bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug-related problems in the elders of the British Virgin Islands
Authors: Titley-Lake Carla , Barber Nick
Published: February 2011

Objective

To explore the extent of drug-related problems in elderly patients in the Caribbean.

Methods

Comprehensive medication reviews were carried out on a 1 in 20 sample of the elderly population of the British Virgin Islands, a UK dependent territory located in the Caribbean. Fifty non-institutionalised patients, 65 years or older and taking at least one prescribed medicine, were interviewed for the study.

Key findings

On average, 4.5 prescribed medications, 4.7 over-the-counter preparations and 3.3 herbal remedies/natural products were used by the sample. A mean of 5.9 potential drug-related problems per patient were identified and a mean of 3.7 complications relating to the sub-optimal use of medicines per patient were observed.

Conclusion

This study has highlighted the need for a multidisciplinary review of the prescribing, dispensing and monitoring of elderly patients receiving prescribed medications. The pharmacist has a role to play in helping prescribers achieve this review, and in educating patients in ways in which they can get the best out of their medicines.
Student assessment of postgraduate clinical pharmacy programmes in the United Kingdom (2): results of the course experience questionnaire
Authors: Quinn John , Bates Ian , Cox Roy
Published: February 2011

Objective

The principal objective of this paper was to use the course experience questionnaire (CEQ30) instrument to compare and evaluate aspects of provision of postgraduate clinical pharmacy programmes available through institutions of higher education in the United Kingdom.

Method

A postal survey, using the CEQ, of graduates from clinical pharmacy postgraduate programmes. Cases were subject to factor analysis, comparative statistics and regression analysis to describe differences between aspects of programme provision.

Setting

Graduates from 10 different postgraduate clinical pharmacy programmes in the UK since 1990 were surveyed. A total of 511 questionnaires were distributed and 364 were returned (72 per cent).

Key findings

Significant differences between institutions were identified in key factors of student-evaluated aspects of higher education. Factors were generally rated low by respondents. Some programmes appear more likely to encourage surface approaches to learning rather than deep learning. Analysis of factor scores enabled a ranking table to be drawn up for the postgraduate programmes included.

Conclusions

Evaluation of individual programmes shows differences in rating of aspects of provision. There is scope for postgraduate clinical pharmacy programmes to improve. The study findings raise the question of whether these differences in the learning experience may affect the quality of clinical pharmacy graduate.
Professional perspectives on a feasibility study of GP-pharmacist collaboration in the management of angina
Authors: Ryan-Woolley B M , Cantrill J A
Published: February 2011

Objective

To report the views and experiences of a convenience sample of community pharmacists and general practitioners (GPs) who participated in a five-month feasibility study exploring the ways in which community pharmacists could contribute to the management of patients with stable angina when working in partnership with GPs.

Method

Five pharmacists delivered a specified model of care, which represented one component of a district-wide strategy aimed at improving the management of ischaemic heart disease (IHD), to 208 patients in eight general practices. The care involved six evidence-based interventions: smoking cessation, dietary advice, exercise, aspirin, beta-blockers and statins. This paper illuminates professional perspectives concerning involvement in the study. The findings of semi-structured interviews exploring views and experiences of the pharmacists during the first and the final month of the study and those of the GPs at completion of the study are reported.

Setting

St Helens and Knowsley, UK, an area with a high IHD standardised mortality rate (SMR).

Key findings

The pharmacists reported high levels of satisfaction and success in relation to the study interventions and more professionally satisfying relationships with patients and GPs. Successes with therapeutic interventions were described, both within and external to the study protocol. The GPs expressed a high level of satisfaction with the conduct and outcome of the pharmacist delivered care and heightened awareness of the need to review their approach to preventive care for IHD patients.

Conclusion

The findings confirm that pharmacists and GPs can work in partnership to deliver a specified model of care to patients with stable IHD and also inform the debate on a role for community pharmacists as dependent prescribers.
Community pharmacy management of acute diarrhoea in adults
Authors: Seston E M , Nicolson M , Hassell K , Cantrill J A , Noyce P R
Published: February 2011

Objective

To study the community pharmacy management of acute diarrhoea in adults and to explore the attitudes and beliefs of community pharmacists towards the management of this common condition.

Method

Data were collected over a four-week period on the incidence and presentation of acute diarrhoea in adults by pharmacy staff in 17 pharmacies who were participating in a community pharmacy research panel. A postal survey on attitudes and beliefs about the treatment of diarrhoea was sent to a random sample of 2,500 community pharmacists.

Key findings

A total of 1,401 community pharmacists responded to the survey (response rate 59 per cent). Their responses suggested ambiguity in the treatment of acute diarrhoea in community pharmacy, particularly in relation to attitudes to oral rehydration and anti-motility drugs. Although the majority of pharmacists surveyed were aware of recommendations to treat adult patients with acute diarrhoea with oral rehydration, in practice many stated that they often sold an anti-motility treatment, a finding borne out by the high percentage of anti-motility sales (61 per cent) in the earlier part of the study. The decision to sell or recommend an anti-motility drug was often motivated by the patient's circumstances and their need for immediate symptomatic relief.

