bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmaceutical care in a community-based practice setting in Jordan: where are we now with our attitudes and perceived barriers?
Authors: AbuRuz Salah , Al-Ghazawi Moatasem , Snyder Ann 
Published: October 2011

Abstract

Objectives
The objective of this study was to answer the following questions. How do community pharmacists in Jordan understand pharmaceutical care? What is the extent of pharmaceutical care practice in community pharmacies in Jordan? What are the main barriers to practising pharmaceutical care in Jordan? What is the attitude of community pharmacies in Jordan when considering provision of pharmaceutical care?

Method
A questionnaire was hand delivered to a random sample of 310 community pharmacists. The questionnaire was composed of six different sections including patient demographics, pharmacists' understanding of pharmaceutical care, frequencies of practice of pharmaceutical care, pharmacists' general attitudes about pharmaceutical care, pharmacists' intentions to provide specific pharmaceutical care activities and barriers to providing pharmaceutical care. Frequencies, percentages, means and standard deviations were used to describe pharmacists' responses. Chi-square and regression analysis were also conducted to identify important associations.

Key findings
More than 62% of respondents had a correct understanding of the basic concept of pharmaceutical care. The data show that the level of reported pharmaceutical care activities was limited. In general pharmacists have very good attitudes toward pharmaceutical care. Interestingly, more than 90% of respondents fully support the concept of pharmaceutical care. The need for pharmaceutical care training was found to be the top barrier to the provision of pharmaceutical care as indicated by more than 80% of pharmacists.

Conclusions
While pharmaceutical care provision is limited at this stage in Jordan, the responding pharmacists had a good understanding of pharmaceutical care. They expressed a willingness to implement pharmaceutical care practice but have identified a number of barriers to successful implementation. With the introduction of PharmD and Master of Clinical Pharmacy programmes, publication of the results of local studies on the benefit of pharmaceutical care, improved communications with physicians and modification of the current undergraduate pharmacy curriculum to include more focus on therapeutics and pharmaceutical care, many of these perceived barriers may be eliminated in the future.
How do pharmacy students learn professionalism?
Authors: Schafheutle Ellen I , Hassell Karen , Ashcroft Darren M , Hall Jason , Harrison Stephen 
Published: October 2011

Abstract

Objective
To understand and clarify how professionalism is learnt, cultivated and facilitated in pharmacy education.

Methods
Qualitative methodology involving three UK schools of pharmacy was used, including documentary analysis of course materials, interviews with seven teaching staff, six focus groups with 38 final-year pharmacy students and observation of professional pharmacy practice classes. We used a ‘curriculum mapping’ framework; analysis was thematic, with triangulation of methods and constant comparison between groups of participants and schools.

Key findings
Students and teachers found defining professionalism difficult, but they identified common attitudinal and behavioural attributes. These were predominantly based on students' work experience, and role models were identified as particularly influential. Professionalism learning needed to be grounded and longitudinal throughout the curriculum. Practical classes and the use of real-life examples and role plays were influential; and teacher practitioners appeared particularly valuable due to their dual base in practice. Explicit statements in year books and codes of conduct were valuable, especially if they were reinforced and carried through.

Conclusions
This study offers novel insights into professionalism learning during undergraduate education in the UK, by triangulating evidence from different sources and perspectives. It not only underpins the importance of professionalism learning but also highlights approaches which appeared valuable within the constraints of an otherwise artificial university environment.
Dynamic Mapping of the Structures of Content in Clinical Settings (DMSC). A new coding system for analysing the patient's narratives
Authors: Salvatore Sergio , Gennaro Alessandro , Auletta Andrea , Grassi Rossano , Rocco Diego 
Published: October 2011

Objectives. The paper presents a method of content analysis framed within a semiotic and contextual model of the psychotherapy process as a situated dynamics of sensemaking: the Dynamic Mapping of the Structures of Content in Clinical Settings (DMSC).Design. DMSC is a system of content analysis focused on a generalized level of meaning, concerning basic aspects of the patient's narrative (e.g., if the narrative concerns herself or other than herself).Method. The paper presents the result of the application of DMSC to an intensive single‐case analysis (Katja). The method has been applied by judges to the transcripts of sessions and is aimed at identifying patterns of combinations (defined: Patterns of content) of the categories characterizing the patient's narratives (pattern analysis approach) as well as at mapping the transition among these patterns (sequential analysis approach).Results. These results provide evidence of its construct validity. In accordance with the theoretical model grounding the method, we have found that: (a) DMSC provides a meaningful representation of the patient's narratives in terms of Patterns of content; (b) the probability of transition among the Patterns of content have proved to be significantly associated with the clinical quality of the sessions.Conclusion. The DMSC has to be considered an attempt paving the way for further investigations aimed at developing a deeper understanding of the role played by the dynamics of sensemaking in the psychotherapy process.
Comparison of Two Gamma Interferon Release Assays and Tuberculin Skin Testing for Tuberculosis Screening in a Cohort of Patients with Rheumatic Diseases Starting Anti-Tumor Necrosis Factor Therapy
Authors: Vassilopoulos Dimitrios , Tsikrika Stamatoula , Hatzara Chrisoula , Podia Varvara , Kandili Anna , Stamoulis Nikolaos , Hadziyannis Emilia 
Published: October 2011

