Perceptions of Dispensers Regarding Dispensing Practices in ...

African Journals Online (AJOL)

Methods: A qualitative study with snowball sampling technique was used to identify fifteen dispensers working in community pharmacies in Islamabad, Peshawar and Lahore. Semi-structured interviews were conducted with the dispensers until the point of saturation was obtained. The interviews which focused on three ...

[Impact of an automated dispensing system for medical devices in cardiac surgery department].

Science.gov (United States)

Clou, E; Dompnier, M; Kably, B; Leplay, C; Poupon, E; Archer, V; Paul, M

2018-01-01

To secure medical devices' management, the implementation of automated dispensing system in surgical service has been realized. The objective of this study was to evaluate security, organizational and economic impact of installing automated dispensing system for medical devices (ASDM). The implementation took place in a cardiac surgery department. Security impact was assessed by comparing traceability rate of implantable medical devices one year before and one year after installation. Questionnaire on nurses' perception and satisfaction completed this survey. Resupplying costs, stocks' evolution and investments for the implementation of ASDM were the subject of cost-benefit study. After one year, traceability rate is excellent (100%). Nursing staffs were satisfied with 87.5% by this new system. The introduction of ASDM allowed a qualitative and quantitative decrease in stocks, with a reduction of 30% for purchased medical devices and 15% for implantable medical devices in deposit-consignment. Cost-benefit analysis shows a rapid return on investment. Real stock decrease (purchased medical devices) is equivalent to 46.6% of investment. Implementation of ASDM allows to secure storage and dispensing of medical devices. This system has also an important economic impact and appreciated by users. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Application of basic pharmacology and dispensing practice of antibiotics in accredited drug-dispensing outlets in Tanzania

Directory of Open Access Journals (Sweden)

Minzi OM

2013-01-01

Full Text Available OM Minzi,1 VS Manyilizu21Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, 2Logistics System Strengthening Unit, John Snow Inc, Dar es Salaam, TanzaniaBackground: Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs, in Tanzania.Methodology: This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice.Results: As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004. The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg

Dissolvable microneedle fabrication using piezoelectric dispensing technology.

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Allen, Evin A; O'Mahony, Conor; Cronin, Michael; O'Mahony, Thomas; Moore, Anne C; Crean, Abina M

2016-03-16

Dissolvable microneedle (DMN) patches are novel dosage forms for the percutaneous delivery of vaccines. DMN are routinely fabricated by dispensing liquid formulations into microneedle-shaped moulds. The liquid formulation within the mould is then dried to create dissolvable vaccine-loaded microneedles. The precision of the dispensing process is critical to the control of formulation volume loaded into each dissolvable microneedle structure. The dispensing process employed must maintain vaccine integrity. Wetting of mould surfaces by the dispensed formulation is also an important consideration for the fabrication of sharp-tipped DMN. Sharp-tipped DMN are essential for ease of percutaneous administration. In this paper, we demonstrate the ability of a piezoelectric dispensing system to dispense picolitre formulation volumes into PDMS moulds enabling the fabrication of bilayer DMN. The influence of formulation components (trehalose and polyvinyl alcohol (PVA) content) and piezoelectric actuation parameters (voltage, frequency and back pressure) on drop formation is described. The biological integrity of a seasonal influenza vaccine following dispensing was investigated and maintained voltage settings of 30 V but undermined at higher settings, 50 and 80 V. The results demonstrate the capability of piezoelectric dispensing technology to precisely fabricate bilayer DMN. They also highlight the importance of identifying formulation and actuation parameters to ensure controlled droplet formulation and vaccine stabilisation. Copyright © 2015 Elsevier B.V. All rights reserved.

What motivates antibiotic dispensing in accredited drug dispensing outlets in Tanzania? A qualitative study.

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Dillip, Angel; Embrey, Martha; Shekalaghe, Elizabeth; Ross-Degnan, Dennis; Vialle-Valentin, Catherine; Kimatta, Suleiman; Liana, Jafary; Rutta, Edmund; Valimba, Richard; Chalker, John

2015-01-01

Tanzania introduced the accredited drug dispensing outlet (ADDO) program more than a decade ago. Previous evaluations have generally shown that ADDOs meet defined standards of practice better than non-accredited outlets. However, ADDOs still face challenges with overuse of antibiotics for acute respiratory infections (ARI) and simple diarrhea, which contributes to the emergence of drug resistance. This study aimed to explore the attitudes of ADDO owners and dispensers toward antibiotic dispensing and to learn how accreditation has influenced their dispensing behavior. The study used a qualitative approach. We conducted in-depth interviews with ADDO owners and dispensers in Ruvuma and Tanga regions where the government implemented the ADDO program under centralized and decentralized approaches, respectively; a secondary aim was to compare differences between the two regions. Findings indicate that the ADDO program has brought about positive changes in knowledge of dispensing practices. Respondents were able to correctly explain treatment guidelines for ARI and diarrhea. Almost all dispensers and owners indicated that unnecessary use of antibiotics contributed to antimicrobial resistance. Despite this knowledge, translating it to appropriate dispensing practice is still low. Dispensers' behavior is driven by customer demand, habit ("mazoea"), following inappropriate health facility prescriptions, and the need to make a profit. Although the majority of dispensers reported that they had intervened in situations where customers asked for antibiotics unnecessarily, they tended to give in to clients' requests. Small variations were noted between the two study regions; for example, some dispensers in Ruvuma reported sending clients with incorrect prescriptions back to the health facility, a practice that may reflect regional differences in ADDO implementation and in Integrated Management of Childhood Illness training. Dispensers in rural settings reported more challenges

Impact of an automated dispensing system in outpatient pharmacies.

Science.gov (United States)

Humphries, Tammy L; Delate, Thomas; Helling, Dennis K; Richardson, Bruce

2008-01-01

To evaluate the impact of an automated dispensing system (ADS) on pharmacy staff work activities and job satisfaction. Cross-sectional, retrospective study. Kaiser Permanente Colorado (KPCO) outpatient pharmacies in September 2005. Pharmacists and technicians from 18 outpatient pharmacies. All KPCO outpatient pharmacists (n = 136) and technicians (n = 160) were surveyed regarding demographics and work activities and pharmacist job satisfaction. Work activities and job satisfaction were compared between pharmacies with and without ADS. Historical prescription purchase records from ADS pharmacies were assessed for pre-ADS to post-ADS changes in productivity. Self-reported pharmacy staff work activities and pharmacist job satisfaction. Pharmacists who responded to the demographic questionnaire (n = 74) were primarily women (60%), had a bachelor's degree in pharmacy (68%), and had been in practice for 10 years or more (53%). Responding technicians (n = 72) were predominantly women (80%) with no postsecondary degree (90%) and fewer than 10 years (68%) in practice. Pharmacists in ADS pharmacies who responded to the work activities questionnaire (n = 50) reported equivalent mean hours spent in patient care activities and filling medication orders compared with non-ADS pharmacists (n = 33; P > 0.05). Similarly, technicians in ADS pharmacies who responded to the work activities questionnaire (n = 64) reported equivalent mean hours spent in filling medication orders compared with non-ADS technicians (n = 38; P > 0.05). An equivalent proportion of ADS pharmacists reported satisfaction with their current job compared with non-ADS pharmacies (P > 0.05). Mean productivity did not increase appreciably after automation (P >0.05). By itself, installing an ADS does not appear to shift pharmacist work activities from dispensing to patient counseling or to increase job satisfaction. Shifting pharmacist work activities from dispensing to counseling and monitoring drug therapy outcomes

One-Stop Dispensing

DEFF Research Database (Denmark)

Houlind, Morten Baltzer; McNulty, Helle Bach Ølgaard; Treldal, Charlotte

2018-01-01

(1) Objective: To assess hospital medication costs and staff time between One-Stop Dispensing (OSD) and the Traditional Medication System (TMS), and to evaluate patient perspectives on OSD. (2) Methods: The study was conducted at Hvidovre Hospital, University of Copenhagen, Denmark in an elective...... gastric surgery and acute orthopedic surgery department. This study consists of three sub-studies including adult patients able to self-manage medication. In Sub-study 1, staff time used to dispense and administer medication in TMS was assessed. Medication cost and OSD staff time were collected in Sub......-study 2, while patient perspectives were assessed in Sub-study 3. Medication costs with two days of discharge medication were compared between measured OSD cost and simulated TMS cost for the same patients. Measured staff time in OSD was compared to simulated staff time in TMS for the same patients...

Recent advances in inkjet dispensing technologies: applications in drug discovery.

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Zhu, Xiangcheng; Zheng, Qiang; Yang, Hu; Cai, Jin; Huang, Lei; Duan, Yanwen; Xu, Zhinan; Cen, Peilin

2012-09-01

Inkjet dispensing technology is a promising fabrication methodology widely applied in drug discovery. The automated programmable characteristics and high-throughput efficiency makes this approach potentially very useful in miniaturizing the design patterns for assays and drug screening. Various custom-made inkjet dispensing systems as well as specialized bio-ink and substrates have been developed and applied to fulfill the increasing demands of basic drug discovery studies. The incorporation of other modern technologies has further exploited the potential of inkjet dispensing technology in drug discovery and development. This paper reviews and discusses the recent developments and practical applications of inkjet dispensing technology in several areas of drug discovery and development including fundamental assays of cells and proteins, microarrays, biosensors, tissue engineering, basic biological and pharmaceutical studies. Progression in a number of areas of research including biomaterials, inkjet mechanical systems and modern analytical techniques as well as the exploration and accumulation of profound biological knowledge has enabled different inkjet dispensing technologies to be developed and adapted for high-throughput pattern fabrication and miniaturization. This in turn presents a great opportunity to propel inkjet dispensing technology into drug discovery.

Understanding the Role of Accredited Drug Dispensing Outlets in Tanzania's Health System.

Directory of Open Access Journals (Sweden)

Martha Embrey

Full Text Available People in many low-income countries access medicines from retail drug shops. In Tanzania, a public-private partnership launched in 2003 used an accreditation approach to improve access to quality medicines and pharmaceutical services in underserved areas. The government scaled up the accredited drug dispensing outlet (ADDO program nationally, with over 9,000 shops now accredited. This study assessed the relationships between community members and their sources of health care and medicines, particularly antimicrobials, with a specific focus on the role ADDOs play in the health care system.Using mixed methods, we collected data in four regions. We surveyed 1,185 households and audited 96 ADDOs and 84 public/nongovernmental health facilities using a list of 17 tracer drugs. To determine practices in health facilities, we interviewed 1,365 exiting patients. To assess dispensing practices, mystery shoppers visited 306 ADDOs presenting one of three scenarios (102 each about a child's respiratory symptoms.Of 614 household members with a recent acute illness, 73% sought outside care-30% at a public facility and 31% at an ADDO. However, people bought medicines more often at ADDOs no matter who recommended the treatment; of the 581 medicines that people had received, 49% came from an ADDO. Although health facilities and ADDOs had similar availability of antimicrobials, ADDOs had more pediatric formulations available (p<0.001. The common perception was that drugs from ADDOs are more expensive, but the difference in the median cost to treat pneumonia was relatively minimal (US$0.26 in a public facility and US$0.30 in an ADDO. Over 20% of households said they had someone with a chronic condition, with 93% taking medication, but ADDOs are allowed to sell very few chronic care-related medicines. ADDO dispensers are trained to refer complicated cases to a health facility, and notably, 99% of mystery shoppers presenting a pneumonia scenario received an

Separation of prescribing and dispensing in Malaysia: the history and challenges.

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Tiong, John Jeh Lung; Mai, Chun Wai; Gan, Pou Wee; Johnson, James; Mak, Vivienne Sook Li

2016-08-01

This article serves as an update to the work by Shafie et al. (2012) which previously reviewed the benefits of policies separating prescribing and dispensing in various countries to advocate its implementation in Malaysia. This article seeks to strengthen the argument by highlighting not only the weaknesses of the Malaysian health care system from the historical, professional and economic viewpoints but also the shortcomings of both medical and pharmacy professions in the absence of separation of dispensing. It also provides a detailed insight into the ongoing initiatives taken to consolidate the role of pharmacists in the health care system in the advent of separation of dispensing. Under the two tier system in Malaysia at present, the separation of prescribing and dispensing is implemented only in government hospitals. The absence of this separation in the private practices has led to possible profit-oriented medical and pharmacy practices which hinder safe and cost-effective delivery of health services. The call for separation of dispensing has gained traction over the years despite various hurdles ranging from the formidable resistance from the medical fraternity to the public's scepticism towards the new policy. With historical testament and present evidence pointing towards the merits of a system in which doctors prescribe and pharmacists dispense, the implementation of this health care model is justified. © 2016 The Authors. IJPP © 2016 Royal Pharmaceutical Society.

Prototype of a Questionnaire and Quiz System for Supporting Increase of Health Awareness During Wait Time in Dispensing Pharmacy

Science.gov (United States)

Toda, Takeshi; Chen, Poa-Min; Ozaki, Shinya; Ideguchi, Naoko; Miyaki, Tomoko; Nanbu, Keiko; Ikeda, Keiko

For quit-smoking clinic and its campaign, there was a need for pharmacists to investigate pediatric patient's parent consciousness to tobacco harm utilizing wait time in a pediatric dispensing pharmacy. In this research, we developed the questionnaire and quiz total system using the tablet for user interface, in which people can easily answer the questionnaire/quiz and quickly see the total results on the spot in order to enhance their consciousness to the tobacco harm. The system also provides their tobacco dependence level based on the questionnaire results and some advice for their health and dietary habits due to the tobacco dependence level. From a field trial with one hundred four examinees in the pediatric dispensing pharmacy, the user interface was useful compared to conventional questionnaire form. The system could enhance their consciousness to tobacco harm and make their beneficial use of waiting time in dispensing pharmacy. Some interesting suggestions for improvement and new services were also obtained.

Safe pill-dispensing.

Science.gov (United States)

Testa, Massimiliano; Pollard, John

2007-01-01

Each patient is supplied with a smart-card containing a Radio Frequency IDentification (RFID) chip storing a unique identification code. The patient places the Smart-card on a pill-dispenser unit containing an RFID reader. The RFID chip is read and the code sent to a Base-station via a wireless Bluetooth link. A database containing both patient details and treatment information is queried at the Base-station using the RFID as the search key. The patient's treatment data (i.e., drug names, quantities, time, etc.) are retrieved and sent back to the pill-dispenser unit via Bluetooth. Appropriate quantities of the required medications are automatically dispensed, unless the patient has already taken his/her daily dose. Safe, confidential communication and operation is ensured.

Perceptions of Dispensers Regarding Dispensing Practices in ...

African Journals Online (AJOL)

Erah

1School of Pharmaceutical Sciences, University Sains Malaysia, 11800 Penang, Malaysia, 2Department of Social ... working in community pharmacies in Islamabad, Peshawar and Lahore. ..... situation regarding dispensing practices in the.

Perceptions of Dispensers Regarding Dispensing Practices in ...

African Journals Online (AJOL)

Methods: A qualitative study with snowball sampling technique was used to ... Semi-structured interviews were conducted with the dispensers until the ... and suggestions for improvements were audio-taped, transcribed verbatim and analyzed.

IoT for Real-Time Measurement of High-Throughput Liquid Dispensing in Laboratory Environments.

Science.gov (United States)

Shumate, Justin; Baillargeon, Pierre; Spicer, Timothy P; Scampavia, Louis

2018-04-01

Critical to maintaining quality control in high-throughput screening is the need for constant monitoring of liquid-dispensing fidelity. Traditional methods involve operator intervention with gravimetric analysis to monitor the gross accuracy of full plate dispenses, visual verification of contents, or dedicated weigh stations on screening platforms that introduce potential bottlenecks and increase the plate-processing cycle time. We present a unique solution using open-source hardware, software, and 3D printing to automate dispenser accuracy determination by providing real-time dispense weight measurements via a network-connected precision balance. This system uses an Arduino microcontroller to connect a precision balance to a local network. By integrating the precision balance as an Internet of Things (IoT) device, it gains the ability to provide real-time gravimetric summaries of dispensing, generate timely alerts when problems are detected, and capture historical dispensing data for future analysis. All collected data can then be accessed via a web interface for reviewing alerts and dispensing information in real time or remotely for timely intervention of dispense errors. The development of this system also leveraged 3D printing to rapidly prototype sensor brackets, mounting solutions, and component enclosures.

Volumetric dispenser for small particles from plural sources

International Nuclear Information System (INIS)

Bradley, R.A.; Miller, W.H.; Sease, J.D.

1975-01-01

Apparatus is described for rapidly and accurately dispensing measured volumes of small particles from a supply hopper. The apparatus includes an adjustable, vertically oriented measuring tube and orifice member defining the volume to be dispensed, a ball plug valve for selectively closing the bottom end of the orifice member, and a compression valve for selectively closing the top end of the measuring tube. A supply hopper is disposed above and in gravity flow communication with the measuring tube. Properly sequenced opening and closing of the two valves provides accurate volumetric discharge through the ball plug valve. A dispensing system is described wherein several appropriately sized measuring tubes, orifice members, and associated valves are arranged to operate contemporaneously to facilitate blending of different particles

Construction of a smart medication dispenser with high degree of scalability and remote manageability.

Science.gov (United States)

Pak, JuGeon; Park, KeeHyun

2012-01-01

We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispensing tray (MDT). In the proposed dispenser, the medication for each patient is stored in an MDT. One smart medication dispenser contains mainly one MDT; however, the dispenser can be extended to include more MDTs in order to support multiple users using one dispenser. For remote management, the proposed dispenser transmits the medication status and the system configurations to the monitoring server. In the case of a specific event such as a shortage of medication, memory overload, software error, or non-adherence, the event is transmitted immediately. All these operations are performed automatically without the intervention of patients, through the agent program installed in the dispenser. Results of implementation and verification show that the proposed dispenser operates normally and performs the management operations from the medication monitoring server suitably.

Construction of a Smart Medication Dispenser with High Degree of Scalability and Remote Manageability

Directory of Open Access Journals (Sweden)

JuGeon Pak

2012-01-01

Full Text Available We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispensing tray (MDT. In the proposed dispenser, the medication for each patient is stored in an MDT. One smart medication dispenser contains mainly one MDT; however, the dispenser can be extended to include more MDTs in order to support multiple users using one dispenser. For remote management, the proposed dispenser transmits the medication status and the system configurations to the monitoring server. In the case of a specific event such as a shortage of medication, memory overload, software error, or non-adherence, the event is transmitted immediately. All these operations are performed automatically without the intervention of patients, through the agent program installed in the dispenser. Results of implementation and verification show that the proposed dispenser operates normally and performs the management operations from the medication monitoring server suitably.

21 CFR 888.4200 - Cement dispenser.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement dispenser. 888.4200 Section 888.4200 Food... DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4200 Cement dispenser. (a) Identification. A cement dispenser is a nonpowered syringe-like device intended for use in placing bone cement (§ 888.3027) into...

Ethanol Distribution, Dispensing, and Use: Analysis of a Portion of the Biomass-to-Biofuels Supply Chain Using System Dynamics

Science.gov (United States)

Vimmerstedt, Laura J.; Bush, Brian; Peterson, Steve

2012-01-01

The Energy Independence and Security Act of 2007 targets use of 36 billion gallons of biofuels per year by 2022. Achieving this may require substantial changes to current transportation fuel systems for distribution, dispensing, and use in vehicles. The U.S. Department of Energy and the National Renewable Energy Laboratory designed a system dynamics approach to help focus government action by determining what supply chain changes would have the greatest potential to accelerate biofuels deployment. The National Renewable Energy Laboratory developed the Biomass Scenario Model, a system dynamics model which represents the primary system effects and dependencies in the biomass-to-biofuels supply chain. The model provides a framework for developing scenarios and conducting biofuels policy analysis. This paper focuses on the downstream portion of the supply chain–represented in the distribution logistics, dispensing station, and fuel utilization, and vehicle modules of the Biomass Scenario Model. This model initially focused on ethanol, but has since been expanded to include other biofuels. Some portions of this system are represented dynamically with major interactions and feedbacks, especially those related to a dispensing station owner’s decision whether to offer ethanol fuel and a consumer’s choice whether to purchase that fuel. Other portions of the system are modeled with little or no dynamics; the vehicle choices of consumers are represented as discrete scenarios. This paper explores conditions needed to sustain an ethanol fuel market and identifies implications of these findings for program and policy goals. A large, economically sustainable ethanol fuel market (or other biofuel market) requires low end-user fuel price relative to gasoline and sufficient producer payment, which are difficult to achieve simultaneously. Other requirements (different for ethanol vs. other biofuel markets) include the need for infrastructure for distribution and dispensing and

Ethanol distribution, dispensing, and use: analysis of a portion of the biomass-to-biofuels supply chain using system dynamics.

Science.gov (United States)

Vimmerstedt, Laura J; Bush, Brian; Peterson, Steve

2012-01-01

The Energy Independence and Security Act of 2007 targets use of 36 billion gallons of biofuels per year by 2022. Achieving this may require substantial changes to current transportation fuel systems for distribution, dispensing, and use in vehicles. The U.S. Department of Energy and the National Renewable Energy Laboratory designed a system dynamics approach to help focus government action by determining what supply chain changes would have the greatest potential to accelerate biofuels deployment. The National Renewable Energy Laboratory developed the Biomass Scenario Model, a system dynamics model which represents the primary system effects and dependencies in the biomass-to-biofuels supply chain. The model provides a framework for developing scenarios and conducting biofuels policy analysis. This paper focuses on the downstream portion of the supply chain-represented in the distribution logistics, dispensing station, and fuel utilization, and vehicle modules of the Biomass Scenario Model. This model initially focused on ethanol, but has since been expanded to include other biofuels. Some portions of this system are represented dynamically with major interactions and feedbacks, especially those related to a dispensing station owner's decision whether to offer ethanol fuel and a consumer's choice whether to purchase that fuel. Other portions of the system are modeled with little or no dynamics; the vehicle choices of consumers are represented as discrete scenarios. This paper explores conditions needed to sustain an ethanol fuel market and identifies implications of these findings for program and policy goals. A large, economically sustainable ethanol fuel market (or other biofuel market) requires low end-user fuel price relative to gasoline and sufficient producer payment, which are difficult to achieve simultaneously. Other requirements (different for ethanol vs. other biofuel markets) include the need for infrastructure for distribution and dispensing and

The impact of automation on workload and dispensing errors in a hospital pharmacy.

Science.gov (United States)

James, K Lynette; Barlow, Dave; Bithell, Anne; Hiom, Sarah; Lord, Sue; Pollard, Mike; Roberts, Dave; Way, Cheryl; Whittlesea, Cate

2013-04-01

To determine the effect of installing an original-pack automated dispensing system (ADS) on dispensary workload and prevented dispensing incidents in a hospital pharmacy. Data on dispensary workload and prevented dispensing incidents, defined as dispensing errors detected and reported before medication had left the pharmacy, were collected over 6 weeks at a National Health Service hospital in Wales before and after the installation of an ADS. Workload was measured by non-participant observation using the event recording technique. Prevented dispensing incidents were self-reported by pharmacy staff on standardised forms. Median workloads (measured as items dispensed/person/hour) were compared using Mann-Whitney U tests and rate of prevented dispensing incidents were compared using Chi-square test. Spearman's rank correlation was used to examine the association between workload and prevented dispensing incidents. A P value of ≤0.05 was considered statistically significant. Median dispensary workload was significantly lower pre-automation (9.20 items/person/h) compared to post-automation (13.17 items/person/h, P automation (0.28%) than pre-automation (0.64%, P automation (ρ = 0.23, P automation improves dispensing efficiency and reduces the rate of prevented dispensing incidents. It is proposed that prevented dispensing incidents frequently occurred during periods of high workload due to involuntary automaticity. Prevented dispensing incidents occurring after a busy period were attributed to staff experiencing fatigue after-effects. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

[Monitoring medication errors in personalised dispensing using the Sentinel Surveillance System method].

Science.gov (United States)

Pérez-Cebrián, M; Font-Noguera, I; Doménech-Moral, L; Bosó-Ribelles, V; Romero-Boyero, P; Poveda-Andrés, J L

2011-01-01

To assess the efficacy of a new quality control strategy based on daily randomised sampling and monitoring a Sentinel Surveillance System (SSS) medication cart, in order to identify medication errors and their origin at different levels of the process. Prospective quality control study with one year follow-up. A SSS medication cart was randomly selected once a week and double-checked before dispensing medication. Medication errors were recorded before it was taken to the relevant hospital ward. Information concerning complaints after receiving medication and 24-hour monitoring were also noted. Type and origin error data were assessed by a Unit Dose Quality Control Group, which proposed relevant improvement measures. Thirty-four SSS carts were assessed, including 5130 medication lines and 9952 dispensed doses, corresponding to 753 patients. Ninety erroneous lines (1.8%) and 142 mistaken doses (1.4%) were identified at the Pharmacy Department. The most frequent error was dose duplication (38%) and its main cause inappropriate management and forgetfulness (69%). Fifty medication complaints (6.6% of patients) were mainly due to new treatment at admission (52%), and 41 (0.8% of all medication lines), did not completely match the prescription (0.6% lines) as recorded by the Pharmacy Department. Thirty-seven (4.9% of patients) medication complaints due to changes at admission and 32 matching errors (0.6% medication lines) were recorded. The main cause also was inappropriate management and forgetfulness (24%). The simultaneous recording of incidences due to complaints and new medication coincided in 33.3%. In addition, 433 (4.3%) of dispensed doses were returned to the Pharmacy Department. After the Unit Dose Quality Control Group conducted their feedback analysis, 64 improvement measures for Pharmacy Department nurses, 37 for pharmacists, and 24 for the hospital ward were introduced. The SSS programme has proven to be useful as a quality control strategy to identify Unit

Towards more reliable automated multi-dose dispensing: retrospective follow-up study on medication dose errors and product defects.

Science.gov (United States)

Palttala, Iida; Heinämäki, Jyrki; Honkanen, Outi; Suominen, Risto; Antikainen, Osmo; Hirvonen, Jouni; Yliruusi, Jouko

2013-03-01

To date, little is known on applicability of different types of pharmaceutical dosage forms in an automated high-speed multi-dose dispensing process. The purpose of the present study was to identify and further investigate various process-induced and/or product-related limitations associated with multi-dose dispensing process. The rates of product defects and dose dispensing errors in automated multi-dose dispensing were retrospectively investigated during a 6-months follow-up period. The study was based on the analysis of process data of totally nine automated high-speed multi-dose dispensing systems. Special attention was paid to the dependence of multi-dose dispensing errors/product defects and pharmaceutical tablet properties (such as shape, dimensions, weight, scored lines, coatings, etc.) to profile the most suitable forms of tablets for automated dose dispensing systems. The relationship between the risk of errors in dose dispensing and tablet characteristics were visualized by creating a principal component analysis (PCA) model for the outcome of dispensed tablets. The two most common process-induced failures identified in the multi-dose dispensing are predisposal of tablet defects and unexpected product transitions in the medication cassette (dose dispensing error). The tablet defects are product-dependent failures, while the tablet transitions are dependent on automated multi-dose dispensing systems used. The occurrence of tablet defects is approximately twice as common as tablet transitions. Optimal tablet preparation for the high-speed multi-dose dispensing would be a round-shaped, relatively small/middle-sized, film-coated tablet without any scored line. Commercial tablet products can be profiled and classified based on their suitability to a high-speed multi-dose dispensing process.

Subsidising patient dispensing fees: the cost of injecting equity into the opioid pharmacotherapy maintenance system.

Science.gov (United States)

Chalmers, Jenny; Ritter, Alison

2012-11-01

Australian pharmacotherapy maintenance programs incur costs to patients. These dispensing fees represent a financial burden to patients and are inconsistent with Australian health-care principles. No previous work has examined the current costs nor the future predicted costs if government subsidised dispensing fees. A system dynamics model, which simulated the flow of patients into and out of methadone maintenance treatment, was developed. Costs were imputed from existing research data. The approach enabled simulation of possible behavioural responses to a fee subsidy (such as higher retention) and new estimates of costs were derived under such scenarios. Current modelled costs (AUS$11.73m per month) were largely borne by state/territory government (43%), with patients bearing one-third (33%) of the total costs and the Commonwealth one-quarter (24%). Assuming no behavioural changes associated with fee subsidies, the cost of subsidising the dispensing fees of Australian methadone patients would be $3.9m per month. If retention were improved as a result of fee subsidy, treatment numbers would increase and the model estimates an additional cost of $0.8m per month. If this was coupled with greater numbers entering treatment, the costs would increase by a further $0.4m per month. In total, full fee subsidy with modelled behavioural changes would increase per annum government expenditure by $81.8m to $175.8m. If government provided dispensing fee relief for methadone maintenance patients, it would be a costly exercise. However, these additional costs are offset by the social and health gains achieved from the methadone maintenance program. © 2012 Australasian Professional Society on Alcohol and other Drugs.

A compact 133Xe gas dispenser

International Nuclear Information System (INIS)

Hawkins, T.; Harris, R.

1977-01-01

A dispenser for 133 Xe gas is described which is compact and simple to use, allowing the xenon to be dispensed from it shipping ampoule to suitable multi-dose injection vials in a controlled manner and with a high degree of operator safety. The apparatus has no joints and only a single rubber teat, minimizing the risks of adsorption and leakage. A scaled drawing of the dispenser is shown. (U.K.)

Evaluation and remediation of bulk soap dispensers for biofilm.

Science.gov (United States)

Lorenz, Lindsey A; Ramsay, Bradley D; Goeres, Darla M; Fields, Matthew W; Zapka, Carrie A; Macinga, David R

2012-01-01

Recent studies evaluating bulk soap in public restroom soap dispensers have demonstrated up to 25% of open refillable bulk-soap dispensers were contaminated with ~ 6 log(10)(CFU ml(-1)) heterotrophic bacteria. In this study, plastic counter-mounted, plastic wall-mounted and stainless steel wall-mounted dispensers were analyzed for suspended and biofilm bacteria using total cell and viable plate counts. Independent of dispenser type or construction material, the bulk soap was contaminated with 4-7 log(10)(CFU ml(-1)) bacteria, while 4-6 log(10)(CFU cm(-2)) biofilm bacteria were isolated from the inside surfaces of the dispensers (n = 6). Dispenser remediation studies, including a 10 min soak with 5000 mg l(-1) sodium hypochlorite, were then conducted to determine the efficacy of cleaning and disinfectant procedures against established biofilms. The testing showed that contamination of the bulk soap returned to pre-test levels within 7-14 days. These results demonstrate biofilm is present in contaminated bulk-soap dispensers and remediation studies to clean and sanitize the dispensers are temporary.

A Simulated Learning Environment for Teaching Medicine Dispensing Skills.

Science.gov (United States)

McDowell, Jenny; Styles, Kim; Sewell, Keith; Trinder, Peta; Marriott, Jennifer; Maher, Sheryl; Naidu, Som

2016-02-25

To develop an authentic simulation of the professional practice dispensary context for students to develop their dispensing skills in a risk-free environment. A development team used an Agile software development method to create MyDispense, a web-based simulation. Modeled on virtual learning environments elements, the software employed widely available standards-based technologies to create a virtual community pharmacy environment. Assessment. First-year pharmacy students who used the software in their tutorials, were, at the end of the second semester, surveyed on their prior dispensing experience and their perceptions of MyDispense as a tool to learn dispensing skills. The dispensary simulation is an effective tool for helping students develop dispensing competency and knowledge in a safe environment.

A frequency conversion mode for dispenser in the service station based on flow rate signal

International Nuclear Information System (INIS)

Liu, Y J; Tang, D; Huang, J B; Liu, J; Jia, P F

2012-01-01

Dispenser is an integrated fuel transport and measurement system at the service station. In this paper, we developed a frequency conversion mode for the dispenser, based on the flow rate signal which is obtained from the converter measuring flow capacity. After introducing the frequency conversion mode to dispenser, we obtained that pump rotates at a high speed when fuelled with high flow rate, and it rotates at a low speed when fuelled with low flow rate. This makes the fuel dispenser more energy-efficient and controllable. We also did some valve optimizations on the dispenser and developed a new control mode for preset refuelling based on the frequency conversion mode, Experimental and theoretical studies have shown that the new dispenser not only can meet the national standards, but also performs better than the ordinary one especially in preset refuelling.

Evaluating the Impact of Drug Dispensing Systems on the Safety and Efficiency in a Singapore Outpatient Pharmacy

Directory of Open Access Journals (Sweden)

Peter Ong Yong Sheng

2014-01-01

Full Text Available Purpose: Automation of pharmacy workflow can reduce medication errors as well as improve efficiency of the medication picking, packing and labeling process. Since September 2012, two drug dispensing systems (DDS began operations in the Singapore General Hospital Specialist Outpatient Clinic Pharmacy. This study sought to evaluate the impact of the DDS on safety and efficiency in the pharmacy. Methods: The primary outcome was the rate of prevented dispensing incidents contributed by DDS or manual picking of medications defined as the number of prevented dispensing incidents per 1000 medications picked. The secondary outcome was the productivity of each full time equivalent (FTE when assigned to either the DDS or manual picking stations. Data pertaining to the primary and secondary outcomes between January and December 2013 were collected and analyzed. The rate of prevented dispensing incidents was expressed in median (interquartile range and compared using Mann-Whitney U test. Other continuous variables were expressed in mean ± standard deviation and compared using independent samples t-test. Results: An average of 59494 medications was picked every month in the pharmacy. DDS accounted for 21.1 percent while manual picking accounted for 78.9 percent of all the medications picked. The median rate of prevented dispensing incidents per month committed by manual picking (2.73 was significantly higher than the DDS (0.00. DDS had greater productivity with each FTE in the DDS having an average of 6175 picks per month which was significantly higher than each FTE in the manual picking stations which had an average of 4867 picks per month. Conclusion: Installation of DDS in an outpatient pharmacy improved safety of the pharmacy workflow by automating the medication picking, packing and labeling process and minimizing human errors. Efficiency of the medication picking, packing and labeling process was also improved by the DDS as there were continuous

21 CFR 872.3080 - Mercury and alloy dispenser.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mercury and alloy dispenser. 872.3080 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3080 Mercury and alloy dispenser. (a) Identification. A mercury and alloy dispenser is a device with a spring-activated valve intended to measure and...

Operating experience of an automated TLD dispensing system at CORAL facility

International Nuclear Information System (INIS)

Ajoy, K.C.; Dhanasekaran, A.; Arun, R.; Yuvaraj, N.; Karthikeyan, D.; Dheeraj, R.; Akila, R.; Santhanam, R.; Rajagopal, V.; Kumar, Amudhu Ramesh

2016-01-01

Monitoring of exposures to occupational workers on individual basis is a regulatory requirement to demonstrate compliance that the dose to the workers is well within the dose limit. Over three decades for monitoring of external exposures, CaSO 4 based Thermo luminescence dosimeters (TLDs), which exhibit the required accuracy, reliability and ruggedness have been employed. TLD cards with unique identification number are loaded in plastic cassettes along with photographs are placed in wooden racks at the entry of the controlled area of the plant. However, there is always a chance that a TLD may be misplaced, used by others or there could be a deliberate act of misuse or abuse. To circumvent this it was decided to install an automated TLD dispensing system with individual TLD tracking as well as locking arrangement. CORAL reprocessing facility at IGCAR was the first to install one such system at Kalpakkam and the operating experience of the system for the last two years is brought out in this paper

Nanoliter Centrifugal Liquid Dispenser Coupled with Superhydrophobic Microwell Array Chips for High-Throughput Cell Assays

Directory of Open Access Journals (Sweden)

Yuyi Wang

2018-06-01

Full Text Available Microfluidic systems have been regarded as a potential platform for high-throughput screening technology in drug discovery due to their low sample consumption, high integration, and easy operation. The handling of small-volume liquid is an essential operation in microfluidic systems, especially in investigating large-scale combination conditions. Here, we develop a nanoliter centrifugal liquid dispenser (NanoCLD coupled with superhydrophobic microwell array chips for high-throughput cell-based assays in the nanoliter scale. The NanoCLD consists of a plastic stock block with an array of drilled through holes, a reagent microwell array chip (reagent chip, and an alignment bottom assembled together in a fixture. A simple centrifugation at 800 rpm can dispense ~160 nL reagents into microwells in 5 min. The dispensed reagents are then delivered to cells by sandwiching the reagent chip upside down with another microwell array chip (cell chip on which cells are cultured. A gradient of doxorubicin is then dispensed to the cell chip using the NanoCLD for validating the feasibility of performing drug tests on our microchip platform. This novel nanoliter-volume liquid dispensing method is simple, easy to operate, and especially suitable for repeatedly dispensing many different reagents simultaneously to microwells.

A model for drug dispensing service based on the care process in the Brazilian health system

Directory of Open Access Journals (Sweden)

Luciano Soares

2013-03-01

Full Text Available Access to medication emphasizes the availability of the product at the expense of providing a service. The goal of this paper is to propose a theoretical model for a drug dispensing service, beginning with a reflection on the current realities of the Unified Health System and drug dispensation in Brazil. A conceptual analytical research made by a methodological course called disciplined imagination was mainly the approach applied to develop the model. The drug dispensing service is part of the care process, which considers access as an attribute; reception, connection and accountability, management, and clinical pharmaceutical aspects as components; and the rational use of drugs as the purpose. The proposed model addresses access to the dispensing service and demands a reorientation of routines, instruments, and practices.O acesso a medicamentos enfatiza a disponibilidade do produto em detrimento da provisão de um serviço. O objetivo deste trabalho é propor um modelo teórico para um serviço de dispensação de medicamentos, iniciando com uma reflexão sobre a realidade atual do Sistema Único de Saúde e a dispensação de medicamentos no Brasil. Uma pesquisa analítica conceitual realizada por meio de um percurso metodológico chamado de imaginação disciplinada constituiu a estratégia principal para o desenvolvimento do modelo. O serviço de dispensação é parte do processo de cuidado, o qual considera o acesso como um atributo; os aspectos acolhimento, vínculo e responsabilização, gestão e clínica farmacêutica como componentes e o uso racional de medicamentos como o propósito. O modelo proposto direciona o acesso para o serviço de dispensação e demanda a reorientação de rotinas, instrumentos e práticas.

Antimalarial Drugs for Pediatrics - Prescribing and Dispensing ...

African Journals Online (AJOL)

Purpose: To assess dispensing and prescribing practices with regard to antimalarial drugs for pediatrics in private pharmacies and public hospitals in Dar es Salaam, Tanzania. Methods: This was a cross-sectional, descriptive study that assessed the knowledge and practice of 200 drug dispensers in the private community ...

14 CFR 137.39 - Economic poison dispensing.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Economic poison dispensing. 137.39 Section... AIRCRAFT OPERATIONS Operating Rules § 137.39 Economic poison dispensing. (a) Except as provided in... economic poison that is registered with the U.S. Department of Agriculture under the Federal Insecticide...

Analysis of costs to dispense prescriptions in independently owned, closed-door long-term care pharmacies.

Science.gov (United States)

Carroll, Norman V; Rupp, Michael T; Holdford, David A

2014-03-01

developed to examine the impact of shorter dispensing cycles on LTC pharmacies' CTD. A prescription volume increase of 19% was assumed based on converting only solid oral branded drugs to short-cycle dispensing. A diverse sample of 64 closed-door LTC pharmacies returned usable surveys. Sales from dispensing to LTC facilities accounted for more than 98% of total sales. Respondents indicated that they currently dispensed 23% of total doses in 14-day-or-less cycles and 76% in 28-31 day cycles. Most pharmacies used automated medication packaging technology, heat and cold package sealers, bar code systems, sterile compounding hoods, LTC printers or labelers, and electronic prescribing. The median CTD was $13.54 with an interquartile range (25th to 75th percentiles) of $10.51 to $17.66. More than half of dispensing-related costs were from personnel expense, of which pharmacists and managers accounted for more than 40%. The results of the fixed and variable cost modeling suggested that converting solid oral brand-name drugs from 30-day to 14-day dispensing cycles would lower the median per prescription CTD to between $11.63 and $12.54, depending on the assumptions made about the effects of semivariable costs. However, this decrease in per prescription dispensing cost is dwarfed by an increase in total dispensing cost incurred by pharmacies that results from doubling the monthly volume of short-cycle prescriptions that must be dispensed. The result is that the typical LTC pharmacy in our sample incurred a CTD of $13.54 if the medication is dispensed in a 30-day cycle or $23.26 if the medication is dispensed in two 14-day cycles (at a cost of $11.63 for each cycle dispensed). Our results indicated a median CTD of $13.54 for the typical independently owned, closed-door LTC pharmacy. Moving to a shorter cycle would reduce pharmacies' average per-prescription CTD but would increase the number of prescriptions dispensed per month. Our results indicated that transitioning solid oral

Digital Imaging and Piezo-dispenser Actuator in Automatic Flocculation Control

Directory of Open Access Journals (Sweden)

Jani TOMPERI

2012-01-01

Full Text Available This study presents an image-based on-line control system for a coiled pipe flocculator. A digital imaging technique developed previously is utilized to measure the characteristic floc size and a high-pressure piezo-dispenser is introduced for accurate dosing and rapid mixing of the flocculant. The controller is a conventional PI controller. Step change experiments on feed water quality, flow rate and desired floc size have been carried out for controller tuning and testing. The paper shows that the piezo-dispenser provides better flocculation results than a conventional dosing pump, and the flocculation result can be automatically controlled even when the feed water quality rapidly changes. The proposed flocculator is a simple, inexpensive and practical system for long-term laboratory tests to investigate the functionality of flocculants on varying feed waters.