Conclusion

This study suggests that the community pharmacy management of acute diarrhoea is characterised by ambiguity and pragmatism. Existing guidelines for the treatment of diarrhoea fail to take into account the social context in which pharmacists operate, particularly in relation to patient demand and the need for symptom relief.
Community pharmacists' views and experiences of counter-prescribing in pregnancy
Authors: Hutchinson Sandra , Mitchell Kelly , Hansford Denise , Stewart Derek
Published: February 2011

Objective

To ascertain the sources of community pharmacists' knowledge base for counter-prescribing in pregnancy, whether sufficient additional information was readily accessible and, if not, to discover pharmacists' areas of concern.

Method

A structured telephone interview of community pharmacists by a single researcher using a pre-piloted questionnaire to obtain both quantitative and qualitative data. Questions covered previous education about counter-prescribing in pregnancy, reference sources used, and satisfaction with available reference sources. Respondents were also asked to cite examples where they would or would not recommend a medicine in pregnancy.

Setting

A random sample of 50 community pharmacies in Scotland.

Key findings

From the high response rate (43 pharmacists, 86 per cent) the topic was demonstrably important to community pharmacists, most of whom perceived their knowledge base for counter-prescribing in pregnancy to be experience-gained. Thirty-four pharmacists (79 per cent) agreed there was a need for more information to be available. Ten pharmacists (23 per cent) highlighted complementary therapies as an area where they found available information inadequate. Examples of requests from pregnant women and the action taken by the pharmacist are reported.

Conclusion

There is a need for an accurate, current and comprehensive data source for counter-prescribing in pregnancy. The field of complementary medicines and therapies is of particular concern to many community pharmacists. More research is required into GP referrals.
Are health professionals ready for the new philosophy of concordance in medicine taking?
Authors: Raynor D K , Thistlethwaite J E , Hart K , Knapp P
Published: February 2011

Objectives

To develop and administer a practical, valid and reliable tool to measure attitudes to concordance in medicine taking, a new concept where decisions depend on an equal partnership between patient and prescriber.

Method

A postal questionnaire was devised comprising statements from the original concordance document, along with statements reflecting the orthodox model of medicine taking. There was a total of 22 statements. Respondents rated each statement on a four-point Likert agreement scale. The questionnaire also included three scenarios of consultations involving medicine prescribing and taking, with associated statements for rating as true or false.

Setting

A random sample of 207 medical, nursing and pharmacy graduates in the North of England at the time of qualification. We received 81 completed questionnaires (39 per cent)

Key findings

Item analysis reduced the 22-item scale to a 12-item scale with good reliability (Cronbach's alpha = 0.79) and construct validity was demonstrated through correlation with responses to the scenarios. Although the typical respondent had a positive attitude towards concordance (mean = 2.3), 25 per cent of respondents had negative attitudes. Pharmacists showed the least favourable attitudes (P<0.05)

Conclusions

The 12-item Leeds Attitude Towards Concordance (LATCon) scale is a reliable and valid tool for assessing health care providers' attitudes to the new concept of concordance in medicine taking. Newly qualified doctors, nurses and pharmacists tended to hold favourable attitudes, although a significant minority — especially pharmacists — hold negative attitudes. These results have implications for undergraduate education and continuing professional education.
Doctors' and pharmacists' attitudes to the use of sugar-free and sugar-containing medicines in the elderly
Authors: Baqir W , Maguire A
Published: February 2011

Background

Much progress has been made towards the prescribing and dispensing of sugar-free alternatives for medicines used long-term in children. However, older people may also take sugar-containing medicines and those with natural teeth are at risk of dental caries.

Objective

To assess the knowledge and attitudes of health professionals with regard to the use of sugar-free medicines with prolonged oral clearance in elderly people.

Method

Postal questionnaire survey of three groups of health professionals (general practitioners, community pharmacists, consultant geriatricians). Statistical analysis using factor analysis, Mann Whitney U test and Kruskal Wallis test.

Setting

Five districts of north-east England.

Key findings

The overall response rate was 66 per cent (349 responses). Support for the use of sugar-free medicines was greater among GPs than pharmacists (P=0.014). There was general agreement that, wherever possible, pharmacists should dispense sugar-free medicines for elderly people, although more GPs (P<0.0001) and consultant geriatricians (P=0.024) agreed than pharmacists. More pharmacists than GPs believed sugar-free medicines to be more expensive although there was general uncertainty about whether this deters doctors and pharmacists from using them. There was a good understanding of the role of sugars in medicines in the aetiology of dental disease, although respondents felt that elderly people were unaware of this link. Only 51 per cent of respondents agreed that government should subsidise sugar-free medicines production. Ninety-four per cent felt that the pharmaceutical industry should produce more sugar-free products.