ABSTRACTGamma interferon release assays (IGRAs) are increasingly used for latentMycobacterium tuberculosisinfection (LTBI) screening in patients with rheumatic diseases starting anti-tumor necrosis factor (anti-TNF) therapies. We compared the performances of two IGRAs, an enzyme-linked immunospot release assay (T-SPOT.TB) and an enzyme-linked immunosorbent assay (QuantiFERON-TB Gold In Tube [QFT-GIT]), to that of tuberculin skin testing (TST) for LTBI screening of 157 consecutive rheumatic patients starting anti-TNF therapies. Among 155 patients with valid results, 58 (37%) were positive by TST, 39 (25%) by T-SPOT.TB assay, and 32 (21%) by QFT-GIT assay. IGRAs were associated more strongly with at least one risk factor for tuberculosis (TB) than TST. Risk factors for a positive assay included chest X-ray findings of old TB (TST), advanced age (both IGRAs), origin from a country with a high TB prevalence, and a positive TST (T-SPOT.TB assay). Steroid use was negatively associated with a positive QFT-GIT assay. The agreement rate between IGRAs was 81% (kappa rate = 0.47), which was much higher than that observed between an IGRA and TST. If positivity by either TST or an IGRA was required for LTBI diagnosis, then the rate of LTBI would have been 46 to 47%, while if an IGRA was performed only for TST-positive patients, the respective rate would have been 11 to 17%. In conclusion, IGRAs appear to correlate better with TB risk than TST and should be included in TB screening of patients starting anti-TNF therapies. In view of the high risk of TB in these patients, a combination of one IGRA and TST is probably more appropriate for LTBI diagnosis.
Generation and Characterization of a Live Attenuated Enterotoxigenic Escherichia coli Combination Vaccine Expressing Six Colonization Factors and Heat-Labile Toxin Subunit B
Authors: Turner Arthur K. , Stephens Jonathan C. , Beavis Juliet C. , Greenwood Judith , Gewert Cornelia , Randall Roger , Freeman Donna , Darsley Michael J. 
Published: October 2011

ABSTRACT

Live attenuated oral enterotoxigenic
Escherichia coli
(ETEC) vaccines have been demonstrated to be safe and immunogenic in human volunteers and to provide a viable approach to provide protection against this important pathogen. This report describes the construction of new ETEC vaccine candidate strains from recent clinical isolates and their characterization. All known genes for ETEC toxins were removed, and attenuating deletion mutations were made in the
aroC
,
ompC
, and
ompF
chromosomal genes. An isolate expressing coli surface antigen 2 (CS2), CS3, heat-labile toxin (LT), heat-stable toxin (ST), and enteroaggregative
Escherichia coli
heat-stable toxin 1 (EAST1) was attenuated to generate ACAM2007. The subsequent insertion of the operon encoding CS1 created ACAM2017, and this was further modified by the addition of an expression cassette containing the
eltB
gene, encoding a pentamer of B subunits of LT (LTB), to generate ACAM2027. Another isolate expressing CS5, CS6, LT, ST, and EAST1 was attenuated to generate ACAM2006, from which a lysogenic prophage was deleted to create ACAM2012 and an LTB gene was introduced to form ACAM2022. Finally, a previously described vaccine strain, ACAM2010, had the
eltB
gene incorporated to generate ACAM2025. All recombinant genes were incorporated into the chromosomal sites of the attenuating mutations to ensure maximal genetic stability. The expression of the recombinant antigens and the changes in plasmids accompanying the deletion of toxin genes are described. Strains ACAM2025, ACAM2022, and ACAM2027 have been combined to create the ETEC vaccine formulation ACE527, which has recently successfully completed a randomized, double-blind, placebo-controlled phase I trial and is currently undergoing a randomized, double-blind placebo-controlled phase II challenge trial, both in healthy adult volunteers.
Case of Secondary Syphilis Presenting with Unusual Complications: Syphilitic Proctitis, Gastritis, and Hepatitis
Authors: Adachi Eisuke , Koibuchi Tomohiko , Okame Michio , Sato Hidenori , Imai Kentaro , Shimizu Shoichi , Tsurita Giichiro , Oyaizu Naoki , Iwamoto Aikichi , Fujii Takeshi 
Published: October 2011

