bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical relevance of distal deep vein thrombosis
Authors: Paris Samuel , Le Gal Grégoire , Laroche Jean-Pierre , Perrier Arnaud , Bounameaux Henri , Righini Marc 
Published: December 2005

SummaryThe standard diagnostic approach of suspected deep vein thrombosis (DVT) is serial lower limb compression ultrasound (CUS) of proximal veins. Although it only assesses the proximal veins, withholding anticoagulant treatment in patients with a negative CUS on day one and after one week has been proven to be safe. However, in many centres, distal DVT is systematically screened for and treated by anticoagulants. The objectives of the review were 1) to evaluate the rate of extension of distal DVTs to proximal veins 2) to compare the safety of proximal limited CUS versus single complete CUS. We performed a MEDLINE search covering the period from January 1983 to January 2005 by using the key-words “calf vein thrombosis”, “distal thrombosis” and “compression ultrasonography”. English, German and French language original studies were retrieved. Moreover, references of retrieved articles were screened in order to detect missed pertinent articles. We pooled data of management studies where proximal or complete (i. e. proximal and distal) CUS were used, respectively. Studies evaluating CUS limited to the proximal veins showed a good safety profile with a pooled estimate of the 3-month thromboembolic rate of 0.6% (95% CI: 0.4–0.9%) in patients in whom anticoagulation was withheld. Studies using proximal and distal CUS showed a similar pooled estimate of the 3-month thromboembolic rate (0.4%, 95% CI: 0.1–0.6%) but distal DVT accounted for as many as 50% of all diagnosed DVTs in those series. Therefore, searching for distal DVT potentially doubles the number of patients given anticoagulant therapy and entails a risk of over-treatment. Data suggesting that anticoagulation is indicated for distal DVT are limited, and realizing distal CUS entails a risk of over-treatment. There is an urgent need for randomised trials assessing the usefulness of anticoagulant treatment in distal DVT.
Marburg I polymorphism of factor VII-activating protease and risk of recurrent venous thromboembolism
Authors: Gulesserian Talin , Hron Gregor , Endler Georg , Eichinger Sabine , Wagner Oswald , Kyrle Paul 
Published: December 2005

SummaryWhether a single nucleotide polymorphism (1601 G>A) in the factor VII-activating protease gene (FSAP Marburg I) is a risk factor for venous thromboembolism (VTE) is unclear. We investigated the relevance of the variant with respect to recurrent VTE. 854 patients with a first unprovoked VTE were followed for an average of 41 months after discontinuation of anticoagulation. Study endpoint was symptomatic recurrent VTE. VTE recurred in 7 of 41 patients (17%) with and in 106 of 813 patients (13%) without the variant. After3 years, the probability of recurrence was 20.0% (95% CI, 5.3% to 34.6%) among patients with and 12.2% (95% CI, 9.6% to 14.8%) among those without FSAP MarburgI (p = 0. 5). The relative recurrence risk among carriers of the variant was 1.3 (95% CI, 0.6 to 2.8; p = 0.5) before and 1.5 (95% CI, 0.7 to 3.3; p = 0. 3) after adjustment for potentially confounding factors. We conclude that FSAP Marburg I is, if at all, only a mild factor for recurrent VTE. Patients with FSAP Marburg I most probably will not benefit from extended anticoagulation.
Migration of dendritic cells across blood and lymphatic endothelial barriers
Authors: Del Prete Annalisa , Locati Massimo , Otero Karel , Riboldi Elena , Mantovani Alberto , Vecchi Annunciata , Sozzani Silvano 
Published: December 2005

SummaryDendritic cells (DC) are professional antigen presenting cells which playa pivotal role in the activation of adaptive immunity. Tissue invasion by pathogens induces the recruitment of blood DC to the site of infection and contributes to their subsequent migration to secondary lymphoid organs. This complex process relies on the expression and regulation of receptors for chemotactic factors on the surface of migrating DC and on the activation of adhesion molecules which allow DC to properly interact with both blood and lymphatic vessels. In the absence of correct tissue localization, DC fail to promote proper immune responses. Therefore, the interaction of DC with endothelial cells represents a fundamental step for DC biology.
Clinical intervention rates in community pharmacy: a randomised trial of the effect of education and a professional allowance
Authors: Benrimoj Shalom I , Langford Jane H , Ward Paul R , Berry Geoffrey , Collins David , Lauchlan Roberta , Stewart Kay 
Published: December 2005