Conclusion

Although there is support for the sugar-free option, there is a need to raise the awareness of health professionals to barriers which currently discourage utilisation, and to encourage a more multi-professional approach in the education of health professionals, health care providers, manufacturers and regulators with regard to sugar control in medicines use and related regulatory issues.
The association of psychosocial and diabetes factors to diabetes knowledge
Authors: Mcclean M T , Mcelnay J C , Andrews W J
Published: February 2011

Focal points
Educational strategies to promote evidence-based community pharmacy practice: a cluster randomised controlled trial
Authors: Watson M C , Bond C M , Grimshaw J M , Mollison J , Ludbrook A
Published: February 2011

Focal points
SIGN guidelines and the management of sore throat in community pharmacy
Authors: Campbell A , Mcgovern E M , Millar H , Bryson S M
Published: February 2011

Focal points
Pharmacists' characteristics and their views of physician-assisted death
Authors: Hackett E , Francis S-A
Published: February 2011

Focal points
Implementation of statin prescribing guidelines: a cost effectiveness analysis
Authors: Morgan J D , Wright D J , Chrystyn H
Published: February 2011

Focal points
Poor correlation between predicted ideal and prescribed digoxin dose: a community-based pharmacokinetic study in the elderly
Authors: Holden K , Sheldon W , Earle P , Dawson A , Frater J
Published: February 2011

Focal points
A search for socio-economic influences in behaviour and attitudes to medicines available for self-medication and NHS prescription
Authors: Johnson B J , Muir A , Hudson S A
Published: February 2011

Focal points
Working alongside nursing staff to review medication in nursing homes
Authors: Hall Jason , Mottram David R , Cairns Chris
Published: February 2011

Focal points
A novel approach for teaching aseptic processing to pharmacy undergraduates
Authors: Abbot Colleen
Published: February 2011

Focal points
Headache experiences and medication use in primary care
Authors: Boardman H F , Thomas E , Croft P R , Millson D S
Published: February 2011

Focal points
Delivering pharmaceutical care: what does it involve?
Authors: Krska Janet , Hansford Denise , Jamieson Debbie , Arris Fiona , Cromarty John
Published: February 2011

Focal points
Professional integration within health centre pharmacies
Authors: Jesson Jill , Rashid Asia , Wilson Keith
Published: February 2011

Focal points
Investigation of community pharmacists' participation in a local medicines management project
Authors: Bennett E V , Jones I F
Published: February 2011

Focal points
Talk-in-interaction in the community pharmacy setting: a conversation analytic approach
Authors: John D N , Housley W
Published: February 2011

Focal points
Mind the gap: how compliance aids increase the distance between patients and their medicines
Authors: Nunney J , Raynor D K
Published: February 2011

Focal points
Gender and age influences on prescription and consultation frequency for multiple sclerosis patients
Authors: Tremlett H L , Evans J , Wiles C M , Luscombe D K
Published: February 2011

Focal points
The use of sublingual glyceryl trinitrate and aspirin in angina patients and enhancement of coronary heart disease databases
Authors: Alford C , Grant E M , Johnston C , McIntyre P
Published: February 2011

Focal points
Validity and reliability of the kidney disease questionnaire in patients receiving continuous ambulatory peritoneal dialysis
Authors: Hughes Carmel M , Al-Ghadeer Abdalaziz , McClean Mary , McElnay James C
Published: February 2011

Focal points
Compliance, concordance and the revolving door of care: caring for elderly people with mental health problems
Authors: Harris Diane , Anderson Claire
Published: February 2011

Focal points
Futile and inappropriate prescribing: an assessment of the issue in a series of patients admitted to a specialist palliative care unit
Authors: Nicholson A , Andrew I , Etherington R , Gamlin R , Lovel T , Lloyd J
Published: February 2011

Focal points
Addressing pharmaceutical and medicines management issues within the cancer network structure
Authors: Hodgetts Alison , Beswick Trevor , Rimmer James , Aspley Sara
Published: February 2011

Focal points
Polypharmacy and asynchronous prescribing in elderly patients within primary care
Authors: Clews P , Hartzig V , Langley C A , Marriott J F , Wilson K A
Published: February 2011

Focal points
Minor ailment consultations: a mismatch of perceptions
Authors: Morris C J , Cantrill J A , Weiss M C
Published: February 2011

Focal points
Non-dispensing of NHS prescriptions in community pharmacies
Authors: SCHAFHEUTLE ELLEN I , HASSELL KAREN , SESTON ELIZABETH M , NOYCE PETER R
Published: February 2011

Objective

To explore non-dispensing of National Health Service (NHS) prescriptions in community pharmacies.

Method

Prospective study on prescription items that were presented and not dispensed. Pharmacy staff recorded reasons for non-dispensing of NHS prescription items and process outcomes, including substitution through other means.

Setting

Sixteen community pharmacies in the North of England.

Key findings

Data are available on 587 items (514 patients). Two main reasons for non-dispensing were identified: those related to the cost of the prescription charge (n=308) and those unrelated to cost (n=279). The latter generally suggested a prescribing issue involving the general practitioner's (GP's) computer system. Cost-related reasons included cheaper availability of over-the-counter (OTC) products (78.6 per cent) and incidents where customers were unwilling or unable to pay the prescription charge (20.1 per cent). Unsurprisingly, cost-related reasons were encountered almost exclusively for patients who were non-exempt from prescription charges, while non-cost reasons were more commonly seen for exempt patients. As a result of non-dispensing because of cost, 242 OTC products were sold, 97.0 per cent of which contained the same active ingredient as had been prescribed by the doctor. There were 62 incidents where a prescribed item was not dispensed, or substituted, because of cost, and more than one-third of these items (n=22) could be considered to be clinically important.

