bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract

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

Abstract

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

Abstract

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

Abstract

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&lt;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

Abstract

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

Abstract

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

Abstract
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

Abstract

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.
Evaluation of a practice-based research design using an asthma care model
Authors: Saini Bandana , Jogia Rajend , Krass Ines , Armour Carol 
Published: February 2011

Abstract

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

Abstract

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

Abstract
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.
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.
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.
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°.