Trends in radiopharmaceutical dispensing in a regional nuclear pharmacy

International Nuclear Information System (INIS)

Basmadjian, G.P.; Johnston, J.; Barker, K.; Ice, R.D.

1982-01-01

Dispensing trends for radiopharmaceuticals at a regional nuclear pharmacy over a 51-month period were studied. dispensing records of a regional nuclear pharmacy were analyzed with a forecasting procedure that uses univariate time data to produce time trends and autoregressive models. The overall number of prescriptions increased from 3500 to 5500 per quarter. Radiopharmaceuticals used in nuclear cardiology studies increased from less than 0.1% to 17.5% of total prescriptions dispensed, while radiopharmaceuticals used for brain imaging showed a steady decline from 29% to 11% of total prescriptions dispensed. The demand for other radiopharmaceuticals increased in areas such as renal studies, bone studies, lung studies, liver-function studies, and 67 Ga tumor-uptake studies, and declined slightly for static liver studies. Changes in dispensing trends for radiopharmaceuticals will continue as the practice of nuclear medicine concentrates more on functional studies and as newer imaging techniques become used for other purposes

46 CFR 105.90-1 - Existing commercial fishing vessels dispensing petroleum products.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Existing commercial fishing vessels dispensing petroleum... AND MISCELLANEOUS VESSELS COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Existing Commercial Fishing Vessels Dispensing Petroleum Products § 105.90-1 Existing commercial fishing vessels dispensing...

46 CFR 105.45-1 - Loading or dispensing petroleum products.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Loading or dispensing petroleum products. 105.45-1... VESSELS COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Special Operating Requirements § 105.45-1 Loading or dispensing petroleum products. (a) A commercial fishing vessel must have aboard a letter of...

Exceptional circumstance drug dispensing: history and expenditures of the Brazilian Ministry of Health.

Science.gov (United States)

Carias, Claudia Mezleveckas; Vieira, Fabíola Sulpino; Giordano, Carlos V; Zucchi, Paola

2011-04-01

To describe the technical aspects of the Exceptional Circumstance Drug Dispensing Program of the Brazilian Ministry of Health, especially with respect to the cost of dispensed medication. Technical information was obtained from the ordinances that regulate the Program. Expenditure from 2000 to 2007 was obtained from the Sistema Único de Saúde's (Unified Healthcare System) Outpatient Information System. All drugs dispensed between 1993 and 2009 and the amount and cost of each procedure were evaluated, based on information from the high-complexity procedure authorization of each of the country's states. The Program changed with the increase in the number of pharmacological agents and presentations distributed by, and the number of diseases contemplated in the program. In 1993, the program distributed 15 pharmacological agents in 31 distinct presentations. This number increased to 109 agents in 243 presentations in 2009. Total Ministry of Health expenditure with medications was R$1,410,181,600.74 in 2007, almost twice the amount spent in 2000, R$684,975,404.43. Diseases whose expenditure increased in the period included chronic renal insufficiency, transplantation, and hepatitis C. The Exceptional Circumstance Drug Dispensing Program is in constant transformation, aimed at building instruments and strategies that can ensure and expand access to medication among the population. Alternatives should be sought to decrease the financial impact of the Program to a level that does not impact other sectors of the health care system, given the high cost associated with novel interventions.

Dispensing of non-prescribed antibiotics in Jordan

Directory of Open Access Journals (Sweden)

Almaaytah A

2015-09-01

Full Text Available Ammar Almaaytah,1 Tareq L Mukattash,2 Julia Hajaj2 1Department of Pharmaceutical Technology, 2Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan Objective: Current regulations in Jordan state that antibiotics cannot be sold without a medical prescription. This study aimed to assess the percentage of pharmacies that dispense antibiotics without a medical prescription in the Kingdom of Jordan and identify and highlight the extent and seriousness of such practices among Jordanian pharmacies. Methods: A prospective study was performed, and five different clinical scenarios were simulated at pharmacies investigated including sore throat, otitis media, acute sinusitis, diarrhea, and urinary tract infection in childbearing-aged women. Three levels of demand were used to convince the pharmacists to sell an antibiotic. Results: A total of 202 total pharmacies in Jordan were visited in the present study. The majority of pharmacies (74.3% dispensed antibiotics without prescription with three different levels of demand. The percentage of pharmacies dispensing antibiotics without a prescription for the sore throat scenario was 97.6%, followed by urinary tract infection (83.3%, diarrhea (83%, and otitis media (68.4%. The lowest percentage of antibiotic dispensing was for the acute sinusitis simulation at 48.5%. Among the pharmacies that dispensed antibiotics, the pharmacists provided an explanation as the number of times per day the drug should be taken in 95.3% of the cases, explained the duration of treatment in 25.7%, and inquired about allergies prior to the sale of the antibiotic in only 17.3%. Only 52 pharmacies (25.7% refused to dispense any kind of antibiotics, the majority (61.5% of this refusal response came from acute sinusitis cases, while the minority (2.4% came from the sore throat cases. Conclusion: The results of this study demonstrate that antibiotics continue to be dispensed

The K-1 Active Dispenser for Orbit Transfer

Science.gov (United States)

Lai, G.; Cochran, D.; Curtis, R.

2002-01-01

Kistler Aerospace Corporation is building the K-1, the world's first fully reusable launch vehicle. The two-stage K- 1 is designed primarily to service the market for low-earth orbit (LEO) missions, due to Kistler's need to recover both stages. For customers requiring payload delivery to high-energy orbits, Kistler can outfit the payload with a K- 1 Active Dispenser (an expendable third stage). The K-1 second stage will deploy the Active Dispenser mated with its payload into a 200 km circular LEO parking orbit. From this orbit, the Active Dispenser would use its own propulsion to place its payload into the final desired drop-off orbit or earth-escape trajectory. This approach allows Kistler to combine the low-cost launch services offered by the reusable two-stage K-1 with the versatility of a restartable, expendable upper stage. Enhanced with an Active Dispenser, the K-1 will be capable of delivering 1,500 kg to a geosynchronous transfer orbit or up to approximately 1,000 kg into a Mars rendezvous trajectory. The list price of a K-1 Active Dispenser launch is 25 million (plus the price of mission unique integration services) significantly less than the price of any launch vehicle service in the world with comparable capability.

Dispenser printed electroluminescent lamps on textiles for smart fabric applications

Science.gov (United States)

de Vos, Marc; Torah, Russel; Tudor, John

2016-04-01

Flexible electroluminescent (EL) lamps are fabricated onto woven textiles using a novel dispenser printing process. Dispenser printing utilizes pressurized air to deposit ink onto a substrate through a syringe and nozzle. This work demonstrates the first use of this technology to fabricate EL lamps. The luminance of the dispenser printed EL lamps is compared to screen-printed EL lamps, both printed on textile, and also commercial EL lamps on polyurethane film. The dispenser printed lamps are shown to have a 1.5 times higher luminance than the best performing commercially available lamp, and have a comparable performance to the screen-printed lamps.

Dispenser printed electroluminescent lamps on textiles for smart fabric applications

International Nuclear Information System (INIS)

De Vos, Marc; Torah, Russel; Tudor, John

2016-01-01

Flexible electroluminescent (EL) lamps are fabricated onto woven textiles using a novel dispenser printing process. Dispenser printing utilizes pressurized air to deposit ink onto a substrate through a syringe and nozzle. This work demonstrates the first use of this technology to fabricate EL lamps. The luminance of the dispenser printed EL lamps is compared to screen-printed EL lamps, both printed on textile, and also commercial EL lamps on polyurethane film. The dispenser printed lamps are shown to have a 1.5 times higher luminance than the best performing commercially available lamp, and have a comparable performance to the screen-printed lamps. (paper)

Dispensing of vitamin products by retail pharmacies in South Africa ...

African Journals Online (AJOL)

Ilse Truter

Survey) years.7 About 39% of US residents have used at least one multivitamin and ... The ATC Classification system is recommended by the. World Health ... Females in the 30 to 39-year age group were dispensed 21.95% of products ...

Impact assessment of an automated drug-dispensing system in a tertiary hospital

Directory of Open Access Journals (Sweden)

Débora de-Carvalho

Full Text Available OBJECTIVE: To evaluate the costs and patient safety of a pilot implementation of an automated dispensing cabinet in a critical care unit of a private tertiary hospital in São Paulo/Brazil. METHODS: This study considered pre- (January-August 2013 and post- (October 2013-October 2014 intervention periods. We considered the time and cost of personnel, number of adverse events, audit adjustments to patient bills, and urgent requests and returns of medications to the central pharmacy. Costs were evaluated based on a 5-year analytical horizon and are reported in Brazilian Reals (R$ and US dollars (USD. RESULTS: The observed decrease in the mean number of events reported with regard to the automated drug-dispensing system between pre- and post-implementation periods was not significant. Importantly, the numbers are small, which limits the power of the mean comparative analysis between the two periods. A reduction in work time was observed among the nurses and administrative assistants, whereas pharmacist assistants showed an increased work load that resulted in an overall 6.5 hours of work saved/day and a reduction of R$ 33,598 (USD 14,444 during the first year. The initial investment (R$ 206,065; USD 88,592 would have been paid off in 5 years considering only personnel savings. Other findings included significant reductions of audit adjustments to patient hospital bills and urgent requests and returns of medications to the central pharmacy. CONCLUSIONS: Evidence of the positive impact of this technology on personnel time and costs and on other outcomes of interest is important for decision making by health managers.

A simple low-cost of liquid I-131 dispenser for routine radiopharmaceutical dispensing at nuclear medicine department, Institut Kanser Negara

Energy Technology Data Exchange (ETDEWEB)

Said, M. A.; Suhaimi, N. E. F. [Fakulti Sains dan Teknologi, Universiti Kebangsaan Malaysia, 43600 UKM, Bangi Selangor (Malaysia); Ashhar, Z. N., E-mail: aminhpj@gmail.com [Institut Kanser Negara, No 4, Jalan P7, Presint 7, 62250 Putrajaya (Malaysia); Zainon, R. [Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Pulau Pinang (Malaysia)

2016-01-22

In routine radiopharmaceutical Iodine-131 ({sup 131}I) dispensing, the amount of radiation dose received by the personnel depends on the distance between the personnel and the source, the time spent manipulating the source and the amount of shielding used to reduce the dose rate from the source. The novel iRAD-I131 dispenser using recycle {sup 131}I liquid lead pot will lead into low cost production, less maintenance and low dose received by the personnel that prepared the {sup 131}I. The new fabricated of low cost {sup 131}I dispenser was tested and the dose received by personnel were evaluated. The body of lead material is made from 2.5 cm lead shielded coated with epoxy paint to absorb the radiation dose up to 7.4 GBq of {sup 131} I. The lead pot was supported with two stainless steel rod. The Optically Stimulated Luminescence (OSL) nanodot was used in this study to measure the dose rate at both extremities for every personnel who prepared the {sup 131}I. Each OSL nanodot was attached at the fingertip. Three different personnel (experienced between one to ten years above in preparing the radiopharmaceuticals) were participated in this study. The average equivalent dose at right and left hand were 122.694 ± 121.637 µSv/GBq and 77.281 ± 62.146 µSv/GBq respectively. This study found that the dose exposure received using iRAD-I131 was less up to seven times compared to the conventional method. The comparison of experimental data using iRAD-I131 and established radiopharmaceutical dispenser was also discussed. The innovation of {sup 131}I dispenser is highly recommended in a small radiopharmaceutical facility with limited budget. The novel iRAD-I131 enables implementation of higher output liquid dispensing with low radiation dose to the personnel.

46 CFR 105.05-1 - Commercial fishing vessels dispensing petroleum products.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Commercial fishing vessels dispensing petroleum products... MISCELLANEOUS VESSELS COMMERCIAL FISHING VESSELS DISPENSING PETROLEUM PRODUCTS Application § 105.05-1 Commercial fishing vessels dispensing petroleum products. (a) The provisions of this part, with the exception of...

Energy-efficiency potential of water dispensers; Energieeffizienzpotenzial bei Wasser-Dispensern

Energy Technology Data Exchange (ETDEWEB)

Grieder, T.

2003-07-01

This final report for the Swiss Federal Office of Energy presents the results of study carried out to assess the energy-savings potential available in the operation of water dispensers often found in banks, stores and offices. The energy consumption of three types of dispenser is examined and compared with American 'EnergyStar'-guidelines. The results of measurements made for day and night-time operation are presented and the energy-savings potentials offered by more appropriate operating scenarios are discussed. Recommendations are made to all parties involved, from the dispenser's manufacturer, water-supplier and service organisation through to the end user. For each category, a catalogue of measures that can be taken is presented, including modifications to the dispensers themselves and the installation of timers. Also, the energy consumption of dispensers is compared with that of using traditional mineral water bottles and a small conventional refrigerator.

Slow Release of Plant Volatiles Using Sol-Gel Dispensers.

Science.gov (United States)

Bian, L; Sun, X L; Cai, X M; Chen, Z M

2014-12-01

The black citrus aphid, also known as the tea aphid, (Toxoptera aurantii Boyer) attacks economically important crops, including tea (Camellia sinensis (L.) O. Kuntze). In the current study, silica sol-gel formulations were screened to find one that could carry and release C. sinensis plant volatiles to lure black citrus aphids in a greenhouse. The common plant volatile trans-2-hexen-1-al was used as a model molecule to screen for suitable sol-gel formulations. A zNose (Electronic Sensor Technology, Newbury Park, CA) transportable gas chromatograph was used to continuously monitor the volatile emissions. A sol-gel formulation containing tetramethyl orthosilicate and methyltrimethoxysilane in an 8:2 (vol:vol) ratio was selected to develop a slow-release dispenser. The half-life of trans-2-hexen-1-al in the sol-gel dispenser increased slightly with the volume of this compound in the dispenser. Ten different volatiles were tested in the sol-gel dispenser. Alcohols of 6-10 carbons had the longest half-lives (3.01-3.77 d), while esters of 6-12 carbons had the shortest (1.53-2.28 d). Release of these volatiles from the dispensers could not be detected by the zNose after 16 d (cis-3-hexenyl acetate) to 26 d (3,7-dimethylocta-1,6-dien-3-ol). In greenhouse experiments, trans-2-hexen-1-al and cis-3-hexen-1-ol released from the sol-gel dispensers attracted aphids for ≍17 d, and release of these volatiles could not be detected by the zNose after ≍24 d. The sol-gel dispensers performed adequately for the slow release of plant volatiles to trap aphids in the greenhouse. © 2014 Entomological Society of America.

Identification of risks associated with the prescribing and dispensing of oral anticancer medicines in Ireland.

LENUS (Irish Health Repository)

Hammond, Lisa

2012-09-09

Background Oral anticancer medicines (OAM) facilitate transfer of cancer care into the community, where safeguards developed in hospitals that control their prescribing, dispensing and administration may not exist. Objective To determine if the systems of prescribing and dispensing OAM in Ireland facilitate clinical verification of the prescription, thereby ensuring treatment is tailored and appropriate for the patient. Setting Randomly selected community pharmacies in Ireland and all Irish hospitals with cancer services. Method A questionnaire was sent to a random selection of Irish community pharmacists. A different questionnaire was sent to all Irish hospitals treating cancer patients. One hundred OAM prescriptions were retrospectively reviewed, to assess the information presented and the potential barriers to a community pharmacist performing a clinical verification of the prescription. Main outcome measure Community pharmacist survey: problems experienced when dispensing OAM and risk factors identified with the current system. Hospital pharmacist survey: proportion of hospitals that clinically verify prescriptions for parenteral versus oral anticancer medicines and associated policies. OAM prescription review: proportion of OAM prescriptions that contained sufficient information for a community pharmacist to clinically verify the prescription and safely dispense the medication. Results Sixty-four percent of community pharmacist respondents felt they did not have enough information available to them to safely dispense these prescriptions, and 74 % felt that patients are at risk with the current Irish system of prescribing and dispensing OAM. Irish hospitals do not have systems to ensure that all OAM prescriptions are clinically verified by a pharmacist. Seventeen different agents were prescribed on the prescriptions reviewed. The information provided to the community pharmacist would have allowed them to clinically verify 7 % of the OAM prescriptions

The fabrication of front electrodes of Si solar cell by dispensing printing

International Nuclear Information System (INIS)

Kim, Do-Hyung; Ryu, Sung-Soo; Shin, Dongwook; Shin, Jung-Han; Jeong, Jwa-Jin; Kim, Hyeong-Jun; Chang, Hyo Sik

2012-01-01

Highlights: ► We propose the process for the front silver electrode by employing dispensing method. ► The dispensing method is a non-contact printing process. ► The electrode by dispensing method has more uniform and narrower shape. ► The dispensing method helped to enhance the efficiency of solar cell by 0.8% absolute. - Abstract: The dispensing printing was applied to fabricate the front electrodes of silicon solar cell. In this method, a micro channel nozzle and normal Ag paste were employed. The aspect ratio and line width of electrodes could be controlled by the process variables such as the inner diameter of nozzle, dispensing speed, discharge pressure, and the gap between wafer and nozzle. For the nozzle with the inner diameter of 50 μm, the line width and aspect ratio of electrode were under 90 μm and more than ∼0.2, respectively. When comparing the efficiency of solar cell prepared by conventional screen printing and the dispensing printing, the latter exhibited 19.1%, which is 0.8% absolute higher than the former even with the same Ag paste. This is because the electrode by dispensing printing has uniform aspect ratio and narrow line width over the length of electrode.

Design of a new non-sterile glove-dispensing unit to reduce touch-based contamination

Directory of Open Access Journals (Sweden)

Jennifer R Amos

2014-06-01

Full Text Available Background Despite best efforts by healthcare providers to sterilise their hands through hand washing prior to touching medical equipment and patients, bacteria are still present and can be spread through physical contact. We aimed to reduce the spread of touch-induced and airborne bacteria and virus spreading by using a touch-free glove-dispensing system that minimally exposes gloves in the box to air. Method The team met multiple times to undertake early prototyping and present ideas for the design. We experimented with folding gloves in varying patterns, similar to facial tissue-dispensing boxes, and tried several methods of opening/closing the glove box to determine the most effective way to access gloves with the least amount of physical contact. We considered the user experience and obtained user feedback after each design iteration. Results Ultimately, we decided on a vertically oriented box with optional holes for dispensing a glove on the side of the box or on the bottom by means of the pull-down drawer mechanism. This system will dispense a single glove at a time to the user with the option of using a pull-down drawer trigger to decrease the likelihood of physical contact with unused gloves. Both methods dispense a single glove. Conclusion: By reducing physical contact between the healthcare practitioner and the gloves, we are potentially reducing the spread of bacteria. This glove box design ensures that gloves are not exposed to the air in the clinic or hospital setting, thereby further reducing spread of airborne germs. This could assist in decreasing the risk of nosocomial infections in healthcare settings.

ASHP national survey of pharmacy practice in hospital settings: dispensing and administration--2011.

Science.gov (United States)

Pedersen, Craig A; Schneider, Philip J; Scheckelhoff, Douglas J

2012-05-01

Results of the 2011 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are presented. A stratified random sample of pharmacy directors at 1401 general and children's medical-surgical hospitals in the United States were surveyed by mail. In this national probability sample survey, the response rate was 40.1%. Decentralization of the medication-use system continues, with 40% of hospitals using a decentralized system and 58% of hospitals planning to use a decentralized model in the future. Automated dispensing cabinets were used by 89% of hospitals, robots were used by 11%, carousels were used in 18%, and machine-readable coding was used in 34% of hospitals to verify doses before dispensing. Overall, 65% of hospitals had a United States Pharmacopeia chapter 797 compliant cleanroom for compounding sterile preparations. Medication administration records (MARs) have become increasingly computerized, with 67% of hospitals using electronic MARs. Bar-code-assisted medication administration was used in 50% of hospitals, and 68% of hospitals had smart infusion pumps. Health information is becoming more electronic, with 67% of hospitals having partially or completely implemented an electronic health record and 34% of hospitals having computerized prescriber order entry. The use of these technologies has substantially increased over the past year. The average number of full-time equivalent staff per 100 occupied beds averaged 17.5 for pharmacists and 15.0 for technicians. Directors of pharmacy reported declining vacancy rates for pharmacists. Pharmacists continue to improve medication use at the dispensing and administration steps of the medication-use system. The adoption of new technology is changing the philosophy of medication distribution, and health information is rapidly becoming electronic.

A new protocol for evaluating the efficacy of some dispensing systems of a packaging in the microbial protection of water-based preservative-free cosmetic products.

Science.gov (United States)

Devlieghere, F; De Loy-Hendrickx, A; Rademaker, M; Pipelers, P; Crozier, A; De Baets, B; Joly, L; Keromen, S

2015-12-01

A new protocol is described for assessing the efficacy of the dispenser of some packaging systems (PSs) of preservative-free cosmetic products in protecting both their contained formula and their delivered doses. Practically, aiming at mimicking contacts with a non-sterile skin or fingers, the dispensing system is put into contact with a pre-contaminated fabric by a standardized colonization of P. aeruginosa. When applied to three different types of packaging, results show clear differences in both criteria between these conditioning articles, that is variable efficacies in protecting the contained product and the delivered doses, knowing that the first aspect is of paramount importance. The proposed protocol is proved being able to discriminate between different PSs and provides information on strong and weak features of certain types dispensing technologies prone to efficiently decrease either the dose contamination or to prevent contamination in reaching the contained product. Therefore, the proposed protocol can contribute to an objective selection of a PS for protecting a cosmetic care product with a low content of preservative or preservative free. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Anthelmintic drug dispensing in South Africa: An analysis of ...

African Journals Online (AJOL)

More than two billion people worldwide are infected with helminths. The primary aim of the study was to evaluate the dispensing patterns of anthelmintic products using dispensing data of South African community pharmacies. A retrospective, cross-sectional drug utilisation study was conducted on a 2013 community ...

Impact of Robotic Dispensing Machines in German Pharmacies on ...

African Journals Online (AJOL)

To assess the impact of robotic dispensing machines in community pharmacies on staff efficiency and sales of over-the-counter drugs. Setting: The study was done on 253 community pharmacies in Germany that use a robotic dispensing machine manufactured by ROWA during 2008. Method: Data concerning the financial ...

Influence of container structures and content solutions on dispensing time of ophthalmic solutions

Directory of Open Access Journals (Sweden)

Keiji Yoshikawa

2010-05-01

Full Text Available Keiji Yoshikawa1, Hiroshi Yamada21Yoshikawa Eye Clinic, Tokyo, Japan; 2Santen Pharmaceutical Co., Ltd., Osaka, JapanPurpose: To investigate the influence of container structures and content solutions on the time of dispensing from eye dropper bottles.Methods: Eye dropper bottle models, solution models (filtrate water/surfactant solution and a dispensing time measuring apparatus were prepared to measure the dispensing time.Results: With filtrate water and pressure thrust load of 0.3 MPa, the dispensing time significantly increased from 1.1 ± 0.5 seconds to 4.6 ± 1.1 seconds depending on the decrease of inner aperture diameters from 0.4 mm to 0.2 mm (P < 0.0001. When using the bottle models with inner aperture diameters of 0.4 mm or larger, the dispensing time became constant. The dispensing time using surfactant solution showed the same tendency as above. When pressure thrust load was large (0.07 MPa, the solution flew out continuously with inner aperture diameters of 0.4 mm or larger and the dispensing time could not be measured. The inner aperture diameter most strongly explained the variation of the dispensing time in both the content solutions in the multiple linear regression analysis (filtrate water: 46%, R2 = 0.462, surfactant solution: 56%, R2 = 0.563.Conclusions: Among content solutions and container structures, the dispensing time was mostly influenced by the diameter of the inner aperture of bottles.Keywords: dispensing time, model eye dropper bottle, model ophthalmic solution, nozzle internal space volume, nozzle inner aperture diameter

Regulations, Codes, and Standards (RCS) Template for California Hydrogen Dispensing Stations

Energy Technology Data Exchange (ETDEWEB)

Rivkin, C.; Blake, C.; Burgess, R.; Buttner, W.; Post, M.

2012-11-01

This report explains the Regulations, Codes, and Standards (RCS) requirements for hydrogen dispensing stations in the State of California. The reports shows the basic components of a hydrogen dispensing station in a simple schematic drawing; the permits and approvals that would typically be required for the construction and operation of a hydrogen dispensing station; and a basic permit that might be employed by an Authority Having Jurisdiction (AHJ).

Steam sterilization and automatic dispensing of [18F]fludeoxyglucose (FDG) for injection

International Nuclear Information System (INIS)

Karwath, Pascal; Sartor, Johannes; Gries, Wolfgang; Wodarski, Christine; Dittmar, Claus; Biersack, Hans J.; Guhlke, Stefan

2005-01-01

For the purpose of implementing steam sterilization of 2-[ 18 F]FDG (FDG) in the final container into routine production, we have validated and established a fully automated dispensing and sterilization system, thereby considerably reducing the radiation burden to the personnel. Methods: The commercially available system combines aseptic dispensing of the product solution under a miniaturized laminar flow unit with subsequent steam sterilization, realized by heating of the product in the final containers by an autoclave included in the dispensing unit, thus incorporating current pharmaceutical manufacturing standards for the production of parental radiopharmaceuticals. The efficiency of the used sterilization cycle, the stability of FDG under the conditions of sterilization and the stability of the final product towards radiolysis was investigated with respect to various pH-formulations. Results: The system was found to be fully valid for filling of vials in a laminar flow class A (US-class 100) environment and for sterilization of FDG in the final container. The pH for sterilizing FDG solutions must be slightly acidic to avoid decomposition. A pH of 5.5 appears to be optimal and gives FDG of very high radiochemical purity (∼99%). In addition, radiolysis of FDG in solutions of high activity concentration was significantly lower at pH 5.5 than at neutral pH. Conclusion: Terminal sterilization enables the production of FDG in full compliance with GMP-regulations even in Class C or D (US class 10,000 or 100,000) laboratories

Hand sanitizer dispensers and associated hospital-acquired infections: friend or fomite?

Science.gov (United States)

Eiref, Simon D; Leitman, I Michael; Riley, William

2012-06-01

Waterless alcohol-based hand sanitizers are an increasingly popular method of hand hygiene and help prevent hospital-acquired infection (HAI). Whether hand sanitizer dispensers (HSDs) may themselves harbor pathogens or act as fomites has not been reported. All HSDs in the surgical intensive care unit of an urban teaching hospital were cultured at three sites: The dispenser lever, the rear underside, and the area surrounding the dispensing nozzle. All HSDs yielded one or more bacterial species, including commensal skin flora and enteric gram-negative bacilli. Colonization was greatest on the lever, where there is direct hand contact. Hand sanitizer dispensers can become contaminated with pathogens that cause HAI and thus are potential fomites.

Do Pregnant Women Report Use of Dispensed Medications?

DEFF Research Database (Denmark)

Olesen, Charlotte; Søndergaard, Charlotte; Thrane, Nana

2001-01-01

Surveillance of drug safety in pregnancy often draws on administrative prescription registries. Noncompliance in the use of prescribed medication may be frequent among pregnant women owing to their fear of fetotoxic side effects. To estimate compliance in the use of prescription drugs dispensed...... during pregnancy, we compared prescription data from the North Jutland Prescription Database with information on drug use provided by pregnant women to the Danish National Birth Cohort (DNBC), which is a health interview survey. We used the North Jutland Prescription Database to identify all prescription...... drugs dispensed during pregnancy for the 2,041 women who were enrolled in the DNBC in the County of North Jutland, Denmark. Compliance was defined as the probability of reporting drug use in DNBC after purchasing a dispensed prescription drug. The overall compliance to drugs purchased within 120 days...

The 340B discount program: outpatient prescription dispensing patterns through contract pharmacies in 2012.

Science.gov (United States)

Clark, Bobby L; Hou, John; Chou, Chia-Hung; Huang, Elbert S; Conti, Rena

2014-11-01

Section 340B of the Public Health Service Act provides qualified organizations serving vulnerable populations with deep discounts for some outpatient medications. A 2010 regulatory change widely expanded the 340B program's reach, allowing these organizations to contract with retail pharmacies to dispense medications for eligible patients. Little is known about which medications are dispensed by contract pharmacies under the expanded program. We provide the first comparison of 340B prescriptions and all prescriptions dispensed in contract pharmacies. We used 2012 data from Walgreens, the national leader in 340B contract pharmacies. Medications used to treat chronic conditions such as diabetes, high cholesterol levels, asthma, and depression accounted for an overwhelming majority of all prescriptions dispensed at Walgreens as part of the 340B program. A higher percentage of antiretrovirals used to treat HIV/AIDS were dispensed through 340B prescriptions than through all prescriptions dispensed at Walgreens. The majority of 340B prescriptions dispensed at Walgreens originated at tuberculosis clinics, consolidated health centers, disproportionate-share hospitals, and Ryan White clinics. Our results suggest that 340B contract pharmacies dispense medications used to treat Americans' chronic disease burden and disproportionately dispense medications used by key vulnerable populations targeted by the program. Project HOPE—The People-to-People Health Foundation, Inc.

Pharmacists' role in opioid overdose: Kentucky pharmacists' willingness to participate in naloxone dispensing.

Science.gov (United States)

Freeman, Patricia R; Goodin, Amie; Troske, SuZanne; Strahl, Audra; Fallin, Amanda; Green, Traci C

To assess pharmacists' willingness to initiate the dispensing of naloxone. As of 2015, Kentucky law permits certified pharmacists to dispense naloxone under a physician-approved protocol. Electronic survey (e-mail) gauging perception of pharmacists' role in opioid overdose and attitudes toward, and barriers to, naloxone dispensing. All Kentucky pharmacists with active licenses in 2015. Ordinal logistic regression was used to estimate the impact of pharmacist characteristics and attitudes on willingness to initiate naloxone dispensing, where the dependent variable was operationalized as a Likert-type question on a scale of 1 (not at all willing) to 6 (very willing). Of 4699 practicing Kentucky pharmacists, 1282 responded, of which 834 were community practitioners (response rate 27.3%). Pharmacists reported varying willingness to initiate naloxone dispensing, with 37.3% very willing (score 5 or 6) and 27.9% not willing (score 1 or 2). However, a majority of pharmacists reported willingness to dispense naloxone with a valid prescription (54.0%, score 5 or 6). Women pharmacists were 1.3 times more likely than men to be willing to initiate naloxone dispensing (95% confidence interval [CI] 1.0-1.6). Those who reported confidence in identifying individuals at risk for overdose were 1.2 times more likely to initiate dispensing, and those who reported confidence in ability to educate patients about overdose were 1.6 times more likely to express willingness to initiate naloxone dispensing (95% CIs, respectively, 1.0-1.3 and 1.4-1.8). Community pharmacists reported barriers to naloxone access at higher rates than pharmacists from other practice settings. Kentucky pharmacists are divided in their willingness to initiate naloxone dispensing; however, those who are confident in their ability to identify overdose risks are more willing. Increasing pharmacist confidence through appropriately designed education programs could facilitate pharmacist participation in naloxone

Poorly processed reusable surface disinfection tissue dispensers may be a source of infection.

Science.gov (United States)

Kampf, Günter; Degenhardt, Stina; Lackner, Sibylle; Jesse, Katrin; von Baum, Heike; Ostermeyer, Christiane

2014-01-21

Reusable surface disinfectant tissue dispensers are used in hospitals in many countries because they allow immediate access to pre-soaked tissues for targeted surface decontamination. On the other hand disinfectant solutions with some active ingredients may get contaminated and cause outbreaks. We determined the frequency of contaminated surface disinfectant solutions in reusable dispensers and the ability of isolates to multiply in different formulations. Reusable tissue dispensers with different surface disinfectants were randomly collected from healthcare facilities. Solutions were investigated for bacterial contamination. The efficacy of two surface disinfectants was determined in suspension tests against two isolated species directly from a contaminated solution or after 5 passages without selection pressure in triplicate. Freshly prepared use solutions were contaminated to determine survival of isolates. 66 dispensers containing disinfectant solutions with surface-active ingredients were collected in 15 healthcare facilities. 28 dispensers from nine healthcare facilities were contaminated with approximately 107 cells per mL of Achromobacter species 3 (9 hospitals), Achromobacter xylosoxidans or Serratia marcescens (1 hospital each). In none of the hospitals dispenser processing had been adequately performed. Isolates regained susceptibility to the disinfectants after five passages without selection pressure but were still able to multiply in different formulations from different manufacturers at room temperature within 7 days. Neglecting adequate processing of surface disinfectant dispensers has contributed to frequent and heavy contamination of use-solutions based on surface active ingredients. Tissue dispenser processing should be taken seriously in clinical practice.

Dispensing processes impact apparent biological activity as determined by computational and statistical analyses.

Directory of Open Access Journals (Sweden)

Sean Ekins

Full Text Available Dispensing and dilution processes may profoundly influence estimates of biological activity of compounds. Published data show Ephrin type-B receptor 4 IC50 values obtained via tip-based serial dilution and dispensing versus acoustic dispensing with direct dilution differ by orders of magnitude with no correlation or ranking of datasets. We generated computational 3D pharmacophores based on data derived by both acoustic and tip-based transfer. The computed pharmacophores differ significantly depending upon dispensing and dilution methods. The acoustic dispensing-derived pharmacophore correctly identified active compounds in a subsequent test set where the tip-based method failed. Data from acoustic dispensing generates a pharmacophore containing two hydrophobic features, one hydrogen bond donor and one hydrogen bond acceptor. This is consistent with X-ray crystallography studies of ligand-protein interactions and automatically generated pharmacophores derived from this structural data. In contrast, the tip-based data suggest a pharmacophore with two hydrogen bond acceptors, one hydrogen bond donor and no hydrophobic features. This pharmacophore is inconsistent with the X-ray crystallographic studies and automatically generated pharmacophores. In short, traditional dispensing processes are another important source of error in high-throughput screening that impacts computational and statistical analyses. These findings have far-reaching implications in biological research.

Steam sterilization and automatic dispensing of [{sup 18}F]fludeoxyglucose (FDG) for injection

Energy Technology Data Exchange (ETDEWEB)

Karwath, Pascal [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany) and MC-Pharma GmbH (MCP), Bonn (Germany); Sartor, Johannes [MC-Pharma GmbH (MCP), Bonn (Germany); Gries, Wolfgang [MC-Pharma GmbH (MCP), Bonn (Germany); Wodarski, Christine [MC-Pharma GmbH (MCP), Bonn (Germany); Dittmar, Claus [MC-Pharma GmbH (MCP), Bonn (Germany); Biersack, Hans J [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Guhlke, Stefan [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany) and MC-Pharma GmbH (MCP), Bonn (Germany)

2005-04-01

For the purpose of implementing steam sterilization of 2-[{sup 18}F]FDG (FDG) in the final container into routine production, we have validated and established a fully automated dispensing and sterilization system, thereby considerably reducing the radiation burden to the personnel. Methods: The commercially available system combines aseptic dispensing of the product solution under a miniaturized laminar flow unit with subsequent steam sterilization, realized by heating of the product in the final containers by an autoclave included in the dispensing unit, thus incorporating current pharmaceutical manufacturing standards for the production of parental radiopharmaceuticals. The efficiency of the used sterilization cycle, the stability of FDG under the conditions of sterilization and the stability of the final product towards radiolysis was investigated with respect to various pH-formulations. Results: The system was found to be fully valid for filling of vials in a laminar flow class A (US-class 100) environment and for sterilization of FDG in the final container. The pH for sterilizing FDG solutions must be slightly acidic to avoid decomposition. A pH of 5.5 appears to be optimal and gives FDG of very high radiochemical purity ({approx}99%). In addition, radiolysis of FDG in solutions of high activity concentration was significantly lower at pH 5.5 than at neutral pH. Conclusion: Terminal sterilization enables the production of FDG in full compliance with GMP-regulations even in Class C or D (US class 10,000 or 100,000) laboratories.

Bacterial hand contamination and transfer after use of contaminated bulk-soap-refillable dispensers.

Science.gov (United States)

Zapka, Carrie A; Campbell, Esther J; Maxwell, Sheri L; Gerba, Charles P; Dolan, Michael J; Arbogast, James W; Macinga, David R

2011-05-01

Bulk-soap-refillable dispensers are prone to extrinsic bacterial contamination, and recent studies demonstrated that approximately one in four dispensers in public restrooms are contaminated. The purpose of this study was to quantify bacterial hand contamination and transfer after use of contaminated soap under controlled laboratory and in-use conditions in a community setting. Under laboratory conditions using liquid soap experimentally contaminated with 7.51 log(10) CFU/ml of Serratia marcescens, an average of 5.28 log(10) CFU remained on each hand after washing, and 2.23 log(10) CFU was transferred to an agar surface. In an elementary-school-based field study, Gram-negative bacteria on the hands of students and staff increased by 1.42 log(10) CFU per hand (26-fold) after washing with soap from contaminated bulk-soap-refillable dispensers. In contrast, washing with soap from dispensers with sealed refills significantly reduced bacteria on hands by 0.30 log(10) CFU per hand (2-fold). Additionally, the mean number of Gram-negative bacteria transferred to surfaces after washing with soap from dispensers with sealed-soap refills (0.06 log(10) CFU) was significantly lower than the mean number after washing with contaminated bulk-soap-refillable dispensers (0.74 log(10) CFU; P soap (P soap from bulk-soap-refillable dispensers can increase the number of opportunistic pathogens on the hands and may play a role in the transmission of bacteria in public settings.

Dispensing apparatus for use in a cued food delivery task.

Science.gov (United States)

Deweese, Menton M; Claiborne, Kimberly N; Ng, Jennifer; Dirba, Danika D; Stewart, Hannah L; Schembre, Susan M; Versace, Francesco

2015-01-01

Neurobiological models of obesity postulate that obese individuals have difficulty regulating food intake partly because they attribute excessive salience to stimuli signaling food availability. Typically, human studies that investigate the relationship between brain responses to food-related stimuli and obesity present food cues without subsequent delivery of food. However, in order to identify the brain correlates of cue reactivity, we must record brain responses to food-related cues signaling food availability. Therefore, we have developed a dispensing apparatus for use in a cued-food delivery task in which event-related potentials (ERPs) to food-related images predicting food delivery and images not predicting food delivery can be recorded. Here, we describe a method where:•The experimental apparatus dispenses an edible item (i.e., a chocolate candy) which may or may not be eaten, or a non-edible control item (e.g., a plastic bead).•Deposit boxes are available to store uneaten candies and the non-edible control items.•The dispensing mechanism is capable of recording the exact timestamp when each delivery event occurs (e.g., release from the dispenser, arrival in the receptacle, storage in the deposit box).

[Dispensing care at the dispensing counter in the conditions of a Czech pharmacy].