Conclusions

In addition to issues of GP prescribing, the cost of the prescription charge was identified as a major factor in non-dispensing. Many of the items were substituted by cheaper OTC products, yet some clinically important drugs were not dispensed or substituted, suggesting that a review of the UK charge system is appropriate.
The issue of territoriality between pharmacists and physicians in primary care
Authors: Reebye Rajiv N , Avery Anthony J , Bissell Paul , van Weel Chris
Published: February 2011

This paper discusses the utility of the concept of territoriality in order to understand relationships between pharmacists and physicians in the primary care setting. First, we provide background information on the concept of human territoriality. Secondly, we discuss its potential application to the relationships between pharmacists and physicians. Finally, we suggest ways in which understanding and tackling territorial issues may strengthen the pharmacist-physician link and, in doing so, may improve patient care.
The influence of pharmacy staff in non-prescription medicine sales
Authors: Emmerton Lynne , Shaw John
Published: February 2011

Objective

To monitor sales of non-prescription medicines from pharmacies in New Zealand, and report specifically on the involvement and influence of pharmacy staff.

Method

Purchasers of non-prescription medicines were interviewed in-store immediately following their purchase. A brief structured questionnaire was used to record current and previous medicine purchases, influences on first-time purchases and demographic descriptors. Non-intrusive observational data were collected where possible in the case of non-response.

Setting

Data were collected in 12 pharmacies in New Zealand during winter 1999. Pharmacies were selected to approximate the population distribution, and had a range of sizes and practice settings. Interviews took place over five consecutive days in each pharmacy.

Key findings

The recorded purchases totalled 2,597 (69–397 per pharmacy), representing 71.2 per cent of observed medicine sales. Some two-thirds of all medicines had been purchased on a previous occasion. In two-thirds of sales, pharmacy assistants provided consultation with no pharmacist input. Two-thirds of purchases were for a pre-determined brand, and consultation occurred less frequently when these were self-selected from the shelf. Involvement by pharmacy staff was particularly noted when a change of brand occurred, when a desired brand was sought from staff, and when no particular brand was sought. For first-time purchases, the influence of pharmacy staff (62.2 per cent of all influences recorded) dominated that of family and friends (15.5 per cent).

Conclusion

Pharmacy staff play an active role in non-prescription medicine sales, despite most purchases apparently being straightforward in nature. Guidelines for appropriate product selection and advice are particularly important when training pharmacy assistants.
Managing medicines mishaps: understanding the systems
Authors: Savage Imogen
Published: February 2011

With the new National Patient Safety Agency starting to roll out its “error and near miss” reporting system across the UK National Health Service, the 8th Health Services Research and Pharmacy Practice conference, held in Leeds on April 11–12, provided a timely introduction to the science of human error, as Imogen Savage reports
Evaluation of a practice-based research design using an asthma care model
Authors: Saini Bandana , Jogia Rajend , Krass Ines , Armour Carol
Published: February 2011

Objective

To evaluate a quasi-experimental research design using a practice-based model in community pharmacy by comparing baseline characteristics of the control and intervention samples used.

Methods

An asthma care model was chosen to trial the use of a quasi-experimental design. Two geographically separate areas were selected as intervention and control areas. Pharmacists from the intervention area were trained and provided with resources to set up asthma specialty practices and recruit intervention patients. Control area pharmacists were not offered training but were requested to recruit patients with asthma to act as a control sample to data being collected from the intervention population. The research design aimed to establish equivalence between the two groups. In both cases, data were gathered using an “asthma file,” which consisted of a patient demographics and asthma information form and a series of previously validated questionnaires to examine humanistic outcomes.

Setting

Community pharmacies in two non-urban areas of New South Wales, Australia.

Key findings

Nine of 15 intervention pharmacies recruited 52 patients into the study and 11 of 20 control pharmacies recruited 50 patients. No apparent differences existed between the two samples with respect to the humanistic parameters of asthma-related quality of life, asthma general knowledge and perceived control of asthma. In terms of asthma severity and disease-specific parameters, such as asthma-related hospitalisations, no statistically significant differences were found. Control and intervention groups were thus found to be equivalent for the purposes of the study.

Conclusion

The data support the use of the quasi-experimental research method employed in the study.
How effective are pharmacists who work with medical practitioners? A study of interventions intended to influence prescribing
Authors: Teal Sheridan , Ricketts Lucianne , Belton Andrew , Allsopp George , Silcock Jonathan , Wright David J
Published: February 2011

Objective

This study was designed to describe the interventions made by pharmacists working within different therapeutic areas in medical practices in primary care and to estimate the effects on prescribing.

Method

All medical practices and community pharmacists in one health authority area in England were invited to participate. Pharmacists were allocated to work with specific practices and training was provided in musculoskeletal, respiratory and anxiolytic/hypnotic (sedative) prescribing. Pharmacists negotiated and agreed with their medical practice the type of interventions which would meet the practice's needs. Pharmacists were remunerated to provide a maximum of eight three-hour sessions in each medical practice on each therapeutic area over a 12-month period. Details of all interventions were recorded by each pharmacist and countersigned by a practice GP. A summary form was then sent to the health authority. Analysis of prescribing data before and after intervention in all practices was carried out using a predictive model to calculate estimated costs.