AbstractObjectivesTo quantify the rate of clinical interventions by community pharmacists, and to determine the effect of providing targeted education and/or fee-for-service professional remuneration on the rate of clinical interventions.MethodsA randomised trial involving four groups of 10 community pharmacies: group A served as a control and received neither education nor remuneration; group B received education and professional remuneration; group C received “advanced” education and professional remuneration; and group D received professional remuneration with no education. Pharmacists in all groups documented interventions for three one-week periods. Types of intervention were pre-specified by the researchers and logged as such by the pharmacists. Interventions were categorised as “reactive” or “proactive” by a panel comprising a community pharmacist and a hospital pharmacist. Logistic regression analysis was used to compare differences in intervention rates between the groups at baseline, between groups over time (six weeks), and within groups over time.Results87,130 prescription items were dispensed in the study period, and there were 762 clinical interventions, an intervention rate of 0.87%. Of the total, 375 (0.43%) were proactive and 387 (0.44%) were reactive. Groups B and C showed increases in clinical intervention rates immediately after the educational intervention, but these rates then decreased between week 1 and 2. Over the study period, group D had statistically significant reductions in intervention rates from baseline (total, reactive and proactive), and group A showed statistically significant reductions in reactive intervention rates.ConclusionsThe results from this study show that providing remuneration alone or maintaining the status quo (ie, neither remuneration nor education) did not lead to an increase in clinical interventions in community pharmacies. Increases in rates within the groups receiving education and remuneration were short lived. Developing and implementing educational programmes in addition to fee-for-service remuneration packages may have a positive impact on clinical intervention rates. Longitudinal work is required to investigate the sustainable effects of longer-term education strategies on clinical interventions in community pharmacy.
A national survey of pharmacist transcribing of discharge prescriptions
Authors: Hobson Rachel J , Sewell Graham J 
Published: December 2005

AbstractObjectiveTo provide quantitative data on pharmacist discharge prescription transcription service (PDPTS) provision in UK hospitals.MethodPostal questionnaire survey of clinical pharmacy managers.SettingSelection criteria included one hospital in each acute trust in the UK.Key findingsThe response rate was 66% (135/206). In mid-2001, a PDPTS was provided by 49 hospital pharmacy departments (36%). PDPTS was the most common prescribing activity undertaken by pharmacists, followed by a prescription amendment policy (29%), prescribing in pre-admission clinics (18%) and re-writing drug charts (15%). 59 departments (44%) did not undertake any prescribing activity.Of the 86 non-transcribing hospitals, 69% undertook no prescribing activity (range = 0 to 3 prescribing activities). Transcribing hospitals offered a wider range of prescribing activities (range = 1 to 8 prescribing activities). A weak relationship was found between the number of pharmacists employed per hospital and the number of prescribing activities undertaken (correlation coefficient = 0.208, P = 0.018). The most frequently used PDPTS model (78%) involved pharmacists transcribing the discharge prescriptions for their own wards. The number of pharmacists transcribing discharge prescriptions per hospital ranged from 1 to 89 (mean = 8, mode = 2, median = 5, 25% percentile = 2, 75% percentile = 10). The majority of pharmacists (52%) reported writing less than five prescriptions per day; 35% were writing 5–10 prescriptions per day. The most common training requirement for pharmacists to start transcribing was an in-house training programme (55%). The majority of departments (80%) did not re-assess the ability of their pharmacists to transcribe.ConclusionHospital pharmacy departments in the UK have started to take on prescribing roles, especially transcribing discharge prescriptions. However, it would appear that the majority of the PDPTS schemes are not being run extensively throughout the hospitals. It is of concern that the principles of clinical governance are not being met in terms of training and re-assessment of the pharmacists who are undertaking this service. The reasons why the service has developed in some hospitals and not others are not known. In order to extend this service, funding, resources and skill-mix maximisation need to be considered. This will enable patients to gain the maximum benefit from this service development.
Clinical significance of clinical interventions in community pharmacy: a randomised trial of the effect of education and a professional allowance
Authors: Benrimoj Shalom I , Langford Jane H , Ward Paul R , Berry Geoffrey , Collins David , Lauchlan Roberta , Stewart Kay 
Published: December 2005

AbstractObjectivesTo assess the clinical significance of clinical interventions undertaken by community pharmacists, and to explore the effect of providing education and/or remuneration on the clinical significance of interventions.DesignRandomised trial involving four groups of community pharmacists; expert panel to assess the clinical significance of the interventions.MethodsThe “proactive” clinical interventions undertaken by community pharmacists during the trial were reviewed by an expert panel for assessment of avoided adverse health consequences and clinical significance. The panel used a validated assessment instrument developed from the existing research literature and a pilot study by the authors.Data analysisAgreement between experts was determined using the kappa statistic. In addition, the results of the expert panel were analysed for cases where the majority of experts provided the same assessment of clinical significance (ie, consensus).ResultsOverall, there was no statistically significant difference in the clinical significance of clinical interventions undertaken by the four study groups. However, there were significant differences (95% CI) in the types of proactive interventions undertaken, with the two groups that received an educational intervention being more likely to engage in more complex intervention areas, such as drug/drug interactions and adverse/side effects. Analysis of consensus revealed that 52% of proactive clinical interventions were deemed to be “clinically significant” and 2% were deemed to be either “clinically very significant” or “potentially life-saving”. When extrapolated to national Australian prescribing figures, a mean of 3,752 potentially life-saving interventions by community pharmacists could be expected per year (95% CI 454 to 13,554).ConclusionThe results of this study provide the first estimates of the potential clinical benefits associated with clinical interventions in Australian community pharmacies. The study contributes evidence on the value of pharmaceutical services to the health care system. As such, it is expected that the study findings will provide a platform for discussion and decision-making.
Liquid medication dosing errors: a pre-post time series in India
Authors: Angalakuditi Mallik V , Sunderland V Bruce 
Published: December 2005