Science.gov (United States)

Macesková, B; Plevacová, H

2005-03-01

Evaluation of 108 cases when the pharmacist found a need to intervene into prescription verified the use of internationally employed system of classification of pharmaceutical interventions in the conditions of the Czech pharmacy of the basic type. The so-called dispensing care at the counter was provided by five participating pharmacists (out of seven working in the pharmacy) for a period of six months. The most frequently identified problems included: inappropriate use of medicaments--overdose, use at unsuitable time (28.7 %), a need to inform the patient (17.6 %), potentially ineffective therapy (12.9 %), drug interactions (7.4 %), suspected and potential undesirable effects of prescribed medicaments (7.4 %), and insufficient compliance (6.5 %). Solution of problems with medicaments was most frequently: a change in dosage (25.9 %), recommendation to consult the physician (24.1 %), and professional counselling on pharmacotherapy (23.1 %). The pharmacotherapeutic group identified as the one most frequently requiring a telephone consultation of the pharmacist and the physician was antibiotics, including antibacterial chemotherapeutic agents.

Hand sanitizer-dispensing door handles increase hand hygiene compliance: a pilot study.

Science.gov (United States)

Babiarz, Lukasz S; Savoie, Brent; McGuire, Mark; McConnell, Lauren; Nagy, Paul

2014-04-01

Improving rates of hand hygiene compliance (HHC) has been shown to reduce nosocomial disease. We compared the HHC for a traditional wall-mounted unit and a novel sanitizer-dispensing door handle device in a hospital inpatient ultrasound area. HHC increased 24.5%-77.1% (P sanitizer-dispensing door handle, whereas it remained unchanged for the other rooms. Technical improvements like a sanitizer-dispensing door handle can improve hospital HHC. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Methods for dispensing mercury into devices

Science.gov (United States)

Grossman, Mark W.; George, William A.

1987-04-28

A process for dispensing mercury into devices which requires mercury. Mercury is first electrolytically separated from either HgO or Hg.sub.2 Cl.sub.2 and plated onto a cathode wire. The cathode wire is then placed into a device requiring mercury.

Cell dispensing in low-volume range with the immediate drop-on-demand technology (I-DOT).

Science.gov (United States)

Schober, Lena; Büttner, Evy; Laske, Christopher; Traube, Andrea; Brode, Tobias; Traube, Andreas Florian; Bauernhansl, Thomas

2015-04-01

Handling and dosing of cells comprise the most critical step in the microfabrication of cell-based assay systems for screening and toxicity testing. Therefore, the immediate drop-on-demand technology (I-DOT) was developed to provide a flexible noncontact liquid handling system enabling dispensing of cells and liquid without the risk of cross-contamination down to a precise volume in the nanoliter range. Liquid is dispensed from a source plate within nozzles at the bottom by a short compressed air pulse that is given through a quick release valve into the well, thus exceeding the capillary pressure in the nozzle. Droplets of a defined volume can be spotted directly onto microplates or other cell culture devices. We present a study on the performance and biological impact of this technology by applying the cell line MCF-7, human fibroblasts, and human mesenchymal stem cells (hMSCs). For all cell types tested, viability after dispensing is comparable to the control and exhibits similar proliferation rates in the absence of apoptotic cells, and the differentiation potential of hMSCs is not impaired. The immediate drop-on-demand technology enables accurate cell dosage and offers promising potential for single-cell applications. © 2014 Society for Laboratory Automation and Screening.

ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration--2014.

Science.gov (United States)

Pedersen, Craig A; Schneider, Philip J; Scheckelhoff, Douglas J

2015-07-01

The results of the 2014 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are described. A stratified random sample of pharmacy directors at 1435 general and children's medical-surgical hospitals in the United States were surveyed by mail. In this national probability sample survey, the response rate was 29.7%. Ninety-seven percent of hospitals used automated dispensing cabinets in their medication distribution systems, 65.7% of which used individually secured lidded pockets as the predominant configuration. Overall, 44.8% of hospitals used some form of machine-readable coding to verify doses before dispensing in the pharmacy. Overall, 65% of hospital pharmacy departments reported having a cleanroom compliant with United States Pharmacopeia chapter 797. Pharmacists reviewed and approved all medication orders before the first dose was administered, either onsite or by remote order view, except in procedure areas and emergency situations, in 81.2% of hospitals. Adoption rates of electronic health information have rapidly increased, with the widespread use of electronic health records, computer prescriber order entry, barcodes, and smart pumps. Overall, 31.4% of hospitals had pharmacists practicing in ambulatory or primary care clinics. Transitions-of-care services offered by the pharmacy department have generally increased since 2012. Discharge prescription services increased from 11.8% of hospitals in 2012 to 21.5% in 2014. Approximately 15% of hospitals outsourced pharmacy management operations to a contract pharmacy services provider, an increase from 8% in 2011. Health-system pharmacists continue to have a positive impact on improving healthcare through programs that improve the efficiency, safety, and clinical outcomes of medication use in health systems. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Community pharmacists’ attitudes and knowledge on dispensing drugs.

Directory of Open Access Journals (Sweden)

Baldon JP

2006-03-01

Full Text Available The present study aimed to assess knowledge and attitudes of the pharmacists on dispensing drugs to pregnant women. Methods: Cross-sectional study in 150 community pharmacies randomly selected in Curitiba (Brazil. A closed end questionnaire with 25 questions were used, including dispensing scenarios containing risk types A, B, D or X and questions on pharmacist interaction with pregnant women, physicians, and information sources availability. Results: Pharmacists performed appropriately in 53% of the encounters. Lower success were associated to prednison and captopril (24.8% in both, end cases producing more doubts were captopril (31.7% and simvastatin (30.7%. Most of the pharmacists state have advised drugs to pregnant women or contact to the physician to discuss about a prescription related with this issue. A Majority (64.4% did not feel able to understand FDA risk classification and did not have trustable information sources in pharmacy. Conclusions: Pharmacists dispensing drugs in Curitiba are not able to interpret information on the use of drugs in pregnant women, and they don have reliable information sources on the use of dugs in pregnancy. However, they advice and counsel drugs to pregnant women and discuss with physicians therapeutic strategies.

High-Precision Dispensing of Nanoliter Biofluids on Glass Pedestal Arrays for Ultrasensitive Biomolecule Detection.

Science.gov (United States)

Chen, Xiaoxiao; Liu, Yang; Xu, QianFeng; Zhu, Jing; Poget, Sébastien F; Lyons, Alan M

2016-05-04

Precise dispensing of nanoliter droplets is necessary for the development of sensitive and accurate assays, especially when the availability of the source solution is limited. Conventional approaches are limited by imprecise positioning, large shear forces, surface tension effects, and high costs. To address the need for precise and economical dispensing of nanoliter volumes, we developed a new approach where the dispensed volume is dependent on the size and shape of defined surface features, thus freeing the dispensing process from pumps and fine-gauge needles requiring accurate positioning. The surface we fabricated, called a nanoliter droplet virtual well microplate (nVWP), achieves high-precision dispensing (better than ±0.5 nL or ±1.6% at 32 nL) of 20-40 nL droplets using a small source drop (3-10 μL) on isolated hydrophilic glass pedestals (500 μm on a side) bonded to arrays of polydimethylsiloxane conical posts. The sharp 90° edge of the glass pedestal pins the solid-liquid-vapor triple contact line (TCL), averting the wetting of the glass sidewalls while the fluid is prevented from receding from the edge. This edge creates a sufficiently large energy barrier such that microliter water droplets can be poised on the glass pedestals, exhibiting contact angles greater >150°. This approach relieves the stringent mechanical alignment tolerances required for conventional dispensing techniques, shifting the control of dispensed volume to the area circumscribed by the glass edge. The effects of glass surface chemistry and dispense velocity on droplet volume were studied using optical microscopy and high-speed video. Functionalization of the glass pedestal surface enabled the selective adsorption of specific peptides and proteins from synthetic and natural biomolecule mixtures, such as venom. We further demonstrate how the nVWP dispensing platform can be used for a variety of assays, including sensitive detection of proteins and peptides by fluorescence

Determinants of Dispensing Location in the TRICARE Senior Pharmacy Program

Science.gov (United States)

2005-01-01

proximity to an MTF on TSRx use and on uti - lization of the different dispensing locations; and the impact of MTF formulary restrictions on use of the...Conclusions and Policy Implications Our analysis of the TSRx program, which focused on describing uti - lization patterns by dispensing location and on...manufacturers do. In the public sector, some Medicaid programs have recently hired physicians and pharmacists to visit doctors’ offices and encourage them to

Dispensing Equipment Testing with Mid-Level Ethanol/Gasoline Test Fluid: Summary Report

Energy Technology Data Exchange (ETDEWEB)

Boyce, K.; Chapin, J. T.

2010-11-01

The National Renewable Energy Laboratory's (NREL) Nonpetroleum-Based Fuel Task addresses the hurdles to commercialization of biomass-derived fuels and fuel blends. One such hurdle is the unknown compatibility of new fuels with current infrastructure, such as the equipment used at service stations to dispense fuel into automobiles. The U.S. Department of Energy's (DOE) Vehicle Technology Program and the Biomass Program have engaged in a joint project to evaluate the potential for blending ethanol into gasoline at levels higher than nominal 10 volume percent. This project was established to help DOE and NREL better understand any potentially adverse impacts caused by a lack of knowledge about the compatibility of the dispensing equipment with ethanol blends higher than what the equipment was designed to dispense. This report provides data about the impact of introducing a gasoline with a higher volumetric ethanol content into service station dispensing equipment from a safety and a performance perspective.

Through-Silicon-Via Underfill Dispensing for 3D Die/Interposer Stacking

Science.gov (United States)

Le, Fuliang

The next generation packaging keeps up with the increased demands of functionality by using the third dimension. 3D chip stacking with TSVs has been identified as one of the major technologies to achieve higher silicon density and shorter interconnection. In order to protect solder interconnections from hostile environments and redistribute thermal stress caused by CTE mismatch, underfill should be applied for the under-chip spaces. In this study, TSV underfill dispensing is introduced to address the underfill challenge for 3D chip stacks. The material properties are first measured and the general trend indicates viscosity and contact angle dropping significantly with an increase in temperature, and surface tension falling slightly as the temperature increases. Underfill should assure a complete encapsulation, avoiding excessive filling time that can result in substantial manufacturing delays. Typically, the inflows for TSV underfill can be free droplets or a constant flow rate. For a constant inflow, the underfill flow is driven by pressure difference and the filling time is governed by flow radius, gap clearance and the constant flow rate. For an inflow of free droplets, the underfill flow is driven by capillary action and the filling time is related to viscosity, flow radius, gap clearance, surface tension, contact angle and TSV size. In general, TSV underfill dispensing with a constant inflow has much shorter filling time than dispensing with an inflow of free droplets. TSV underfill dispensing on a 3D chip stack may induce the risk of an edge flood failure. In order to avoid an edge flood, fluid pressure around the sidewalls of a 3D chip stack cannot exceed limit equilibrium pressure. For TSV dispensing with free droplets, there is no risk of forming an edge flood. However, for a constant inflow, TSV dispensing should be carefully controlled to avoid excessive pressure. Besides, it is suggested that the TSVs in stacked chips be aligned in the vertical

Numerical Simulation Analysis of High-precision Dispensing Needles for Solid-liquid Two-phase Grinding

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Li, Junye; Hu, Jinglei; Wang, Binyu; Sheng, Liang; Zhang, Xinming

2018-03-01

In order to investigate the effect of abrasive flow polishing surface variable diameter pipe parts, with high precision dispensing needles as the research object, the numerical simulation of the process of polishing high precision dispensing needle was carried out. Analysis of different volume fraction conditions, the distribution of the dynamic pressure and the turbulence viscosity of the abrasive flow field in the high precision dispensing needle, through comparative analysis, the effectiveness of the abrasive grain polishing high precision dispensing needle was studied, controlling the volume fraction of silicon carbide can change the viscosity characteristics of the abrasive flow during the polishing process, so that the polishing quality of the abrasive grains can be controlled.

Dispensing with conscience: a legal and ethical assessment.

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Wernow, Jerome R; Grant, Donald G

2008-11-01

For over 30 years, pharmacists have exercised the right to dispense medications in accordance with moral convictions based upon a Judeo-Christian ethic. What many of these practitioners see as an apparent shift away from this time-honored ethic has resulted in a challenge to this right. To review and analyze pharmacy practice standards, legal proceedings, and ethical principles behind conflicts of conscientious objection in dispensing drugs used for emergency contraception. We first searched the terms conscience and clause and Plan B and contraception and abortion using Google, Yahoo, and Microsoft Networks (2006-September 26, 2008). Second, we used Medscape to search professional pharmacy and other medical journals, restricting our terms to conscience, Plan B, contraceptives, and abortifacients. Finally, we employed Loislaw, an online legal archiving service, and did a global search on the phrase conscience clause to determine the status of the legal discussion. To date, conflicts in conscientious objection have arisen when a pharmacist believes that dispensing an oral contraceptive violates his or her moral understanding for the promotion of human life. Up to this time, cases in pharmacy have involved only practitioners from orthodox Christian faith communities, primarily devout Roman Catholics. A pharmacist's right to refuse the dispensing of abortifacients for birth control according to moral conscience over against a woman's right to reproductive birth control has created a conflict that has yet to be reconciled by licensing agents, professional standards, or courts of law. Our analysis of prominent conflicts suggests that the underlying worldviews between factions make compromise improbable. Risks and liabilities are dependent upon compliance with evolving state laws, specific disclosure of a pharmacist's moral objections, and professionalism in the handling of volatile situations. Objecting pharmacists and their employers should have clear policies and

Direct-Dispense Polymeric Waveguides Platform for Optical Chemical Sensors

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Mohamad Hajj-Hassan

2008-12-01

Full Text Available We describe an automated robotic technique called direct-dispense to fabricate a polymeric platform that supports optical sensor arrays. Direct-dispense, which is a type of the emerging direct-write microfabrication techniques, uses fugitive organic inks in combination with cross-linkable polymers to create microfluidic channels and other microstructures. Specifically, we describe an application of direct-dispensing to develop optical biochemical sensors by fabricating planar ridge waveguides that support sol-gelderived xerogel-based thin films. The xerogel-based sensor materials act as host media to house luminophore biochemical recognition elements. As a prototype implementation, we demonstrate gaseous oxygen (O2 responsive optical sensors that operate on the basis of monitoring luminescence intensity signals. The optical sensor employs a Light Emitting Diode (LED excitation source and a standard silicon photodiode as the detector. The sensor operates over the full scale (0%-100% of O2 concentrations with a response time of less than 1 second. This work has implications for the development of miniaturized multisensor platforms that can be cost-effectively and reliably mass-produced.

Twenty-year trends in benzodiazepine dispensing in the Australian population.

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Islam, M M; Conigrave, K M; Day, C A; Nguyen, Y; Haber, P S

2014-01-01

Considerable concern has been expressed about overprescribing of benzodiazepines and related harms. Past analyses have relied on World Health Organization-defined daily doses (DDD) which are sometimes out of keeping with clinical usage. This study examines 20-year (1992-2011) trends of benzodiazepine dispensing in Australia using both DDD and Ashton equivalent dose. Data from the Drug Utilisation Sub-Committee and the Pharmaceutical Benefits Scheme (PBS) website were analysed. Trends in number of prescriptions, DDD/1000 people/day and DDD/prescription were examined over time, and between states/territories. In the 20-year period, 174 080 904 scripts were recorded, with temazepam the most dispensed benzodiazepine (35% of scripts), followed by diazepam (23%). Overall recorded utilisation fell from 27.7 DDD/1000 people/day in 1992 to 20.8 in 2011 (24.9% decrease). There were striking changes in use of individual benzodiazepines over time, with reductions in oxazepam and flunitrazepam and dramatic increases in alprazolam. Since 1998, there has been a steady increase, albeit modest, in per script DDD. The DDD/1000 people/day for items dispensed through PBS/Repatriaton-PBS was highest in Tasmania and lowest in Northern Territory. Despite a modest overall decline in the amount of benzodiazepine dispensed, the level of use is still likely to reflect relative over-prescribing given the paucity of accepted indications for long-term use. Since 1998, there was a polynomial increase in quantity dispensed per script. The WHO-defined DDD for clonazepam seems inappropriate and could impede monitoring of its abuse. Other problems include lack of national data for medications not subsidised on PBS/Repatriation PBS. A broad policy approach is required, not one which targets only one particular benzodiazepine. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Alcohol Dispenser Training in Amherst Massachusetts

Science.gov (United States)

Riccelli, Carlene

1986-01-01

Reviews efforts of the Alcohol Dispenser Training program in Amherst, Massachusetts over a five-year period. Evaluations indicate that participants agree that training is worthwhile, that they are more aware of the effects of alcohol on their patrons, and that they have better knowledge of appropriate strategies for preventing intoxication of…

MANUAL FOOD AND BEVERAGE DISPENSING EQUIPMENT. NATIONAL SANITATION FOUNDATION STANDARD NO. 18.

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National Sanitation Foundation, Ann Arbor, MI.

THIS STANDARD COVERS THE SANITATION REQUIREMENTS FOR EQUIPMENT AND DEVICES WHICH DISPENSE FOOD OR BEVERAGE EITHER IN BULK OR PORTIONS. VENDING MACHINES OR BULK MILK DISPENSING EQUIPMENT ARE NOT COVERED IN THIS STANDARD. ITEMS COVERED INCLUDE THE BASIC PRINCIPLES OF DESIGN AND CONSTRUCTION, FOOD PROTECTION AND FREEDOM FROM HARBORAGES. MINIMUM…

Automated drug dispensing systems in the intensive care unit: a financial analysis.

Science.gov (United States)

Chapuis, Claire; Bedouch, Pierrick; Detavernier, Maxime; Durand, Michel; Francony, Gilles; Lavagne, Pierre; Foroni, Luc; Albaladejo, Pierre; Allenet, Benoit; Payen, Jean-Francois

2015-09-09

To evaluate the economic impact of automated-drug dispensing systems (ADS) in surgical intensive care units (ICUs). A financial analysis was conducted in three adult ICUs of one university hospital, where ADS were implemented, one in each unit, to replace the traditional floor stock system. Costs were estimated before and after implementation of the ADS on the basis of floor stock inventories, expired drugs, and time spent by nurses and pharmacy technicians on medication-related work activities. A financial analysis was conducted that included operating cash flows, investment cash flows, global cash flow and net present value. After ADS implementation, nurses spent less time on medication-related activities with an average of 14.7 hours saved per day/33 beds. Pharmacy technicians spent more time on floor-stock activities with an average of 3.5 additional hours per day across the three ICUs. The cost of drug storage was reduced by €44,298 and the cost of expired drugs was reduced by €14,772 per year across the three ICUs. Five years after the initial investment, the global cash flow was €148,229 and the net present value of the project was positive by €510,404. The financial modeling of the ADS implementation in three ICUs showed a high return on investment for the hospital. Medication-related costs and nursing time dedicated to medications are reduced with ADS.

[Economic impact of an automated dispensing system in an intensive care unit].

Science.gov (United States)

Kheniene, F; Bedouch, P; Durand, M; Marie, F; Brudieu, E; Tourlonnias, M-M; Bongi, P; Allenet, B; Calop, J

2008-03-01

Automated dispensing systems (ADS) allow a reduction of medication errors and an improvement of drug distribution in clinical ward. The objective of this study was to evaluate the economic impact of ADS in an intensive care unit. A cost-benefit model was constructed based on the hospital perspective. The system was evaluated before-after implementation of an ADS in a 12-bed cardiovascular intensive care unit of a French teaching hospital: (a) by a measuring nurse and pharmacy technician working time required for various tasks; (b) by measuring the cost of drug storage and the cost of expired drug; (c) by measuring the nurses' acceptability. After ADS was installed, nursing personnel spent less time on medication-related activities (mean of 1.9 hour/day of nursing time). Pharmacy technicians spent more time on floor-stock activities (mean of 0.7 hour/day of technician time). Implementation reduced the cost of drug storage by 56% (14,742 euros) and cost of expired drug by 9,086 euros per year. Finally, cost-benefit analysis including potential savings in terms of working time showed a net benefit of 71,586 euros (14,317 euros/year). The ADS was given high marks by the nurses; 77% wanted to keep it on their unit. Implementation of ADS is expected to generate direct savings for the hospital and working time reallocation, for nurses to interact with patients and for pharmacy technicians to get involved on the ward.

A Review of the Anthropometric Characteristics, Grading and Dispensation of Junior and Youth Rugby Union Players in Australia.

Science.gov (United States)

Patton, Declan Alexander; McIntosh, Andrew Stuart; Denny, Greg

2016-08-01

The grading of Australian junior and youth rugby union players has received substantial media attention in recent years. Media reports have focussed on size mismatches observed between players, especially players with Polynesian heritage, and the concerned parents who fear for the safety of their child owing to perceived mismatches. Although such concerns are well meaning, few media reports recognise the need for substantial evidence to determine the best grading system for junior and youth rugby union players. The current study reviewed relevant literature pertinent to the grading and dispensation of junior and youth rugby union players. Using primary and secondary search strategies, a total of 33 articles reporting the anthropometric characteristics of junior and youth rugby players were identified. Anthropometric data from the literature were compared with normative population data and currently used dispensation criteria. Junior and youth rugby players were found to be taller and heavier than normative population data. Current dispensation criteria, in terms of body mass, were found to vary and it is suggested that criteria be revised and standardised across rugby unions throughout Australia. Although it is acknowledged that other factors are important for grading players, anthropometric characteristics should be considered as potential dispensation criteria to supplement current age-based grading for junior and youth rugby union players. Measuring the body mass and stature of each junior player upon pre-season registration is suggested, which would provide data to establish valid dispensation criteria for the following season.

Homogeneous Crystallization of Micro-DispensedTIPS-Pentacene Using a Two-Solvent System toEnable Printed Inverters on Foil Substrates

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Indranil Bose

2015-08-01

Full Text Available We report on a micro-dispensing system for 6,13-Bis(triisopropylsilylethynylpentacene (TIPS-pentacene to enable homogenous crystallization and uniform filmmorphology of the dispensed droplets using a two-solvent mixture along with the use of aninsulating binder. This solution composition results in a controlled evaporation of the dropletin ambient air such that the Marangoni flow counteracts the outward convective flow toenable uniform radial crystal growth from the edge towards the center of the drops.The consequence of this process is the high degree of uniformity in the crystallization of thedrops, which results in a reduction in the performance spread of the organic field effecttransistors (OFET created using this process. The addition of the insulating binder furtherimproves the reduction in the spread of the results as a trade-off to the reduction in mobilityof the transistors. The transfer curves of the OFETs show a tight grouping due to thecontrolled self-alignment of the TIPS-pentacene crystals; this repeatability was furtherhighlighted by fabricating p-type inverters with driver to load ratios of 8:1, wherein theoutput inverter curves were also grouped tightly while exhibiting a gain of greater than 4 inthe switching region. Therefore, the reliability and repeatability of this process justifies itsuse to enable large area solution-processed printed circuits at the cost of reduced mobility.

Evaluation of community pharmacies regarding dispensing practices of antibiotics in two districts of central Nepal.

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Mukhtar Ansari

Full Text Available To evaluate the status of community pharmacies, their staff, and practices toward dispensing antibiotics.Cross-sectional, prospective.Community pharmacies in two districts of central Nepal, from March 2016 to May 2016.A systematic random sampling approach was adopted to sample 161 community pharmacies. Data on the registration status of pharmacies, qualification or training of dispensing staff, and the practice of dispensing antibiotics were collected using a pre-tested questionnaire. Face to face interviews were carried out by a previously trained interviewer. Data were analyzed for descriptive and inferential statistics using IBM SPSS Statistics 21.Among 161 community pharmacies, 25% were not registered and most of them were located in rural areas. It was typical (66.5% to dispense antibiotics without prescription and most (91.4% of the staffs involved in dispensing were non-pharmacists. Furthermore, the study revealed common practices of replacing one brand of antibiotic with other brands (66%, dispensing incomplete courses of antibiotics (73%, and not giving any advice regarding antibiotic use (39% or completion of a full course of therapy (80%. There were significant (p < 0.001 relationships between the location of pharmacies (rural vs urban and the qualifications of the pharmacy staff.Dispensing antibiotics without prescription and by non-pharmacists are common in this region. The study also found several issues regarding the irrational use of antibiotics. Thus, there is an urgent need to address these issues and promote the informed use of antibiotics.

Smart DNA Fabrication Using Sound Waves: Applying Acoustic Dispensing Technologies to Synthetic Biology.

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Kanigowska, Paulina; Shen, Yue; Zheng, Yijing; Rosser, Susan; Cai, Yizhi

2016-02-01

Acoustic droplet ejection (ADE) technology uses focused acoustic energy to transfer nanoliter-scale liquid droplets with high precision and accuracy. This noncontact, tipless, low-volume dispensing technology minimizes the possibility of cross-contamination and potentially reduces the costs of reagents and consumables. To date, acoustic dispensers have mainly been used in screening libraries of compounds. In this paper, we describe the first application of this powerful technology to the rapidly developing field of synthetic biology, for DNA synthesis and assembly at the nanoliter scale using a Labcyte Echo 550 acoustic dispenser. We were able to successfully downscale PCRs and the popular one-pot DNA assembly methods, Golden Gate and Gibson assemblies, from the microliter to the nanoliter scale with high assembly efficiency, which effectively cut the reagent cost by 20- to 100-fold. We envision that acoustic dispensing will become an instrumental technology in synthetic biology, in particular in the era of DNA foundries. © 2015 Society for Laboratory Automation and Screening.

Prescription, dispensation and marketing patterns of methylphenidate

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Edson Perini

2014-12-01

Full Text Available OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales – psychoactive and others – subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines.

[Quality evaluation of rhubarb dispensing granules based on multi-component simultaneous quantitative analysis and bioassay].

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Tan, Peng; Zhang, Hai-Zhu; Zhang, Ding-Kun; Wu, Shan-Na; Niu, Ming; Wang, Jia-Bo; Xiao, Xiao-He

2017-07-01

This study attempts to evaluate the quality of Chinese formula granules by combined use of multi-component simultaneous quantitative analysis and bioassay. The rhubarb dispensing granules were used as the model drug for demonstrative study. The ultra-high performance liquid chromatography (UPLC) method was adopted for simultaneously quantitative determination of the 10 anthraquinone derivatives (such as aloe emodin-8-O-β-D-glucoside) in rhubarb dispensing granules; purgative biopotency of different batches of rhubarb dispensing granules was determined based on compound diphenoxylate tablets-induced mouse constipation model; blood activating biopotency of different batches of rhubarb dispensing granules was determined based on in vitro rat antiplatelet aggregation model; SPSS 22.0 statistical software was used for correlation analysis between 10 anthraquinone derivatives and purgative biopotency, blood activating biopotency. The results of multi-components simultaneous quantitative analysisshowed that there was a great difference in chemical characterizationand certain differences inpurgative biopotency and blood activating biopotency among 10 batches of rhubarb dispensing granules. The correlation analysis showed that the intensity of purgative biopotency was significantly correlated with the content of conjugated anthraquinone glycosides (Panalysis and bioassay can achieve objective quantification and more comprehensive reflection on overall quality difference among different batches of rhubarb dispensing granules. Copyright© by the Chinese Pharmaceutical Association.

Distance traveled and frequency of interstate opioid dispensing in opioid shoppers and nonshoppers.

Science.gov (United States)

Cepeda, M Soledad; Fife, Daniel; Yuan, Yingli; Mastrogiovanni, Greg

2013-10-01

Little is known about how far opioid shoppers travel or how often they cross state lines to fill their opioid prescriptions. This retrospective cohort study evaluated these measures for opioid shoppers and nonshoppers using a large U.S. prescription database. Patients with ≥3 opioid dispensings were followed for 18 months. A subject was considered a shopper when he or she filled overlapping opioid prescriptions written by >1 prescriber at ≥3 pharmacies. A heavy shopper had ≥5 shopping episodes. Outcomes assessed were distance traveled among pharmacies and number of states visited to fill opioid prescriptions. A total of 10,910,451 subjects were included; .7% developed any shopping behavior and their prescriptions accounted for 8.6% of all opioid dispensings. Shoppers and heavy shoppers were younger than the nonshoppers. Shoppers traveled a median of 83.8 miles, heavy shoppers 199.5 miles, and nonshoppers 0 miles. Almost 20% of shoppers or heavy shoppers, but only 4% of nonshoppers, visited >1 state. Shoppers traveled greater distances and more often crossed state borders to fill opioid prescriptions than nonshoppers, and their dispensings accounted for a disproportionate number of opioid dispensings. Sharing of data among prescription-monitoring programs will likely strengthen those programs and may decrease shopping behavior. This study shows that opioid shoppers travel greater distances and more often cross state borders to fill opioid prescriptions than nonshoppers, and their dispensings accounted for a disproportionate number of opioid dispensings. The findings support the need for data sharing among prescription-monitoring programs to deter opioid shopping behavior. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

Pharmacoepidemiological Data from Drug Dispensing Charities as a Measure of Health Patterns in a Population not Assisted by the Italian National Health Service.

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Bini, Silvia; Cerri, Cesare; Rigamonti, Antonello E; Bertazzi, Pietro A; Fiorini, Gianfrancesco; Cella, Silvano G

2016-08-19

We analysed drug dispensation by charitable organisations in a year time. Drugs were grouped according to the Anatomic Therapeutic Chemical classification and the amount dispensed was calculated with the system of the Daily Defined Dose (DDD) and expressed as DDD/1000 subjects/day. A number of 87,550 subjects were studied (13,308 Italians; 74,242 Immigrants). Though we noticed a great sesonal variability, the drugs most frequently dispensed were those for the respiratory, cardiovascular and gastrointestinal system and antibiotics, which is different from the rest of the Italian population and the immigrant population assisted by our National Health Service (NHS). We also found that chronic diseases are increasing in these subjects. We conclude that the subjects not receiving NHS assitance have, at least in part, different health patterns and requirements. This should be considered when planning tailored interventions.

Pharmacoepidemiological data from drug dispensing charities as a measure of health patterns in a population not assisted by the Italian National Health Service

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Silvia Bini

2016-08-01

Full Text Available We analysed drug dispensation by charitable organisations in a year time. Drugs were grouped according to the Anatomic Therapeutic Chemical classification and the amount dispensed was calculated with the system of the Daily Defined Dose (DDD and expressed as DDD/1000 subjects/day. A number of 87,550 subjects were studied (13,308 Italians; 74,242 Immigrants. Though we noticed a great sesonal variability, the drugs most frequently dispensed were those for the respiratory, cardiovascular and gastrointestinal system and antibiotics, which is different from the rest of the Italian population and the immigrant population assisted by our National Health Service (NHS. We also found that chronic diseases are increasing in these subjects. We conclude that the subjects not receiving NHS assitance have, at least in part, different health patterns and requirements. This should be considered when planning tailored interventions.

A systematic approach for the location of hand sanitizer dispensers in hospitals.

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Cure, Laila; Van Enk, Richard; Tiong, Ewing

2014-09-01

Compliance with hand hygiene practices is directly affected by the accessibility and availability of cleaning agents. Nevertheless, the decision of where to locate these dispensers is often not explicitly or fully addressed in the literature. In this paper, we study the problem of selecting the locations to install alcohol-based hand sanitizer dispensers throughout a hospital unit as an indirect approach to maximize compliance with hand hygiene practices. We investigate the relevant criteria in selecting dispenser locations that promote hand hygiene compliance, propose metrics for the evaluation of various location configurations, and formulate a dispenser location optimization model that systematically incorporates such criteria. A complete methodology to collect data and obtain the model parameters is described. We illustrate the proposed approach using data from a general care unit at a collaborating hospital. A cost analysis was performed to study the trade-offs between usability and cost. The proposed methodology can help in evaluating the current location configuration, determining the need for change, and establishing the best possible configuration. It can be adapted to incorporate alternative metrics, tailored to different institutions and updated as needed with new internal policies or safety regulation.

Hydrogen Station Compression, Storage, and Dispensing Technical Status and Costs: Systems Integration

Energy Technology Data Exchange (ETDEWEB)

Parks, G.; Boyd, R.; Cornish, J.; Remick, R.

2014-05-01

At the request of the U.S. Department of Energy Fuel Cell Technologies Office (FCTO), the National Renewable Energy Laboratory commissioned an independent review of hydrogen compression, storage, and dispensing (CSD) for pipeline delivery of hydrogen and forecourt hydrogen production. The panel was asked to address the (1) cost calculation methodology, (2) current cost/technical status, (3) feasibility of achieving the FCTO's 2020 CSD levelized cost targets, and to (4) suggest research areas that will help the FCTO reach its targets. As the panel neared the completion of these tasks, it was also asked to evaluate CSD costs for the delivery of hydrogen by high-pressure tube trailer. This report details these findings.

Justice Dispensation through the Alternative Dispute Resolution System in India

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Krishna Agrawal

2014-01-01

Full Text Available The Law Commission of India in its 222nd report emphasized the need for Alternative Disputes Resolution (ADR for the dispensation of justice, because the courts are inaccessible owing to various factors, e.g., poverty, social and political backwardness, illiteracy, ignorance, procedural formalities and inordinate delay in judgments. During the ancient period the disputes were resolved in an informal manner by neutral third persons or people’s court in villages and it continued till the middle of the 20th century. Unfortunately, after the Independence of India in 1947, this system was dissuaded and the government permitted to continue the adversarial system of justice. In 1980, a committee was set up. It recommended Lok Adalats (People’s Courts. In 1987, the Legal Services Authorities Act was enacted. This Act obligates the states to provide free legal aid to poor persons. Besides this, the Act provides for the establishment of permanent Lok Adalats.This is one of the important modes of ADR. Lok Adalats have been established in all the districts of the country. They bring conciliatory settlement in complicated cases arising out of matrimonial, landlord-tenants, property, insurance and commercial disputes. There are four methods of ADR, viz., negotiation, mediation, conciliation and arbitration. Mediation and arbitration are widely preferred. They are alternatives to litigation. The Arbitration Act for the first time was enacted in 1889 and it was subsequently amended many times. On the objections raised by the Supreme Court of India and also on the adoption of UNCITRAL Model Law on International Commercial Arbitration, in 1996 Arbitration and Conciliation Act was enacted. This law is almost the same as is almost in all the countries.Further, the Government of India established International Centre for Alternative Disputes Resolution (CADR with the objectives of promotion, propagation, and popularizing the settlement of domestic and

Foreign private capital inflows in Nigeria's democratic dispensation ...

African Journals Online (AJOL)

FPCI) in Nigeria in the current democratic dispensation with a view to finding out whether the inflows have recorded significant increase since the institution of Democracy in the country. Relevant theories and empirical data were reviewed.

Refinement of Foam Backfill Technology for Expedient Airfield Damage Repair; Phase 2: Development of Prototype Foam Dispensing Equipment and Improved Tactics, Techniques and Procedures

Science.gov (United States)

2017-12-01

ER D C TR -1 7- 14 U.S. Air Force Rapid Airfield Damage Repair Modernization Program Refinement of Foam Backfill Technology for...Backfill Technology for Expedient Airfield Damage Repair Phase II: Development of Prototype Foam Dispensing Equipment and Improved Tactics...procedures (TTPs) for rapid airfield damage repair (RADR) using foam backfill technology . Three different prototype foam dispensing systems were

Efficacy of a Feed Dispenser for Horses in Decreasing Cribbing Behaviour

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Silvia Mazzola

2016-01-01

Full Text Available Cribbing is an oral stereotypy, tends to develop in captive animals as a means to cope with stress, and may be indicative of reduced welfare. Highly energetic diets ingested in a short time are one of the most relevant risk factors for the development of cribbing. The aim of this study was to verify whether feeding cribbing horses through a dispenser that delivers small quantities of concentrate when activated by the animal decreases cribbing behaviour, modifies feeding behaviour, or induces frustration. Ten horses (mean age 14 y, balanced for sex, breed, and size (mean height 162 cm, were divided into two groups of 5 horses each: Cribbing and Control. Animals were trained to use the dispenser and videorecorded continuously for 15 consecutive days from 1 h prior to feeding to 2 h after feeding in order to measure their behaviours. The feed dispenser, Quaryka®, induced an increase in time necessary to finish the ration in both groups of horses (P<0.05. With Quaryka, cribbers showed a significant reduction of time spent cribbing (P<0.05. After removal of the feed dispenser (Post-Quaryka, cribbing behaviour significantly increased. The use of Quaryka may be particularly beneficial in horses fed high-energy diets and ingesting the food too quickly.

What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study.

Science.gov (United States)

Garada, Mona; McLachlan, Andrew J; Schiff, Gordon D; Lehnbom, Elin C

2017-11-15

Documenting the indication on prescriptions and dispensed medicines labels is not standard practice in Australia. However, previous studies that have focused on the content and design of dispensed medicines labels, have suggested including the indication as a safety measure. The aim of this study was to investigate the perspectives of Australian consumers, pharmacists and prescribers on documenting the indication on prescriptions and dispensed medicines labels. Semi-structured interviews were conducted and mock-up of dispensed medicines labels were designed for participants. Consumers (n = 19) and pharmacists (n = 7) were recruited by convenience sample at community pharmacies in Sydney (Australia) and prescribers (n = 8), including two medical students, were recruited through snowballing. Thirty-four participants were interviewed. Most participants agreed that documenting the indication would be beneficial especially for patients who are forgetful or take multiple medications. Participants also believed it would improve consumers' medication understanding and adherence. Prescribers and pharmacists believed it could help reduce prescribing and dispensing errors by matching the drug/dosage to the correct indication. Prescribers refrained from documenting the indication to protect patients' privacy; however, most patients did not consider documenting the indication as a breach of privacy. Prescribers raised concerns about the extra time to include indications on prescriptions and best language to document indications, using plain language as opposed to medical terminology. All interviewed stakeholders identified numerous benefits of documenting the indication on prescriptions and dispensed medicines labels. Whether these potential benefits can be realized remains unknown and addressing prescribers' concern regarding the time involved in documenting the indication on prescriptions remains a challenge for vendors of electronic medication management systems.

What do Australian consumers, pharmacists and prescribers think about documenting indications on prescriptions and dispensed medicines labels?: A qualitative study

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Mona Garada

2017-11-01

Full Text Available Abstract Background Documenting the indication on prescriptions and dispensed medicines labels is not standard practice in Australia. However, previous studies that have focused on the content and design of dispensed medicines labels, have suggested including the indication as a safety measure. The aim of this study was to investigate the perspectives of Australian consumers, pharmacists and prescribers on documenting the indication on prescriptions and dispensed medicines labels. Methods Semi-structured interviews were conducted and mock-up of dispensed medicines labels were designed for participants. Consumers (n = 19 and pharmacists (n = 7 were recruited by convenience sample at community pharmacies in Sydney (Australia and prescribers (n = 8, including two medical students, were recruited through snowballing. Results Thirty-four participants were interviewed. Most participants agreed that documenting the indication would be beneficial especially for patients who are forgetful or take multiple medications. Participants also believed it would improve consumers’ medication understanding and adherence. Prescribers and pharmacists believed it could help reduce prescribing and dispensing errors by matching the drug/dosage to the correct indication. Prescribers refrained from documenting the indication to protect patients’ privacy; however, most patients did not consider documenting the indication as a breach of privacy. Prescribers raised concerns about the extra time to include indications on prescriptions and best language to document indications, using plain language as opposed to medical terminology. Conclusions All interviewed stakeholders identified numerous benefits of documenting the indication on prescriptions and dispensed medicines labels. Whether these potential benefits can be realized remains unknown and addressing prescribers’ concern regarding the time involved in documenting the indication on prescriptions

[Design and piloting of a structured service medication dispensing process].

Science.gov (United States)

Abaurre, Raquel; García-Delgado, Pilar; Maurandi, M Dolores; Arrebola, Cristóbal; Gastelurrutia, Miguel Ángel; Martínez-Martínez, Fernando

2015-01-01

The aim of this article is to design and pilot a protocol for the dispensing of medications service. Using the requirements proposed in the Ministry of Health Pharmaceutical Care Consensus, a literature search was made applying qualitative consensus techniques. An observational, cross-sectional study was conducted from March to June 2009. A total of 53 community pharmacies from 24 Spanish counties. Patients who requested one or more particular medications with or without medical prescription for their own use or for someone in their care. The personalised medication information (IPM), the problems associated with the medications (PRM), and the negative results associated with the medication (RNM), detected by the pharmacist each time medication was dispensed, as well as the perception of the pharmacist on the operability of the protocol were recorded. A total of 870 medications were dispensed, with 423 (48.6%) cases of lack of personalised medication information (IPM) being detected. PRM were detected in 10.11% of the dispensed medications, as well as 68 (7.81%) suspected RNM: safety (n = 35; 51.5%), effectiveness (n = 29; 42.6%) and necessity (n = 4; 5.8%). Almost two-thirds (65.21%) of the pharmacists said that the protocol is in operation. The designed protocol helped to detect deficiencies in the information to the patients about their medications, as well as the PRM and RNM, and is shown to be tool that is easy to use and apply. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

21 CFR 866.2500 - Microtiter diluting and dispensing device.

Science.gov (United States)

2010-04-01

... SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2500... a mechanical device intended for medical purposes to dispense or serially dilute very small...