Key findings

Twenty-seven pharmacists working with 39 medical practices participated in the study. Pharmacist interventions resulted in 165 dose changes, 368 drug changes, 470 drug discontinuations and 1,042 patient reviews. On average, £3.99 was saved for each musculoskeletal intervention made. This compared with an additional cost of £15.50 and £17.92 for each intervention in sedative and respiratory prescribing, respectively. Analysis of prescribing data showed that the total spend in musculoskeletal and sedative prescribing in participating practices one year after intervention was lower than that predicted.

Conclusion

Accurate recording of individual interventions with reasons, outcomes and direct cost consequences allows purchasers to make more informed decisions about the potential benefits of practice pharmacists. This method may, however, underestimate the pharmacist's indirect impact on prescribing since it does not take into account any educational effect on prescribers.
Sociological Theory and Pharmacy Practice Research: (4) The contribution of interactionist sociology to understanding the experience of health and illness
Authors: Bissell Paul , Traulsen Janine Morgall , Haugbølle Lotte Stig
Published: February 2011

So far in this series, we have explored the relevance of the work of Talcott Parsons and Karl Marx to pharmacy practice research.1, 2 Both these writers placed an emphasis on the ways in which human actions and, moreover, human consciousness are shaped by the requirements of the social system. Such perspectives came under fire, often from sociologists within the US, during the 1950s and 1960s. These sociologists were concerned to place the activities, experiences and understandings of human beings at the centre of the sociological endeavour. In doing so, they have provided some highly insightful examples of sociological research, especially as applied to health, illness and health care. It is this reaction against the “dehumanising” aspects of Marxist, functionalist and other sociological theories that we now turn to in our consideration of the emergence of symbolic interactionist sociology. Symbolic interactionist sociology has been partially responsible for the rise of a set of research techniques and theoretical concepts that will be familiar to many readers — the use of “naturalistic” methods of social research (observational or ethnographic work) and grounded theory,3 both of which figure increasingly within health services and pharmacy practice research. In this paper, we will look at the origins of interactionist sociology and comment on its relevance and application to the research agenda of pharmacy practice.
Assessing clinical outcome after high technology home treatment for cystic fibrosis
Authors: Thornton J , Elliott R , Tully M P
Published: February 2011

Focal points
Patients' experiences of over-the-counter treatments for irritable bowel syndrome
Authors: Anderson H , Bartley E , Davison A M , Haines S L , Rogers P J
Published: February 2011

Focal points
Osteoporosis assessment tool for Sunderland city hospitals
Authors: Collins Noreen B , Beard Rod J , Candlish Carol A , Worsley Alan J
Published: February 2011

Focal points
Regional anaesthetic practice in orthopaedic surgery
Authors: Alageel Sinaa , Elliott Rachel , Noyce Peter
Published: February 2011

Focal points
Pain relief in the elderly: are we doing enough?
Authors: Taylor E K , Petty D , Goldstein R , Raynor D K
Published: February 2011

Focal points
Public perceptions on doping in sport
Authors: Woodruff Helen , Thompkins Abigail , Mottram David , Williamson Peter
Published: February 2011

Focal points
Patients' own drugs and self-administration of medication schemes in the United Kingdom
Authors: Ansar S , Silverthorne J
Published: February 2011

Focal points
Community pharmacist's roles: nursing home staff and community pharmacists' views
Authors: Akiya Y , Anderson C , Avery A
Published: February 2011

Focal points
Types and preferred sources of information concerning herbal medicinal products: face-to-face interviews with users of herbal medicinal products
Authors: Gulian Claire , Barnes Jo , Francis Sally-Anne
Published: February 2011

Focal points
The influence of organisational characteristics on pharmacological management of depression in US nursing homes
Authors: Hughes Carmel M , Lapane Kate L
Published: February 2011

Focal points
Validation of the Welsh general practice morbidity database
Authors: Offia A , Walker R
Published: February 2011

Focal points
Signal generation in prescription event monitoring: investigation of a possible signal of colitis during rofecoxib treatment
Authors: Heeley Emma L , Layton Deborah , Shakir Saad A
Published: February 2011

Focal points
Community pharmacist perceptions of the loss of resale price maintenance
Authors: Mohammed J , Marriott J F , Langley C A , Wilson K A
Published: February 2011

Focal points
An assessment of the accuracy of electrolyte concentrations in neonatal parenteral nutrition
Authors: Wright J , Marriott J F , Langley C A , Wilson K A , Smith J
Published: February 2011

Focal points
The extent and reasons for compliance failure with oral treatment regimens in haematology outpatients
Authors: Stokes L , Smith A , Langley C A , Marriott J F , Wilson K A
Published: February 2011

Focal points
Comparison of gastrointestinal events reported for rofecoxib and meloxicam using prescription-event monitoring data in England
Authors: Layton Deborah , Heeley Emma , Hughes Kerry , Shakir Saad A W
Published: February 2011