ABSTRACT

We report the first known case of syphilis with simultaneous manifestations of proctitis, gastritis, and hepatitis. The diagnosis of syphilitic proctitis and gastritis was established by the demonstration of spirochetes with anti-
Treponema pallidum
antibody staining in biopsy specimens. Unusual manifestations of secondary syphilis completely resolved after 4 weeks of antibiotic therapy.
Septic Arthritis Due to Cellulosimicrobium cellulans
Authors: Magro-Checa César , Chaves-Chaparro Lara , Parra-Ruiz Jorge , Peña-Monje Alejandro , Rosales-Alexander José Luis , Salvatierra Juan , Raya Enrique 
Published: October 2011

ABSTRACT

Cellulosimicrobium cellulans
has been reported as a rare cause of human pathogenesis. Infections mainly occur in immunocompromised patients and very often are associated with a foreign body. We report the first case of septic arthritis caused by
C. cellulans
in an immunocompetent patient. Our patient suffered a penetrating palm tree thorn injury to his left knee 8 weeks before admission. Although no foreign objects were found, they were suspected because previous reports suggest a frequent association with this microorganism, and open debridament was performed. Removal of foreign bodies related to this organism must be considered a high-priority treatment in these patients to achieve a complete recovery.
Canadian Multicenter Laboratory Study for Standardized Second-Line Antimicrobial Susceptibility Testing of Mycobacterium tuberculosis
Authors: Sharma Meenu , Thibert Louise , Chedore Pamela , Shandro Cary , Jamieson Frances , Tyrrell Gregory , Christianson Sara , Soualhine Hafid , Wolfe Joyce 
Published: October 2011

ABSTRACT

The purpose of this study was to establish a standardized protocol for second-line antimicrobial susceptibility testing of
Mycobacterium tuberculosis
using the Bactec MGIT 960 system in Canadian laboratories. Four Canadian public health laboratories compared the susceptibility testing results of 9 second-line antimicrobials between the Bactec 460 and Bactec MGIT 960 systems. Based on the data generated, we have established that the Bactec MGIT 960 system provides results comparable to those obtained with the previous Bactec 460 method. The critical concentrations established for the testing of the antimicrobials used are as follows: amikacin, 1 μg/ml; capreomycin, 2.5 μg/ml; ethionamide, 5 μg/ml; kanamycin, 2.5 μg/ml; linezolid, 1 μg/ml; moxifloxacin, 0.25 μg/ml; ofloxacin, 2 μg/ml;
p
-aminosalicylic acid, 4 μg/ml; rifabutin, 0.5 μg/ml.
tuf
Gene Sequence Analysis Has Greater Discriminatory Power than 16S rRNA Sequence Analysis in Identification of Clinical Isolates of Coagulase-Negative Staphylococci
Authors: Hwang Sang Mee , Kim Myoung Shin , Park Kyoung Un , Song Junghan , Kim Eui-Chong 
Published: October 2011

ABSTRACT

We compared and analyzed 16S rRNA and
tuf
gene sequences for 97 clinical isolates of coagulase-negative staphylococci (CNS) by use of the GenBank, MicroSeq, EzTaxon, and BIBI databases. Discordant results for definitive identification were observed and differed according to the different databases and target genes. Although higher percentages of sequence identity were obtained with GenBank and MicroSeq for 16S rRNA analysis, the BIBI and EzTaxon databases produced less ambiguous results. Greater discriminatory power and fewer multiple probable identifications were observed with
tuf
gene analysis than with 16S rRNA analysis. The most pertinent results for
tuf
gene analysis were obtained with the GenBank database when the cutoff values for the percentage of identity were adjusted to be greater than or equal to 98.0%, with >0.8% separation between species. Analysis of the
tuf
gene proved to be more discriminative for certain CNS species; further, this method exhibited better distinction in the identification of CNS clinical isolates.
Age- and Gender-Associated Staphylococcus aureus spa Types Found among Nasal Carriers in a General Population: the Tromsø Staph and Skin Study
Authors: Sangvik Maria , Olsen Renate Slind , Olsen Karina , Simonsen Gunnar Skov , Furberg Anne-Sofie , Sollid Johanna U. Ericson 
Published: October 2011