Factors affecting patients' knowledge about dispensed medicines: A Qualitative study of healthcare professionals and patients in Pakistan.

Science.gov (United States)

Saqib, Anum; Atif, Muhammad; Ikram, Raazeyah; Riaz, Fatima; Abubakar, Muhammad; Scahill, Shane

2018-01-01

Patients' knowledge about their prescribed medicines is one of the most important antecedents of successful therapy. Poor knowledge about medicines can lead to serious consequences such as non-adherence and misunderstanding of the significance of adverse events. The objective of this study is to understand the factors that are responsible for a patients' lack of knowledge regarding their medicines, by taking the perspective of the patient as well as that of healthcare professionals. Much of the work in this area has been undertaken in the setting of developed or semi-developed countries, and there is a scarcity of information from developing nations such as Pakistan. This was a large qualitative study set in the hospital outpatient environment in a teaching hospital in the Punjab province of Pakistan. Data were collected from dialogue with patients (n = 19) and healthcare providers (n = 16) i.e., doctors and dispensers (where a dispenser is a person who merely dispenses medicines; i.e. is not a pharmacist) through in-depth semi-structured interviews. Patients having limited knowledge about their dispensed medicines were assessed using a checklist. The healthcare providers were recruited through a convenience sampling strategy, based on their availability and willingness to participate in the study. Based on the objectives of the study, a pilot tested interview protocol was developed, and used to conduct the interviews. The sample size was controlled by using saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using inductive thematic content analysis. The analysis of data yielded 31 categories (patients = 19, healthcare professionals = 12), 10 subthemes and three themes. The major themes were healthcare professional-related factors, patient-related factors and system-related factors. The health professional related subthemes included: behaviour and attitude and professional liabilities

Early experiences with the multidose drug dispensing system – A matter of trust?

Science.gov (United States)

Wekre, Liv Johanne; Melby, Line; Grimsmo, Anders

2011-01-01

Objective To study early experiences with multidose drug dispensing (MDD) among different groups of health personnel. Design Qualitative study based on focus-group interviews. Setting Primary health care, Trondheim, Norway. Main outcome The importance of trust in the technology and in collaborating partners is actualized in the early implementation of MDD. Results GPs, home-care nurses, pharmacists, and medical secretaries trusted the new MDD technology. The quality of the GPs’ medication records improved. However, health personnel, including the GPs themselves, would not always trust the medication records of the GPs. Checking the multidose bags arriving from the pharmacy was considered unnecessary in the written routines dealing with MDD. However, home-care nurses experienced errors and continued to manually check the bags. Nurses in the home-care service felt a loss of knowledge with regard to the patients’ medications and in turn experienced reduced ability to give medical information to patients and to observe the effects of the drugs. The home-care services’ routines for drug handling were not always trusted by the other groups of health personnel involved. Conclusion Health personnel faced some challenges during the implementation of the MDD system, but most of them remained confident in the new system. Building trust has to be a process that runs in parallel with the introduction of new technology and the establishment of new routines for improving the quality in handling of medicines and to facilitate better cooperation and communication. PMID:21323496

The expected and unexpected benefits of dispensing the exact number of pills.

Science.gov (United States)

Treibich, Carole; Lescher, Sabine; Sagaon-Teyssier, Luis; Ventelou, Bruno

2017-01-01

From November 2014 to November 2015, an experiment in French community pharmacies replaced traditional pre-packed boxes by per-unit dispensing of pills in the exact numbers prescribed, for 14 antibiotics. A cluster randomised control trial was carried out in 100 pharmacies. 75 pharmacies counted out the medication by units (experimental group), the other 25 providing the treatment in the existing pharmaceutical company boxes (control group). Data on patients under the two arms were compared to assess the environmental, economic and health effects of this change in drug dispensing. In particular, adherence was measured indirectly by comparing the number of pills left at the end of the prescribed treatment. Out of the 1185 patients included during 3 sessions of 4 consecutive weeks each, 907 patients experimented the personalized delivery and 278 were assigned to the control group, consistent with a 1/3 randomization-rate at the pharmacy level. 80% of eligible patients approved of the per-unit dispensing of their treatment. The initial packaging of the drugs did not match with the prescription in 60% of cases and per-unit dispensing reduced by 10% the number of pills supplied. 13.1% of patients declared that they threw away pills residuals instead of recycling-no differences between groups. Finally, per-unit dispensing appeared to improve adherence to antibiotic treatment (marginal effect 0.21, IC 95, 0.14-0.28). Supplying antibiotics per unit is not only beneficial in terms of a reduced number of pills to reimburse or for the environment (less pills wasted and non-recycled), but also has a positive and unexpected impact on adherence to treatment, and thus on both individual and public health.

Large area dispenser cathode applied to high current linac

International Nuclear Information System (INIS)

Yang Anmin; China Academy of Engineering Physics, Mianyang; Wu Dengxue; Liu Chenjun; Xia Liansheng; Wang Wendou; Zhang Kaizhi

2005-01-01

The paper introduced a dispenser cathode (411 M) which was 55 mm in diameter. A 200 kV long pulsed power generator with 2 μs flattop based on Marx-PEN and system with heat and voltage insulation were built. A 52 A space charge limited current was gained, when the temperature was 1165 degree C and the filament current was 18 A on the cathode and the voltage of the pulse was 75 kV at the cathode test stand. Experimental results show that the current values are consistent with the numerical simulation. The experiment reveals that the deflated gas will influence the cathode emission ability. (authors)

[Dispensing prescriptions to persons affiliated with the Seguro Popular de Salud de México].

Science.gov (United States)

Garrido-Latorre, Francisco; Hernández-Llamas, Héctor; Gómez-Dantés, Octavio

2008-01-01

Measure and compare the percentage of prescriptions fully dispensed to persons with and without Popular Health Insurance (SPS in Spanish) who use ambulatory and general hospital services associated with the Mexico State Health Services (SESA in Spanish), and taking into account insurance status. SESA user satisfaction was also measured with respect to access to medication. Information for the study was taken from four surveys of SESA ambulatory and hospital units that included probabilistic samples with state representativity. Samples of ambulatory units were selected by stratification according to level of care and association to the SPS service network. The findings indicate that the percentage of prescriptions fully dispensed in SESA ambulatory units has improved, reaching approximately 90%, especially among those units offering services to persons affiliated with SPS. Nevertheless, these percentages continue to be lower than those of ambulatory units associated with social security institutions. Percentages of prescriptions fully dispensed have also improved in SESA hospital units, but continue to be relatively low. In nearly all states, as the percentage of prescriptions fully dispensed has increased, user satisfaction with access to medication has also improved. In 2006 more than 50% of the states had high levels of fully dispensed prescriptions among persons with SPS (> or =90%). The more significant problem exists among hospitals, since only 44% of users who received a prescription in SESA hospitals in 2006 had their prescriptions fully dispensed. This finding requires a review of SPS medication policies, which have favored highly prescribed low-cost medications at ambulatory services at the expense of higher cost and more therapeutically effective medications for hospital care, the latter having a greater impact on household budgets.

Increasing Access to Subsidized Artemisinin-based Combination Therapy through Accredited Drug Dispensing Outlets in Tanzania

Directory of Open Access Journals (Sweden)

Gabra Michael

2011-06-01

Full Text Available Abstract Background In Tanzania, many people seek malaria treatment from retail drug sellers. The National Malaria Control Program identified the accredited drug dispensing outlet (ADDO program as a private sector mechanism to supplement the distribution of subsidized artemisinin-based combination therapies (ACTs from public facilities and increase access to the first-line antimalarial in rural and underserved areas. The ADDO program strengthens private sector pharmaceutical services by improving regulatory and supervisory support, dispenser training, and record keeping practices. Methods The government's pilot program made subsidized ACTs available through ADDOs in 10 districts in the Morogoro and Ruvuma regions, covering about 2.9 million people. The program established a supply of subsidized ACTs, created a price system with a cost recovery plan, developed a plan to distribute the subsidized products to the ADDOs, trained dispensers, and strengthened the adverse drug reactions reporting system. As part of the evaluation, 448 ADDO dispensers brought their records to central locations for analysis, representing nearly 70% of ADDOs operating in the two regions. ADDO drug register data were available from July 2007-June 2008 for Morogoro and from July 2007-September 2008 for Ruvuma. This intervention was implemented from 2007-2008. Results During the pilot, over 300,000 people received treatment for malaria at the 448 ADDOs. The percentage of ADDOs that dispensed at least one course of ACT rose from 26.2% during July-September 2007 to 72.6% during April-June 2008. The number of malaria patients treated with ACTs gradually increased after the start of the pilot, while the use of non-ACT antimalarials declined; ACTs went from 3% of all antimalarials sold in July 2007 to 26% in June 2008. District-specific data showed substantial variation among the districts in ACT uptake through ADDOs, ranging from ACTs representing 10% of all antimalarial sales

Use of direct washing of chemical dispense nozzle for defect control

Science.gov (United States)

Linnane, Michael; Mack, George; Longstaff, Christopher; Winter, Thomas

2006-03-01

Demands for continued defect reduction in 300mm IC manufacturing are driving process engineers to examine all aspects of the chemical apply process for improvement. Historically, the defect contribution from photoresist apply nozzles has been minimized through a carefully controlled process of "dummy dispenses" to keep the photoresist in the tip "fresh" and remove any solidified material, a preventive maintenance regime involving periodic cleaning or replacing of the nozzles, and reliance on a pool of solvent within the nozzle storage block to keep the photoresist from solidifying at the nozzle tip. The industry standard has worked well for the most part but has limitations in terms of cost effectiveness and absolute defect elimination. In this study, we investigate the direct washing of the chemical apply nozzle to reduce defects seen on the coated wafer. Data is presented on how the direct washing of the chemical dispense nozzle can be used to reduce coating related defects, reduce material costs from the reduction of "dummy dispense", and can reduce equipment downtime related to nozzle cleaning or replacement.

Microbiological quality of drinking water from dispensers in roadside restaurants of Bangladesh.

Science.gov (United States)

Moniruzzaman, M; Akter, S; Islam, M A; Mia, Z

2011-01-15

The microbiological status of water from dispensers in different roadside restaurants of Dhaka city and Savar area was analyzed in this study. Seven samples from Dhaka and 8 samples of Savar were checked. The heterotrophic plate count was in a range of 1.0 x 10(3) CFU mL(-1) to 2.0 x 10(4) CFU mL(-1) (from new bottles), 1.0 x 10(3) to 1.5 x 10(4) CFU mL(-1) (after dispensation), and 1.5 x 10(3) CFU mL(-1) to 1.0 x l0(5) CFU mL(-1) (from serving glass). In several of the samples, the heterotrophic plate count was higher than the count in water from new bottle or after dispensation, suggesting added contamination from the serving glass. 80% of the samples were contaminated with total and fecal coliform bacteria, which render these waters unacceptable for human consumption. The samples were found to contain gram negative bacteria like E coli, Shigella sp., Klebsiella sp., Enterobacter sp., Pseudomonas sp., and Salmonella sp., which are potential pathogens and thus pose a serious threat to public health. This study elucidates the importance of monitoring the bottling companies and the restaurants and put them under strict regulations to prevent future outbreak of any water borne diseases caused by consumption of dispensed water.

All dispenser printed flexible 3D structured thermoelectric generators

Science.gov (United States)

Cao, Z.; Shi, J. J.; Torah, R. N.; Tudor, M. J.; Beeby, S. P.

2015-12-01

This work presents a vertically fabricated 3D thermoelectric generator (TEG) by dispenser printing on flexible polyimide substrate. This direct-write technology only involves printing of electrodes, thermoelectric active materials and structure material, which needs no masks to transfer the patterns onto the substrate. The dimension for single thermoelectric element is 2 mm × 2 mm × 0.5 mm while the distance between adjacent cubes is 1.2 mm. The polymer structure layer was used to support the electrodes which are printed to connect the top ends of the thermoelectric material and ensure the flexibility as well. The advantages and the limitations of the dispenser printed 3D TEGs will also be evaluated in this paper. The proposed method is potential to be a low-cost and scalable fabrication solution for TEGs.

Rational dispensing and use of artemether-lumefantrine during ...

African Journals Online (AJOL)

This was a prospective-descriptive study involving visits to 200 private retail pharmacies (using a mystery shopper) and interviewing pregnant women at the municipal public hospitals in Dar es Salaam, ... There is therefore a need for continuing training of drug dispensers regarding antimalarial drugs use in pregnancy.

Factors affecting patients' knowledge about dispensed medicines: A Qualitative study of healthcare professionals and patients in Pakistan.

Directory of Open Access Journals (Sweden)

Anum Saqib

Full Text Available Patients' knowledge about their prescribed medicines is one of the most important antecedents of successful therapy. Poor knowledge about medicines can lead to serious consequences such as non-adherence and misunderstanding of the significance of adverse events. The objective of this study is to understand the factors that are responsible for a patients' lack of knowledge regarding their medicines, by taking the perspective of the patient as well as that of healthcare professionals. Much of the work in this area has been undertaken in the setting of developed or semi-developed countries, and there is a scarcity of information from developing nations such as Pakistan.This was a large qualitative study set in the hospital outpatient environment in a teaching hospital in the Punjab province of Pakistan. Data were collected from dialogue with patients (n = 19 and healthcare providers (n = 16 i.e., doctors and dispensers (where a dispenser is a person who merely dispenses medicines; i.e. is not a pharmacist through in-depth semi-structured interviews. Patients having limited knowledge about their dispensed medicines were assessed using a checklist. The healthcare providers were recruited through a convenience sampling strategy, based on their availability and willingness to participate in the study. Based on the objectives of the study, a pilot tested interview protocol was developed, and used to conduct the interviews. The sample size was controlled by using saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using inductive thematic content analysis.The analysis of data yielded 31 categories (patients = 19, healthcare professionals = 12, 10 subthemes and three themes. The major themes were healthcare professional-related factors, patient-related factors and system-related factors. The health professional related subthemes included: behaviour and attitude and professional

The role of pharmacists and emergency contraception: Are pharmacists' perceptions of emergency contraception predictive of their dispensing practices?

Science.gov (United States)

Richman, Alice R; Daley, Ellen M; Baldwin, Julie; Kromrey, Jeff; O'Rourke, Kathleen; Perrin, Kay

2012-10-01

Pharmacists can play a critical role in the access to emergency contraception (EC). We assessed if knowledge and attitudes were predictive of EC dispensing among a statewide sample of Florida pharmacists, who have legal authority to refuse to dispense medications. In 2008, surveys were mailed to a random sample of 1264 pharmacists registered with the Florida Board of Pharmacy. Data from 272 pharmacists (22% response rate) were analyzed using bivariate and multivariate logistic regression. Fifty-six percent of respondents incorrectly answered that EC causes birth defects, and 46% replied that it causes abortion. Only 22% said that EC can be purchased in advance of need. Many felt uncomfortable dispensing to adolescents (61%) and men (58%). Knowledge about EC was the most important predictor of dispensing [odds ratio (OR)=1.57, 95% confidence interval (CI) 1.22-2.03]. In particular, pharmacists who reported that EC does not act as an abortifacient were more likely to dispense it (OR=4.64, 95% CI 2.15-10.00). Correct information about EC was the most important predictor of pharmacists' dispensing EC. To expand availability of EC, pharmacists will have to become better informed. Copyright © 2012 Elsevier Inc. All rights reserved.

Occurrence of heterotrophic and coliform bacteria in liquid hand soaps from bulk refillable dispensers in public facilities.

Science.gov (United States)

Chattman, Marisa; Gerba, Sheri L; Maxwell, Charles P

2011-03-01

The goal of the study discussed in this article was to determine the occurrence of heterotrophic and coliform bacteria in liquid soap from bulk refillable dispensers, obtained from restrooms in a variety of public facilities. A total of 541 samples was collected from five U.S. cities. Liquid soap from dispensers in public areas was found to contain heterotrophic and coliform bacterial numbers averaging more than 106 CFU/mL in 24.8% of the dispensers.

21 CFR 866.2440 - Automated medium dispensing and stacking device.

Science.gov (United States)

2010-04-01

... SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2440... stacking device is a device intended for medical purposes to dispense a microbiological culture medium into...

Dose dispenser for radioactive gas

International Nuclear Information System (INIS)

Horwitz, N.H.; Gutkowski, R.E.

1977-01-01

An activity metering apparatus for metering predetermined activities of radioactive gas from a supply ampul to dose vials is described. The apparatus includes a shielded ampul housing, a fine metering valve communicating with the ampul housing chamber, a shielded vial housing and a hypodermic needle communicating with the metering valve and received through an opening in the vial housing. A Geiger-Muller tube is adjustably supported opposite an opening in the vial housing, whereby the activity of the radioactive gas dispensed to a partially evacuated vial within the vial chamber may be read directly by a standard laboratory rate meter

Multi-dose drug dispensing is a challenge across the primary-secondary care interface

DEFF Research Database (Denmark)

Reuther, Lene Orskov; Lysen, Charlotte; Faxholm, Mette

2011-01-01

Multi-dose drug dispensing (MDDD) signifies that the patient's medicine is packed in disposable bags corresponding to the dose that should be taken. The purpose of the present study was to investigate how a hospital MDDD instruction was followed.......Multi-dose drug dispensing (MDDD) signifies that the patient's medicine is packed in disposable bags corresponding to the dose that should be taken. The purpose of the present study was to investigate how a hospital MDDD instruction was followed....

Electronic vending machines for dispensing rapid HIV self-testing kits: a case study.

Science.gov (United States)

Young, Sean D; Klausner, Jeffrey; Fynn, Risa; Bolan, Robert

2014-02-01

This short report evaluates the feasibility of using electronic vending machines for dispensing oral, fluid, rapid HIV self-testing kits in Los Angeles County. Feasibility criteria that needed to be addressed were defined as: (1) ability to find a manufacturer who would allow dispensing of HIV testing kits and could fit them to the dimensions of a vending machine, (2) ability to identify and address potential initial obstacles, trade-offs in choosing a machine location, and (3) ability to gain community approval for implementing this approach in a community setting. To address these issues, we contracted a vending machine company who could supply a customized, Internet-enabled machine that could dispense HIV kits and partnered with a local health center available to host the machine onsite and provide counseling to participants, if needed. Vending machines appear to be feasible technologies that can be used to distribute HIV testing kits.

Reformulation of controlled-release oxycodone and pharmacy dispensing patterns near the US-Canada border.

Science.gov (United States)

Gomes, Tara; Paterson, J Michael; Juurlink, David N; Dhalla, Irfan A; Mamdani, Muhammad M

2012-01-01

In August 2010, a tamper-resistant formulation of controlled-release oxycodone (OxyContin-OP) was introduced in the United States but not in Canada. Our objective was to determine whether introduction of OxyContin-OP in the United States influenced prescription volumes for the original controlled-release oxycodone formulation (OxyContin) at Canadian pharmacies near the international border. We conducted a population-based, serial, cross-sectional study of prescriptions dispensed from pharmacies in the 3 cities with the highest volume of US-Canada border crossings in Ontario: Niagara Falls, Windsor and Sarnia. We analyzed data on all outpatient prescriptions for OxyContin dispensed by Canadian pharmacies near each border crossing between 2010 Apr. 1 and 2012 Feb. 29. We calculated and compared monthly prescription rates, adjusted per 1000 population and stratified by tablet strength. The number of tablets dispensed near 4 border crossings in the 3 Canadian cities remained stable over the study period. However, the rate of dispensing at pharmacies near the Detroit-Windsor Tunnel increased roughly 4-fold between August 2010 and February 2011, from 505 to 1969 tablets per 1000 population. By April 2011, following warnings to prescribers and pharmacies regarding drug-seeking behaviour, the dispensing rate declined to 1683 tablets per 1000 population in this area. By November 2011, the rate had returned to levels observed in early 2010. Our analyses suggest that 242 075 excess OxyContin tablets were dispensed near the Detroit-Windsor Tunnel between August 2010 and October 2011. Prescribing of the original formulation of controlled-release oxycodone rose substantially near a major international border crossing following the introduction of a tamper-resistant formulation in the United States. It is possible that the restriction of this finding to the area surrounding the Detroit-Windsor Tunnel reflects specific characteristics of this border crossing, including its high

E85 Dispenser Study

Energy Technology Data Exchange (ETDEWEB)

Moriarty, K.; Johnson, C.; Sears, T.; Bergeron, P.

2009-12-01

This study reviews E85 dispensing infrastructure advances and issues and evaluates the geographic concentration of flexible fuel vehicles (FFVs), E85 stations, ethanol production facilities, and E85 suppliers. Costs, space, financial incentives, and barriers to adding E85 fueling equipment at existing stations are also assessed. This study found that E85 is increasingly available in the U.S. in half of the states; however, the other half have minimal or no E85 fueling options. Despite these gains, E85 is only available at 1% of U.S. gasoline stations. Ethanol production reached 9.5 billion gallons in 2008, but less than 1% is consumed as E85. FFVs have not reached a significant concentration in any county, metropolitan area, or state.

Can formalizing links among community health workers, accredited drug dispensing outlet dispensers, and health facility staff increase their collaboration to improve prompt access to maternal and child care? A qualitative study in Tanzania.

Science.gov (United States)

Dillip, Angel; Kimatta, Suleiman; Embrey, Martha; Chalker, John C; Valimba, Richard; Malliwah, Mariam; Meena, John; Lieber, Rachel; Johnson, Keith

2017-06-19

In Tanzania, progress toward achieving the 2015 Millennium Development Goals for maternal and newborn health was slow. An intervention brought together community health workers, health facility staff, and accredited drug dispensing outlet (ADDO) dispensers to improve maternal and newborn health through a mechanism of collaboration and referral. This study explored barriers, successes, and promising approaches to increasing timely access to care by linking the three levels of health care provision. The study was conducted in the Kibaha district, where we applied qualitative approaches with in-depth interviews and focus group discussions. In-depth interview participants included retail drug shop dispensers (36), community health workers (45), and health facility staff members (15). We conducted one focus group discussion with district officials and four with mothers of newborns and children under 5 years old. Relationships among the three levels of care improved after the linkage intervention, especially for ADDO dispensers and health facility staff who previously had no formal communication pathway. The study participants perceptions of success included improved knowledge of case management and relationships among the three levels of care, more timely access to care, increased numbers of patients/customers, more meetings between community health workers and health facility staff, and a decrease in child and maternal mortality. Reported challenges included stock-outs of medicines at the health facility, participating ADDO dispensers who left to work in other regions, documentation of referrals, and lack of treatment available at health facilities on the weekend. The primary issue that threatens the sustainability of the intervention is that local council health management team members, who are responsible for facilitating the linkage, had not made any supervision visits and were therefore unaware of how the program was running. The study highlights the benefits of

Surface contamination of counting tools after mock dispensing of cyclophosphamide in a simulated outpatient pharmacy.

Science.gov (United States)

Chaffee, Bruce W; Lander, Michael J; Christen, Catherine; Redic, Kimberly A

2018-01-01

Purpose The primary aim was to determine if dispensing of cyclophosphamide tablets resulted in accumulated residue on pharmacy counting tools during a simulated outpatient dispensing process. Secondary objectives included determining if cyclophosphamide contamination exceeded a defined threshold level of 1 ng/cm 2 and if a larger number of prescriptions dispensed resulted in increased contamination. Methods Mock prescriptions of 40 cyclophosphamide 50 mg tablets were counted on clean trays in three scenarios using a simulated outpatient pharmacy after assaying five cleaned trays as controls. The three scenarios consisted of five simulated dispensings of one, three, or six prescriptions dispensed per scenario. Wipe samples of trays and spatulas were collected and assayed for all trays, including the five clean trays used as controls. Contamination was defined as an assayed cyclophosphamide level at or above 0.001 ng/cm 2 and levels above 1 ng/cm 2 were considered sufficient to cause risk of human uptake. Mean contamination for each scenario was calculated and compared using one-way analysis of variance. P-values of contamination on trays used to count one, three, and six cyclophosphamide prescriptions was 0.51 ± 0.10 (p=0.0003), 1.02 ± 0.10 (p contamination. Increasing the number of prescriptions dispensed from 1 to 3, 1 to 6, and 3 to 6 counts increased contamination by 0.51 ± 0.15 (p = 0.0140), 1.31 + 0.15 (p contaminates pharmacy counting tools, and an increased number of prescriptions dispensed correlates with increased level of contamination. Counting out three or more prescriptions leads to trays having contamination that surpasses the threshold at which worker exposure may be increased. Pharmacies should consider devoting a separate tray to cyclophosphamide tablets, as cross-contamination could occur with other drugs and the efficacy of decontamination methods is unclear. Employee exposure could be minimized with the use

The knowledge of emergency contraception and dispensing practices of Patent Medicine Vendors in South West Nigeria.

Science.gov (United States)

Fayemi, Mojisola M; Oduola, Olufemi L; Ogbuji, Queen C; Osinowo, Kehinde A; Oyewo, Adejoke E; Osiberu, Olabimpe M

2010-09-01

Patent Medicine Vendors (PMVs) can play a critical role in increasing access to emergency contraceptive pills (ECPs) in developing countries, but few studies have examined their knowledge and dispensing practices. Using cluster sampling, the authors selected and interviewed 97 PMVs (60.8 per cent female) in Oyo and Ogun States of Nigeria to assess their knowledge, dispensing practices, and referral for ECPs. About one-third (27.8 per cent) of respondents were not aware of ECPs, and only half knew that ECPs could prevent pregnancy. Forty per cent had ever dispensed ECPs. Reasons proffered by those who do not dispense ECPs included barriers from the State Ministry of Health, police, other regulatory agencies, and religious beliefs. Only 50.5 per cent have referral arrangements for clients. Strategies to increase access to ECPs through PMVs include training on counseling techniques and referral, effective government regulation, and community involvement. Where unsafe abortion is a major cause of maternal mortality, these strategies offer protection for many women in the future.

College Cafeteria Signage Increases Water Intake but Water Position on the Soda Dispenser Encourages More Soda Consumption.

Science.gov (United States)

Montuclard, Astrid Linn; Park-Mroch, Jennifer; O'Shea, Amy M J; Wansink, Brian; Irvin, Jill; Laroche, Helena H

2017-10-01

To evaluate the effects of improved water location visibility and water dispenser position on the soda dispenser on undergraduate students' beverage choices. Two focus groups with pilot intervention surveys before and after, adding a small sign above the soda dispensers' water button for 6 weeks in a large US university's all-you-can-eat, prepaid dining hall (measured with chi-square tests and logistic and ordinal logistic regression). Focus groups included 15 students. Survey participants included 357 students before and 301 after the intervention. After the intervention, more students reported ever having drunk water with the meal (66.4% to 77.0%; P = .003) and water consumption frequency increased (P = .005). Postintervention, the odds of drinking water increased by 1.57. Preference for other drinks was the main reason for not drinking water. A total of 59% of students had ever changed their preference from water to soda. The clear indication of the water's location increased students' reported water consumption. Further investigation is needed into how a non-independent water dispenser influences students' beverage choice. Clearly labeled, independent water dispensers are recommended. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

The challenge of responsible dispensing: formal education versus professional practice

Directory of Open Access Journals (Sweden)

Nadine Judith Bezzegh

2011-03-01

Full Text Available The aim of the present study was to evaluate the education of Pharmaceutical Technicians for the activity of responsible dispensing. Based on a questionnaire with open and closed questions, the study sought to characterize the students, identify knowledge and attitudes regarding the Rational Use of Medications while addressing the limits and possibilities of professional and ethical dispensing in practice. In addition, a group dynamics session - focus group - was held as a forum for debate on responsible dispensing. The results showed that students tended to be mature, currently employed and were predominately women. Displaying adequate knowledge on Rational Use of Medications and of the corresponding legislation, the students reported difficulties exercising compatible practice. While the diagnosis pointed to the need for student preparation to enable ethical dispensing, the Focus Group highlighted the possibility for inclusion of a forum for reflection and debate on the ethics of dispensing as part of the Pharmaceutical Technician training.O presente trabalho tem como proposta avaliar a formação do Técnico em Farmácia para o exercício da dispensação responsável. A partir de um questionário com perguntas fechadas e abertas, o estudo envolveu a caracterização dos alunos, a identificação de conhecimentos e atitudes em relação ao Uso Racional dos Medicamentos com vistas ao delineamento dos limites e possibilidades do exercício profissional ético na dispensação. Além disso, foi realizada uma dinâmica grupal - grupo focal - com o objetivo de apreciar a constituição de um espaço de reflexão sobre a dispensação responsável. Os resultados evidenciaram um alunato de maior idade, inserido no mercado de trabalho e predominância de mulheres. Dispondo de conhecimento adequado sobre o Uso Racional dos Medicamentos e da legislação correspondente os alunos fazem referência às dificuldades no exercício de uma pr

Isolation of Raoultella planticola from refillable antimicrobial liquid soap dispensers in a dental setting.

Science.gov (United States)

Momeni, Stephanie S; Tomlin, Nancy; Ruby, John D

2015-04-01

Liquid antimicrobial soaps are commonly used in the dental health care setting for hand washing to minimize the potential spread of infectious agents to health care workers and patients. The purpose of the current study was to evaluate possible bacterial contamination of antimicrobial liquid soap dispensers located in 2 institutional comprehensive dental care clinics. Fourteen soap dispensers and 16 original stock containers were sampled. A 1-milliliter aliquot was diluted in 10 mL of phosphate buffer (Tween-80; Acros). Serial dilutions were plated in duplicate on neutralizing agar and incubated for 7 days. Molecular identification was performed using 500 base pair comparisons of 16S ribosomal ribonucleic acid sequencing. Taq polymerase chain reaction was performed with sequence-specific primers for Raoultella species. Bacterial growth was observed at 18 hours for 57% (8 of 14) of soap dispenser samples. Bacterial densities ranged from 4 × 10(2) to 6 × 10(9) colony-forming units per milliliter. Original commercial containers exhibited no growth. Isolates were identified as Raoultella (Klebsiella) planticola. This is the first study to the authors' knowledge indicating recovery of R. planticola from antimicrobial liquid soap dispensers. R. planticola is a recognized environmental opportunistic pathogen that potentially poses a health concern. These findings indicate compliance problems with infection prevention recommendations and support the US Centers for Disease Control and Prevention's recommendation that dispensers should not be topped off. High bacterial loads of R. planticola are inconsistent with infection control practices and are a concern because transmission and possible infection to the health care worker or the patient may occur. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Effect of Hydrogen and Hydrogen Enriched Compressed Natural Gas Induction on the Performance of Rubber Seed Oil Methy Ester Fuelled Common Rail Direct Injection (CRDi Dual Fuel Engines

Directory of Open Access Journals (Sweden)

Mallikarjun Bhovi

2017-06-01

Full Text Available Renewable fuels are in biodegradable nature and they tender good energy security and foreign exchange savings. In addition they address environmental concerns and socio-economic issues. The present work presents the experimental investigations carried out on the utilization of such renewable fuel combinations for diesel engine applications. For this a single-cylinder four-stroke water cooled direct injection (DI compression ignition (CI engine provided with CMFIS (Conventional Mechanical Fuel Injection System was rightfully converted to operate with CRDi injection systems enabling high pressure injection of Rubber seed oil methyl ester (RuOME in the dual fuel mode with induction of varied gas flow rates of hydrogen and hydrogen enriched CNG (HCNG gas combinations. Experimental investigations showed a considerable improvement in dual fuel engine performance with acceptable brake thermal efficiency and reduced emissions of smoke, hydrocarbon (HC, carbon monoxide (CO and slightly increased nitric oxide (NOx emission levels for increased hydrogen and HCNG flow rates. Further CRDi facilitated dual fuel engine showed improved engine performance compared to CMFIS as the former enabled high pressure (900 bar injection of the RuOME and closer to TDC (Top Dead Centre as well. Combustion parameters such as ignition delay, combustion duration, pressure-crank angle and heat release rates were analyzed and compared with baseline data generated. Combustion analysis showed that the rapid rate of burning of hydrogen and HCNG along with air mixtures increased due to presence of hydrogen in total and in partial combination with CNG which further resulted into higher cylinder pressures and energy release rates. However, sustained research that can provide feasible engine technology operating on such fuels in dual fuel operation can pave the way for continued fossil fuel usage.

Using Healthcare Failure Mode and Effect Analysis to reduce medication errors in the process of drug prescription, validation and dispensing in hospitalised patients.

Science.gov (United States)

Vélez-Díaz-Pallarés, Manuel; Delgado-Silveira, Eva; Carretero-Accame, María Emilia; Bermejo-Vicedo, Teresa

2013-01-01

To identify actions to reduce medication errors in the process of drug prescription, validation and dispensing, and to evaluate the impact of their implementation. A Health Care Failure Mode and Effect Analysis (HFMEA) was supported by a before-and-after medication error study to measure the actual impact on error rate after the implementation of corrective actions in the process of drug prescription, validation and dispensing in wards equipped with computerised physician order entry (CPOE) and unit-dose distribution system (788 beds out of 1080) in a Spanish university hospital. The error study was carried out by two observers who reviewed medication orders on a daily basis to register prescription errors by physicians and validation errors by pharmacists. Drugs dispensed in the unit-dose trolleys were reviewed for dispensing errors. Error rates were expressed as the number of errors for each process divided by the total opportunities for error in that process times 100. A reduction in prescription errors was achieved by providing training for prescribers on CPOE, updating prescription procedures, improving clinical decision support and automating the software connection to the hospital census (relative risk reduction (RRR), 22.0%; 95% CI 12.1% to 31.8%). Validation errors were reduced after optimising time spent in educating pharmacy residents on patient safety, developing standardised validation procedures and improving aspects of the software's database (RRR, 19.4%; 95% CI 2.3% to 36.5%). Two actions reduced dispensing errors: reorganising the process of filling trolleys and drawing up a protocol for drug pharmacy checking before delivery (RRR, 38.5%; 95% CI 14.1% to 62.9%). HFMEA facilitated the identification of actions aimed at reducing medication errors in a healthcare setting, as the implementation of several of these led to a reduction in errors in the process of drug prescription, validation and dispensing.

Raw Milk Hygiene at Local Markets and Automatic Milk Dispenser Machines

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Gheorghe Şteţca

2014-11-01

Full Text Available In Romania, direct sales of raw milk to the final consumer is developed based on the local regulations. These are in accordance to European Regulation that must meet some quality requirements for the total number of germs, somatic cells, without antibiotics, coming from healthy animals who did not suffer from diseases that can be transmitted to humans through milk. Raw milk is sold in Romania in local markets and by automatic milk dispenser machines. Based on these regulations, a study regarding the quality and security to human health of raw milk was conducted on the commercialized milk in local markets and automatic milk dispensers. During May-June 2014 samples of raw milk were collected from Cluj-Napoca local markets and automatic milk dispensers. All samples were kept to refrigeration conditions until the moment of analyze which took place at the sampling day. The following parameters were taken into account: fat content, protein, casein, lactose, nonfat dry matter, pH, milk freezing point, added water, antibiotics residues, milk urea, number of germ cells and somatic cells. All obtained results were verified by the validated methods applied. Our research can be forward conducted in order to verify the hygiene and composition of milk from the whole dairy chain. 

Effective reprocessing of reusable dispensers for surface disinfection tissues – the devil is in the details

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Kampf, Günter; Degenhardt, Stina; Lackner, Sibylle; Ostermeyer, Christiane

2014-01-01

Background: It has recently been reported that reusable dispensers for surface disinfection tissues may be contaminated, especially with adapted Achromobacter species 3, when products based on surface-active ingredients are used. Fresh solution may quickly become recontaminated if dispensers are not processed adequately. Methods: We evaluated the abilities of six manual and three automatic processes for processing contaminated dispensers to prevent recolonisation of a freshly-prepared disinfectant solution (Mikrobac forte 0.5%). Dispensers were left at room temperature for 28 days. Samples of the disinfectant solution were taken every 7 days and assessed quantitatively for bacterial contamination. Results: All automatic procedures prevented recolonisation of the disinfectant solution when a temperature of 60–70°C was ensured for at least 5 min, with or without the addition of chemical cleaning agents. Manual procedures prevented recontamination of the disinfectant solution when rinsing with hot water or a thorough cleaning step was performed before treating all surfaces with an alcohol-based disinfectant or an oxygen-releaser. Other cleaning and disinfection procedures, including the use of an alcohol-based disinfectant, did not prevent recolonisation. Conclusions: These results indicate that not all processes are effective for processing reusable dispensers for surface-disinfectant tissues, and that a high temperature during the cleaning step or use of a biofilm-active cleaning agent are essential. PMID:24653973

Effective reprocessing of reusable dispensers for surface disinfection tissues – the devil is in the details

Directory of Open Access Journals (Sweden)

Kampf, Günter

2014-03-01

Full Text Available [english] Background: It has recently been reported that reusable dispensers for surface disinfection tissues may be contaminated, especially with adapted , when products based on surface-active ingredients are used. Fresh solution may quickly become recontaminated if dispensers are not processed adequately. Methods: We evaluated the abilities of six manual and three automatic processes for processing contaminated dispensers to prevent recolonisation of a freshly-prepared disinfectant solution (Mikrobac forte 0.5%. Dispensers were left at room temperature for 28 days. Samples of the disinfectant solution were taken every 7 days and assessed quantitatively for bacterial contamination. Results: All automatic procedures prevented recolonisation of the disinfectant solution when a temperature of 60–70°C was ensured for at least 5 min, with or without the addition of chemical cleaning agents. Manual procedures prevented recontamination of the disinfectant solution when rinsing with hot water or a thorough cleaning step was performed before treating all surfaces with an alcohol-based disinfectant or an oxygen-releaser. Other cleaning and disinfection procedures, including the use of an alcohol-based disinfectant, did not prevent recolonisation.Conclusions: These results indicate that not all processes are effective for processing reusable dispensers for surface-disinfectant tissues, and that a high temperature during the cleaning step or use of a biofilm-active cleaning agent are essential.

Trends in radiopharmaceutical dispensing in a regional nuclear pharmacy

International Nuclear Information System (INIS)

Basmadjian, G.P.; Barker, K.; Johnston, J.; Stinchcomb, R.; Tarman, B.; Ice, R.D.

1983-01-01

In the last five years, the practice of nuclear medicine has undergone changes due to the advent of new imaging technologies and radiopharmaceuticals. These changes have had an impact upon the number and the type of radiopharmaceuticals dispensed in centralized nuclear pharmacies. With the advent of Computerized Axial Tomography Scanners (CAT), sophistication and wider acceptance of the Ultrasound imaging modality, nuclear medicine has had to change directions from utilizing radiopharmaceuticals for static organ imaging to functional type imaging and to resort to the use of new radiopharmaceuticals or to find other uses for the existing radiopharmaceuticals. The following trends in radiopharmaceutical dispensing in a regional nuclear pharmacy are evident: Brain procedures have declined by about 67% while nuclear cardiology studies have increased by over 2000%. Bone scans have increased by 72% while liver, renal and lung studies have shown no significant increase. These changes will continue as the practice of nuclear medicine concentrates more on functional studies and relegates other studies to newer imaging modalities

Aspects of Chemical Composition and Somatic Cell count of Cow Milk Marketed at Dispensers

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Mircea Valentin MUNTEAN

2018-05-01

Full Text Available Milk quality is influenced by many factors: lactation, fat, protein, lactose, number of somatic cells. In order to process raw milk and compare with criteria of quality and food safety the Regulation of European Parliament and the council no. 853/2004. Analysing the total number of somatic cells (SCC in the period July-August 2017 it is noted that in case of samples collected from first automatic milk dispenser exceed 2 times the maximum admissible values and the samples collected from second automatic milk dispenser are up to the maximum allowable values which show that milking hygiene and animal health are at the European standards required. Analysis of fat content for both cases indicates that it is within the standard values for cow's milk and fat variations for DM1 samples are very low at temperatures above 30 degrees Celsius which shows that high temperatures do not influence these parameters. The biological material study was represented analysed by 30 samples of milk from only two cow milk dispensers functional located in this period in Cluj-Napoca city. These samples were collected at the same time period during July-August months. The aim of present study is to determine whether milk marketed through dispensers under the high temperature conditions specific to this period is affected in terms of qualitative parameter analysis.