Focal points
The provision of anticoagulant services by primary care groups and trusts: has community pharmacy a role to play?
Authors: Khan A , Rutter P M
Published: February 2011

Focal points
Content validity of indicators of the appropriateness of long-term prescribing started during a hospital admission
Authors: Javed N , Tully M P
Published: February 2011

Focal points
Roles for pharmacists in the treatment of depression in primary care
Authors: Garfield S , Smith F J , Francis S A
Published: February 2011

Focal points
Users and costs of the Scottish Direct Supply of Medicines scheme
Authors: Schafheutle Ellen I , Noyce Peter R , Sheehy Christine , Jones Lyn
Published: February 2011

Focal points
Medication use and health care consultation for headache in older adults
Authors: Boardman H F , Thomas E , Millson D S , Croft P R
Published: February 2011

Focal points
Evaluation of a primary care-based temazepam withdrawal programme
Authors: Evans S , Taylor J , Walker R
Published: February 2011

Focal points
Someone like me? Inhaler-users' views of the models who demonstrate inhaler technique
Authors: Savage Imogen
Published: February 2011

Focal points
How can the interprofessional relationship between community pharmacists and GPs in Sefton Health Authority be improved for the benefit of patients?
Authors: Wilson J N R , Berry M I , Cope L
Published: February 2011

Focal points
The effects of patient personality traits on relationships with health care professionals and on adherence to medication regimens
Authors: Hughes C , Miller E F R , Peat J , McElnay J C
Published: February 2011

Focal points
Exploiting IT: benefits for community pharmacy and consumers
Authors: Inch J , Bond C M , Grant A M , Laing A W
Published: February 2011

Focal points
Activation of silent and weak synapses by cAMP‐dependent protein kinase in cultured cerebellar granule neurons
Authors: Cousin Michael A. , Evans Gareth J. O.
Published: February 2011

Non‐technical summary  It is accepted that learning involves creating or increasing the activity of existing chemical connections (synapses) between neurons. Some connections, known as ‘silent synapses’, have no detectable activity under resting conditions but can be switched on by electrical stimuli that mimic learning. To better understand how this occurs, we compared silent and active synapses in cultured neurons. When neurons were challenged with electrical stimulation, the extent of activation of previously active synapses was unchanged, whereas silent synapses were activated. Silent synapse activation did not correlate with increases in intracellular calcium (which evokes neurotransmitter release), but was dependent on the action of the enzyme protein kinase A. A large proportion of synapses in the adult brain are thought to be silent, and therefore a detailed knowledge of silent synapse activation could give insights into the mechanisms of learning and memory.
Combined inhibition of nitric oxide and vasodilating prostaglandins abolishes forearm vasodilatation to systemic hypoxia in healthy humans
Authors: Markwald Rachel R. , Kirby Brett S. , Crecelius Anne R. , Carlson Rick E. , Voyles Wyatt F. , Dinenno Frank A.
Published: February 2011

Non‐technical summary  During hypoxia, there is less oxygen in the air we breathe and also in the blood being pumped away from the heart. Our blood vessels must relax in order to deliver more blood to match the resting oxygen demand of the muscles. The way in which multiple systems in the body coordinate this response is not well known. We examined the local response of the blood vessels to a hypoxic stimulus and show that two substances that the body produces, nitric oxide and prostaglandins, are necessary to cause relaxation of the blood vessels and increases in blood flow. These results help us better understand how oxygen delivery is regulated and may be especially important for populations that are unable to produce these substances that help increase blood flow, such as people with sleep apnoea, heart failure and diabetes.
Turning Black-Box Functions Into White Functions
Authors: Shan Songqing , Wang G. Gary
Published: February 2011

A recently developed metamodel, radial basis function-based high-dimensional model representation (RBF-HDMR), shows promise as a metamodel for high-dimensional expensive black-box functions. This work extends the modeling capability of RBF-HDMR from the current second-order form to any higher order. More importantly, the modeling process “uncovers” black-box functions so that not only is a more accurate metamodel obtained, but also key information about the function can be gained and thus the black-box function can be turned “white.” The key information that can be gained includes: (1) functional form, (2) (non)linearity with respect to each variable, and (3) variable correlations. The black-box “uncovering” process is based on identifying the existence of certain variable correlations through two derived theorems. The adaptive process of exploration and modeling reveals the black-box functions until all significant variable correlations are found. The black-box functional form is then represented by a structure matrix that can manifest all orders of correlated behavior of the variables. The resultant metamodel and its revealed inner structure lend themselves well to applications such as sensitivity analysis, decomposition, visualization, and optimization. The proposed approach is tested with theoretical and practical examples. The test results demonstrate the effectiveness and efficiency of the proposed approach.
Swelling Measurements and Prediction of Heave for a Lacustrine Clay
Authors: Noble Calvin A
Published: February 2011