ABSTRACT

Staphylococcus aureus
nasal carriers risk autoinfection; however, knowledge about the factors that make specific strains successful colonizers is limited. This study was undertaken to identify the most successful
S. aureus
clones in nasal carriers and compare their distribution among host groups. The population structure of
S. aureus
isolates from healthy adults was investigated by
spa
typing 1,981 isolates from persistent and intermittent nasal carriers participating in a health survey. In the baseline screening (1,113 isolates), the most common
spa
types were t012 (8.4%), t084 (7.6%), and t065 (4.9%). Three large
spa
clonal complexes (
spa
CC012,
spa
CC065, and
spa
CC084) comprised 62.4% of the isolates. In multivariate models adjusted for age and smoking status, male sex was associated with higher risk for
spa
type t084 (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.06 to 2.77), and lower risk of
spa
type t012 (OR, 0.60; 95% CI, 0.39 to 0.92) colonization. The prevalence of
spa
type t012 decreased significantly with increasing age (
P
= 0.03), with a prevalence almost twice as high in the youngest group (age 30 to 44 years, prevalence = 11.1%) as in the oldest group (age, 60 to 87 years; prevalence = 5.6%). Among baseline isolates,
spa
type t084 had a twofold-higher prevalence among intermittent carriers than among persistent carriers (10.6% versus 5.5%;
P
= 0.04). In summary, the two most prevalent
spa
types found in this study were significantly associated with age and/or gender. This may provide valuable clues to the multifactorial mechanisms, among them bacterial factors, involved in nasal colonization with
S. aureus
.
Evaluation of the Impact of Direct Plating, Broth Enrichment, and Specimen Source on Recovery and Diversity of Methicillin-Resistant Staphylococcus aureus Isolates among HIV-Infected Outpatients
Authors: McAllister S. K. , Albrecht V. S. , Fosheim G. E. , Lowery H. K. , Peters P. J. , Gorwitz R. , Guest J. L. , Hageman J. , Mindley R. , McDougal L. K. , Rimland D. , Limbago B. 
Published: October 2011

ABSTRACT

We compared recovery of
Staphylococcus aureus
and methicillin-resistant
S. aureus
(MRSA) from nasal and groin swab specimens of 600 HIV-infected outpatients by selective and nonselective direct plating and broth enrichment. Swabs were collected at baseline, 6-month, and 12-month visits and cultured by direct plating to mannitol salt agar (MSA) and CHROMagar MRSA (CM) and overnight broth enrichment with subculture to MSA (broth). MRSA isolates were characterized by pulsed-field gel electrophoresis (PFGE), staphylococcal cassette chromosome
mec
(SCC
mec
) typing, and PCR for the Panton-Valentine leukocidin. At each visit, 13 to 15% of patients were colonized with MRSA and 30 to 33% were colonized with methicillin-susceptible
S. aureus
(MSSA). Broth, CM, and MSA detected 95%, 82%, and 76% of MRSA-positive specimens, respectively. MRSA recovery was significantly higher from broth than CM (
P
≤ 0.001) or MSA (
P
≤ 0.001); there was no significant difference in recovery between MSA and CM. MSSA recovery also increased significantly when using broth than when using MSA (
P
≤ 0.001). Among specimens collected from the groin, broth, CM, and MSA detected 88%, 54%, and 49% of the MRSA-positive isolates, respectively. Broth enrichment had a greater impact on recovery of MRSA from the groin than from the nose compared to both CM (
P
≤ 0.001) and MSA (
P
≤ 0.001). Overall, 19% of MRSA-colonized patients would have been missed with nasal swab specimen culture only. USA500/Iberian and USA300 were the most common MRSA strains recovered, and USA300 was more likely than other strain types to be recovered from the groin than from the nose (
P
= 0.05).
Detection of an Unusual
van
Genotype in a Vancomycin-Resistant Enterococcus faecium Hospital Isolate
Authors: Teo Jeanette W. P. , Krishnan Prabha , Jureen Roland , Lin Raymond T. P. 
Published: October 2011

ABSTRACT

We highlight the detection of a rare
vanM
genotype in
Enterococcus faecium.
This isolate exhibited a VanB phenotype, with high levels of resistance to vancomycin (MIC, >256 mg/liter) and susceptibility to teicoplanin (MIC, 1 mg/liter). It was, however,
vanB
negative by PCR. Further screening for other
van
loci revealed the presence of a complete
vanM
operon.
Three-Year History of Transcription-Mediated Amplification-Based Trichomonas vaginalis Analyte-Specific Reagent Testing in a Subacute Care Patient Population
Authors: Napierala Maureen , Munson Erik , Munson Kimber L. , Kramme Timothy , Miller Cheryl , Burtch Jason , Olson Robin , Hryciuk Jeanne E. 
Published: October 2011