The association between lifting an administrative restriction on antidepressant dispensing and treatment patterns in Iceland

DEFF Research Database (Denmark)

Thengilsdottir, G; Gardarsdottir, H; Almarsdóttir, Anna Birna

2013-01-01

On March 1st 2009, restrictions on the dispensing of selective serotonin reuptake inhibitors (SSRI) in Iceland were lifted. Incident rates and changes in early discontinuation and switching before and after the change were investigated.......On March 1st 2009, restrictions on the dispensing of selective serotonin reuptake inhibitors (SSRI) in Iceland were lifted. Incident rates and changes in early discontinuation and switching before and after the change were investigated....

ORF43 of maize rayado fino virus is dispensable for systemic infection of maize and transmission by leafhoppers.

Science.gov (United States)

Edwards, Michael C; Weiland, John J; Todd, Jane; Stewart, Lucy R; Lu, Shunwen

2016-04-01

Maize rayado fino virus (MRFV) possesses an open reading frame (ORF43) predicted to encode a 43 kDa protein (p43) that has been postulated to be a viral movement protein. Using a clone of MRFV (pMRFV-US) from which infectious RNA can be produced, point mutations were introduced to either prevent initiation from three potential AUG initiation codons near the 5'-end of ORF43 or prematurely terminate translation of ORF43. Inoculation of maize seed via vascular puncture inoculation (VPI) resulted in plants exhibiting symptoms typical of MRFV infection for all mutants tested. Furthermore, corn leafhoppers (Dalbulus maidis) transmitted the virus mutants to healthy plants at a frequency similar to that for wild-type MRFV-US. Viral RNA recovered from plants infected with mutants both prior to and after leafhopper transmission retained mutations blocking ORF43 expression. The results indicate that ORF43 of MRFV is dispensable for both systemic infection of maize and transmission by leafhoppers.

Population prevalence of high dose paracetamol in dispensed paracetamol/opioid prescription combinations: an observational study

Science.gov (United States)

2012-01-01

Background Paracetamol (acetaminophen) is generally considered a safe medication, but is associated with hepatotoxicity at doses above doses of 4.0 g/day, and even below this daily dose in certain populations. Methods The Nova Scotia Prescription Monitoring Program (NSPMP) in the Canadian province of Nova Scotia is a legislated organization that collects dispensing information on all out-of-hospital prescription controlled drugs dispensed for all Nova Scotia residents. The NSPMP provided data to track all paracetamol/opioids redeemed by adults in Nova Scotia, from July 1, 2005 to June 30, 2010. Trends in the number of adults dispensed these prescriptions and the numbers of prescriptions and tablets dispensed over this period were determined. The numbers and proportions of adults who filled prescriptions exceeding 4.0 g/day and 3.25 g/day were determined for the one-year period July 1, 2009 to June 30, 2010. Data were stratified by sex and age (paracetamol/opioid prescription was lower in each successive one-year period. From July 2009 to June 2010, one in 12 adults (n = 59,197) filled prescriptions for over 13 million paracetamol/opioid tablets. Six percent (n = 3,786) filled prescriptions that exceeded 4.0 g/day and 18.6% (n = 11,008) exceeded 3.25 g/day of paracetamol at least once. These findings exclude non-prescription paracetamol and paracetamol–only prescribed medications. Conclusions A substantial number of individuals who redeem prescriptions for paracetamol/opioid combinations may be at risk of paracetamol-related hepatotoxicity. Healthcare professionals must be vigilant when prescribing and dispensing these medications in order to reduce the associated risks. PMID:22709372

Fabrication and Measurement of Low Work Function Cesiated Dispenser Photocathodes

CERN Document Server

Moody, Nathan A; Jensen, Kevin

2005-01-01

Photoinjector performance is a limiting factor in the continued development of high powered FELs and electron beam-based accelerators. Presently available photocathodes are plagued with limited efficiency and short lifetime in an RF-gun environment, due to contamination or evaporation of a photosensitive surface layer. An ideal photocathode should have high efficiency at long wavelengths, long lifetime in practical vacuum environments, and prompt emission. Cathodes with high efficiency typically have limited lifetime, and vice versa, and the needs of the photocathode are generally at odds with those of the drive laser. A potential solution is the low work function dispenser cathode, where lifetime issues are overcome by periodic in situ regeneration that restores the photosensitive surface layer, analogous to those used in the microwave power tube industry. This work reports on the fabrication techniques and performance of cesiated metal photocathodes and cesiated dispenser cathodes, with a focus on understan...

Dispensing of drugs with and without a prescription from private ...

African Journals Online (AJOL)

There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in Tanzania. The present study assessed the patterns of drug acquisition from pharmacies by customers: whether by prescription, recommended by pharmacist, or requested by a customer without a prescription.

The impact of ethnic density on dispensing of antipsychotic and antidepressant medication among immigrants in the Netherlands.

Science.gov (United States)

Termorshuizen, Fabian; Heerdink, Eibert R; Selten, Jean-Paul

2018-06-12

A higher own-group ethnic density in the area of residence is often associated with a lower risk for psychotic disorder. For common mental disorders the evidence is less convincing. This study explores whether these findings are mirrored in data on dispensing of antipsychotics and antidepressants. Health insurance data on dispensed medication among all adults living in the four largest Dutch cities were linked to demographic data from Statistics Netherlands. Dispensing of antipsychotics and antidepressants in 2013 was analyzed in relation to the proportion of the own ethnic group in the neighborhood. Higher own-group ethnic density was associated with lower dispensing of antipsychotics among the Moroccan-Dutch (N = 115,455), after adjusting for age, gender, and SES of the neighborhood (OR adj for the highest vs. the lowest density quintile = 0.72 [0.66-0.79]). However, this association vanished after adjustment for household composition (OR adj  = 0.93 [0.85-1.03]). Similar results were found for the Turkish-Dutch (N = 105,460) (OR adj  = 0.86 [0.76-0.96] and 1.05 [0.94-1.18]). For those of Surinamese (N = 147,123) and Antillean origin (N = 41,430), in contrast, the association between ethnic density and lower risk remained after each adjustment (P density was consistently found for those of Antillean origin (OR adj  = 0.62 [0.52-0.74]) only. These data on dispensing of psychomedication confirm the ethnic density hypothesis for psychosis alongside earlier equivocal findings for other mental disorders. The negative association between own-group ethnic density and dispensing of antipsychotics among the Moroccan- and Turkish-Dutch may be explained, at least in part, by a favourable household composition (i.e., living in a family) in high-density neighborhoods. Copyright © 2018 Elsevier Ltd. All rights reserved.

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Science.gov (United States)

2010-07-01

... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000... 40 Protection of Environment 14 2010-07-01 2010-07-01 false Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More...

Dispensing of very low volumes of ultra high viscosity alginate gels: a new tool for encapsulation of adherent cells and rapid prototyping of scaffolds and implants.

Science.gov (United States)

Gepp, Michael M; Ehrhart, Friederike; Shirley, Stephen G; Howitz, Steffen; Zimmermann, Heiko

2009-01-01

We present a tool for dispensing very low volumes (20 nL or more) of ultra high viscosity (UHV) medical-grade alginate hydrogels. It uses a modified piezo-driven micrometering valve, integrated into a versatile system that allows fast prototyping of encapsulation procedures and scaffold production. Valves show excellent dispensing properties for UHV alginate in concentrations of 0.4% and 0.7% and also for aqueous liquids. An optimized process flow provides excellent handling of biological samples under sterile conditions. This technique allows the encapsulation of adherent cells and structuring of substrates for biotechnology and regenerative medicine. A variety of cell lines showed at least 70% viability after encapsulation (including cell lines that are relevant in regenerative medicine like Hep G2), and time-lapse analysis revealed cells proliferating and showing limited motility under alginate spots. Cells show metabolic activity, gene product expression, and physiological function. Encapsulated cells have contact with the substrate and can exchange metabolites while being isolated from macromolecules in the environment. Contactless dispensing allows structuring of substrates with alginate, isolation and transfer of cell-alginate complexes, and the dispensing of biological active hydrogels like extracellular matrix-derived gels.

Dispensing of vitamin products by retail pharmacies in South Africa ...

African Journals Online (AJOL)

Objective: The objective of this study was to analyse the dispensing patterns of vitamins (Anatomical Therapeutic Chemical (ATC) group A11) over a one-year period in a group of community pharmacies in South Africa. Design and setting: A retrospective drug utilisation study was conducted on community pharmacy ...

Integration of dispenser-printed ultra-low-voltage thermoelectric and energy storage devices

International Nuclear Information System (INIS)

Wang, Z; Chen, A; Winslow, R; Madan, D; Nill, M; Wright, P K; Juang, R C; Evans, J W

2012-01-01

This paper reports on an integrated energy harvesting prototype that consists of dispenser-printed thermoelectric energy harvesting and electrochemical energy storage devices. Parallel-connected thermoelectric devices with low internal resistances were designed, fabricated and characterized. The use of a commercially available dc-to-dc converter was explored to step-up a 27.1 mV input voltage from a printed thermoelectric device to a regulated 2.34 V output at a maximum of 34% conversion efficiency. The regulated power succeeds in charging dispenser-printed, zinc-based micro-batteries with charging efficiencies of up to 67%. The prototype presented in this work demonstrates the feasibility of deploying a printable, cost-effective and perpetual power solution for practical wireless sensor network applications. (paper)

ELECTROSPUN MESOFIBERS, A NOVEL BIODEGRADABLE PHEROMONE DISPENSER TECHNOLOGY, ARE COMBINED WITH MECHANICAL DEPLOYMENT FOR EFFICIENT IPM OF LOBESIA BOTRANA IN VINEYARDS.

Science.gov (United States)

Hummel, Hans E; Langner, S S; Breuer, M

2015-01-01

Behaviour modifying pheromones are well known agents for disrupting mating communication of pest insects. For optimal activity, they must be dispensed in time and space at a quantitatively measurable, predetermined release rate covering the flight period of the target species. Pheromones appeal to environmentally conscientious entomologists for their biodegradability, non-toxicity and ecological compatibility. In attempts of combining the virtues of pheromones, suitable slow release dispensers, and their mechanical deployment, an ecologically sensible, reasonably priced and patented procedure was developed and tested with the vineyard pest Lobesia botrana (Lep.: Tortricidae). It is characterized by (1) Electrospun mesofibers with diameters ranging from 0.6 to 3.5 micrometres, containing disruptants and dispensing it by slow release diffusion into the crop, (2) simultaneous application of the fully biodegradable combination of pheromone with Ecoflex polyester mesofiber, (3) combination of mechanical deployment by multi-purpose cultivators of the prefabricated pheromone dispensers with other simultaneous cultivation measures, and thus further reducing labour time and treatment costs. The dispensers are biodegradable within half a year without leaving any objectionable residues. In the standard eco-toxicology tests pheromone dispensers are harmless to non-target organisms. The disruptive effect of one treatment lasts for seven weeks which covers well one of several flight periods of L. botrana.

Impact of Robotic Dispensing Machines in German Pharmacies on ...

African Journals Online (AJOL)

As a result of using a robotic dispensing machine, personnel costs were reduced by an average of 4.6% during the first 12 months after start-up. Over-the-counter sales increased in the same period by an average of 6.8%. Despite average initial costs of 118,000 euros, total costs within the first 12 months fell in 50% of cases ...

Impact of one-dose package dispensing with patient counseling on medication adherence in geriatrics suffering from chronic disorders

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Narayana Goruntla

2018-01-01

Full Text Available Introduction: Medication nonadherence in elderly patients could result in a waste of medical expenses in a long-time span as well as deterioration of the patient's medical condition. Aim: The aim of this study is to evaluate the impact of one-dose package dispensing with patient counseling on medication adherence among elderly patients suffering from chronic disorders. Settings and Design: This is prospective, open-labeled, randomized trial carried out at dispensing pharmacy of the secondary care referral hospital, located in resource-limited settings of Anantapur District, Andhra Pradesh, India. Subjects and Methods: A total of 330 (aged ≥60 years patients were randomly assigned to one of three study groups: Group A (n = 110, no change in dosing and packing; Group B (n = 110, one-dose package dispensing; Group C (n = 110, One-dose package dispensing with patient counseling. Medication adherence levels were measured using a pill count and visual analog scale (VAS method at baseline and follow-up (after 1 month. Statistical Analysis: Descriptive statistics were used to represent the sociodemographic, clinical, and medication adherence profile of study participants. One-way ANOVA test is used to assess significant differences between three groups with a P 60 years who are on multiple medications can benefit from one-dose package dispensing and appropriate counseling. This will improve medication adherence hence better outcomes.

Louisiana SIP: LAC 33:III Ch 2132. Stage II Vapor Recovery Systems for Control of Vehicle Refuelling Emissions at Gasoline Dispensing Facilities; SIP effective 2011-08-04 (LAd34) and 2016-02-29 (LAd47) to 2017-09-27

Science.gov (United States)

Louisiana SIP: LAC 33:III Ch 2132. Stage II Vapor Recovery Systems for Control of Vehicle Refuelling Emissions at Gasoline Dispensing Facilities; SIP effective 2011-08-04 (LAd34) and 2016-02-29 (LAd47) to 2017-09-27

Development of alloy-film coated dispenser cathode for terahertz vacuum electron devices application

International Nuclear Information System (INIS)

Barik, R.K.; Bera, A.; Raju, R.S.; Tanwar, A.K.; Baek, I.K.; Min, S.H.; Kwon, O.J.; Sattorov, M.A.; Lee, K.W.; Park, G.-S.

2013-01-01

High power terahertz vacuum electron devices demand high current density and uniform emission dispenser cathode. It was found that the coating of noble metals e.g., Os, Ir, and Re on the surface of tungsten dispenser cathodes enhances the emission capabilities and uniformity. Hence metal coated cathode might be the best candidate for terahertz devices applications. In this study, ternary-alloy-film cathode (2Os:2Re:1 W) and Os coated cathode have been developed and the results are presented. The cathodes made out of this alloy coating showed 1.5 times higher emission and 0.02 eV emission uniformity as compared to those of simply Os coated cathodes which can be used in terahertz devices application.

Development of alloy-film coated dispenser cathode for terahertz vacuum electron devices application

Energy Technology Data Exchange (ETDEWEB)

Barik, R. K.; Bera, A. [School of Electrical Engineering and Computer Science, Seoul National University, Seoul (Korea, Republic of); Raju, R. S. [Central Electronics Engineering Research Institute (CEERI), Rajasthan (India); Tanwar, A. K.; Baek, I. K.; Min, S. H.; Kwon, O. J.; Sattorov, M. A. [Department of Physics and Astronomy, Center for THz-Bio Application Systems, and Seoul-Teracom Inc., Seoul National University, Seoul (Korea, Republic of); Lee, K. W. [LIG Nex1, Seoul (Korea, Republic of); Park, G.-S., E-mail: gunsik@snu.ac.kr [School of Electrical Engineering and Computer Science, Seoul National University, Seoul (Korea, Republic of); Department of Physics and Astronomy, Center for THz-Bio Application Systems, and Seoul-Teracom Inc., Seoul National University, Seoul (Korea, Republic of); Advanced Institute of Convergence Technology, Suwon-si, Gyeonggi-do (Korea, Republic of)

2013-07-01

High power terahertz vacuum electron devices demand high current density and uniform emission dispenser cathode. It was found that the coating of noble metals e.g., Os, Ir, and Re on the surface of tungsten dispenser cathodes enhances the emission capabilities and uniformity. Hence metal coated cathode might be the best candidate for terahertz devices applications. In this study, ternary-alloy-film cathode (2Os:2Re:1 W) and Os coated cathode have been developed and the results are presented. The cathodes made out of this alloy coating showed 1.5 times higher emission and 0.02 eV emission uniformity as compared to those of simply Os coated cathodes which can be used in terahertz devices application.

Validation of a proxy for estrogen receptor status in breast cancer patients using dispensing data.

Science.gov (United States)

Srasuebkul, Preeyaporn; Dobbins, Timothy A; Pearson, Sallie-Anne

2014-06-01

To assess the performance of a proxy for estrogen receptor (ER) status in breast cancer patients using dispensing data. We derived our proxy using 167 patients. ER+ patients had evidence of at least one dispensing record for hormone therapy during the lookback period, irrespective of diagnosis date and ER- had no dispensing records for hormone therapy during the period. We validated the proxy against our gold standard, ER status from pathology reports or medical records. We assessed the proxy's performance using three lookback periods: 4.5 years, 2 years, 1 year. More than half of our cohort (62%) were >50 years, 54% had stage III/IV breast cancer at recruitment, (46%) were diagnosed with breast cancer in 2009 and 23% were diagnosed before 2006. Sensitivity and specificity were high for the 4.5 year lookback period (93%, 95% CI: 86-96%; and 95%: 83-99%), respectively) and remained high for the 2-year lookback period (91%: 84-95%; and 95%: 83-99%). Sensitivity decreased (83%: 75.2-89%) but specificity remained high (95%: 83-99%) using the 1-year lookback period and the period is long enough to allow sufficient time for hormone therapy to be dispensed. Our proxy accurately infers ER status in studies of breast cancer treatment based on secondary health data. The proxy is most robust with a minimum lookback period of 2 years. © 2012 Wiley Publishing Asia Pty Ltd.

Treatment practices of households and antibiotic dispensing in medicine outlets in developing countries: The case of Ghana

DEFF Research Database (Denmark)

Tersbøl, Britt Pinkowski

2018-01-01

in households and the antibiotic dispensing practices of medicine sales outlets in Eastern region, Ghana. Method: Twice-weekly illness recall visits were made to 12 households in three rural communities over eight consecutive weeks. Detailed fieldnotes were taken and analysed using a thematic approach....... Quantitative counts of health events and treatment were also conducted. Dispensing practices were systematically observed and documented in three rural and three urban medicine outlets for analysis. Result: Fever, abdominal, and respiratory symptoms were the most common causes of ill-health in the 12...... an integral part of healthcare in the study settings and the qualitative data provides a contextual understanding of over-the-counter antibiotic acquisition and use. Inappropriate antibiotic use is apparent in the study settings. Stricter regulation of the pharmaceutical sector, training of dispensers...

Providers′ knowledge, attitude and dispensing practices of E-Pills in government dispensaries of south district in Delhi, India

Directory of Open Access Journals (Sweden)

Kishore Vertika

2010-01-01

Full Text Available Background: South Delhi is one of the well developed districts in the capital with best public health care facilities. Knowledge, attitude and dispensing practices of emergency contraceptive pills (E-pills were assessed among health care providers of government dispensaries in South Delhi. Study Design: A descriptive epidemiological study. Materials and Methods: Both medical and paramedical (n = 428 providers in 63 government health care facilities were interviewed between August to December 2007 using a semi-structured interview schedule. Results: Among the different categories of the providers, medical officers were observed to be most knowledgeable about E-pills and the pharmacists were the least. The correct prescribed dose of E-pill was known only to 32% of the providers while 49% knew about its right time of intake. Misconceptions and apprehensions for promoting its use were very much prevalent even among medical officers as majority felt that open access to E-pills would increase promiscuity. The dispensing practice of providers was found positively ( P < 0.05 correlated with their knowledge. Training resulted a significant ( P < 0.05 improvement in knowledge, attitude and dispensing practice of the providers. Knowledge and training combined together contributed 35% to the dispensing practice (R 2 = 0.35. Conclusion: Besides knowledge, behavior change communication strategies should form a part of the training curricula of health care providers that would help to improve the dispensing practice of E-pills.

Design, microfabrication, and characterization of a moulded PDMS/SU-8 inkjet dispenser for a Lab-on-a-Printer platform technology with disposable microfluidic chip.

Science.gov (United States)

Bsoul, Anas; Pan, Sheng; Cretu, Edmond; Stoeber, Boris; Walus, Konrad

2016-08-16

In this paper, we present a disposable inkjet dispenser platform technology and demonstrate the Lab-on-a-Printer concept, an extension of the ubiquitous Lab-on-a-Chip concept, whereby microfluidic modules are directly integrated into the printhead. The concept is demonstrated here through the integration of an inkjet dispenser and a microfluidic mixer enabling control over droplet composition from a single nozzle in real-time during printing. The inkjet dispenser is based on a modular design platform that enables the low-cost microfluidic component and the more expensive actuation unit to be easily separated, allowing for the optional disposal of the former and reuse of the latter. To limit satellite droplet formation, a hydrophobic-coated and tapered micronozzle was microfabricated and integrated with the fluidics to realize the dispenser. The microfabricated devices generated droplets with diameters ranging from 150-220 μm, depending mainly on the orifice diameter, with printing rates up to 8000 droplets per second. The inkjet dispenser is capable of dispensing materials with a viscosity up to ∼19 mPa s. As a demonstration of the inkjet dispenser function and application, we have printed type I collagen seeded with human liver carcinoma cells (cell line HepG2), to form patterned biological structures.

Recent trends in the dispensing of 90-day-supply prescriptions at retail pharmacies: implications for improved convenience and access.

Science.gov (United States)

Liberman, Joshua N; Girdish, Charmaine

2011-03-01

Mail-service pharmacies offer consumers the convenience of prescriptions filled with a 90-day supply of medication. Unlike mail-service pharmacies, retail pharmacies traditionally dispensed maintenance medication prescriptions with a 30-day supply. However, the retail landscape changed in May 2008 with Walmart's announcement of an extension of its $4 Prescription Program to include 90-day-supply prescriptions. To evaluate recent changes in access to and use of 90-day-supply maintenance medications dispensed via retail pharmacy. As of the first quarter of 2007, the proportion of retail-dispensed maintenance medications with a 90-day supply (compared with all maintenance prescriptions dispensed) among Medicare Part D plans, self-insured employers, and private health plans was 5.1%, 5.1%, and 5.0%, respectively. As of December 2009, this ratio had risen to 8.0% for Medicare plans and 8.1% for commercial health plans; the ratio among employers had risen more modestly to 6.1%. Of particular interest and importance, the proportion increased similarly for brand and for generic medications. There has been substantial growth in 90-day prescriptions dispensed via retail pharmacy, a trend that is likely to continue as more insurance providers adopt compatible benefit designs. It is important to continue monitoring these trends and to identify opportunities to rigorously evaluate their impact on medication adherence and healthcare costs.

Measurement of microbic contamination rate in the dispensing process making suspension of barium sulfate powder

International Nuclear Information System (INIS)

Kim, Young Keun; Lee, Yang Sub; Cho, Cheong Chan; Ryu, Meung Sun; Lee, Kyung Sup

2001-01-01

The purpose of this study is to investigate the contamination rate of barium sulfate suspension made in the exposed state in usual circumstances. This study was performed in four university hospital using the contrast media by barium sulfate powder. The specimen were detected at dispensing water, agitator and mixing tank. We also classified the suspension into general bacteria, mycete and Bacillus coli infection. The tap water were used to dispense water in the all hospitals. Bacillus coli were not detected in the all. General bacteria and mycete were not detected in the one specimen, but detected in two specimen over defined value. In the contamination rate of agitator, mixing tank, and the manufactured. Bacillus coli were not detected in all. However, general bacteria and mycete were detected too numberous to count. In conclusion, the refined water must be used in dispensing water in manufacturing suspension. The disinfectant is also used in washing the agitator and mixing tank for sterilization. Hand washing is indispensable to manufacturing suspension for preventing from infection

Microfluidic device and method for focusing, segmenting, and dispensing of a fluid stream

Science.gov (United States)

Jacobson, Stephen C [Knoxville, TN; Ramsey, J Michael [Knoxville, TN

2008-09-09

A microfluidic device and method for forming and dispensing minute volume segments of a material are described. In accordance with the present invention, a microfluidic device and method are provided for spatially confining the material in a focusing element. The device is also adapted for segmenting the confined material into minute volume segments, and dispensing a volume segment to a waste or collection channel. The device further includes means for driving the respective streams of sample and focusing fluids through respective channels into a chamber, such that the focusing fluid streams spatially confine the sample material. The device may also include additional means for driving a minute volume segment of the spatially confined sample material into a collection channel in fluid communication with the waste reservoir.

Pharmacy Malpractice: The rate and prevalence of dispensing high-risk prescription-only medications at community pharmacies in Saudi Arabia.

Science.gov (United States)

Alshammari, Thamir M; Alhindi, Salman A; Alrashdi, Ahmed M; Benmerzouga, Imaan; Aljofan, Mohamad

2017-07-01

To assess the compliance of community pharmacies with the regulations that prohibit the dispensing of prescription-only medications in the absence of a physician prescription in Saudi Arabia. A cross-sectional study was conducted in the period between October 2014 and January 2015. A list of 10 prescription-only medications were selected to be studied. 150 community pharmacies were visited across 6 major regions in Saudi Arabia to assess the prevalence of non-compliance among community pharmacies. Pharmacies were selected in random and researchers (disguised as patients) requested to purchase prescription-only medications in the absence of a prescription. Not all medications were purchased at once. Data were recorded per pharmacy, where pharmacies that approved dispense of the selected drug were scored as non-compliant and the pharmacies that rejected dispense of the selected drug were scored as compliant. Compliance rate was calculated per region per drug. Pharmacies based in governmental hospitals were visited in parallel. A total of 20 were visited. Data and statistical analysis were performed using Statistical Analyses Software (SAS 9.3). A total of 150 pharmacies were visited over a period of 3 months. On average, the percent approved dispense of prescription-only drugs across 6 regions in Saudi Arabia is 63% and the percent rejected dispense is 37% representing a significant non-compliance rate regarding the selected list of medications in this study. The frequency of dispense per medication across 6 major regions in Saudi Arabia is as follows: Isosorbide dinitrate (86%), Enoxaparin (82%), nitroglycerin (74%), Propranolol (73%), Verapamil (70%), Warfarin (65%), Methyldopa (64%), Ciprofloxacin (57%) and Codeine (4%). Non-compliance of community pharmacies with the law of pharmaceutical practice is at an alarming rate in the Kingdom of Saudi Arabia and authoritative figures must intervene to impede and combat such activities .

Polymer dispensing and embossing technology for the lens type LED packaging

Science.gov (United States)

Chien, Chien-Lin Chang; Huang, Yu-Che; Hu, Syue-Fong; Chang, Chung-Min; Yip, Ming-Chuen; Fang, Weileun

2013-06-01

This study presents a ring-type micro-structure design on the substrate and its corresponding micro fabrication processes for a lens-type light-emitting diode (LED) package. The dome-type or crater-type silicone lenses are achieved by a dispensing and embossing process rather than a molding process. Silicone with a high viscosity and thixotropy index is used as the encapsulant material. The ring-type micro structure is adopted to confine the dispensed silicone encapsulant so as to form the packaged lens. With the architecture and process described, this LED package technology herein has three merits: (1) the flexibility of lens-type LED package designs is enhanced; (2) a dome-type package design is used to enhance the intensity; (3) a crater-type package design is used to enhance the view angle. Measurement results show the ratio between the lens height and lens radius can vary from 0.4 to 1 by changing the volume of dispensed silicone. The view angles of dome-type and crater-type packages can reach 155° ± 5° and 175° ± 5°, respectively. As compared with the commercial plastic leaded chip carrier-type package, the luminous flux of a monochromatic blue light LED is improved by 15% by the dome-type package (improved by 7% by the crater-type package) and the luminous flux of a white light LED is improved by 25% by the dome-type package (improved by 13% by the crater-type package). The luminous flux of monochromatic blue light LED and white light LED are respectively improved by 8% and 12% by the dome-type package as compare with the crater-type package.

Implementation of information systems at pharmacies - a case study from the re-regulated pharmacy market in Sweden.

Science.gov (United States)

Hammar, Tora; Ohlson, Mats; Hanson, Elizabeth; Petersson, Göran

2015-01-01

When the Swedish pharmacy market was re-regulated in 2009, Sweden moved from one state-owned pharmacy chain to several private pharmacy companies, and four new dispensing systems emerged to replace the one system that had previously been used at all Swedish pharmacies for more than 20 years. The aim of this case study was to explore the implementation of the new information systems for dispensing at pharmacies. The vendors of the four dispensing systems in Sweden were interviewed, and a questionnaire was sent to the managers of the pharmacy companies. In addition, a questionnaire was sent to 350 pharmacists who used the systems for dispensing prescriptions. The implementation of four new dispensing systems followed a strict time frame set by political decisions, involved actors completely new to the market, lacked clear regulation and standards for functionality and quality assurance, was complex and resulted in variations in quality. More than half of the pharmacists (58%) perceived their current dispensing system as supporting safe dispensing of medications, 26% were neutral and 15% did not perceive it to support a safe dispensing. Most pharmacists (80%) had experienced problems with their dispensing system during the previous month. The pharmacists experienced problems included reliability issues, usability issues, and missing functionality. In this case study exploring the implementation of new information systems for dispensing prescriptions at pharmacies in Sweden, weaknesses related to reliability, functionality and usability were identified and could affect patient safety. The weaknesses of the systems seem to result from the limited time for the development and implementation, the lack of comprehensive and evidence-based requirements for dispensing systems, and the unclear distribution of quality assurance responsibilities among involved stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

Concern about the Expanding Prescription Drug Epidemic: A Survey of Licensed Prescribers and Dispensers.

Science.gov (United States)

Wright, R Eric; Reed, Nia; Carnes, Neal; Kooreman, Harold E

2016-01-01

Prescription drug misuse and abuse has reached epidemic levels in the U.S., and stands as a leading cause of death. As the primary gatekeepers to the medications contributing to this epidemic, it is critical to understand the views of licensed health care professionals. In this study, we examine health care professionals' concern regarding prescription drug abuse in their communities and the impact their concern has had on their prescribing and dispensing practices. An online survey of licensed health care providers. Conducted in Indiana. This study was a state-wide evaluation of Indiana's prescription drug monitoring program. The questionnaire asked respondents how concerned they were about prescription drug abuse in their community. Variation in the level of concern was examined using ordinary least squares regression and information about the respondents' demographic background and clinical experience. In addition, we used logistic regression to examine whether concern was associated with changing prescribing and/or dispensing behavior. The majority of providers indicated they were "moderately" or "extremely concerned" about prescription drug abuse in their communities. The level of concern, however, varied significantly by profession, with pharmacists, physicians, nurse practitioners/physician assistants being more concerned than dentists. Additional analyses indicate that providers with higher levels of concern were those who also reported recently changing their prescribing and/or dispensing behavior. The voluntary nature and geographical focus of the study limits the generalizability of the findings. Concern about prescription drug abuse is generally high across the major health care professions; however, a significant minority of providers, particularly among dentists, expressed little or no concern about the epidemic. Increasing health care providers' general level of concern about prescription drug abuse may be an effective public health tool for

Use of simulated patients to evaluate combined oral contraceptive dispensing practices of community pharmacists.

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Paulo Roque Obreli-Neto

Full Text Available BACKGROUND: Combined oral contraceptive (COC use is the most commonly used reversible method of birth control. The incorrect use of COCs is frequent and one of the most common causes of unintended pregnancies. Community pharmacists (CPs are in a strategic position to improve COC use because they are the last health professional to interact with patients before drug use. OBJECTIVE: To evaluate the COC dispensing practices of CPs in a developing country. METHOD: A cross-sectional study was conducted in community pharmacies of Assis and Ourinhos microregions, Brazil, between June 1, 2012, and October 30, 2012. Four simulated patients (SPs (with counseled audio recording visited community pharmacies with a prescription for Ciclo 21(® (a COC containing ethinyl estradiol 30 mcg + levonorgestrel 15 mcg. The audio recording of every SP visit was listened to independently by 3 researchers to evaluate the COC dispensing practice. The percentage of CPs who performed a screening for safe use of COCs (i.e., taking of patients' medical and family history, and measuring of blood pressure and provided counseling, as well as the quality of the screening and counseling, were evaluated. RESULTS: Of the 185 CPs contacted, 41 (22.2% agreed to participate in the study and finished the study protocol. Only 3 CPs asked the SP a question (1 question asked by each professional, and all of the questions were closed-ended, viz., "do you smoke?" (n = 2 and "what is your age?" (n = 1. None of the CPs measured the patient's blood pressure. Six CPs provided counseling when dispensing COCs (drug dosing, 5 CPs; possible adverse effects, 2 CPs, and one CP provided counseling regarding both aspects. CONCLUSION: The CPs evaluated did not dispense COC appropriately and could influence in the occurrence of negatives therapeutic outcomes such as adverse effects and treatment failure.

Hydrogen-Enhanced Natural Gas Vehicle Program

Energy Technology Data Exchange (ETDEWEB)

Hyde, Dan; Collier, Kirk

2009-01-22

The project objective is to demonstrate the viability of HCNG fuel (30 to 50% hydrogen by volume and the remainder natural gas) to reduce emissions from light-duty on-road vehicles with no loss in performance or efficiency. The City of Las Vegas has an interest in alternative fuels and already has an existing hydrogen refueling station. Collier Technologies Inc (CT) supplied the latest design retrofit kits capable of converting nine compressed natural gas (CNG) fueled, light-duty vehicles powered by the Ford 5.4L Triton engine. CT installed the kits on the first two vehicles in Las Vegas, trained personnel at the City of Las Vegas (the City) to perform the additional seven retrofits, and developed materials for allowing other entities to perform these retrofits as well. These vehicles were used in normal service by the City while driver impressions, reliability, fuel efficiency and emissions were documented for a minimum of one year after conversion. This project has shown the efficacy of operating vehicles originally designed to operate on compressed natural gas with HCNG fuel incorporating large quantities of exhaust gas recirculation (EGR). There were no safety issues experienced with these vehicles. The only maintenance issue in the project was some rough idling due to problems with the EGR valve and piping parts. Once the rough idling was corrected no further maintenance issues with these vehicles were experienced. Fuel economy data showed no significant changes after conversion even with the added power provided by the superchargers that were part of the conversions. Driver feedback for the conversions was very favorable. The additional power provided by the HCNG vehicles was greatly appreciated, especially in traffic. The drivability of the HCNG vehicles was considered to be superior by the drivers. Most of the converted vehicles showed zero oxides of nitrogen throughout the life of the project using the State of Nevada emissions station.

Understanding vs. Competency: The Case of Accuracy Checking Dispensed Medicines in Pharmacy

Science.gov (United States)

James, K. Lynette; Davies, J. Graham; Kinchin, Ian; Patel, Jignesh P.; Whittlesea, Cate

2010-01-01

Ensuring the competence of healthcare professionals' is core to undergraduate and post-graduate education. Undergraduate pharmacy students and pre-registration graduates are required to demonstrate competence at dispensing and accuracy checking medicines. However, competence differs from understanding. This study determined the competence and…

Emission characteristics of dispenser cathodes with a fine-grained tungsten top layer

Science.gov (United States)

Kimura, S.; Higuchi, T.; Ouchi, Y.; Uda, E.; Nakamura, O.; Sudo, T.; Koyama, K.

1997-02-01

In order to improve the emission stability of the Ir-coated dispenser cathode under ion bombardment, a fine-grained tungsten top layer was applied on the substrate porous tungsten plug before Ir coating. The emission characteristics were studied after being assembled in a CRT gun. Cathode current was measured under pulse operation in a range of 0.1-9% duty. Remarkable anti-ion bombardment characteristics were observed over the range of 1-6% duty. The improved cathode showed 1.5 times higher emission current than that of a conventional Ir-coated dispenser cathode at 4% duty. AES analysis showed that the recovering rates of surface Ba and O atoms after ion bombardment were 2.5 times higher. From these results it is confirmed that the Ir coated cathode with a fine-grained tungsten top layer is provided with a good tolerance against the ion bombardment.

Multi-chamber actuated micro-dispensing with a single nozzle for sub-nanoliter droplet formation

International Nuclear Information System (INIS)

Song, Sukho; Kim, Sangjin; Kim, Changsung Sean; Kang, Philjoong; Ku, Bosung

2014-01-01

A novel concept of single-nozzle micro-dispensing device with multiple pressurizing chambers is proposed for high-throughput drug screening applications such as arraying new drug candidates with sub-nanoliter volume. The theoretical study with a simplified electrical circuit model of the fluidic system shows that the proposed model is effective to sustain jetting stability at high frequency due to an increase in the natural frequency of the fluidic system and high attenuation of the negative pressure wave in the fluidic system. The fabricated device was able to form uniform droplets at up to 7 kHz having 115 pL (1.15 × 10 −10  L) in volume and 1.8 m s −1  ∼ 2.5 m s −1  in velocity. (paper)

PROJECT OF COAGULANT DISPENSER IN PULVERIZATION AERATOR WITH WIND DRIVE

Directory of Open Access Journals (Sweden)

Ewa Osuch

2017-09-01

Full Text Available Lakes are one of most important freshwater ecosystems, playing significant role in functioning of nature and human economy. Swarzędzkie Lake is good example of ecosystem, which in last half-century was exposed to the influence of strong anthropopressure. Direct inflow of sewage with large number of biogens coming to the lake with water of inflows caused distinct disturbance of its functioning. In autumn 2011 restoration begined on Swarzędzkie Lake for reduction of lake trophy and improvement of water quality. For achieving better and quicker effect, simultaneously combination of some methods was applied, among others method of oxygenation of over-bottom water with help of pulverization aerator and method of precise inactivation of phosphorus in water depths. Characterization and analysis of improved coagulant dispenser applying active substance only during work of pulverization aerator is the aim of this thesis. Principle of dispenser work, its structure and location in pulverization aerator were explained. It was stated, that introduction to water a factor initiating process of phosphorus inactivation causes significant reduction of mineral phosphorus in water and size of coagulant dose correlates with intensity of work of pulverization aerator with wind drive.

A Curriculum For Dispensing Optician A Case Study In Vietnam

Directory of Open Access Journals (Sweden)

Duong Dieu MD

2015-08-01

Full Text Available Until 2011 there had been no full-time training course for dispensing optician diploma in Vietnam. Most of the practicing opticians with no qualification and formal training have learnt their skills through apprentice. In response to the demand of the industry Nguyen Tat Thanh University Vietnam has teamed up with Bradford College United Kingdom to develop a curriculum for a of formal 2-year full-time training for dispensing optician. The curriculum is applied for 4 semesters and graduate gets called Intermediate Professional Diploma level included 4 semesters. In VN after high school students can obtain different many levels of study such as Intermediate Professional Diploma College Bachelor Master and PhD. The 1st semester is basis of Intermediate Professional Diploma level. The 2nd semester is the study of refractive error and primary care each for 4 weeks 100 hours in theory and primary eye care 4 weeks for theory 100 hours. Also in this semester the learners have practiced clinical rotation at the Ophthalmic Hospital Ophthalmic Service in General Hospital for 10 weeks. The 3rd semester is specialized of dispensing Optician included Lenses frame contact lenses and laboratory for optician. In the 4th semester the training concentrates in the management of the eyeglasses shop and practicing in making spectacles for customers are in the 4th semester. The 1st intake of the course was opened started in 2011 and had 30 students graduated in 2013. This paper describes the experience of developing the curriculum in the context of a developing country where the industry is still under regulated and less developed. The first program optician that privileged on primary eye care will be satisfied for community WHO 2020 1 optometrist for 50.000 people and 10 ophthalmologists for 1.000.000 people. Some characteristics of first course students have been noted. The result of this curriculum will be evaluated in the coming time.

The degree of integration of non-dispensing pharmacists in primary care practice and the impact on health outcomes: A systematic review.