The swelling characteristics of a postglacial lacustrine clay were studied by means of standard consolidation apparatus. The amount of swelling was measured for undisturbed specimens and remoulded specimens prepared to constant initial conditions. Specimens were allowed to swell under various surcharge loads. An empirical relationship was obtained between volume change, surcharge load, and initial water content. Swelling pressure for no volume change was obtained by three experimental procedures for different initial water contents and compared to values calculated from physico-chemica1 equations. Undisturbed specimens showed less swelling than remoulded specimens, but otherwise the results showed similar trends.
AN ADAPTIVE FACE RECOGNITION IN COMBINED GLOBAL AND LOCAL PRESERVING FEATURE SPACE
Authors: SOUNDAR K. RUBA , MURUGESAN K.
Published: February 2011

Computer face recognition promises to be a powerful tool and is becoming important in our security-heightened world. Several research works on face recognition based on appearance, features like intensity, color, textures or shape have been done over the last decade. In those works, mostly the classification is achieved by finding the minimum distance or maximum variance among the training and testing feature set. This leads to the wrong classification when presenting the untrained image or unknown image, since the classification process locates at least one winning cluster having minimum distance or maximum variance among the existing clusters. But for the security related applications, these new facial image should be reported and necessary action has to be taken accordingly. In this paper, we propose the following two techniques for this purpose:

(i) Use a threshold value calculated by finding the average of the minimum matching distances of the wrong classifications encountered during the training phase.

(ii) Use the fact that the wrong classification increases the ratio of within-class distance and between-class distance.

Experiments have been conducted using the ORL facial database and a fair comparison is made with the conventional feature spaces to show the efficiency of these techniques.
BACKGROUND ESTIMATION IN KERNEL SPACE
Authors: KASHANI HAMIDREZA BARADARAN , YAZDI HADI SADOGHI , SEYEDIN SEYED ALIREZA
Published: February 2011

One problem in background estimation is the inherent change in the background such as waving tree branches, water surfaces, camera shakes, and the existence of moving objects in every image. In this paper, a new method for background estimation is proposed based on function approximation in kernel domain. For this purpose, Weighted Kernel-based Learning Algorithm (WKLA) is designed. WKLA includes a weighted type of kernel least mean square algorithm with ability to function approximation in the presence of noise. So, the proposed background estimation method includes two stages: firstly, a novel algorithm for outlier detection namely Fuzzy Outlier Detector (FOD) is applied. Then obtained results are fed to the WKLA. The proposed approach can handle scenes containing moving backgrounds, gradual illumination changes, camera vibrations, and non-empty backgrounds. The qualitative results and quantitative evaluations on various indoor and outdoor sequences relative to existing approaches show the high accuracy and effectiveness of the proposed method in background estimation and foreground detection.
CONTOUR BASED MULTI-ROI MULTI-QUALITY ROI CODING FOR STILL IMAGE
Authors: ZHANG YAN , GU HAI-MING
Published: February 2011

Region-of-interest (ROI) image coding is one of the new features included in the JPEG2000 image coding standard. Two methods are defined in the standard: the Maxshift method and the generic scaling based method. In this paper, a new region-of-interest coding method called Contour-based Multi-ROI Multi-quality Image Coding (CMM) is proposed. Unlike other existing methods, the CMM method takes the contour and texture of the whole image as a special ROI, which makes the visually most important parts (in both ROI and Background) to be coded first. Experimental results indicate that the proposed method significantly outperforms the previous ROI coding schemes in the overall ROI coding performance.
DISCRIMINATIVE LOCAL LEARNING PROJECTION FOR FACE RECOGNITION
Authors: CHEN YU , HUANG JIAN , XU XIAOHONG , LAI JIANHUANG
Published: February 2011

Subspace learning method has commonly been used as a popular way to understand high dimensional data such as face images. In this paper, a novel subspace learning method called Discriminative Local Learning Projection (DLLP) is proposed for face recognition. By characterizing the local structures and dissimilarities between the supervised data manifolds, a linear transformation that can maximize the dissimilarities between all manifolds and simultaneously minimize the local estimation error can be computed. Thus the proposed algorithm embeds the discriminative information as well as the local geometry of samples into the objective function. And the abilities of preserving the local structure in each manifold and classification are both combined into the algorithm. Extensive experiments on face databases demonstrate the effectiveness of DLLP.
A MULTI-LAYER CONTRAST ANALYSIS METHOD FOR TEXTURE CLASSIFICATION BASED ON LBP
Authors: CHEN HENG-XIN , TANG Y. Y. , FANG BIN , WANG PATRICK S. P.
Published: February 2011

Texture classification is one of the important fields in pattern recognition and machine vision research. LBP method,13–15 proposed by Ojala, can be used to classify texture images effectively. And the LBP method has rotation-invariant, illumination-invariant, multi-resolution characteristics. But, since the contrast is not considered between neighbor pixels, the correct classification rate produced by this method has been remarkably influenced by light source type and light source orientation. The LMLCP (Local Multiple Layer Contrast Pattern) method, proposed by this paper, maps the contrast value between two near pixels to a rank value, which represent a relative contrast value range, and computes the statistic histogram referring to the work in LBP method. The LMLCP method can bring out the rapid expansion of feature dimension, so a special feature encoding method used in 3DLBP6 is adopted by this paper. The experiment, which is built based on Outex_TC_00012,12 demonstrates that the LMLCP can evidently make a more accurate classification rate than LBP method.
A NOVEL APPROACH FOR AUTHENTICATION OF ONLINE HANDWRITTEN SIGNATURE BASED ON RESIDUALS, POLES AND ZEROS
Authors: RADHIKA K. R. , VENKATESHA M. K. , SEKHAR G. N.
Published: February 2011