ABSTRACT

A total of 7,899 specimens submitted for live clinical
Trichomonas vaginalis
analyte-specific reagent (ASR) screening from 2008 to 2010 were audited on the basis of patient gender, specimen source, molecular
Neisseria gonorrhoeae
and
Chlamydia trachomatis
results, and relative light unit (RLU) data yielded by
T. vaginalis
ASR. Only 1.4% of the screening was ordered by emergency department clinicians. The screening volume in 2010 was 126% higher than that in 2008. The proportions of annual female and male screening remained consistent throughout the 3-year interval (∼92 and 8%, respectively). Although 71.8 and 9.5% of screening was performed on endocervical and vaginal specimens, respectively, over the 3-year period, no significant difference was noted in the
T. vaginalis
detection rates (8.9 and 8.6%,
P
= 0.85). Increased
T. vaginalis
detection was derived from female urine specimens (12.6%) compared to female genital swabs (
P
= 0.0004). The proportion of female urine screening increased during the 3-year interval (
P
< 0.0002).
T. vaginalis
detection rate in males was 6.6%, with no difference between urethral and urine
T. vaginalis
detection (
P
= 0.53). The mean RLU value for 714 positive specimens was 3,971,441; analogous values for each female specimen source and combined male source testing showed no variance (
P
≥ 0.29). Combined-gender
T. vaginalis
detection rate (9.1%) was significantly greater than those of
C. trachomatis
(5.9%) and
N. gonorrhoeae
(1.5%;
P
< 0.0002). Equivocal results presented at a rate of 0.4%.
T. vaginalis
ASR is an increasingly utilized assay that yields higher detection rates than other sexually transmitted infection etiologies in this community subacute care setting.
Staphylococcus hyicus Bacteremia in a Farmer
Authors: Casanova Carlo , Iselin Lukas , von Steiger Niklaus , Droz Sara , Sendi Parham 
Published: October 2011

ABSTRACTBacteria known in animal infectious diseases can cause challenges in human diagnostic laboratories. We present pitfalls in the identification and susceptibility testing ofStaphylococcus hyicus, a pathogen that typically causes exudative epidermitis in pigs. In this case, the coagulase-positive staphylococcus isolated from a septic patient was misidentified asStaphylococcus aureus.
Recurring Klebsiella pneumoniae Pyogenic Liver Abscesses in a Resident of San Diego, California, Due to a K1 Strain Carrying the Virulence Plasmid
Authors: Fierer Joshua , Walls Lorraine , Chu Pauline 
Published: October 2011

ABSTRACT

We report a diabetic patient who had three episodes of cryptogenic liver abscess due to
Klebsiella pneumoniae
. He was a Caucasian who lived in California and had no epidemiological connection to East Asia. The isolate from his third episode was a hyperviscous K1 strain that carried the
Klebsiella
virulence plasmid.
Generation and Comprehensive Analysis of an Influenza Virus Polymerase Cellular Interaction Network
Authors: Tafforeau Lionel , Chantier Thibault , Pradezynski Fabrine , Pellet Johann , Mangeot Philippe E. , Vidalain Pierre-Olivier , Andre Patrice , Rabourdin-Combe Chantal , Lotteau Vincent 
Published: October 2011

ABSTRACT
The influenza virus transcribes and replicates its genome inside the nucleus of infected cells. Both activities are performed by the viral RNA-dependent RNA polymerase that is composed of the three subunits PA, PB1, and PB2, and recent studies have shown that it requires host cell factors to transcribe and replicate the viral genome. To identify these cellular partners, we generated a comprehensive physical interaction map between each polymerase subunit and the host cellular proteome. A total of 109 human interactors were identified by yeast two-hybrid screens, whereas 90 were retrieved by literature mining. We built the FluPol interactome network composed of the influenza virus polymerase (PA, PB1, and PB2) and the nucleoprotein NP and 234 human proteins that are connected through 279 viral-cellular protein interactions. Analysis of this interactome map revealed enriched cellular functions associated with the influenza virus polymerase, including host factors involved in RNA polymerase II-dependent transcription and mRNA processing. We confirmed that eight influenza virus polymerase-interacting proteins are required for virus replication and transcriptional activity of the viral polymerase. These are involved in cellular transcription (C14orf166, COPS5, MNAT1, NMI, and POLR2A), translation (EIF3S6IP), nuclear transport (NUP54), and DNA repair (FANCG). Conversely, we identified PRKRA, which acts as an inhibitor of the viral polymerase transcriptional activity and thus is required for the cellular antiviral response.