Science.gov (United States)

Hazen, Ankie C M; de Bont, Antoinette A; Boelman, Lia; Zwart, Dorien L M; de Gier, Johan J; de Wit, Niek J; Bouvy, Marcel L

2018-03-01

A non-dispensing pharmacist conducts clinical pharmacy services aimed at optimizing patients individual pharmacotherapy. Embedding a non-dispensing pharmacist in primary care practice enables collaboration, probably enhancing patient care. The degree of integration of non-dispensing pharmacists into multidisciplinary health care teams varies strongly between settings. The degree of integration may be a determinant for its success. This study investigates how the degree of integration of a non-dispensing pharmacist impacts medication related health outcomes in primary care. In this literature review we searched two electronic databases and the reference list of published literature reviews for studies about clinical pharmacy services performed by non-dispensing pharmacists physically co-located in primary care practice. We assessed the degree of integration via key dimensions of integration based on the conceptual framework of Walshe and Smith. We included English language studies of any design that had a control group or baseline comparison published from 1966 to June 2016. Descriptive statistics were used to correlate the degree of integration to health outcomes. The analysis was stratified for disease-specific and patient-centered clinical pharmacy services. Eighty-nine health outcomes in 60 comparative studies contributed to the analysis. The accumulated evidence from these studies shows no impact of the degree of integration of non-dispensing pharmacists on health outcomes. For disease specific clinical pharmacy services the percentage of improved health outcomes for none, partial and fully integrated NDPs is respectively 75%, 63% and 59%. For patient-centered clinical pharmacy services the percentage of improved health outcomes for none, partial and fully integrated NDPs is respectively 55%, 57% and 70%. Full integration adds value to patient-centered clinical pharmacy services, but not to disease-specific clinical pharmacy services. To obtain maximum benefits

Pheromone dispensers, including organic polymer fibers, described in the crop protection literature: comparison of their innovation potential.

Science.gov (United States)

Hummel, Hans E; Langner, S S; Eisinger, M-T

2013-01-01

parameters, they hold considerable promise for future pest control against a variety of pest insects. In combination with well known synthetic sex pheromones, they can be used for communication disruption studies. One example, the pheromone of the European grape vine moth Lobesia botrana (Lepidoptera: Tortricidae), in combination with Ecoflex fibers, has been thoroughly tested in vineyards of Freiburg, Southwest Germany, with promising results. Seven weeks of communication disruption have been achieved, long enough to cover any one of several flights of this multivoltine grape pest. Disruption effects of around 95% have been achieved which are statistically indistinguishable from positive controls tested simultaneously with Isonet LE fibers, while an untreated negative control is significantly different. Ecoflex is a cheap organic co-polyester and completely biodegradable within half a year. Thus, an extra recovery step as with some other dispensers is unnecessary. This co-polyester is also of proven non-toxicity. The extension of the seven week disruption period towards half a year (the entire duration of all 3 Lobesia flights combined) is desirable and is under additional investigation in the near future. The discovery of suitable mesofibers is protected by European and US patents. The pheromone literature appearing between 1959 and today contains more than 25,000 references. This wealth of information is immediately applicable to pest management. It has major impacts on chemical ecology and IPM. In this paper, an attempt is made to compare the systems described in the literature and to derive some predictions about their prospective innovation potential. Special emphasis is given to the new development of organic biodegradable microfibers. To this end, a new electronic searching algorithm is introduced for reviewing the entries to be found in 4 specific databases. Its prominent features will be described. Surprisingly we found no previous entries in the literature linking

Drug-dispensing errors in the hospital pharmacy Erros de dispensação de medicamentos em farmácia hospitalar

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Tânia Azevedo Anacleto

2007-01-01

Full Text Available OBJECTIVE: To determine the dispensing error rate and to identify factors associated with them, and to propose prevention actions. METHODS: A cross-sectional study focusing on the occurrence of dispensing errors in a general hospital in Belo Horizonte that uses a mixed system (a combination of multidose and unit dose systems of collective and individualized dosing. RESULTS: A total of 422 prescription order forms were analyzed, registering 81.8% with at least 1 dispensing error. Opportunities for errors were higher in the pretyped prescription order forms (odds ratio = 4.5; P OBJETIVO: Determinar a taxa de erros de dispensação e identificar fatores associados, propondo ações de prevenção. MÉTODOS: Estudo transversal investigou-se a ocorrência de erros de dispensação em um hospital geral de Belo Horizonte que emprega um sistema misto de dose coletiva e individualizada. RESULTADOS: Foram analisadas 422 prescrições, registrando em 81,8% destas pelo menos um erro de dispensação. Oportunidades de erros foram maiores nas prescrições pré-digitadas (Odds Ratio=4,5; p<0,001, naquelas com nove ou mais medicamentos (Odds Ratio=4,0; p<0,001 e com os injetáveis (Odds Ratio=5,0; p<0,001. Uma das equipes de profissionais apresentou maior chance de erros (Odds Ratio=2,0; p=0,02. A análise multivariada ratifica estes resultados. CONCLUSÃO: Conclui-se que o sistema de dispensação da farmácia apresenta muitas falhas latentes e poucas defesas, com diversas condições que predispõe a ocorrência de erros, contribuindo para a elevada taxa registrada.

Methodological challenges in assessment of current use of warfarin among patients with atrial fibrillation using dispensation data from administrative health care databases.

Science.gov (United States)

Sinyavskaya, Liliya; Matteau, Alexis; Johnson, Sarasa; Durand, Madeleine

2018-06-05

Algorithms to define current exposure to warfarin using administrative data may be imprecise. Study objectives were to characterize dispensation patterns, to measure gaps between expected and observed refill dates for warfarin and direct oral anticoagulants (DOACs). Retrospective cohort study using administrative health care databases of the Régie de l'assurance-maladie du Québec. We identified every dispensation of warfarin, dabigatran, rivaroxaban, or apixaban for patients with AF initiating oral anticoagulants between 2010 and 2015. For each dispensation, we extracted date and duration. Refill gaps were calculated as difference between expected and observed dates of successive dispensation. Refill gaps were summarized using descriptive statistics. To account for repeated observations nested within patients and to assess the components of variance of refill gaps, we used unconditional multilevel linear models. We identified 61 516 new users. Majority were prescribed warfarin (60.3%), followed by rivaroxaban (16.4%), dabigatran (14.5%), apixaban (8.8%). Most frequent recorded duration of dispensation was 7 days, suggesting use of pharmacist-prepared weekly pillboxes. The average refill gap from multilevel model was higher for warfarin (9.28 days, 95%CI:8.97-9.59) compared with DOACs (apixaban 3.08 days, 95%CI: 2.96-3.20, dabigatran 3.70, 95%CI: 3.56-3.84, rivaroxaban 3.15, 95%CI: 3.03-3.27). The variance of refill gaps was greater among warfarin users than among DOAC users. Greater refill gaps for warfarin may reflect inadequate capture of the period covered by the number of dispensed pills recorded in administrative data. A time-dependent definition of exposure using dispensation data would lead to greater misclassification of warfarin than DOACs use. Copyright © 2018 John Wiley & Sons, Ltd.

Guide to Permitting Hydrogen Motor Fuel Dispensing Facilities

Energy Technology Data Exchange (ETDEWEB)

Rivkin, Carl [National Renewable Energy Lab. (NREL), Golden, CO (United States); Buttner, William [National Renewable Energy Lab. (NREL), Golden, CO (United States); Burgess, Robert [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2016-03-28

The purpose of this guide is to assist project developers, permitting officials, code enforcement officials, and other parties involved in developing permit applications and approving the implementation of hydrogen motor fuel dispensing facilities. The guide facilitates the identification of the elements to be addressed in the permitting of a project as it progresses through the approval process; the specific requirements associated with those elements; and the applicable (or potentially applicable) codes and standards by which to determine whether the specific requirements have been met. The guide attempts to identify all applicable codes and standards relevant to the permitting requirements.

Evaluation of antibiotics dispensing profile in Tubarão, Santa Catarina, Brazil

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Claudia Rauber

2009-12-01

Full Text Available Antibiotics are drugs widely used in prophylaxis and treatment of a great number of diseases. However, their use must be carefully controlled as acquisition in pharmacies, often without medical prescription, is elevated. The role of pharmacists in these circumstances is to practice dispensation in a rational manner. Through a structured questionnaire with open and closed questions, this study investigated the profile of antibiotics dispensed in pharmacies of Tubarão, Santa Catarina, Brazil. From the responses, it was observed that 85.0% dispense this class of medicine without medical prescription, mainly for treatment of respiratory (62.8% and urinary (12.0% tract disorders. Moreover, pharmacists' guidance was largely focused on posology (66.6% and drug interaction (12.6%, in addition to the interactions with contraceptives, alcohol and milk. The importance of avoiding antibiotics dispensation without medical prescription must be emphasized, as well as the benefits of educating the population to promote the rational use of medicines.Antibióticos são fármacos amplamente utilizados na profilaxia e no tratamento de grande número de doenças. Entretanto, seu uso deve ser cuidadosamente controlado nas farmácias, uma vez que nestas a aquisição sem prescrição médica é elevada. O papel dos farmacêuticos nessas circunstâncias é o de praticar a dispensação de maneira racional. Por meio de questionário estruturado, com questões abertas e fechadas, investigou-se o perfil dos antibióticos dispensados em farmácias de Tubarão, Santa Catarina, Brasil. Pelas respostas, observou-se que 85% das dispensa essa classe de medicamentos sem prescrição médica, principalmente para o tratamento de problemas dos tratos respiratório (62,8% e urinário (12,0%. Além disso, a orientação dos farmacêuticos se focou amplamente na posologia (66,6%e nas interações com fármacos (12,6%, em adição às interações com anticoncepcionais, álcool e

Inkjet metrology: high-accuracy mass measurements of microdroplets produced by a drop-on-demand dispenser.

Science.gov (United States)

Verkouteren, R Michael; Verkouteren, Jennifer R

2009-10-15

We describe gravimetric methods for measuring the mass of droplets generated by a drop-on-demand (DOD) microdispenser. Droplets are deposited, either continuously at a known frequency or as a burst of known number, into a cylinder positioned on a submicrogram balance. Mass measurements are acquired precisely by computer, and results are corrected for evaporation. Capabilities are demonstrated using isobutyl alcohol droplets. For ejection rates greater than 100 Hz, the repeatability of droplet mass measurements was 0.2%, while the combined relative standard uncertainty (u(c)) was 0.9%. When bursts of droplets were dispensed, the limit of quantitation was 72 microg (1490 droplets) with u(c) = 1.0%. Individual droplet size in a burst was evaluated by high-speed videography. Diameters were consistent from the tenth droplet onward, and the mass of an individual droplet was best estimated by the average droplet mass with a combined uncertainty of about 1%. Diameters of the first several droplets were anomalous, but their contribution was accounted for when dispensing bursts. Above the limits of quantitation, the gravimetric methods provided statistically equivalent results and permit detailed study of operational factors that influence droplet mass during dispensing, including the development of reliable microassays and standard materials using DOD technologies.

Effect of Biodiesel Fuel Injection Timing and Venture for Gaseous Fuel Induction on the Performance, Emissions and Combustion Characteristics of Dual Fuel Engine

Directory of Open Access Journals (Sweden)

Mallikarjun Bhovi

2018-02-01

Full Text Available Advancing or retarding pilot fuel injection timing in a diesel engine provided with either conventional mechanical fuel injection (CMFIS or high pressure injection as in common rail fuel injection (CRDI systems can significantly affect its performance and tail pipe emissions. Performance of diesel engine when fueled with various biofuels as well as gaseous fuels tends to vary with subsequent changes in pilot fuel injection timings. Biodiesel derived from rubber seed oil called Rubber Seed Oil Methyl Ester (RuOME and hydrogen (H2 and hydrogen enriched compressed natural gas called (HCNG both being renewable fuels when used in diesel engines modified to operate in dual fuel mode can provide complete replacement for fossil diesel. In the present study, effect of injection timings and venture design for gas mixing on the performance, combustion and emission characteristics of dual fuel engine fitted with both CMFIS and CRDI injection systems and operated on RuOME and HCNG/hydrogen has been investigated. Results showed that high pressure CRDI assisted injection of RuOME with optimized mixing chamber (carburetor for hydrogen induction in dual fuel engine performed improved compared to that with CMFIS. In addition, for the same fuel combinations, CRDI resulted in lower biodiesel consumption, lower carbon monoxide (BSCO and hydrocarbon (BSHC emissions and increased NOx emissions than CMFIS operation.

Flow Channel Influence of a Collision-Based Piezoelectric Jetting Dispenser on Jet Performance

Directory of Open Access Journals (Sweden)

Can Zhou

2018-04-01

Full Text Available To improve the jet performance of a bi-piezoelectric jet dispenser, mathematical and simulation models were established according to the operating principle. In order to improve the accuracy and reliability of the simulation calculation, a viscosity model of the fluid was fitted to a fifth-order function with shear rate based on rheological test data, and the needle displacement model was fitted to a nine-order function with time based on real-time displacement test data. The results show that jet performance is related to the diameter of the nozzle outlet and the cone angle of the nozzle, and the impacts of the flow channel structure were confirmed. The approach of numerical simulation is confirmed by the testing results of droplet volume. It will provide a reliable simulation platform for mechanical collision-based jet dispensing and a theoretical basis for micro jet valve design and improvement.

Does anti-malarial drug knowledge predict anti-malarial dispensing practice in drug outlets? A survey of medicine retailers in western Kenya

Directory of Open Access Journals (Sweden)

Rusk Andria

2012-08-01

Full Text Available Abstract Background Malaria is a major cause of morbidity and mortality in Kenya, where it is the fifth leading cause of death in both children and adults. Effectively managing malaria is dependent upon appropriate treatment. In Kenya, between 17 to 83 percent of febrile individuals first seek treatment for febrile illness over the counter from medicine retailers. Understanding medicine retailer knowledge and behaviour in treating suspected malaria and dispensing anti-malarials is crucial. Methods To investigate medicine retailer knowledge about anti-malarials and their dispensing practices, a survey was conducted of all retail drug outlets that sell anti-malarial medications and serve residents of the Webuye Health and Demographic Surveillance Site in the Bungoma East District of western Kenya. Results Most of the medicine retailers surveyed (65% were able to identify artemether-lumefantrine (AL as the Kenyan Ministry of Health recommended first-line anti-malarial therapy for uncomplicated malaria. Retailers who correctly identified this treatment were also more likely to recommend AL to adult and paediatric customers. However, the proportion of medicine retailers who recommend the correct treatment is disappointingly low. Only 48% would recommend AL to adults, and 37% would recommend it to children. It was discovered that customer demand has an influence on retailer behaviour. Retailer training and education were found to be correlated with anti-malarial drug knowledge, which in turn is correlated with dispensing practices. Medicine retailer behaviour, including patient referral practice and dispensing practices, are also correlated with knowledge of the first-line anti-malarial medication. The Kenya Ministry of Health guidelines were found to influence retailer drug stocking and dispensing behaviours. Conclusion Most medicine retailers could identify the recommended first-line treatment for uncomplicated malaria, but the percentage that could

Medication Incidents Related to Automated Dose Dispensing in Community Pharmacies and Hospitals - A Reporting System Study

Science.gov (United States)

Cheung, Ka-Chun; van den Bemt, Patricia M. L. A.; Bouvy, Marcel L.; Wensing, Michel; De Smet, Peter A. G. M.

2014-01-01

Introduction Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. Methods The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers. Main Outcome Measures Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. Results From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. Conclusion A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident

Extent of dispensing prescription-only medications without a prescription in community drug retail outlets in Addis Ababa, Ethiopia: a simulated-patient study

Directory of Open Access Journals (Sweden)

Erku DA

2016-07-01

Full Text Available Daniel Asfaw Erku,1 Abebe Basazn Mekuria,2 Abdrrahman Shemsu Surur,1 Begashaw Melaku Gebresillassie3 1Department of Pharmaceutical Chemistry, 2Department of Pharmacology, 3Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia Purpose: This study was aimed at assessing the extent of dispensing prescription-only medications without a prescription in community drug retail outlets (CDROs of Addis Ababa, Ethiopia.Methods: A descriptive cross-sectional observational study design was used to sample 31 pharmacies, 25 drug stores, and two rural drug vendors from August 11, 2015, to October 21, 2015, through a simple random sampling method. A simulated-patient method of visit was implemented to collect data. Requests of six tracer prescription-only medicines (amoxicillin + clavulanic acid capsule, amitriptyline, captopril, glibenclamide [also known as glyburide], omeprazole capsule, and sildenafil citrate and upper respiratory tract infection were selected as the simulated clinical scenario.Results: Amoxicillin–clavulanic acid capsule was dispensed when requested in 87.93% of the dispensaries. All of the CDROs dispensed omeprazole upon request. Sildenafil citrate (Viagra was in stock in 96.55% of the CDROs, all of which issued the requested number of tablets without asking why or for whom the drug was needed. Amitriptyline, captopril, and glibenclamide (glyburide were dispensed in 84.48%, 89.65%, and 87.93% of CDROs upon the provision of an empty container. Antibiotics were obtained from 75.86% of CDROs for presentation of upper respiratory tract infection symptoms. Among the dispensed antibiotics, the most common was amoxicillin (93.18%, followed by amoxicillin–clavulanic acid capsule (72.72%, and azithromycin (50%. Only 4.5% of the dispensaries asked about drug allergies, and 15.9% of the CDROs informed the simulated patient about the possible side effects of the drugs.Conclusion: This study revealed a very high

How complete is the information on preadmission psychotropic medications in inpatients with dementia? A comparison of hospital medical records with dispensing data.

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Pisa, Federica Edith; Palese, Francesca; Romanese, Federico; Barbone, Fabio; Logroscino, Giancarlo; Riedel, Oliver

2018-06-05

Reliable information on preadmission medications is essential for inpatients with dementia, but its quality has hardly been evaluated. We assessed the completeness of information and factors associated with incomplete recording. We compared preadmission medications recorded in hospital electronic medical records (EMRs) with community-pharmacy dispensations in hospitalizations with discharge code for dementia at the University Hospital of Udine, Italy, 2012-2014. We calculated: (a) prevalence of omissions (dispensed medication not recorded in EMRs), additions (medication recorded in EMRs not dispensed), and discrepancies (any omission or addition); (b) multivariable logistic regression odds ratio, with 95% confidence interval (95% CI), of ≥1 omission. Among 2,777 hospitalizations, 86.1% had ≥1 discrepancy for any medication (Kappa 0.10) and 33.4% for psychotropics. When psychotropics were recorded in EMR, antipsychotics were added in 71.9% (antidepressants: 29.2%, antidementia agents: 48.2%); when dispensed, antipsychotics were omitted in 54.4% (antidepressants: 52.7%, antidementia agents: 41.5%). Omissions were 92% and twice more likely in patients taking 5 to 9 and ≥10 medications (vs. 0 to 4), 17% in patients with psychiatric disturbances (vs. none), and 41% with emergency admission (vs. planned). Psychotropics, commonly used in dementia, were often incompletely recorded. To enhance information completeness, both EMRs and dispensations should be used. Copyright © 2018 John Wiley & Sons, Ltd.

Rates of opioid dispensing and overdose after introduction of abuse-deterrent extended-release oxycodone and withdrawal of propoxyphene.

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Larochelle, Marc R; Zhang, Fang; Ross-Degnan, Dennis; Wharam, J Frank

2015-06-01

In the second half of 2010, abuse-deterrent extended-release oxycodone hydrochloride (OxyContin; Purdue Pharma) was introduced and propoxyphene was withdrawn from the US market. The effect of these pharmaceutical market changes on opioid dispensing and overdose rates is unknown. To evaluate the association between 2 temporally proximate changes in the opioid market and opioid dispensing and overdose rates. Claims from a large national US health insurer were analyzed, using an interrupted time series study design. Participants included an open cohort of 31.3 million commercially insured members aged 18 to 64 years between January 1, 2003, and December 31, 2012, with median follow-up of 20 months (last follow-up, December 31, 2012). Introduction of abuse-deterrent OxyContin (resistant to crushing or dissolving) on August 9, 2010, and market withdrawal of propoxyphene on November 19, 2010. Standardized opioid dispensing rates and prescription opioid and heroin overdose rates were the primary outcomes. We used segmented regression to analyze changes in outcomes from 30 quarters before to 8 quarters after the 2 interventions. Two years after the opioid market changes, total opioid dispensing decreased by 19% from the expected rate (absolute change, -32.2 mg morphine-equivalent dose per member per quarter [95% CI, -38.1 to -26.3]). By opioid subtype, the absolute change in dispensing by milligrams of morphine-equivalent dose per member per quarter at 2 years was -11.3 (95% CI, -12.4 to -10.1) for extended-release oxycodone, 3.26 (95% CI, 1.40 to 5.12) for other long-acting opioids, -8.19 (95% CI, -9.30 to -7.08) for propoxyphene, and -16.2 (95% CI, -18.8 to -13.5) for other immediate-release opioids. Two years after the market changes, the estimated overdose rate attributed to prescription opioids decreased by 20% (absolute change, -1.10 per 100,000 members per quarter [95% CI, -1.47 to -0.74]), but heroin overdose increased by 23% (absolute change, 0.26 per 100

PMD: designing a portable medicine dispenser for persons suffering from Alzheimer’s disease

NARCIS (Netherlands)

de Beer, Roel C.J.M.; Keijers, R.; Shahid, S.; Al Mahmud, A.; Mubin, O.

2010-01-01

In this paper we present the user-centred design of a medicine dispenser for persons suffering from Alzheimer’s disease. The prototype was evaluated in two phases with two caregivers and two Alzheimer’s patients. Caregivers evaluated the device positively. The Alzheimer’s patients faced usability

Configurating computer-controlled bar system

OpenAIRE

Šuštaršič, Nejc

2010-01-01

The principal goal of my diploma thesis is creating an application for configurating computer-controlled beverages dispensing systems. In the preamble of my thesis I present the theoretical platform for point of sale systems and beverages dispensing systems, which are required for the understanding of the target problematics. As with many other fields, computer tehnologies entered the field of managing bars and restaurants quite some time ago. Basic components of every bar or restaurant a...

Validating a proxy for disease progression in metastatic cancer patients using prescribing and dispensing data.

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Joshi, Vikram; Adelstein, Barbara-Ann; Schaffer, Andrea; Srasuebkul, Preeyaporn; Dobbins, Timothy; Pearson, Sallie-Anne

2017-10-01

Routine data collections are used increasingly to examine outcomes of real-world cancer drug use. These datasets lack clinical details about important endpoints such as disease progression. To validate a proxy for disease progression in metastatic cancer patients using prescribing and dispensing claims. We used data from a cohort study of patients undergoing chemotherapy who provided informed consent to the collection of cancer-treatment data from medical records and linkage to pharmaceutical claims. We derived proxy decision rules based on changes to drug treatment in prescription histories (n = 36 patients) and validated the proxy in prescribing data (n = 62 patients). We adapted the decision rules and validated the proxy in dispensing data (n = 109). Our gold standard was disease progression ascertained in patient medical records. Individual progression episodes were the unit of analysis for sensitivity and Positive Predictive Value (PPV) calculations and specificity and Negative Predictive Value (NPV) were calculated at the patient level. The sensitivity of our proxy in prescribing data was 74.3% (95% Confidence Interval (CI), 55.6-86.6%) and PPV 61.2% (95% CI, 45.0-75.3%); specificity and NPV were 87.8% (95% CI, 73.8-95.9%) and 100% (95% CI, 90.3-100%), respectively. In dispensing data, the sensitivity of our proxy was 64% (95% CI, 55.0-77.0%) and PPV 56.0% (95% CI, 43.0-69.0%); specificity and NPV were 81% (95% CI, 70.05-89.0%) and 91.0% (95% CI, 82.0-97.0%), respectively. Our proxy overestimated episodes of disease progression. The proxy's performance is likely to improve if the date of prescribing is used instead of date of dispensing in claims data and by incorporating medical service claims (such as imaging prior to drug changes) in the algorithm. Our proxy is not sufficiently robust for use in real world comparative effectiveness research for cancer medicines. © 2016 John Wiley & Sons Australia, Ltd.

Accurate, consistent, and fast droplet splitting and dispensing in electrowetting on dielectric digital microfluidics

Science.gov (United States)

Nikapitiya, N. Y. Jagath B.; Nahar, Mun Mun; Moon, Hyejin

2017-12-01

This letter reports two novel electrode design considerations to satisfy two very important aspects of EWOD operation—(1) Highly consistent volume of generated droplets and (2) Highly improved accuracy in the generated droplet volume. Considering the design principles investigated two novel designs were proposed; L-junction electrode design to offer high throughput droplet generation and Y-junction electrode design to split a droplet very fast while maintaining equal volume of each part. Devices of novel designs were fabricated and tested, and the results are compared with those of conventional approach. It is demonstrated that inaccuracy and inconsistency of droplet volume dispensed in the device with novel electrode designs are as low as 0.17 and 0.10%, respectively, while those of conventional approach are 25 and 0.76%, respectively. The dispensing frequency is enhanced from 4 to 9 Hz by using the novel design.

A network collaboration implementing technology to improve medication dispensing and administration in critical access hospitals.

Science.gov (United States)

Wakefield, Douglas S; Ward, Marcia M; Loes, Jean L; O'Brien, John

2010-01-01

We report how seven independent critical access hospitals collaborated with a rural referral hospital to standardize workflow policies and procedures while jointly implementing the same health information technologies (HITs) to enhance medication care processes. The study hospitals implemented the same electronic health record, computerized provider order entry, pharmacy information systems, automated dispensing cabinets (ADC), and barcode medication administration systems. We conducted interviews and examined project documents to explore factors underlying the successful implementation of ADC and barcode medication administration across the network hospitals. These included a shared culture of collaboration; strategic sequencing of HIT component implementation; interface among HIT components; strategic placement of ADCs; disciplined use and sharing of workflow analyses linked with HIT applications; planning for workflow efficiencies; acquisition of adequate supply of HIT-related devices; and establishing metrics to monitor HIT use and outcomes.

Multi-pulsed intense electron beam emission from velvet, carbon fibers, carbon nano-tubes and dispenser cathodes

International Nuclear Information System (INIS)

Xia Liansheng; Yang Anmin; Chen Yi; Zhang Huang; Liu Xingguang; Li Jin; Jiang Xiaoguo; Zhang Kaizhi; Shi Jinshui; Deng Jianjun; Zhang Linwen

2010-01-01

The experimental results of studies of four kinds of cathode emitting intense electron beams are demonstrated under multi-pulsed mode based on an experimental setup including two multi-pulse high voltage sources. The tested cathodes include velvet, carbon fibers, carbon nano-tubes (CNTs) and dispenser cathodes. The results indicate that all four are able to emit multi-pulsed beams. For velvet, carbon fiber and CNTs, the electron induced cathode plasma emission may be the main process and this means that there are differences in beam parameters from pulse to pulse. For dispenser cathodes tested in the experiment, although there is a little difference from pulse to pulse for some reason, thermal-electric field emission may be the main process. (authors)

Dispensing inhalers to patients with chronic obstructive pulmonary disease on hospital discharge: Effects on prescription filling and readmission.

Science.gov (United States)

Blee, John; Roux, Ryan K; Gautreaux, Stefani; Sherer, Jeffrey T; Garey, Kevin W

2015-07-15

The effects of dispensing inhalers to patients with chronic obstructive pulmonary disease (COPD) on hospital discharge were evaluated. Data were collected in 2011-12 for patients with COPD who had hospital orders for the study inhalers (preintervention group) and after implementation of the multidose medication dispensing on discharge (MMDD) service (2013-14) (postintervention group). The primary objective of this study was to assess inhaler adherence and readmission rates before and after MMDD implementation. Adherence was defined as filling the discharge prescription for the multidose inhaler at a Harris Health pharmacy within three days of discharge or having at least seven days of medication left in an inhaler from a previous prescription that was filled or refilled before hospital admission. All patients in the postintervention group were considered adherent, since every patient was given the remainder of his or her multidose inhaler when discharged. Data from 620 patients (412 in the preintervention group, 208 in the postintervention group) were collected. During the preintervention time period, 88 of 412 patients were readmitted within 30 days compared with 18 of 208 patients during the postintervention period (p filling behavior, and reduced rates of 30- and 60-day hospital readmissions. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Randomized crossover study evaluating the effect of a hand sanitizer dispenser on the frequency of hand hygiene among anesthesiology staff in the operating room.

Science.gov (United States)

Munoz-Price, L Silvia; Patel, Zalak; Banks, Shawn; Arheart, Kristopher; Eber, Scott; Lubarsky, David A; Birnbach, David J

2014-06-01

Forty anesthesia providers were evaluated with and without hand sanitizer dispensers present on the anesthesia machine. Having a dispenser increased the frequency of hand hygiene only from 0.5 to 0.8 events per hour (P = .01). Other concomitant interventions are needed to further increase hand hygiene frequency among anesthesia providers.

[Food and beverages available in automatic food dispensers in health care facilities of the Portugal North Health Region].

Science.gov (United States)

Rodrigues, Filipa Gomes; Ramos, Elisabete; Freitas, Mário; Neto, Maria

2010-01-01

Patients and health staff frequently need to stay in health care facilities for quite a long time. Therefore, it's necessary to create the conditions that allow the ingestion of food during those periods, namely through the existence of automatic food dispensers. However, the available food and beverages might not always be compatible with a healthy diet. The aim of this work was to evaluate if the food and beverages available in automatic food dispensers in public Ambulatory Care Facilities (ACF) and Hospitals of the Portugal North Health Region were contributing to a healthy diet, during the year of 2007. A questionnaire was elaborated and sent to the Coordinators of the Health Sub-Regions and to the Hospital Administrators. The questionnaire requested information about the existence of automatic food dispensers in the several departments of each health care facility, as well as which food and beverages were available and most sold. Afterwards, the pre-processing of the results involved the classification of the food and beverages in three categories: recommended, sometimes recommended and not recommended. The questionnaire reply ratio was 71% in ACF and 83% in Hospitals. Automatic food dispensers were available in all the Hospitals and 86.5% of ACF. It wasn't possible to acquire food in 37% of the health facility departments. These departments were all located in ACF. The more frequently available beverages in departments with automatic food dispensers were coffee, still water, tea, juices and nectars and soft drinks. Still water, coffee, yogurt, juices and nectars and soft drinks were reported as the most sold. The more frequently avaliable food items were chocolate, recommended cookies, not recommended cakes, recommended sandwiches and sometimes recommended croissants. The food items reported as being the most sold were recommended sandwiches, chocolate, recommended cookies, sometimes recommended croissants and not recommended cookies. The beverages in the

Dicer is dispensable for asymmetric RISC loading in mammals.

Science.gov (United States)

Betancur, Juan G; Tomari, Yukihide

2012-01-01

In flies, asymmetric loading of small RNA duplexes into Argonaute2-containing RNA-induced silencing complex (Ago2-RISC) requires Dicer-2/R2D2 heterodimer, which acts as a protein sensor for the thermodynamic stabilities of the ends of small RNA duplexes. However, the mechanism of small RNA asymmetry sensing in mammalian RISC assembly remains obscure. Here, we quantitatively examined RISC assembly and target silencing activity in the presence or absence of Dicer in mammals. Our data show that, unlike the well-characterized fly Ago2-RISC assembly pathway, mammalian Dicer is dispensable for asymmetric RISC loading in vivo and in vitro.

Reducing the default dispense quantity for new opioid analgesic prescriptions: study protocol for a cluster randomised controlled trial.

Science.gov (United States)

Bachhuber, Marcus A; Nash, Denis; Southern, William N; Heo, Moonseong; Berger, Matthew; Schepis, Mark; Cunningham, Chinazo O

2018-04-20

As opioid analgesic consumption has grown, so have opioid use disorder and opioid-related overdoses. Reducing the quantity of opioid analgesics prescribed for acute non-cancer pain can potentially reduce risks to the individual receiving the prescription and to others who might unintentionally or intentionally consume any leftover tablets. Reducing the default dispense quantity for new opioid analgesic prescriptions in the electronic health record (EHR) is a promising intervention to reduce prescribing. This study is a prospective cluster randomised controlled trial with two parallel arms. Primary care sites (n=32) and emergency departments (n=4) will be randomised in matched pairs to either a modification of the EHR so that new opioid analgesic prescriptions default to a dispense quantity of 10 tablets (intervention) or to no EHR change (control). The dispense quantity will remain fully modifiable by providers in both arms. From 6 months preintervention to 18 months postintervention, patient-level data will be analysed (ie, the patient is the unit of inference). Patient eligibility criteria are: (A) received a new opioid analgesic prescription, defined as no other opioid analgesic prescription in the prior 6 months; (B) age ≥18 years; and (C) no cancer diagnosis within 1 year prior to the new opioid analgesic prescription. The primary outcome will be the quantity of opioid analgesics prescribed in the initial prescription. Secondary outcomes will include opioid analgesic reorders and health service utilisation within 30 days after the initial prescription. Outcomes will be compared between study arms using a difference-in-differences analysis. This study has been approved by the Montefiore Medical Center/Albert Einstein College of Medicine Institutional Review Board with a waiver of informed consent (2016-6036) and is registered on ClinicalTrials.gov (NCT03003832, 6 December 2016). Findings will be disseminated through publication, conferences and meetings

Drug dispensing practices at pharmacies in Bengaluru: A cross-sectional study

OpenAIRE

R Soumya; Vijayalakshmi Devarashetty; C R Jayanthi; M Sushma

2016-01-01

Objectives: Pharmacists are one of the crucial focal points for health care in the community. They have tremendous outreach to the public as pharmacies are often the first-port-of-call. With the increase of ready-to-use drugs, the main health-related activity of a pharmacist today is to assure the quality of dispensing, a key element to promote rational medicine use. Materials and Methods: A cross-sectional study of 200 pharmacies, 100 each in various residential (R) and commercial (C) areas ...

Dispensers, obeah and quackery: medical rivalries in post-slavery British Guiana.

Science.gov (United States)

De Barros, Juanita

2007-08-01

This paper examines the ambiguous place of medical assistants-dispensers-in a post-slavery British Caribbean colony, British Guiana, from the end of slavery in the 1830s to the early twentieth century. Although the latter were crucial to the functioning of the colonial medical system, local physicians resented them, complaining about the economic threat they posed and at times condemning them as quacks. These attacks were part of a wider discussion about the composition of the medical profession and the role of medical auxiliaries in colonial society, and to an extent, they echoed debates conducted in other jurisdictions in this period. But in the British Caribbean, this discussion was significantly different. There, long-standing views about obeah-an Afro-Creole medico-religious practice-as a particularly dangerous and uncivilised type of quackery was part of the discursive context. That those participating in this debate included African-descended physicians whose arrival in the medical profession was recent and contested demonstrates the vexed and complex nature of professionalisation in a post-slavery society.

A case of adverse drug reaction induced by dispensing error.

Science.gov (United States)

Gallelli, L; Staltari, O; Palleria, C; Di Mizio, G; De Sarro, G; Caroleo, B

2012-11-01

To report about a case of acute renal failure due to absence of communication between physician and patient. A 78 year old man with human immunodeficiency virus (HIV) accessed our hospital and was brought to our attention in August 2011 for severe renal failure. Clinical history revealed that he had been taking highly active antiretroviral therapy with lamivudine/abacavir and fosamprenavir since 2006. In April 2011 due to an augmentation in creatinine plasma levels, a reduction in lamivudine dosage to 100 mg/day and the prescription of abacavir 300 mg/day became necessary. Unfortunately, the patient took both lamivudine and abacavir therefore the association of the two medications (lamivudine/abacavir) lead to asthenia and acute renal failure within a few days. This case emphasizes the importance about how physicians must pay very careful attention during drug prescription, most particularly, as far as elderly patients are concerned. In fact, communication improvement between physicians and patients can prevent increase of adverse drug reactions related to drug dispensing, with consequential reduction of costs in the healthcare system. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Gas recovery and self-testing systm in gasoline stations. Execution of practical field tests / phase of tests in the wholistic system; Gasrueckfuehrung und selbstueberwachende Systeme an Tankstellen. Durchfuehrung von praktischen Feldtests/Testphase im ganzheitlichen System

Energy Technology Data Exchange (ETDEWEB)

Altmann, B.R.; Kunter, S.; Maurer, C.; Schneider, T.; Schrittenlacher, W.; Maahsen, H.; Arts, M.

2003-04-01

The amendment of the 21{sup st} Regulation on Air-Pollution Control dated 17.05.2002 describes continuous control of the function of gas recovery systems in gasoline stations by automatic control systems. Both systems available in the market (supplied by FAFNIR and TOKHEIM) were tested in extensive field tests. Both systems are ready for mass production. New dispensers are delivered with self control systems per production-type since 1.04.2003. Supplementary kits for the different dispenser types are available. (orig.)

Use of standardised patients to assess antibiotic dispensing for tuberculosis by pharmacies in urban India: a cross-sectional study.

Science.gov (United States)

Satyanarayana, Srinath; Kwan, Ada; Daniels, Benjamin; Subbaraman, Ramnath; McDowell, Andrew; Bergkvist, Sofi; Das, Ranendra K; Das, Veena; Das, Jishnu; Pai, Madhukar

2016-11-01

India's total antibiotic use is the highest of any country. Patients often receive prescription-only drugs directly from pharmacies. Here we aimed to assess the medical advice and drug dispensing practices of pharmacies for standardised patients with presumed and confirmed tuberculosis in India. In this cross-sectional study in the three Indian cities Delhi, Mumbai, and Patna, we developed two standardised patient cases: first, a patient presenting with 2-3 weeks of pulmonary tuberculosis symptoms (Case 1); and second, a patient with microbiologically confirmed pulmonary tuberculosis (Case 2). Standardised patients were scheduled to present each case once to sampled pharmacies. We defined ideal management for both cases a priori as referral to a health-care provider without dispensing antibiotics or steroids or both. Between April 1, 2014, and Nov 29, 2015, we sampled 622 pharmacies in Delhi, Mumbai, and Patna. Standardised patients completed 1200 (96%) of 1244 interactions. We recorded ideal management (defined as referrals without the use of antibiotics or steroids) in 80 (13%) of 599 Case 1 interactions (95% CI 11-16) and 372 (62%) of 601 Case 2 interactions (95% CI 58-66). Antibiotic use was significantly lower in Case 2 interactions (98 [16%] of 601, 95% CI 13-19) than in Case 1 (221 [37%] of 599, 95% CI 33-41). First-line anti-tuberculosis drugs were not dispensed in any city. The differences in antibiotic or steroid use and number of medicines dispensed between Case 1 and Case 2 were almost entirely attributable to the difference in referral behaviour. Only some urban Indian pharmacies correctly managed patients with presumed tuberculosis, but most correctly managed a case of confirmed tuberculosis. No pharmacy dispensed anti-tuberculosis drugs for either case. Absence of a confirmed diagnosis is a key driver of antibiotic misuse and could inform antimicrobial stewardship interventions. Grand Challenges Canada, Bill & Melinda Gates Foundation, Knowledge for

Acidic pH and divalent cation sensing by PhoQ are dispensable for systemic salmonellae virulence.

Science.gov (United States)

Hicks, Kevin G; Delbecq, Scott P; Sancho-Vaello, Enea; Blanc, Marie-Pierre; Dove, Katja K; Prost, Lynne R; Daley, Margaret E; Zeth, Kornelius; Klevit, Rachel E; Miller, Samuel I

2015-05-23

Salmonella PhoQ is a histidine kinase with a periplasmic sensor domain (PD) that promotes virulence by detecting the macrophage phagosome. PhoQ activity is repressed by divalent cations and induced in environments of acidic pH, limited divalent cations, and cationic antimicrobial peptides (CAMP). Previously, it was unclear which signals are sensed by salmonellae to promote PhoQ-mediated virulence. We defined conformational changes produced in the PhoQ PD on exposure to acidic pH that indicate structural flexibility is induced in α-helices 4 and 5, suggesting this region contributes to pH sensing. Therefore, we engineered a disulfide bond between W104C and A128C in the PhoQ PD that restrains conformational flexibility in α-helices 4 and 5. PhoQ(W104C-A128C) is responsive to CAMP, but is inhibited for activation by acidic pH and divalent cation limitation. phoQ(W104C-A128C) Salmonella enterica Typhimurium is virulent in mice, indicating that acidic pH and divalent cation sensing by PhoQ are dispensable for virulence.

Using Multispectral Imaging to Measure Temperature Profiles and Emissivity of Large Thermionic Dispenser, Cathodes

International Nuclear Information System (INIS)

Simmons, D.F.; Fortgang, C.M.; Holtkamp, D.B.