AbstractObjectiveTo evaluate the influence of pharmacist intervention on the level of parental dosing measurement errors and paediatrician dosage prescribing in a clinic in India.Setting and study designThe study was conducted at Srujan Hospital for Sick Children, India. It used a time series design with two groups of patients. Group 1 involved 175 children prescribed paracetamol and assigned to usual care. Following an educational intervention for the hospital paediatricians, including feedback on dosages prescribed for Group 1 and promotion of a dosing chart, 162 patients were recruited to the intervention group (Group 2). Parents in Group 1 received paracetamol suspension and verbal instructions from hospital staff (standard care). Parents in Group 2 were provided with a syringe with a line marking the prescribed dose and its use was demonstrated to them by the pharmacist. Data on the dosages prescribed and measurement accuracy by parents were obtained for both groups.Main outcome measuresMeasurement of correct dosages by parents, and prescribing of appropriate dosages by paediatricians.ResultsIn Group 1, 85 of 175 parents (48.6%) measured the correct dose (±0.5 ml) and paediatricians prescribed appropriate dosages in 67 of 175 cases (38.2%). In Group 2, 160 of 162 parents (98.7%) measured the correct dose and paediatricians prescribed appropriate dosages in 160 of 162 cases (98.7%), showing statistically significant improvements in both indicators (P &lt; 0.001). When the impact of prescribing and dosing correctness was combined on an individual patient basis, 76 of 175 (43.4%) were appropriate in Group 1, and 160 of 162 (98.7%) were appropriate in Group 2. There was a statistically significant improvement (P &lt; 0.001) in appropriate dosing outcome between the two groups.ConclusionPharmacist intervention through patient education, including the use of a syringe, significantly improved parents' dosing accuracy. Pharmacists' feedback resulted in a reduction in physicians' prescribing errors in a country where pharmacist involvement is currently minimal.
Health, wealth and the way we live now
Authors: Savage Imogen 
Published: December 2005

Abstract
The 9th Health Services Research and Pharmacy Practice Conference was hosted by the clinical and practice research group at the School of Pharmacy, Queen's University Belfast, Northern Ireland, on April 14 and 15, 2003. The opening plenary address focused on the influence that social environment has on health. Imogen Savage reports on this and on some of the other research presented at the conference.
Can a long-term continuing education course in patient counselling promote a change in the practice of Finnish community pharmacists?
Authors: Kansanaho Heli , Pietilä Kirsi , Airaksinen Marja 
Published: December 2005

Abstract

Objective
To assess community pharmacists' perceptions of the impact of a long-term continuing education (CE) course on their patient counselling skills.

Methods
Three focus groups were conducted with the course participants (n = 17) during the last module of the CE course. Data were analysed using computer software for qualitative analysis.

Key findings
The focus groups revealed eight preliminary categories that were further categorised into four themes related to the learning process in patient counselling skills. The first theme related to achieving the learning objectives. The second related to personal development, understanding principles of two-way communication, and problems in their implementation in practice. The third theme related to actions taken by the participants in their work place, and the fourth involved the potential conflict between the new skills gained and the traditional communication culture in the participant's pharmacy.

Conclusion
The CE course provided the community pharmacists with new skills and knowledge in patient counselling and collective in-house training. The findings show that the greatest challenge is to change the communication culture of the pharmacy. To achieve this, it may be necessary for more than one pharmacist from the same pharmacy to participate in the training process at the same time.
Interactional issues in the provision of counselling to pharmacy customers
Authors: Norris Pauline , Rowsell Bridget 
Published: December 2005

