of the cell. Ring-forms comprised 1/3 of the total heterophil population in the marrow. Eosinophils and basophils also demonstrated annular nucleated forms. Mature heterophils tended to have a scarcity of stainable specific granulation. Eosinophil granules were larger than those of the heterophil, slightly refractile and did not react avidly with eosin. Basophil granules, conversely, reacted strongly with the methylene-blue component of Wright-Giemsa stain and were metachromatic. Normoblasts retained their cytoplasmic basophilia to a greater degree than comparable cells in man.
Cuffed tube tracheostomy in the dog
Authors: Leverment J. N. , Rae S.
Published: July 2007

A surgical technique of performing tracheostomy in dogs requiring prolonged intubation with either cuffed or uncuffed tubes is described. Cannulae used in humans are anatomically unsuitable for the dog. The cannula and cuff described in this paper did not predispose to severe mechanical trauma to the trachea and we attempted to minimize factors that may predispose to tracheal damage during the period of intubation and the subsequent development of late tracheal injuring after extubation.

A simple method of humidification in these healthy dogs proved adequate; neither tenacious tracheobronchial secretion nor the retention of secretions were seen.
Intraocular melanoma in the rat
Authors: Magnusson G. , Majeed S. , Offer J. M.
Published: July 2007

8 cases are reported of intraocular melanoma encountered in treated and untreated rats from 6 chronic toxicity studies.
Colonization resistance of the digestive tract and gastro-intestinal transit time in SPF mice
Authors: Koopman J. P. , Kennis Henriëtte M. , Van Druten J. A. M.
Published: July 2007

The gastro-intestinal colonization resistance to Escherichia coli was assessed in individual CBA/Rij, C3H/StZ and Swiss/Cpb:SE mice. Gastro-intestinal transit time was determined by feeding small steel balls and x-ray examination of sequentially collected faeces. No correlation was found between transit times measured on 3 subsequent days, nor between them and colonization resistance.