2001-01-01

Thermionic dispenser cathodes are widely used in modern high-power microwave tubes. Use of these cathodes has led to significant improvement in performance. In recent years these cathodes have been used in electron linear accelerators (LINACs), particularly in induction LINACs, such as the Experimental Test Accelerator at Lawrence Livermore National Laboratory and the Relativistic Test Accelerator at Lawrence Berkeley National Laboratory. For induction LINACs, the thermionic dispenser cathode provides greater reproducibility, longer pulse lengths, and lower emittance beams than does a field emission cathode. Los Alamos National Laboratory is fabricating a dual-axis X-ray radiography machine called dual-axis radiograph hydrodynamic test (DARHT). The second axis of DARHT consists of a 2-kA, 20-MeV induction LINAC that uses a 3.2-MeV electron gun with a tungsten thermionic-dispenser cathode. Typically the DARHT cathode current density is 10 A/cm 2 at 1050 C. Under these conditions current density is space-charge limited, which is desirable since current density is independent of temperature. At lower temperature (the temperature-limited regime) there are variations in the local current density due to a nonuniform temperature profile. To obtain the desired uniform current density associated with space-charge limited operation, the coolest area on the cathode must be at a sufficiently high temperature so that the emission is space-charge limited. Consequently, the rest of the cathode is emitting at the same space-charge-limited current density but is at a higher temperature than necessary. Because cathode lifetime is such a strong function of cathode temperature, there is a severe penalty for nonuniformity in the cathode temperature. For example, a temperature increase of 50 C means cathode lifetime will decrease by a factor of at least four. Therefore, we are motivated to measure the temperature profiles of our large-area cathodes

The tungsten powder study of the dispenser cathode

International Nuclear Information System (INIS)

Bao Jixiu; Wan Baofei

2006-01-01

The intercorrelation of tungsten powder properties, such as grain size, distribution and morphology, and porous matrix parameters with electron emission capability and longevity of Ba dispenser cathodes has been investigated for the different grain morphologies. It is shown that a fully cleaning step of the tungsten powder is so necessary that the tungsten powder will be reduction of oxide in hydrogen atmosphere above 700 deg. C. The porosity of the tungsten matrix distributes more even and the closed pore is fewer, the average granule size of the tungsten powder distributes more convergent. The porosity of the tungsten matrix and the evaporation of the activator are bigger and the pulse of the cathode is smaller when the granularity is bigger by the analysis of the electronic microscope and diode experiment

The tungsten powder study of the dispenser cathode

Science.gov (United States)

Bao, Ji-xiu; Wan, Bao-fei

2006-06-01

The intercorrelation of tungsten powder properties, such as grain size, distribution and morphology, and porous matrix parameters with electron emission capability and longevity of Ba dispenser cathodes has been investigated for the different grain morphologies. It is shown that a fully cleaning step of the tungsten powder is so necessary that the tungsten powder will be reduction of oxide in hydrogen atmosphere above 700 °C. The porosity of the tungsten matrix distributes more even and the closed pore is fewer, the average granule size of the tungsten powder distributes more convergent. The porosity of the tungsten matrix and the evaporation of the activator are bigger and the pulse of the cathode is smaller when the granularity is bigger by the analysis of the electronic microscope and diode experiment.

Correlation of emission capability and longevity of dispenser cathodes with characteristics of tungsten powders

Science.gov (United States)

Melnikova, Irina P.; Vorozheikin, Victor G.; Usanov, Dmitry A.

2003-06-01

The intercorrelation of tungsten powder properties, such as grain size, distribution and morphology, and porous matrix parameters with electron emission capability and longevity of Ba dispenser cathodes are investigated for three different grain morphologies. Best results of tungsten cathode life were found for isoaxis polyhedron morphology in combination with certain powder and matrix parameters.

Correlation of emission capability and longevity of dispenser cathodes with characteristics of tungsten powders

International Nuclear Information System (INIS)

Melnikova, Irina P.; Vorozheikin, Victor G.; Usanov, Dmitry A.

2003-01-01

The intercorrelation of tungsten powder properties, such as grain size, distribution and morphology, and porous matrix parameters with electron emission capability and longevity of Ba dispenser cathodes are investigated for three different grain morphologies. Best results of tungsten cathode life were found for isoaxis polyhedron morphology in combination with certain powder and matrix parameters

Correlation of emission capability and longevity of dispenser cathodes with characteristics of tungsten powders

Energy Technology Data Exchange (ETDEWEB)

Melnikova, Irina P.; Vorozheikin, Victor G.; Usanov, Dmitry A

2003-06-15

The intercorrelation of tungsten powder properties, such as grain size, distribution and morphology, and porous matrix parameters with electron emission capability and longevity of Ba dispenser cathodes are investigated for three different grain morphologies. Best results of tungsten cathode life were found for isoaxis polyhedron morphology in combination with certain powder and matrix parameters.

Associations Between Personality Traits and Adherence to Antidepressants Assessed Through Self-Report, Electronic Monitoring, and Pharmacy Dispensing Data: A Pilot Study.

Science.gov (United States)

Wouters, Hans; Amin, Darya F H; Taxis, Katja; Heerdink, Eibert R; Egberts, Antoine C G; Gardarsdottir, Helga

2016-10-01

Treatment with antidepressants is often compromised by substantial nonadherence. To understand nonadherence, specific medication-related behaviors and beliefs have been studied, but less is known about broader and temporally stable personality "traits." Furthermore, adherence has often been assessed by a single method. Hence, we investigated associations between the Big Five personality traits and adherence assessed by self-report, electronic drug use monitoring, and dispensing data. Using the Big Five Inventory, we assessed the personality traits "openness," "conscientiousness," "extraversion," "agreeableness," and "neuroticism" of patients treated with antidepressants who were invited through community pharmacies. Self-reported adherence was assessed with the Medication Adherence Rating Scale (score >24), electronic monitoring with medication event monitoring system (MEMS) devices (therapy days missed ≤ 10% and personality traits, the third and fourth quartiles of "conscientiousness" were associated with better self-reported adherence (odds ratio, 3.63; 95% confidence interval, 1.34-9.86 and odds ratio, 2.97; 95% confidence interval, 1.09-8.08; P ≤ 0.05). No relationships were found between personality traits and adherence assessed through electronic drug use monitoring or dispensing data. We therefore conclude that adherence to antidepressant therapy seems to be largely unrelated to personality traits.

Effect of holed reflector on acoustic radiation force in noncontact ultrasonic dispensing of small droplets

Science.gov (United States)

Tanaka, Hiroki; Wada, Yuji; Mizuno, Yosuke; Nakamura, Kentaro

2016-06-01

We investigated the fundamental aspects of droplet dispensing, which is an important procedure in the noncontact ultrasonic manipulation of droplets in air. A holed reflector was used to dispense a droplet from a 27.4 kHz standing-wave acoustic field to a well. First, the relationship between the hole diameter of the reflector and the acoustic radiation force acting on a levitated droplet was clarified by calculating the acoustic impedance of the point just above the hole. When the hole diameter was half of (or equal to) the acoustic wavelength λ, the acoustic radiation force was ∼80% (or 50%) of that without a hole. The maximal diameters of droplets levitated above the holes through flat and half-cylindrical reflectors were then experimentally investigated. For instance, with the half-cylindrical reflector, the maximal diameter was 5.0 mm for a hole diameter of 6.0 mm, and droplets were levitatable up to a hole diameter of 12 mm (∼λ).

Control of microbial contamination in drinking water from microfiltering dispensers by dialysis ultrafilters

Directory of Open Access Journals (Sweden)

Bolelli Luca

2016-12-01

Full Text Available Tap water filtering devices are widely employed to improve odor and taste of tap water, or to obtain refrigerated or sparkling drinking water. The presence of disinfectants-resistant bacteria in tap water is responsible of the biofilm formation inside tubes and tanks. The consequent contamination of dispensed water is a well-known hygiene problem because of the quite constant presence of potentially pathogenic bacteria likes P. aeruginosa. In this study, we tested the technical feasibility and effectiveness of the addition to different commercial devices of a packaged polysulphone fibers filter. We aimed to find a simple solution to implement the quality of the delivered water. Water contamination levels were determined in a wide selection of microfiltered water dispensers and we selected among them a representative group of 10 devices, new or in use. The packaged ultrafilter was introduced in about half of them, to monitor, when possible, in parallel the contamination levels and flow rate of a couple of identical units, with and without the filter. The placement of the dialysis filters resulted feasible at different positions along the water circuits of the variously designed filtration units. Delivered water resulted completely free from bacteria when the filter was placed exactly at, or very close to, the outlet in spite of the inner surfaces contamination. This performance was not obtained in presence of a more or less long tract of water circuits downstream the ultrafilter: a significant but not complete reduction of the plate count numbers was observed. The filters worked in continue over the whole study period, ten months, showing exactly the same efficiency. Moreover, the flow rate in presence of the filter was quite unaffected. The addition of this kind of filter to already in use water dispensers was technically easy, and its use can be recommended in all cases a simple but reliable water sanitization is requested.

Prescription Drug Monitoring Programs and Pharmacist Orientation Toward Dispensing Controlled Substances.

Science.gov (United States)

Fendrich, Michael; Bryan, Janelle K; Hooyer, Katinka

2018-01-03

We sought to understand how pharmacists viewed and used a newly implemented prescription drug monitoring program (PDMP). We also sought to understand pharmacist orientation toward dispensing of controlled substances and the people who obtain them. We conducted three mini focus groups. The focus group findings were used to inform the design of a structured survey. We emailed a survey to 160 pharmacists who were employed in one statewide community chain store; we obtained 48 survey responses. Focus groups findings suggested that, in relation to the dispensing of scheduled prescription medication, pharmacists were either "healthcare" oriented, "law-enforcement" oriented, or an orientation that combined these two perspectives. Surveys suggested that pharmacists found PDMPs easy to use and that they used them frequently - often to contact physicians directly. Surveys suggested that pharmacists were typically either "healthcare" oriented or "mixed" (combined perspectives). Pharmacist orientation was associated with the frequency with which they counseled patients about medication risk and the frequency with which they used the PDMP as the basis for contacting prescribers. Ongoing tracking of pharmacists' use of PDMPs is important both at the implementation stage and as PDMPs develop over time. The orientation construct developed here is useful in understanding pharmacist behavior and attitudes towards patients potentially at risk for misuse of controlled substance medications. Further research on this construct could shed light on barriers and incentives for pharmacist PDMP participation and use and provide guidance for pharmacist training, ultimately enhancing patient care.

Analyzing the effectiveness of flare dispensing programs against pulse width modulation seekers using self-organizing maps

Science.gov (United States)

Şahingil, Mehmet C.; Aslan, Murat Š.

2013-10-01

Infrared guided missile seekers utilizing pulse width modulation in target tracking is one of the threats against air platforms. To be able to achieve a "soft-kill" protection of own platform against these type of threats, one needs to examine carefully the seeker operating principle with its special electronic counter-counter measure (ECCM) capability. One of the cost-effective ways of soft kill protection is to use flare decoys in accordance with an optimized dispensing program. Such an optimization requires a good understanding of the threat seeker, capabilities of the air platform and engagement scenario information between them. Modeling and simulation is very powerful tool to achieve a valuable insight and understand the underlying phenomenology. A careful interpretation of simulation results is crucial to infer valuable conclusions from the data. In such an interpretation there are lots of factors (features) which affect the results. Therefore, powerful statistical tools and pattern recognition algorithms are of special interest in the analysis. In this paper, we show how self-organizing maps (SOMs), which is one of those powerful tools, can be used in analyzing the effectiveness of various flare dispensing programs against a PWM seeker. We perform several Monte Carlo runs for a typical engagement scenario in a MATLAB-based simulation environment. In each run, we randomly change the flare dispending program and obtain corresponding class: "successful" or "unsuccessful", depending on whether the corresponding flare dispensing program deceives the seeker or not, respectively. Then, in the analysis phase, we use SOMs to interpret and visualize the results.

Tiger Teams Technical Assistance: Reliable, Universal Open Architecture for Card Access to Dispense Alternative Fuels

Energy Technology Data Exchange (ETDEWEB)

2002-03-01

Report discusses the dilemma of incorporating consistent, convenient, universal card access (or ''pay-at-the-pump'') systems into alternative fueling stations across the country. The state of California continues to be in the forefront of implementing alternative fuels for transportation applications. Aggressive efforts to deploy alternative fuel vehicles (AFVs) in California have highlighted the need to provide adequate fueling stations and develop appropriate, user-friendly means to purchase fuel at the pump. Since these fuels are not typically provided by petroleum companies at conventional fueling stations, and acceptance of cash is often not an option, a payment method must be developed that is consistent with the way individual AFV operators are accustomed to purchasing automotive fuels--with a credit card. At the same time, large fleets like the California Department of General Services must be able to use a single fuel card that offers comprehensive fleet management services. The Gas Technology Institute's Infrastructure Working Group (IWG) and its stakeholders have identified the lack of a common card reader system as a hurdle to wider deployment of AFVs in California and the United States. In conjunction with the U.S. Department of Energy's (DOE) National Clean Cities Program, the IWG has outlined a multi-phased strategy to systematically address the barriers to develop a more ''open'' architecture that's similar to the way gasoline and diesel are currently dispensed. Under the auspices of the IWG, survey results were gathered (circa 1999) from certain fuel providers, as a means to more carefully study card reader issues and their potential solutions. Pilot programs featuring card reader systems capable of accepting wider payment options have been attempted in several regions of the United States with mixed success. In early 2001, DOE joined the National Renewable Energy Laboratory (NREL), the

Systems and methods for laser assisted sample transfer to solution for chemical analysis

Science.gov (United States)

Van Berkel, Gary J; Kertesz, Vilmos; Ovchinnikova, Olga S

2013-08-27

Systems and methods are described for laser ablation of an analyte from a specimen and capturing of the analyte in a dispensed solvent to form a testing solution. A solvent dispensing and extraction system can form a liquid microjunction with the specimen. The solvent dispensing and extraction system can include a surface sampling probe. The laser beam can be directed through the surface sampling probe. The surface sampling probe can also serve as an atomic force microscopy probe. The surface sampling probe can form a seal with the specimen. The testing solution including the analyte can then be analyzed using an analytical instrument or undergo further processing.

Systemic LPS Translocation Activates Cross-Presenting Dendritic Cells but Is Dispensable for the Breakdown of CD8+ T Cell Peripheral Tolerance in Irradiated Mice.

Directory of Open Access Journals (Sweden)

Gabriel Espinosa-Carrasco

Full Text Available Lymphodepletion is currently used to enhance the efficacy of cytotoxic T lymphocyte adoptive transfer immunotherapy against cancer. This beneficial effect of conditioning regimens is due, at least in part, to promoting the breakdown of peripheral CD8+ T cell tolerance. Lymphodepletion by total body irradiation induces systemic translocation of commensal bacteria LPS from the gastrointestinal tract. Since LPS is a potent activator of the innate immune system, including antigen presenting dendritic cells, we hypothesized that LPS translocation could be required for the breakdown of peripheral tolerance observed in irradiated mice. To address this issue, we have treated irradiated mice with antibiotics in order to prevent LPS translocation and utilized them in T cell adoptive transfer experiments. Surprisingly, we found that despite of completely blocking LPS translocation into the bloodstream, antibiotic treatment did not prevent the breakdown of peripheral tolerance. Although irradiation induced the activation of cross-presenting CD8+ dendritic cells in the lymphoid tissue, LPS could not solely account for this effect. Activation of dendritic cells by mechanisms other than LPS translocation is sufficient to promote the differentiation of potentially autoreactive CD8+ T cells into effectors in irradiated mice. Our data indicate that LPS translocation is dispensable for the breakdown of CD8+ T cell tolerance in irradiated mice.

Analysis system for characterisation of simple, low-cost microfluidic components

CSIR Research Space (South Africa)

Smith, S

2014-03-01

Full Text Available mechanism is used to introduce and dispense a sample of blood, while a reagent is released into the microfluidic system through compression and bursting of a blister pack. Mixing and dispensing of the sample and reagent are facilitated via air actuation...

Efficiency potential of hot-drink dispensing machines in commercial catering; Effizienzpotenzial bei Heissgetraenkeautomaten in der Betriebsverpflegung

Energy Technology Data Exchange (ETDEWEB)

Grieder, T; Huser, A [Encontrol GmbH, Niederrohrdorf (Switzerland); Schmitz, R [Electrosuisse, Fehraltorf (Switzerland)

2003-07-01

This final report for the Swiss Federal Office of Energy (SFOE) discusses the findings of a project that looked into the energy consumption of automatic hot-drink dispensing machines. The report presents the results of a survey made in Switzerland together with various manufacturers and operators of such machines that are used in the company refreshments sector. The survey provides important information on the current market situation, markets and market shares of individual operating companies as well as on machine technology and energy consumption. Also, obstacles to the improvement of energy efficiency in this area are looked at. Important savings that can be made in the operation of such machines are quoted. The report recommends that the results of a parallel survey of domestic coffee-making machines be taken note of and that effort should rather be concentrated in this area, where energy consumption at the national level is quoted as being around twice as high as for the commercial automatic hot-drink dispensing machines.

Analyzing implementation dynamics using theory-driven evaluation principles: lessons learnt from a South African centralized chronic dispensing model.

Science.gov (United States)

Magadzire, Bvudzai Priscilla; Marchal, Bruno; Mathys, Tania; Laing, Richard O; Ward, Kim

2017-12-04

Centralized dispensing of essential medicines is one of South Africa's strategies to address the shortage of pharmacists, reduce patients' waiting times and reduce over-crowding at public sector healthcare facilities. This article reports findings of an evaluation of the Chronic Dispensing Unit (CDU) in one province. The objectives of this process evaluation were to: (1) compare what was planned versus the actual implementation and (2) establish the causal elements and contextual factors influencing implementation. This qualitative study employed key informant interviews with the intervention's implementers (clinicians, managers and the service provider) [N = 40], and a review of policy and program documents. Data were thematically analyzed by identifying the main influences shaping the implementation process. Theory-driven evaluation principles were applied as a theoretical framework to explain implementation dynamics. The overall participants' response about the CDU was positive and the majority of informants concurred that the establishment of the CDU to dispense large volumes of medicines is a beneficial strategy to address healthcare barriers because mechanical functions are automated and distribution of medicines much quicker. However, implementation was influenced by the context and discrepancies between planned activities and actual implementation were noted. Procurement inefficiencies at central level caused medicine stock-outs and affected CDU activities. At the frontline, actors were aware of the CDU's implementation guidelines regarding patient selection, prescription validity and management of non-collected medicines but these were adapted to accommodate practical realities and to meet performance targets attached to the intervention. Implementation success was a result of a combination of 'hardware' (e.g. training, policies, implementation support and appropriate infrastructure) and 'software' (e.g. ownership, cooperation between healthcare

International Space Station (ISS) Potable Water Dispenser (PWD) Beverage Adapter (BA) Redesign

Science.gov (United States)

Edgerly, Rachel; Benoit, Jace; Shindo, David

2012-01-01

The Potable Water Dispenser used on the International Space Station (ISS) interfaces with food and drink packages using the Beverage Adapter and Needle. Unexpected leakage has been seen in this interface. The Beverage Adapter used on ]orbit was returned to the ground for Test, Teardown, and Evaluation. The results of that investigation prompted a redesign of the Beverage Adapter and Needle. The Beverage Adapter materials were changed to be more corrosion resistant, and the Needle was redesigned to preclude leakage. The redesigns have been tested and proven.

A microfluidic distribution system for an array of hollow microneedles

International Nuclear Information System (INIS)

Hoel, Antonin; Jullien, Marie-Caroline; Baron, Nolwenn; Cabodevila, Gonzalo

2008-01-01

We report a microfluidic device able to control the ejection of fluid through a matrix of out-of-plane microneedles. The device comprises a matrix of open dispensing units connected to needles and filled by a common filling system. A deformable membrane (e.g. in PDMS) is brought into contact with the dispensing units. Pressure exerted on the deformable membrane closes (and thus individualizes) each dispensing unit and provokes the ejection of the dispensing unit content through the outlets. Sufficient pressure over the deformable membrane ensures that all dispensing units deliver a fixed volume (their content) irrespective of the hydrodynamic pressure outside the dispensing unit outlet. The size of the ensemble matrix of dispensing units, the number of liquid reservoirs, as well as the material can vary depending on the considered application of the device or on the conditions of use. In the present paper, the liquid reservoirs are geometrically identical. The geometrical parameters of the device are optimized to avoid as much dead volume as possible, as it was to handle plasmid DNA solutions which are very expensive. The conception, the fabrication and the experimental results are described in this paper. Our prototype is conceived to inject in a uniform way 10 µl of drug through 100 microneedles distributed over 1 cm 2

Estimating the real world daily usage and cost for exenatide twice daily and liraglutide in Germany, the Netherlands, and the UK based on volumes dispensed by pharmacies

Directory of Open Access Journals (Sweden)

McDonell AL

2015-01-01

Full Text Available Amanda L McDonell,1 Urpo Kiiskinen,2 Danielle C Zammit,3 Robert W Kotchie,1 Per-Olof Thuresson,3 Claudia Nicolay,4 Thomas Haslam,1 Michiel Bruinsma,5 Anne-Jeanine Janszen-Van Oosterhout,6 Thorsten Otto41IMS Health, London, UK; 2Eli Lilly and Company, Helsinki, Finland; 3IMS Health, Basel, Switzerland; 4Eli Lilly and Company, Bad Homburg, Germany; 5IMS Health, Rotterdam, the Netherlands; 6Eli Lilly Nederland, Houten, the NetherlandsBackground: Glucagon-like peptide-1 (GLP-1 receptor agonists are indicated for improvement of glycemic control in adults with type 2 diabetes. Cost is one aspect of treatment to be considered, in addition to clinical benefits, when selecting optimal therapy for a patient. The objective of this study was to estimate the average dose usage and real world daily cost of the GLP-1 receptor agonists, exenatide twice daily and liraglutide once daily, in Germany, the Netherlands, and the UK.Methods: Administrative databases were used to source the data from longitudinal records of dispensed prescriptions. Data were extracted from the IMS Longitudinal Prescription database which captures details of prescriptions dispensed in pharmacies. Information on the dispensed quantity of each product was used to estimate average daily usage per patient. Daily dose usage was multiplied by the public price per unit to estimate daily cost.Results: The dispensed volume in Germany corresponded to a mean dispensed daily dose of 16.81 µg for exenatide twice daily and 1.37 mg for liraglutide (mean daily cost €4.02 and €4.54, respectively. In the Netherlands, average dispensed daily doses of 17.07 µg and 1.49 mg were observed for exenatide twice daily and liraglutide (mean daily cost €3.05 and €3.97, respectively. In the UK, the mean dispensed volume corresponded to a daily usage of 20.49 µg for exenatide twice daily and 1.50 mg for liraglutide (mean daily cost £2.53 and £3.28, respectively.Conclusion: Estimates of average daily

Fast switching of alkali atom dispensers using laser-induced heating

International Nuclear Information System (INIS)

Griffin, P.F.; Weatherill, K.J.; Adams, C.S.

2005-01-01

We show that by using an intense laser source to locally heat an alkali atom dispenser, one can generate a high flux of atoms followed by fast recovery (<100 ms) of the background pressure when the laser is extinguished. For repeated heating pulses a switch-on time for the atomic flux of 200 ms is readily attainable. This technique is suited to ultracold atom experiments using simple ultrahigh vacuum (UHV) chambers. Laser-induced heating provides a fast repetition of the experimental cycle, which, combined with low atom loss due to background gas collisions, is particularly useful for experiments involving far-off resonance optical traps, where sufficient laser power (0.5-4 W) is readily available

The US Food and Drug Administration’s drug safety recommendations and long-acting beta2-agonist dispensing pattern changes in adult asthma patients: 2003–2012

Directory of Open Access Journals (Sweden)

Zhou EH

2017-03-01

Full Text Available Esther H Zhou,1 Sally Seymour,2 Margie R Goulding,1 Elizabeth M Kang,1 Jacqueline M Major,1 Solomon Iyasu1 1Division of Epidemiology, Office of Surveillance and Epidemiology, 2Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA Background: Emerging safety issues associated with long-acting beta2-agonist (LABA have led to multiple regulatory activities by the US Food and Drug Administration (FDA since 2003, including Drug Safety Communications (DSCs in 2010. These DSCs had three specific recommendations for the safe use of LABA products in adult asthma treatment. Methods: We examined the initiation of LABA-containing products for adult asthma treatment using an intermittent time series approach in a claims database from 2003 to 2012. We assessed the alignment of dispensing patterns with the following 2010 FDA recommendations: 1 contraindicated use of single-ingredient (SI-LABA without an asthma controller medication (ACM; 2 a LABA should only be used when asthma is not adequately controlled on inhaled corticosteroids (ICSs or ACM; and 3 step-down asthma therapy (e.g., discontinue LABA when asthma control is achieved. Results: There were 477,922 adults (18–64 years old dispensed a new LABA during 2003–2012. Among LABA initiators, patients who initiated an SI-LABA and who did “not” have an ACM dispensed on the same date decreased from >9% in 2003 (the initial labeling change to <2% post 2010 DSCs (p-value <0.0001 in the segmented regression model. The proportion of asthma patients dispensed an ICS in 6 months prior to initiating LABA treatment did not increase. The proportion of patients with longer than 4 months of continuous treatment did not decrease over the study period. Conclusion: Although the decrease in SI-LABA initiation is consistent with FDA’s recommendations, low ICS dispensing before initiating a LABA and LABA continuation practices require further efforts

Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India.

Science.gov (United States)

Thite, Nilesh; Shah, Ukti; Mehta, Jasmin; Jurkus, Janice

2015-01-01

To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). Two focus group discussions were conducted to design questionnaires regarding the prescribing habits for multifocal contact lenses (MFCL). Questions on potential barriers and motivators were included. The questionnaires were distributed among 133 eye care practitioners across Mumbai, India. Practitioners fitting one or less patient per month with MFCL completed the survey describing potential barriers, while those who prescribed more MFCL's per month completed the survey describing enablers and motivators. Responses from 102 practitioners were received. Most common potential barriers in prescribing MFCL were increased chair time (75%), lack of readily available trials (69%) and limitation in power range (63%). Lack of awareness among patients (90%) was the most common barrier from patients' outlook. Professional satisfaction (88%) and better business proposition (82%) were observed as main motivators while availability of the trials (84%) and correct patient selection (82%) were the major enablers. Graduate Optometrists felt dispensing MFCL did not offer a good business proposition (p=0.02). Experienced practitioners were observed to be least motivated (p=0.01) and believed that their patients found these lenses expensive (p=0.02). To enhance the MFCL practice, barriers like lack of awareness and limitations in power range must be addressed. Trial lens availability may motivate practitioners to prescribe MFCL. Further probing is required to understand lack of motivation among experienced practitioners. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

75 FR 28651 - In the Matter of Certain Electronic Paper Towel Dispensing Devices and Components Thereof; Notice...

Science.gov (United States)

2010-05-21

... INTERNATIONAL TRADE COMMISSION [Inv. No. 337-TA-718] In the Matter of Certain Electronic Paper Towel Dispensing Devices and Components Thereof; Notice of Investigation AGENCY: International Trade... that a complaint was filed with the U.S. International Trade Commission on April 19, 2010, under...

Pharmacy Professionals' Dispensing Practice, Knowledge, and Attitude towards Emergency Contraceptives in Gondar Town, Northwestern Ethiopia: A Cross-Sectional Study.

Science.gov (United States)

Belachew, Sewunet Admasu; Yimenu, Dawit Kumilachew; Gebresillassie, Begashaw Melaku

2017-01-01

Pharmacy professionals, as the most available members of medical team, have an important role in educating patients about the effective and appropriate use of contraceptives. The purpose of this study was to assess pharmacy professionals' dispensing practice, knowledge, and attitude towards emergency contraceptives use in Gondar town, northwestern Ethiopia. An institution based cross-sectional study was employed from May 14 to June 14, 2016, on 60 pharmacy professionals, who have been working in 8 randomly selected pharmacies and 6 drug stores. The collected data was entered to and analyzed using Statistical Packages for Social Sciences (SPSS) version 20. More than half 33 (55.0%) of the participants were druggist with 5-9 years of experience. About 56 (93.3%) of the participants knew about the dosing schedule (when and how much to take) and side effects of emergency contraceptives. More than two-thirds of the participants (39, 65%) agreed that the existence of emergency contraceptives is a positive thing and considered their use is ethical (42, 63.3%). The majority of participants (51, 85%) also reported that they counsel all women when dispensing emergency contraceptive pills (ECPs). This study revealed that knowledge, attitude, and dispensing practice of emergency contraceptives are very good even though there were variations with respect to different factors. Findings suggested that additional training and proper counseling technique on emergency contraceptives will improve the service delivery.

Extension of the commercial agreement on water dispensers: appendices 1-4; Erweiterung der Branchenvereinbarung Wasserdispenser. Anhaenge 1-4

Energy Technology Data Exchange (ETDEWEB)

Grieder, T.; Huser, A.

2006-07-01

These appendices to a final report for the Swiss Federal Office of Energy (SFOE) present the results of work done within the framework of a voluntary agreement between the Federal Office of Energy and the four most important suppliers of bottled water dispensers in Switzerland. The first appendix lists water dispensers with water-mains connections and quotes figures on the number of units and their energy use. Two prognoses are presented for the year 2015, one with and one without any action being taken. The second appendix presents the German Gas and Water association's suggestion for standards, while the third appendix presents the hygiene regulations of the Swiss Department of Home Affairs. The fourth appendix presents the answer sent by the U.S.A's Environmental Protection Agency to an e-mail on the subject.

An automated system for the preparation of Large Size Dried (LSD) Spikes

International Nuclear Information System (INIS)

Verbruggen, A.; Bauwens, J.; Jakobsson, U.; Eykens, R.; Wellum, R.; Aregbe, Y.; Van De Steene, N.

2008-01-01

Large size dried (LSD) spikes have been produced to fulfill the existing requirement for reliable and traceable isotopic reference materials for nuclear safeguards. A system to produce certified nuclear isotopic reference material as a U/Pu mixture in the form of large size dried spikes, comparable to those produced using traditional methods has been installed in collaboration with Nucomat, a company with a recognized reputation in design and development of integrated automated systems. The major components of the system are a robot, two balances, a dispenser and a drying unit fitted into a glove box. The robot is software driven and designed to control all movements inside the glove-box, to identify unambiguously the penicillin vials with a bar-code reader, to dispense the LSD batch solution into the vials and to weigh the amount dispensed. The system functionality has been evaluated and the performance validated by comparing the results from a series of samples dispensed and weighed by the automated system with the results by manual substitution weighing. After applying the proper correction factors to the data from the automated system balance no significant difference was observed between the two. However, an additional component of uncertainty of 3*10 -4 is introduced in the uncertainty budget for the certified weights provided by the automatic system. (authors)

An automated system for the preparation of Large Size Dried (LSD) Spikes

Energy Technology Data Exchange (ETDEWEB)

Verbruggen, A.; Bauwens, J.; Jakobsson, U.; Eykens, R.; Wellum, R.; Aregbe, Y. [European Commission - Joint Research Centre, Institute for Reference Materials and Measurements (IRMM), Retieseweg 211, B2440 Geel (Belgium); Van De Steene, N. [Nucomat, Mercatorstraat 206, B9100 Sint Niklaas (Belgium)

2008-07-01

Large size dried (LSD) spikes have been produced to fulfill the existing requirement for reliable and traceable isotopic reference materials for nuclear safeguards. A system to produce certified nuclear isotopic reference material as a U/Pu mixture in the form of large size dried spikes, comparable to those produced using traditional methods has been installed in collaboration with Nucomat, a company with a recognized reputation in design and development of integrated automated systems. The major components of the system are a robot, two balances, a dispenser and a drying unit fitted into a glove box. The robot is software driven and designed to control all movements inside the glove-box, to identify unambiguously the penicillin vials with a bar-code reader, to dispense the LSD batch solution into the vials and to weigh the amount dispensed. The system functionality has been evaluated and the performance validated by comparing the results from a series of samples dispensed and weighed by the automated system with the results by manual substitution weighing. After applying the proper correction factors to the data from the automated system balance no significant difference was observed between the two. However, an additional component of uncertainty of 3*10{sup -4} is introduced in the uncertainty budget for the certified weights provided by the automatic system. (authors)

Lipid Droplet Formation Is Dispensable for Endoplasmic Reticulum-associated Degradation*

Science.gov (United States)

Olzmann, James A.; Kopito, Ron R.

2011-01-01

Proteins that fail to fold or assemble in the endoplasmic reticulum (ER) are destroyed by cytoplasmic proteasomes through a process known as ER-associated degradation. Substrates of this pathway are initially sequestered within the ER lumen and must therefore be dislocated across the ER membrane to be degraded. It has been proposed that generation of bicellar structures during lipid droplet formation may provide an “escape hatch” through which misfolded proteins, toxins, and viruses can exit the ER. We have directly tested this hypothesis by exploiting yeast strains defective in lipid droplet formation. Our data demonstrate that lipid droplet formation is dispensable for the dislocation of a plant toxin and the degradation of both soluble and integral membrane glycoproteins. PMID:21693705

Care relationships at stake? Home healthcare professionals' experiences with digital medicine dispensers - a qualitative study.

Science.gov (United States)

Nakrem, Sigrid; Solbjør, Marit; Pettersen, Ida Nilstad; Kleiven, Hanne Hestvik

2018-01-15

Although digital technologies can mitigate the burdens of home healthcare services caused by an ageing population that lives at home longer with complex health problems, research on the impacts and consequences of digitalised remote communication between patients and caregivers is lacking. The present study explores how home healthcare professionals had experienced the introduction of digital medicine dispensers and their influence on patient-caregiver relationships. The multi-case study comprised semi-structured interviews with 21 healthcare professionals whose home healthcare service involved using the digital medicine dispensers. The constant comparative method was used for data analyses. Altogether, interviewed healthcare professionals reported three main technology-related impacts upon their patient-caregiver relationships. First, national and local pressure to increase efficiency had troubled their relationships with patients who suspected that municipalities have sought to lower costs by reducing and digitalising services. Participants reported having to consider such worries when introducing technologies into their services. Second, participants reported a shift towards empowering patients. Digital technology can empower patients who value their independence, whereas safety is more important for other patients. Healthcare professionals needed to ensure that replacing care tasks with technology implies safe and improved care. Third, the safety and quality of digital healthcare services continues to depend upon surveillance and control mechanisms that compensate for less face-to-face monitoring. Participants did not consider the possibility that surveillance exposes information about patients' everyday lives to be problematic, but to constitute opportunities for adjusting services to meet patients' needs. Technologies such as digital medicine dispensers can improve the efficiency of healthcare services and enhance patients' independence when introduced in a

Orthotics, prosthesis and mobility aids (OPM dispensation in the Regional Health Department of the 3RD Region of Sao Paulo State

Directory of Open Access Journals (Sweden)

Camila Caminha Caro

2014-12-01

Full Text Available Objective: To identify the process of dispensation of orthotics, prostheses and mobility aids (OPM by the Unified Health System (SUS in the Regional Health Department of the 3rd Region (DRSIII of Sao Paulo state; perform a mapping of the existing physical rehabilitation services in that region; and subsequently correlate the data with applicable laws. Methodology: This is an exploratory cross-sectional qualitative study whose subjects were the main professionals involved in the process of OPM dispensation, or responsible for their acquisition flow in the cities of that region. Data collection was carried out through a semi-structured questionnaire, developed by the researchers themselves, composed of questions aiming to identify the physical rehabilitation centers in the towns, the staff members involved, the provision of assistive technology through SUS, delivery time and existence of waiting lists. Results and discussion: The data were statistically measured, categorized, described and correlated with the current legislation aimed to guarantee access to assistive technology. We observed that the practice around this resource in the 3rd region concentrates in a single care center, causing long waits and poor efficiency of the services provided, in addition to maintaining a paternalistic aspect. Conclusion: This study provides evidence that, although the right to access to assistive technology is legally guaranteed, there are still many difficulties and challenges around this practice.

Pharmacy Professionals’ Dispensing Practice, Knowledge, and Attitude towards Emergency Contraceptives in Gondar Town, Northwestern Ethiopia: A Cross-Sectional Study

Directory of Open Access Journals (Sweden)

Sewunet Admasu Belachew

2017-01-01

Full Text Available Background. Pharmacy professionals, as the most available members of medical team, have an important role in educating patients about the effective and appropriate use of contraceptives. The purpose of this study was to assess pharmacy professionals’ dispensing practice, knowledge, and attitude towards emergency contraceptives use in Gondar town, northwestern Ethiopia. Methods. An institution based cross-sectional study was employed from May 14 to June 14, 2016, on 60 pharmacy professionals, who have been working in 8 randomly selected pharmacies and 6 drug stores. The collected data was entered to and analyzed using Statistical Packages for Social Sciences (SPSS version 20. Result. More than half 33 (55.0% of the participants were druggist with 5–9 years of experience. About 56 (93.3% of the participants knew about the dosing schedule (when and how much to take and side effects of emergency contraceptives. More than two-thirds of the participants (39, 65% agreed that the existence of emergency contraceptives is a positive thing and considered their use is ethical (42, 63.3%. The majority of participants (51, 85% also reported that they counsel all women when dispensing emergency contraceptive pills (ECPs. Conclusion. This study revealed that knowledge, attitude, and dispensing practice of emergency contraceptives are very good even though there were variations with respect to different factors. Findings suggested that additional training and proper counseling technique on emergency contraceptives will improve the service delivery.

Dispensing-based bioprinting of mechanically-functional hybrid scaffolds with vessel-like channels for tissue engineering applications - A brief review.

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Naghieh, Saman; Sarker, Md; Izadifar, Mohammad; Chen, Xiongbiao

2018-02-01

Over the past decades, significant progress has been achieved in the field of tissue engineering (TE) to restore/repair damaged tissues or organs and, in this regard, scaffolds made from biomaterials have played a critical role. Notably, recent advances in biomaterials and three-dimensional (3D) printing have enabled the manipulation of two or more biomaterials of distinct, yet complementary, mechanical and/or biological properties to form so-called hybrid scaffolds mimicking native tissues. Among various biomaterials, hydrogels synthesized to incorporate living cells and/or biological molecules have dominated due to their hydrated tissue-like environment. Moreover, dispensing-based bioprinting has evolved to the point that it can now be used to create hybrid scaffolds with complex structures. However, the complexities associated with multi-material bioprinting and synthesis of hydrogels used for hybrid scaffolds pose many challenges for their fabrication. This paper presents a brief review of dispensing-based bioprinting of hybrid scaffolds for TE applications. The focus is on the design and fabrication of hybrid scaffolds, including imaging techniques, potential biomaterials, physical architecture, mechanical properties, cell viability, and the importance of vessel-like channels. The key issues and challenges for dispensing-based bioprinting of hybrid scaffolds are also identified and discussed along with recommendations for future research directions. Addressing these issues will significantly enhance the design and fabrication of hybrid scaffolds to and pave the way for translating them into clinical applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

Signaling through IL-17C/IL-17RE is dispensable for immunity to systemic, oral and cutaneous candidiasis.

Science.gov (United States)

Conti, Heather R; Whibley, Natasha; Coleman, Bianca M; Garg, Abhishek V; Jaycox, Jillian R; Gaffen, Sarah L

2015-01-01

Candida albicans is a commensal fungal microbe of the human orogastrointestinal tract and skin. C. albicans causes multiple forms of disease in immunocompromised patients, including oral, vaginal, dermal and disseminated candidiasis. The cytokine IL-17 (IL-17A) and its receptor subunits, IL-17RA and IL-17RC, are required for protection to most forms of candidiasis. The importance of the IL-17R pathway has been observed not only in knockout mouse models, but also in humans with rare genetic mutations that impact generation of Th17 cells or the IL-17 signaling pathway, including Hyper-IgE Syndrome (STAT3 or TYK2 mutations) or IL17RA or ACT1 gene deficiency. The IL-17 family of cytokines is a distinct subclass of cytokines with unique structural and signaling properties. IL-17A is the best-characterized member of the IL-17 family to date, but far less is known about other IL-17-related cytokines. In this study, we sought to determine the role of a related IL-17 cytokine, IL-17C, in protection against oral, dermal and disseminated forms of C. albicans infection. IL-17C signals through a heterodimeric receptor composed of the IL-17RA and IL-17RE subunits. We observed that IL-17C mRNA was induced following oral C. albicans infection. However, mice lacking IL-17C or IL-17RE cleared C. albicans infections in the oral mucosa, skin and bloodstream at rates similar to WT littermate controls. Moreover, these mice demonstrated similar gene transcription profiles and recovery kinetics as WT animals. These findings indicate that IL-17C and IL-17RE are dispensable for immunity to the forms of candidiasis evaluated, and illustrate a surprisingly limited specificity of the IL-17 family of cytokines with respect to systemic, oral and cutaneous Candida infections.