AbstractObjectiveTo investigate issues of manner and politeness in encounters between pharmacy staff and their customers.MethodTwelve surrogate shoppers (research assistants posing as customers) made 360 visits to pharmacies around New Zealand. This paper presents a qualitative analysis of the accounts they gave of these visits.Setting180 community pharmacies throughout New Zealand.Key findingsInteractional issues were important to the shoppers. They expressed a range of concerns about wanting to feel at ease in pharmacies, to feel confident in the quality of counselling, to feel included and to understand the counselling, privacy issues, and wanting to feel genuine concern from the pharmacy staff. Lack of staff attention to these concerns jeopardised the quality of some interactions.ConclusionWe argue that quality interactions are essential conditions for the provision of adequate counselling in pharmacies, and suggest that this is because counselling is not universally accepted as part of pharmacists' role. Pharmacists must make extra efforts to negotiate their role as medication counsellors with customers.
Evaluation of patient opinions in a pharmacy-level intervention study
Authors: Pronk M C M , Blom A Th G , Jonkers R , Bakker A 
Published: December 2005

Abstract

Objective
To explore patients' satisfaction with their community pharmacy's services and to evaluate the effects of an intervention programme in which a trained technician organised patient education activities in the pharmacy.

Method
We surveyed patients visiting the participating pharmacies at three stages: at the start of the intervention period (0 months, T0), at the end (after 12 months, T1), and 12 months after the intervention had been completed (24 months from baseline, T2). At each stage, 500 questionnaires were distributed by each pharmacy.

Setting
28 Dutch community pharmacies: 14 intervention and 14 controls.

Key findings
The response rates were 54%, 44% and 43% at T0, T1 and T2, respectively. Baseline data showed that patients reported satisfaction with helpfulness, waiting time, ease of asking questions, answers to questions, and patient leaflets provided. Around two thirds (59.5%) of the patients said they would ask a pharmacy employee questions if they were concerned about side effects of their medication. Asking questions was not reported to be difficult for most patients (88.9%). The reasons most often given for experiencing difficulties with asking questions were related to lack of privacy (16.9% of all patients), waiting time of other patients (8.8%) and busy pharmacy employees (6.7%). The most frequently reported reason for being less satisfied with the answers to questions was receiving too little information (7.5%). Our analyses showed a significant improvement only on the outcome variable “helpfulness” experienced by patients between 0 (T0) and 12 months (T1), and this was found to be sustained one year later (T2).

Conclusion
The overall findings on patient satisfaction showed that almost two-thirds of the respondents saw the pharmacy as a source of information about medication. Community pharmacies clearly have an important role in providing such information. Lack of privacy was the most common reason for patients reporting difficulties in asking questions about medicines and this needs pharmacists' attention. Our analysis showed that the intervention had an effect on “helpfulness” experienced by patients, which slightly increased in the intervention period (T0-T1 differences) and appeared to have remained at the higher level one year later (T2).
Development of standard therapeutic guidelines for selected common diseases for the primary health care centres of a South Indian district
Authors: Mohan N , Nagavi B G 
Published: December 2005

Abstract

Method
A questionnaire survey of medical officers was conducted to collect data on the most commonly-presenting diseases and doctors' treatment choices in PHCs in Mysore. Draft guidelines were developed for these conditions based on available literature, together with microbiological sensitivity data from the three district hospitals. User feedback on the draft guidelines and on guidelines in general was obtained from medical officers using a postal questionnaire.

Objective
To develop standard therapeutic guidelines for selected common diseases for the primary health care centres (PHCs) of a South Indian district and to evaluate medical officers' perceptions about the proposed guidelines and about guidelines in general.

Setting
Sample of 17 of the 93 PHCs in Mysore.

Key findings
Upper respiratory tract infection was the most commonly-presenting condition. Procaine penicillin was the most commonly-used drug and there were examples of inappropriate treatment choices. The survey produced evidence that access to medicines on the government's “essential” list was not uniform, with many patients having to purchase prescribed drugs that were not on the list. The response rate to the user feedback questionnaire was 62 per cent (31 doctors). The medical officers had positive opinions about guidelines in general and felt that the guidelines we proposed were useful and would help them to improve their prescribing habits.

Conclusions
Prescribing in primary care in India needs to be improved. The involvement of potential users of the guidelines in their development should increase their acceptability and thus their use in practice.
(6) Researching “race”, ethnicity and health: a critical review
Authors: Bissell Paul , Traulsen Janine Morgall , Haugbølle Lotte Stig 
Published: December 2005

Abstract
In a previous article in this series, we posed some questions about the visibility of gender and the relevance of feminism for pharmacy practice research.1 Gendered distinctions are just one of the ways in which sociologists have attempted to categorise and explain the contours of the social world. Another obvious feature of modern societies is their “racialised” or multi-ethnic composition. Recognition of this has focused attention — if somewhat belatedly — on how to account for the health and illness experiences of ethnic or “racial” groups. In this paper, we describe and critique some of the health services and social science research which has explored these issues. Our focus has mainly been the UK literature. Our aim is to raise the profile of questions around “race” and ethnicity within pharmacy practice research, which have hitherto received scant attention.