This paper proposes an online signature authentication based on polynomial modeling. The derived feature acceleration is used. The order of the polynomial is carefully selected for each subject using the acceleration vector. The dynamic warping algorithm and mean squared error measure aid in standard template selection process for a subject. The best fit order is directly dependent on the cursive information of the signature sample. We provide a practical analysis of residual term, number of zeros inside the unit circle and distance measure on pole values for the purpose of classification. Storing order and standard template for a subject, reduces the runtime and memory requirements for a dynamic system. The best performance was achieved based on the number of zeros inside unit circle with false rejection rate as 5% and false acceptance rate as 7%. The aim of the work is to provide simple robust authentication suitable for hand held devices. Even compared to state-of art experiments, the proposed system is aimed to provide authentication using a single derived feature.
IS HAPTIC FEEDBACK NECESSARY TO MICROSURGICAL SUTURING? COMPARATIVE STUDY OF 9/0 AND 10/0 KNOT TYING OPERATED BY 24 SURGEONS
Authors: Panchulidze Irakli , Berner Stacey , Mantovani Gustavo , Liverneaux Philippe
Published: February 2011

Robotically assisted telemanipulators are often criticised for their lack of direct haptic feedback. However, robotically assisted microsurgical sutures have already been achieved successfully. The aim of this study was to demonstrate that haptic feedback is not necessary in microsurgery.

Our series included 24 surgeons of whom 14 were micro-surgeons. Each of them had to tighten a 9/0 and a 10/0 pre-tied nylon thread until getting the sensation of optimal knot tying. The procedure was performed four times, with open and closed eyes. The quality of knot tying was evaluated (fully tied, fairly or incompletely tied, or broken thread).

The results obtained with the eyes open were significantly better. Neither the material size, nor the surgeon's expertise was shown to have an impact on knot tying quality.

Our results demonstrate the uselessness of haptic feedback in microsurgery.
THUMB METACARPOPHALANGEAL ARTHRODESIS WITH LOCAL BONE GRAFTING
Authors: Huffman Rebel , Rayan Ghazi M.
Published: February 2011

A restrospective study identified 47 thumb MP joints in 41 patients who underwent arthrodeses using cup and cone osteotomy secured with Kirschner-wire fixation and augmented with local bone graft from the thumb metacarpal. Union rate was 96% averaging 6.8 weeks. Two patients had nonunion; 6.3 year follow-up of 15 thumbs showed improvement of or no pain. MHQ scores were 56.5 in the operative hand and 66.7 in the contralateral hand. Thumb MP arthrodesis augmented with local bone graft negates the morbidity of obtaining distant graft. It is a safe and effective technique that provides excellent pain relief with an acceptable union rate.
RECONSTRUCTION OF THE FIRST WEB IN CONGENITAL THUMB ANOMALIES
Authors: Morisawa Yasushi , Takayama Shinichiro , Seki Atsuhito , Nakamura Toshiyasu , Ikegami Hiroyasu
Published: February 2011

Reconstruction of the first web is an important technique for thumb adduction contracture accompanying congenital anomalies. Our previous cases have been reviewed here to evaluate and compare the indications, results, and problems for these two techniques. The angle formed by the first and second metacarpals (first-second metacarpal angle; 1–2 MCA) on the anterio-posterior (AP) view of the hand, with the thumb in maximum radial abduction, was measured from X-ray.

There were 37 patients (43 hands: 27 males, ten females). The average age at the time of surgery was 6.6 years (range, two to 22 years). The five-flap Z-plasty was performed on 20 hands. The spinner flap was performed on 23 hands. The Spinner flap is indicated when contractures are severe or when the preoperative 1–2 MCA is <20°. The five-flap Z-plasty is indicated when contractures are mild or when the preoperative 1–2 MCA is ≥20°.
BILATERAL CONGENITAL HYPOPLASIA OF THE EXTENSOR TENDONS OF THE HAND: A CASE REPORT
Authors: Tungshusakul Samuch , Leechavengvongs Somsak , Uerpairojkit Chairoj
Published: February 2011

Congenital hypoplasia of the extensor tendons, which is defined as a congenital anomaly of the hand involving the extensor mechanism, is a rare condition and there are few previous reports in literature. We reported a case of bilateral congenital hypoplasia of the extensor tendons in a 12-year-old boy who presented with inability to extend his middle and ring fingers treated by the flexor carpi radialis tendon transfers.
INTRAVENOUS PYOGENIC GRANULOMA OF THE HAND — A CASE REPORT
Authors: Joethy J. , Al Jajeh I. , Tay S. C.
Published: February 2011

Intravenous pyogenic granuloma represents a variant of the common pyogenic granuloma in which the capillary proliferation is entirely confined to the lumen of a vein. To our knowledge, this entity is rare and only a few cases have been reported before in the hand. We present a case of intravenous pyogenic granuloma of the hand and a review of this entity from previous published cases.