Signaling through IL-17C/IL-17RE Is Dispensable for Immunity to Systemic, Oral and Cutaneous Candidiasis

Science.gov (United States)

Conti, Heather R.; Whibley, Natasha; Coleman, Bianca M.; Garg, Abhishek V.; Jaycox, Jillian R.; Gaffen, Sarah L.

2015-01-01

Candida albicans is a commensal fungal microbe of the human orogastrointestinal tract and skin. C. albicans causes multiple forms of disease in immunocompromised patients, including oral, vaginal, dermal and disseminated candidiasis. The cytokine IL-17 (IL-17A) and its receptor subunits, IL-17RA and IL-17RC, are required for protection to most forms of candidiasis. The importance of the IL-17R pathway has been observed not only in knockout mouse models, but also in humans with rare genetic mutations that impact generation of Th17 cells or the IL-17 signaling pathway, including Hyper-IgE Syndrome (STAT3 or TYK2 mutations) or IL17RA or ACT1 gene deficiency. The IL-17 family of cytokines is a distinct subclass of cytokines with unique structural and signaling properties. IL-17A is the best-characterized member of the IL-17 family to date, but far less is known about other IL-17-related cytokines. In this study, we sought to determine the role of a related IL-17 cytokine, IL-17C, in protection against oral, dermal and disseminated forms of C. albicans infection. IL-17C signals through a heterodimeric receptor composed of the IL-17RA and IL-17RE subunits. We observed that IL-17C mRNA was induced following oral C. albicans infection. However, mice lacking IL-17C or IL-17RE cleared C. albicans infections in the oral mucosa, skin and bloodstream at rates similar to WT littermate controls. Moreover, these mice demonstrated similar gene transcription profiles and recovery kinetics as WT animals. These findings indicate that IL-17C and IL-17RE are dispensable for immunity to the forms of candidiasis evaluated, and illustrate a surprisingly limited specificity of the IL-17 family of cytokines with respect to systemic, oral and cutaneous Candida infections. PMID:25849644

Comparative genomics and prediction of conditionally dispensable sequences in legume-infecting Fusarium oxysporum formae speciales facilitates identification of candidate effectors.

Science.gov (United States)

Williams, Angela H; Sharma, Mamta; Thatcher, Louise F; Azam, Sarwar; Hane, James K; Sperschneider, Jana; Kidd, Brendan N; Anderson, Jonathan P; Ghosh, Raju; Garg, Gagan; Lichtenzveig, Judith; Kistler, H Corby; Shea, Terrance; Young, Sarah; Buck, Sally-Anne G; Kamphuis, Lars G; Saxena, Rachit; Pande, Suresh; Ma, Li-Jun; Varshney, Rajeev K; Singh, Karam B

2016-03-05

Soil-borne fungi of the Fusarium oxysporum species complex cause devastating wilt disease on many crops including legumes that supply human dietary protein needs across many parts of the globe. We present and compare draft genome assemblies for three legume-infecting formae speciales (ff. spp.): F. oxysporum f. sp. ciceris (Foc-38-1) and f. sp. pisi (Fop-37622), significant pathogens of chickpea and pea respectively, the world's second and third most important grain legumes, and lastly f. sp. medicaginis (Fom-5190a) for which we developed a model legume pathosystem utilising Medicago truncatula. Focusing on the identification of pathogenicity gene content, we leveraged the reference genomes of Fusarium pathogens F. oxysporum f. sp. lycopersici (tomato-infecting) and F. solani (pea-infecting) and their well-characterised core and dispensable chromosomes to predict genomic organisation in the newly sequenced legume-infecting isolates. Dispensable chromosomes are not essential for growth and in Fusarium species are known to be enriched in host-specificity and pathogenicity-associated genes. Comparative genomics of the publicly available Fusarium species revealed differential patterns of sequence conservation across F. oxysporum formae speciales, with legume-pathogenic formae speciales not exhibiting greater sequence conservation between them relative to non-legume-infecting formae speciales, possibly indicating the lack of a common ancestral source for legume pathogenicity. Combining predicted dispensable gene content with in planta expression in the model legume-infecting isolate, we identified small conserved regions and candidate effectors, four of which shared greatest similarity to proteins from another legume-infecting ff. spp. We demonstrate that distinction of core and potential dispensable genomic regions of novel F. oxysporum genomes is an effective tool to facilitate effector discovery and the identification of gene content possibly linked to host

Providers' knowledge, attitude and dispensing practices of e-pills in government dispensaries of South district in delhi, India.

Science.gov (United States)

Kishore, Vertika; Misro, Man M; Nandan, Deoki

2010-01-01

South Delhi is one of the well developed districts in the capital with best public health care facilities. Knowledge, attitude and dispensing practices of emergency contraceptive pills (E-pills) were assessed among health care providers of government dispensaries in South Delhi. A descriptive epidemiological study. Both medical and paramedical (n = 428) providers in 63 government health care facilities were interviewed between August to December 2007 using a semi-structured interview schedule. Among the different categories of the providers, medical officers were observed to be most knowledgeable about E-pills and the pharmacists were the least. The correct prescribed dose of E-pill was known only to 32% of the providers while 49% knew about its right time of intake. Misconceptions and apprehensions for promoting its use were very much prevalent even among medical officers as majority felt that open access to E-pills would increase promiscuity. The dispensing practice of providers was found positively (P pills.

Histone deacetylase 1 phosphorylation at S421 and S423 is constitutive in vivo, but dispensable in vitro

International Nuclear Information System (INIS)

Karwowska-Desaulniers, Paulina; Ketko, Anastasia; Kamath, Nayana; Pflum, Mary Kay H.

2007-01-01

Histone Deacetylase 1 (HDAC1) is a transcriptional regulator associated with proliferation, apoptosis, and tumorigenesis, although its precise cellular role is unclear. HDAC1 was previously characterized as a phosphoprotein where mutation of phosphorylated S421 and S423 resulted in a loss of deacetylase activity and protein association. Here, the role of phosphorylation in regulating HDAC1 function was examined using phospho-specific antibodies. The antibody studies revealed that phosphorylation at S421 and S423 is constant during the cell cycle, under stress conditions, or in the presence of kinase or phosphatase inhibitors. Further, phosphorylation is dispensable for catalysis or protein association in vitro, as revealed by phosphatase studies. Truncation mutants of HDAC1 demonstrated that binding to Sin3A is promoted by S421 and S423 phosphorylation, while interaction with RbAp48 is not. Taken together, the data are consistent with constitutive phosphorylation of HDAC1 at S421 and S423 in vivo, which is dispensable for activity in vitro

Relationship between leukotriene-modifying agent prescriptions dispensed and rate of suicide deaths by county in the US

Directory of Open Access Journals (Sweden)

Schumock GT

2011-09-01

Full Text Available Glen T Schumock1, Robert D Gibbons2, Todd A Lee1,3,4,6, Min J Joo4, Robert J Valuck5, Leslie T Stayner61Center for Pharmacoeconomic Research, and Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA; 2Center for Health Statistics, and Departments of Medicine and Health Studies, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA; 3Center for Management of Complex Chronic Care, Hines VA Hospital, Hines, IL, USA; 4Section of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; 5Department of Clinical Pharmacy, School of Pharmacy, University of Colorado, Aurora, CO, USA; 6Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USABackground: The US Food and Drug Administration has issued warnings about a potential link between leukotriene receptor-modifying agents (LTMA and suicide. These warnings are based on case reports and there is controversy about the association. While spontaneous reporting of suicide-related events attributed to LTMA has risen dramatically, these data may be biased by the warnings. The objective of this study was to explore the relationship between LTMA and suicide deaths using event data preceding the Food and Drug Administration warnings.Methods: We conducted a mixed-effects Poisson regression analysis of the association between LTMA prescriptions dispensed and suicide deaths at the county level. Counts of suicide deaths in each US county, stratified by race, age group, gender, and year were obtained from the National Center for Health Statistics for the period January 1, 1999 to December 31, 2006. Counts of LTMA prescriptions dispensed in each US county were obtained from IMS Health Incorporated. The model estimated the overall suicide rate conditional on LTMA use, adjusted for age, gender, race, year

On demand manufacturing of patient-specific liquid capsules via co-ordinated 3D printing and liquid dispensing.

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Okwuosa, Tochukwu C; Soares, Cindy; Gollwitzer, Verena; Habashy, Rober; Timmins, Peter; Alhnan, Mohamed A

2018-06-15

A method for the production of liquid capsules with the potential of modifying drug dose and release is presented. For the first time, the co-ordinated use of fused deposition modelling (FDM), 3D printing and liquid dispensing to fabricate individualised dosage form on demand in a fully automated fashion has been demonstrated. Polymethacrylate shells (Eudragit EPO and RL) for immediate and extended release were fabricated using FDM 3D printing and simultaneously filled using a computer-controlled liquid dispenser loaded with model drug solution (theophylline) or suspension (dipyridamole). The impact of printing modes: simultaneous shell printing and filling (single-phase) or sequential 3D printing of shell bottom, filling and shell cap (multi-phase), nozzle size, syringe volume, and shell structure has been reported. The use of shell thickness of 1.6 mm, and concentric architecture allowed successful containment of liquid core whilst maintaining the release properties of the 3D printed liquid capsule. The linear relationship between the theoretical and the actual volumes from the dispenser reflected its potential for accurate dosing (R 2  = 0.9985). Modifying the shell thickness of Eudragit RL capsule allowed a controlled extended drug release without the need for formulation change. Owing to its low cost and versatility, this approach can be adapted to wide spectrum of liquid formulations such as small and large molecule solutions and obviate the need for compatibility with the high temperature of FDM 3D printing process. In a clinical setting, health care staff will be able to instantly manufacture in small volumes liquid capsules with individualised dose contents and release pattern in response to specific patient's needs. Copyright © 2018 Elsevier B.V. All rights reserved.

Design and implementation of a smart card based billing system for ...

African Journals Online (AJOL)

A smart card based billing system for petroleum dispenser is just one of the many ways in which smart cards can be employed to make commerce efficient. It incorporates the use of smart card as its legal tender and a smart card reader embedded into the filling station dispenser design. The smart card reader processes the ...

21 CFR 1300.04 - Definitions relating to the dispensing of controlled substances by means of the Internet.

Science.gov (United States)

2010-04-01

... controlled substances by means of the Internet. 1300.04 Section 1300.04 Food and Drugs DRUG ENFORCEMENT... substances by means of the Internet. (a) Any term not defined in this part or elsewhere in this chapter shall... evaluation of the patient. (c) The term deliver, distribute, or dispense by means of the Internet refers...

Communicating doses of pediatric liquid medicines to parents/caregivers: a comparison of written dosing directions on prescriptions with labels applied by dispensed pharmacy.

Science.gov (United States)

Shah, Rita; Blustein, Leona; Kuffner, Ed; Davis, Lisa

2014-03-01

To identify and compare volumetric measures used by healthcare providers in communicating dosing instructions for pediatric liquid prescriptions to parents/caregivers. Dosing instructions were retrospectively reviewed for the 10 most frequently prescribed liquid medications dispensed from 4 community pharmacies for patients aged ≤ 12 years during a 3-month period. Volumetric measures on original prescriptions (ie, milliliters, teaspoons) were compared with those utilized by the pharmacist on the pharmacy label dispensed to the parent/caregiver. Of 649 prescriptions and corresponding pharmacy labels evaluated, 68% of prescriptions and 62% of pharmacy labels communicated dosing in milliliters, 24% of prescriptions and 29% of pharmacy labels communicated dosing in teaspoonfuls, 7% of prescriptions and 0% of pharmacy labels communicated dosing in other measures (ie, milligrams, cubic centimeters, "dose"), and 25% of dispensed pharmacy labels did not reflect units as written in the prescription. Volumetric measures utilized by healthcare professionals in dosing instructions for prescription pediatric oral liquid medications are not consistent. Healthcare professionals and parents/caregivers should be educated on safe dosing practices for liquid pediatric medications. Generalizability to the larger pediatric population may vary depending on pharmacy chain, location, and medications evaluated. Copyright © 2014 Mosby, Inc. All rights reserved.

Molecular Epidemiology of a Pseudomonas aeruginosa Hospital Outbreak Driven by a Contaminated Disinfectant-Soap Dispenser

Science.gov (United States)

Lanini, Simone; D'Arezzo, Silvia; Puro, Vincenzo; Martini, Lorena; Imperi, Francesco; Piselli, Pierluca; Montanaro, Marco; Paoletti, Simonetta; Visca, Paolo; Ippolito, Giuseppe

2011-01-01

Background and Objective Pseudomonas aeruginosa infection represents a main cause of morbidity and mortality among immunocompromised patients. This study describes a fatal epidemic of P. aeruginosa that occurred in a hematology unit in Italy. Methods Retrospective cohort study, prospective surveillance, auditing, extensive testing on healthcare workers and environmental investigation were performed to define the dynamics and potential causes of transmission. RAPD, macrorestriction analyses and sequence typing were used to define relationships between P. aeruginosa isolates. Results Eighteen cases of infection were identified in the different phases of the investigation. Of these, five constitute a significant molecular cluster of infection. A P. aeruginosa strain with the same genetic fingerprint and sequence type (ST175) as clinical isolates strain was also isolated from a heavily contaminated triclosan soap dispenser. Discussion and Conclusions Our results are consistent with the hypothesis that patients became indirectly infected, e.g., during central venous catheter handling through contaminated items, and that the triclosan soap dispenser acted as a common continuous source of P. aeruginosa infection. Since P. aeruginosa is intrinsically unsusceptible to triclosan, the use of triclosan-based disinfectant formulations should be avoided in those healthcare settings hosting patients at high risk of P. aeruginosa infection. PMID:21359222

Dispensing and determinants of non-adherence to treatment for non complicated malaria caused by Plasmodium vivax and Plasmodium falciparum in high-risk municipalities in the Brazilian Amazon.

Science.gov (United States)

Osorio-de-Castro, Claudia G S; Suárez-Mutis, Martha C; Miranda, Elaine S; Luz, Tatiana C B

2015-11-26

In Brazil, 99.7 % of malaria cases occur in the Amazon region. Although the number of cases is decreasing, the country accounted for almost 60 % of cases in the Americas Region, in 2013. Novel approaches for malaria treatment open the possibility of eliminating the disease, but suboptimal dispensing and lack of adherence influence treatment outcomes. The aim of this paper is to show the results on dispensing practices, non-adherence and determinants of non-adherence to treatment of non-complicated malaria. The study was conducted in six high-risk municipalities with Plasmodium vivax and Plasmodium falciparum transmission in the Brazilian Amazon and based on the theoretical framework of the Mafalda Project, which included investigation of dispensing and adherence. The World Health Organization Rapid Evaluation Method has been used to estimate sample size. Individuals over 15 years of age with malaria were approached at health facilities and invited to participate through informed consent. Data was collected in chart review forms focusing on diagnosis, Plasmodium type, prescribing, and dispensing (kind, quantity, labelling and procedures). Follow-up household interviews complemented data collection at health facility. Non-adherence was measured during the implementation phase, by self-reports and pill-counts. Analysis was descriptive and statistical tests were carried out. Determinants of non-adherence and quality of dispensing were assessed according to the literature. The study involved 165 patients. Dispensing was done according to the national guidelines. Labelling was adequate for P. vivax but inadequate for P. falciparum medicines. Non-adherent patients were 12.1 % according to self-reports and 21.8 % according to pill-counts. Results point to greater non-adherence among all P. falciparum patients and among malaria non-naîve patients. More patients informed understanding adverse effects than 'how to use' anti-malarials. Non-adherent patients were mostly those

Radiological safety and GMP in the bulk batch manufacturing, formulation and dispensing of radiopharmaceuticals

International Nuclear Information System (INIS)

Thulasidhasan, A.; Tiwary, Bikash; Kumar, Uma Sheri; Kale, Pooja; Tiwary, Richa; Gaurav, Ananad; Shah, B.K.; Topale, P.D.; Prabhakar, G.; Sachdev, S.S.

2010-01-01

Full text: Radiopharmaceutical Program of BRIT is involved in the manufacturing of ready to use radiopharmaceuticals for therapy for the last three decades. Ready to use Radiopharmaceutical products include, 131 I-Sodium iodide solution and capsules for thyroid carcinoma and metastatic lesions, 131 I MIBG injection for diagnosis and therapy of adrenal medullae tumors and their mets, 153 Sm-EDTMP injection and 32 P- Sodium orthophosphate injection for bone pain palliative treatment. BRIT's radiopharmaceutical production facility is a radioisotope laboratory classified as Type-III facility for handling radioisotopes of Group-II, Group-III and Group-IV approved by AERB. This facility meets all the radiological safety requirements as per AERB guidelines. Production of above mentioned radiopharmaceuticals is carried out in Production Plants (PP), β, γ Glove boxes (GB) and Fume hoods (FH). Typical production procedure involves bulk processing, formulation, sterilization and dispensing of doses. Production Plants (PP) are exclusively designed facilities to carry out the production in a radiologically safe manner, at the same time maintaining aseptic conditions required for injectables as per the current GMP. Each production plant has a leak tight Isolator box, made up of high quality SS which has provisions for remote handling devices like, Tongs, dispensing systems, service points for vacuum, gas, compressed air, water and electric power. This Isolator box is shielded from all sides by required amount of lead (2 inch or 4 inch), and has an access port called 'Transport Port Box' with double door transport lock and is equipped with a trolley. Two filter unit systems are fitted at the top of the plant and each unit comprises of activated Charcoal filter and HEPA filter in tandem, this in turn is connected to special exhaust meant for radioactive gases. Similarly, the designs of β, γ Glove boxes (GB) and Fume hoods (FH) also incorporate all radiological safety features

Care relationships at stake? Home healthcare professionals’ experiences with digital medicine dispensers – a qualitative study

OpenAIRE

Nakrem, Sigrid; Solbjør, Marit; Pettersen, Ida Nilstad; Kleiven, Hanne Hestvik

2018-01-01

Background Although digital technologies can mitigate the burdens of home healthcare services caused by an ageing population that lives at home longer with complex health problems, research on the impacts and consequences of digitalised remote communication between patients and caregivers is lacking. The present study explores how home healthcare professionals had experienced the introduction of digital medicine dispensers and their influence on patient-caregiver relationships. Methods...

Reduced-order modellin for high-pressure transient flow of hydrogen-natural gas mixture

Science.gov (United States)

Agaie, Baba G.; Khan, Ilyas; Alshomrani, Ali Saleh; Alqahtani, Aisha M.

2017-05-01

In this paper the transient flow of hydrogen compressed-natural gas (HCNG) mixture which is also referred to as hydrogen-natural gas mixture in a pipeline is numerically computed using the reduced-order modelling technique. The study on transient conditions is important because the pipeline flows are normally in the unsteady state due to the sudden opening and closure of control valves, but most of the existing studies only analyse the flow in the steady-state conditions. The mathematical model consists in a set of non-linear conservation forms of partial differential equations. The objective of this paper is to improve the accuracy in the prediction of the HCNG transient flow parameters using the Reduced-Order Modelling (ROM). The ROM technique has been successfully used in single-gas and aerodynamic flow problems, the gas mixture has not been done using the ROM. The study is based on the velocity change created by the operation of the valves upstream and downstream the pipeline. Results on the flow characteristics, namely the pressure, density, celerity and mass flux are based on variations of the mixing ratio and valve reaction and actuation time; the ROM computational time cost advantage are also presented.

Public sector refraction and spectacle dispensing in low-resource countries of the Western Pacific.

Science.gov (United States)

Ramke, Jacqueline; du Toit, Rènée; Palagyi, Anna; Williams, Carmel; Brian, Garry

2008-05-01

Given that uncorrected refractive error is a frequent cause of vision impairment, and that there is a high unmet need for spectacles, an appraisal of public sector arrangements for the correction of refractive error was conducted in eight Pacific Island countries. Mixed methods (questionnaire and semi-structured interviews) were used to collect information from eye care personnel (from Fiji, Papua New Guinea, Solomon Islands, Vanuatu, Cook Islands, Samoa, Tonga and Tuvalu) attending a regional eye health workshop in 2005. Fiji, Tonga and Vanuatu had Vision 2020 eye care plans that included refraction services, but not spectacle provision. There was wide variation in public sector spectacle dispensing services, but, except in Samoa, ready-made spectacles and a full cost recovery pricing strategy were the mainstay. There were no systems for the registration of personnel, nor guidelines for clinical or systems management. The refraction staff to population ratio varied considerably. Solomon Islands, Tuvalu and Vanuatu had the best coverage by services, either fixed or outreach. Most services had little promotional activity or community engagement. To be successful, it would seem that public sector refraction services should answer a real and perceived need, fit within prevailing policy and legislation, value, train, retain and equip employees, be well managed, be accessible and affordable, be responsive to consumers, and provide ongoing good quality outcomes. To this end, a checklist to aid the initiation and maintenance of refraction and spectacle systems in low-resource countries has been constructed.

21 CFR 369.3 - Warnings required on drugs exempted from prescription-dispensing requirements of section 503(b)(1...

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Warnings required on drugs exempted from prescription-dispensing requirements of section 503(b)(1)(C). 369.3 Section 369.3 Food and Drugs FOOD AND DRUG... subject to the labeling requirements prescribed in § 310.201(a) of this chapter. Although, for convenience...

Making the case for change: What researchers need to consider when designing behavior change interventions aimed at improving medication dispensing.

Science.gov (United States)

Cadogan, Cathal A; Ryan, Cristín; Hughes, Carmel

2016-01-01

There is a growing emphasis on behavior change in intervention development programmes aimed at improving public health and healthcare professionals' practice. A number of frameworks and methodological tools have been established to assist researchers in developing interventions seeking to change healthcare professionals' behaviors. The key features of behavior change intervention design involve specifying the target group (i.e. healthcare professional or patient cohort), the target behavior and identifying mediators (i.e. barriers and facilitators) of behavior change. Once the target behavior is clearly specified and understood, specific behavior change techniques can then be used as the basis of the intervention to target identified mediators of behavior change. This commentary outlines the challenges for pharmacy practice-based researchers in targeting dispensing as a behavior when developing behavior change interventions aimed at pharmacists and proposes a definition of dispensing to consider in future research. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of Batch Assay and Random Assay Using Automatic Dispenser in Radioimmunoassay

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Moon, Seung Hwan; Jang, Su Jin; Kang, Ji Yeon; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul [Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Lee, Ho Young; Shin, Sun Young; Min, Gyeong Sun; Lee, Hyun Joo [Seoul National University college of Medicine, Seoul (Korea, Republic of)

2009-08-15

Radioimmunoassay (RIA) was usually performed by the batch assay. To improve the efficiency of RIA without increase of the cost and time, random assay could be a choice. We investigated the possibility of the random assay using automatic dispenser by assessing the agreement between batch assay and random assay. The experiments were performed with four items; Triiodothyronine (T3), free thyroxine (fT4), Prostate specific antigen (PSA), Carcinoembryonic antigen (CEA). In each item, the sera of twenty patients, the standard, and the control samples were used. The measurements were done 4 times with 3 hour time intervals by random assay and batch assay. The coefficient of variation (CV) of the standard samples and patients' data in T3, fT4, PSA, and CEA were assessed. ICC (Intraclass correlation coefficient) and coefficient of correlation were measured to assessing the agreement between two methods. The CVs (%) of T3, fT4, PSA, and CEA measured by batch assay were 3.2+-1.7%, 3.9+-2.1%, 7.1+-6.2%, 11.2+-7.2%. The CVs by random assay were 2.1+-1.7%, 4.8+-3.1%, 3.6+-4.8%, and 7.4+-6.2%. The ICC between the batch assay and random assay were 0.9968 (T3), 0.9973 (fT4), 0.9996 (PSA), and 0.9901 (CEA). The coefficient of correlation between the batch assay and random assay were 0.9924(T3), 0.9974 (fT4), 0.9994 (PSA), and 0.9989 (CEA) (p<0.05). The results of random assay showed strong agreement with the batch assay in a day. These results suggest that random assay using automatic dispenser could be used in radioimmunoassay

Comparison of Batch Assay and Random Assay Using Automatic Dispenser in Radioimmunoassay

International Nuclear Information System (INIS)

Moon, Seung Hwan; Jang, Su Jin; Kang, Ji Yeon; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Lee, Ho Young; Shin, Sun Young; Min, Gyeong Sun; Lee, Hyun Joo

2009-01-01

Radioimmunoassay (RIA) was usually performed by the batch assay. To improve the efficiency of RIA without increase of the cost and time, random assay could be a choice. We investigated the possibility of the random assay using automatic dispenser by assessing the agreement between batch assay and random assay. The experiments were performed with four items; Triiodothyronine (T3), free thyroxine (fT4), Prostate specific antigen (PSA), Carcinoembryonic antigen (CEA). In each item, the sera of twenty patients, the standard, and the control samples were used. The measurements were done 4 times with 3 hour time intervals by random assay and batch assay. The coefficient of variation (CV) of the standard samples and patients' data in T3, fT4, PSA, and CEA were assessed. ICC (Intraclass correlation coefficient) and coefficient of correlation were measured to assessing the agreement between two methods. The CVs (%) of T3, fT4, PSA, and CEA measured by batch assay were 3.2±1.7%, 3.9±2.1%, 7.1±6.2%, 11.2±7.2%. The CVs by random assay were 2.1±1.7%, 4.8±3.1%, 3.6±4.8%, and 7.4±6.2%. The ICC between the batch assay and random assay were 0.9968 (T3), 0.9973 (fT4), 0.9996 (PSA), and 0.9901 (CEA). The coefficient of correlation between the batch assay and random assay were 0.9924(T3), 0.9974 (fT4), 0.9994 (PSA), and 0.9989 (CEA) (p<0.05). The results of random assay showed strong agreement with the batch assay in a day. These results suggest that random assay using automatic dispenser could be used in radioimmunoassay

Vital and dispensable roles of Plasmodium multidrug resistance transporters during blood- and mosquito-stage development.

Science.gov (United States)

Rijpma, Sanna R; van der Velden, Maarten; Annoura, Takeshi; Matz, Joachim M; Kenthirapalan, Sanketha; Kooij, Taco W A; Matuschewski, Kai; van Gemert, Geert-Jan; van de Vegte-Bolmer, Marga; Siebelink-Stoter, Rianne; Graumans, Wouter; Ramesar, Jai; Klop, Onny; Russel, Frans G M; Sauerwein, Robert W; Janse, Chris J; Franke-Fayard, Blandine M; Koenderink, Jan B

2016-07-01

Multidrug resistance (MDR) proteins belong to the B subfamily of the ATP Binding Cassette (ABC) transporters, which export a wide range of compounds including pharmaceuticals. In this study, we used reverse genetics to study the role of all seven Plasmodium MDR proteins during the life cycle of malaria parasites. Four P. berghei genes (encoding MDR1, 4, 6 and 7) were refractory to deletion, indicating a vital role during blood stage multiplication and validating them as potential targets for antimalarial drugs. Mutants lacking expression of MDR2, MDR3 and MDR5 were generated in both P. berghei and P. falciparum, indicating a dispensable role for blood stage development. Whereas P. berghei mutants lacking MDR3 and MDR5 had a reduced blood stage multiplication in vivo, blood stage growth of P. falciparum mutants in vitro was not significantly different. Oocyst maturation and sporozoite formation in Plasmodium mutants lacking MDR2 or MDR5 was reduced. Sporozoites of these P. berghei mutants were capable of infecting mice and life cycle completion, indicating the absence of vital roles during liver stage development. Our results demonstrate vital and dispensable roles of MDR proteins during blood stages and an important function in sporogony for MDR2 and MDR5 in both Plasmodium species. © 2016 John Wiley & Sons Ltd.

Dispensação de medicamentos do componente especializado em polos no Estado do Rio de Janeiro Dispensing specialized component medicines in areas of the State of Rio de Janeiro

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Elisangela da Costa Lima-Dellamora

2012-09-01

, compromises the dispensing CEAF medicines in all facilities. The CEAF dispensing procedure, heavily dependent on interaction between prescribers and dispensers, is not carried out as would be expected. It is possible that inadequate performance is also linked to flaws in the planning and organization of services. The results indicate barriers in adherence to PCDT by health professionals, prejudicing health system users and possibly leading them to access medicines by legal means. It is believed that characteristics of the investigated facilities are similar to others in Brazil, and the barriers identified may be the same, compromising healthcare.

All-printed capacitors with continuous solution dispensing technology

Science.gov (United States)

Ge, Yang; Plötner, Matthias; Berndt, Andreas; Kumar, Amit; Voit, Brigitte; Pospiech, Doris; Fischer, Wolf-Joachim

2017-09-01

Printed electronics have been introduced into the commercial markets in recent years. Various printing technologies have emerged aiming to process printed electronic devices with low cost, environmental friendliness, and compatibility with large areas and flexible substrates. The aim of this study is to propose a continuous solution dispensing technology for processing all-printed thin-film capacitors on glass substrates using a leading-edge printing instrument. Among all printing technologies, this study provides concrete proof of the following outstanding advantages of this technology: high tolerance to inks, high throughput, low cost, and precise pattern transfers. Ag nanoparticle ink based on glycol ethers was used to print the electrodes. To obtain dielectric ink, a copolymer powder of poly(methyl methacrylate-co-benzoylphenyl methacrylate) containing crosslinkable side groups was dissolved in anisole. Various layouts were designed to support multiple electronic applications. Scanning electron microscopy and atomic force microscopy were used to investigate the all-printed capacitor layers formed using the proposed process. Additionally, the printed capacitors were electrically characterized under direct current and alternating current. The measured electrical properties of the printed capacitors were consistent with the theoretical results.

Effects of mental demands during dispensing on perceived medication safety and employee well-being: a study of workload in pediatric hospital pharmacies.

Science.gov (United States)

Holden, Richard J; Patel, Neal R; Scanlon, Matthew C; Shalaby, Theresa M; Arnold, Judi M; Karsh, Ben-Tzion

2010-12-01

Pharmacy workload is a modifiable work system factor believed to affect both medication safety outcomes and employee outcomes, such as job satisfaction. This study sought to measure the effect of workload on safety and employee outcomes in 2 pediatric hospitals and to do so using a novel approach to pharmacy workload measurement. Rather than measuring prescription volume or other similar indicators, this study measured the type and intensity of mental demands experienced during the medication dispensing tasks. The effects of external (interruptions, divided attention, and rushing) and internal (concentration and effort) task demands on perceived medication error likelihood, adverse drug event likelihood, job dissatisfaction, and burnout were statistically estimated using multiple linear and logistic regression. Pharmacists and pharmacy technicians reported high levels of external and internal mental demands during dispensing. The study supported the hypothesis that external demands (interruptions, divided attention, and rushing) negatively impacted medication safety and employee well-being outcomes. However, as hypothesized, increasing levels of internal demands (concentration and effort) were not associated with greater perceived likelihood of error, adverse drug events, or burnout and even had a positive effect on job satisfaction. Replicating a prior study in nursing, this study shows that new conceptualizations and measures of workload can generate important new findings about both detrimental and beneficial effects of workload on patient safety and employee well-being. This study discusses what those findings imply for policy, management, and design concerning automation, cognition, and staffing. Copyright © 2010 Elsevier Inc. All rights reserved.

Effects of mental demands during dispensing on perceived medication safety and employee well being: A study of workload in pediatric hospital pharmacies

Science.gov (United States)

Holden, Richard J.; Patel, Neal R.; Scanlon, Matthew C.; Shalaby, Theresa M.; Arnold, Judi M.; Karsh, Ben-Tzion

2009-01-01

Background Pharmacy workload is a modifiable work system factor believed to affect both medication safety outcomes and employee outcomes such as job satisfaction. Objectives This study sought to measure the effect of workload on safety and employee outcomes in two pediatric hospitals and to do so using a novel approach to pharmacy workload measurement. Methods Rather than measuring prescription volume or other similar indicators, this study measured the type and intensity of mental demands experienced during the medication dispensing tasks. The effects of external (interruptions, divided attention, rushing) and internal (concentration, effort) task demands on perceived medication error likelihood, adverse drug event likelihood, job dissatisfaction, and burnout were statistically estimated using multiple linear and logistic regression. Results Pharmacists and pharmacy technicians reported high levels of external and internal mental demands during dispensing. The study supported the hypothesis that external demands (interruptions, divided attention, rushing) negatively impacted medication safety and employee well being outcomes. However, as hypothesized, increasing levels of internal demands (concentration and effort) were not associated with greater perceived likelihood of error, adverse drug events, or burnout, and even had a positive effect on job satisfaction. Conclusion Replicating a prior study in nursing, this study shows that new conceptualizations and measures of workload can generate important new findings about both detrimental and beneficial effects of workload on patient safety and employee well being. This study discusses what those findings imply for policy, management, and design concerning automation, cognition, and staffing. PMID:21111387

Signaling through IL-17C/IL-17RE is dispensable for immunity to systemic, oral and cutaneous candidiasis.

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Heather R Conti

Full Text Available Candida albicans is a commensal fungal microbe of the human orogastrointestinal tract and skin. C. albicans causes multiple forms of disease in immunocompromised patients, including oral, vaginal, dermal and disseminated candidiasis. The cytokine IL-17 (IL-17A and its receptor subunits, IL-17RA and IL-17RC, are required for protection to most forms of candidiasis. The importance of the IL-17R pathway has been observed not only in knockout mouse models, but also in humans with rare genetic mutations that impact generation of Th17 cells or the IL-17 signaling pathway, including Hyper-IgE Syndrome (STAT3 or TYK2 mutations or IL17RA or ACT1 gene deficiency. The IL-17 family of cytokines is a distinct subclass of cytokines with unique structural and signaling properties. IL-17A is the best-characterized member of the IL-17 family to date, but far less is known about other IL-17-related cytokines. In this study, we sought to determine the role of a related IL-17 cytokine, IL-17C, in protection against oral, dermal and disseminated forms of C. albicans infection. IL-17C signals through a heterodimeric receptor composed of the IL-17RA and IL-17RE subunits. We observed that IL-17C mRNA was induced following oral C. albicans infection. However, mice lacking IL-17C or IL-17RE cleared C. albicans infections in the oral mucosa, skin and bloodstream at rates similar to WT littermate controls. Moreover, these mice demonstrated similar gene transcription profiles and recovery kinetics as WT animals. These findings indicate that IL-17C and IL-17RE are dispensable for immunity to the forms of candidiasis evaluated, and illustrate a surprisingly limited specificity of the IL-17 family of cytokines with respect to systemic, oral and cutaneous Candida infections.

What proportion of prescription items dispensed in community pharmacies are eligible for the New Medicine Service?

Science.gov (United States)

Wells, Katharine M; Boyd, Matthew J; Thornley, Tracey; Boardman, Helen F

2014-03-07

The payment structure for the New Medicine Service (NMS) in England is based on the assumption that 0.5% of prescription items dispensed in community pharmacies are eligible for the service. This assumption is based on a theoretical calculation. This study aimed to find out the actual proportion of prescription items eligible for the NMS dispensed in community pharmacies in order to compare this with the theoretical assumption. The study also aimed to investigate whether the proportion of prescription items eligible for the NMS is affected by pharmacies' proximity to GP practices. The study collected data from eight pharmacies in Nottingham belonging to the same large chain of pharmacies. Pharmacies were grouped by distance from the nearest GP practice and sampled to reflect the distribution by distance of all pharmacies in Nottingham. Data on one thousand consecutive prescription items were collected from each pharmacy and the number of NMS eligible items recorded. All NHS prescriptions were included in the sample. Data were analysed and proportions calculated with 95% confidence intervals used to compare the study results against the theoretical figure of 0.5% of prescription items being eligible for the NMS. A total of 8005 prescription items were collected (a minimum of 1000 items per pharmacy) of which 17 items were eligible to receive the service. The study found that 0.25% (95% confidence intervals: 0.14% to 0.36%) of prescription items were eligible for the NMS which differs significantly from the theoretical assumption of 0.5%. The opportunity rate for the service was lower, 0.21% (95% confidence intervals: 0.10% to 0.32%) of items, as some items eligible for the NMS did not translate into opportunities to offer the service. Of all the prescription items collected in the pharmacies, 28% were collected by patient representatives. The results of this study show that the proportion of items eligible for the NMS dispensed in community pharmacies is lower than

Superior PSZ-SOD Gap-Fill Process Integration Using Ultra-Low Dispensation Amount in STI for 28 nm NAND Flash Memory and Beyond

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Chun Chi Lai

2015-01-01

Full Text Available The gap-fill performance and process of perhydropolysilazane-based inorganic spin-on dielectric (PSZ-SOD film in shallow trench isolation (STI with the ultra-low dispensation amount of PSZ-SOD solution have been investigated in this study. A PSZ-SOD film process includes liner deposition, PSZ-SOD coating, and furnace curing. For liner deposition, hydrophilic property is required to improve the contact angle and gap-fill capability of PSZ-SOD coating. Prior to PSZ-SOD coating, the additional treatment on liner surface is beneficial for the fluidity of PSZ-SOD solution. The superior film thickness uniformity and gap-fill performance of PSZ-SOD film are achieved due to the improved fluidity of PSZ-SOD solution. Following that up, the low dispensation rate of PSZ-SOD solution leads to more PSZ-SOD filling in the trenches. After PSZ-SOD coating, high thermal curing process efficiently promotes PSZ-SOD film conversion into silicon oxide. Adequate conversion from PSZ-SOD into silicon oxide further increases the etching resistance inside the trenches. Integrating the above sequence of optimized factors, void-free gap-fill and well-controlled STI recess uniformity are achieved even when the PSZ-SOD solution dispensation volume is reduced 3 to 6 times compared with conventional condition for the 28 nm node NAND flash and beyond.

Studies on the pressed yttrium oxide-tungsten matrix as a possible dispenser cathode material

International Nuclear Information System (INIS)

Yang, Fan; Wang, Jinshu; Liu, Wei; Liu, Xiang; Zhou, Meiling

2015-01-01

Yttrium oxide was chosen as the secondary emission substance based on calculation results through first principle theory method. A new kind of pressed yttrium oxide-tungsten matrix dispenser cathodes are prepared by a sol–gel method combined with high temperature sintering in dry hydrogen atmosphere. The results show that the growth of the grains is hampered by the pinning effect of Y 2 O 3 distributing uniformly between the tungsten particles, resulting in the formation of small grain size. It is found that Y 2 O 3 improves the secondary electron emission property, i.e., the secondary emission yield increases with the increase of Y 2 O 3 content in the samples. The maximum secondary emission yield δ max of the cathode with 15% amount of Y 2 O 3 can reach 2.92. Furthermore, the cathode shows a certain thermionic emission performance. The zero field emission current density J 0 of 4.18A/cm 2 has reached at 1050 °C b for this kind of cathode after being activated at 1200 °C b , which are much higher than that of rare earth oxide doped molybdenum (REO-Mo) cathode reported in the previous work. - Highlights: • Yttrium oxide was chosen as the secondary emission substance based on first principle calculation result. • A new kind of cathode has been successfully obtained. • Pressed yttrium oxide-tungsten matrix dispenser cathode exhibits good emission properties. • The improvement of the cathode emission can be well explained by the surface analysis results presented in this work

Microencapsulation system and method

Science.gov (United States)

Morrison, Dennis R. (Inventor)

2009-01-01

A microencapsulation apparatus is provided which is configured to form co-axial multi-lamellar microcapsules from materials discharged from first and second microsphere dispensers of the apparatus. A method of fabricating and processing microcapsules is also provided which includes forming distinct droplets comprising one or more materials and introducing the droplets directly into a solution bath to form a membrane around the droplets such that a plurality of microcapsules are formed. A microencapsulation system is provided which includes a microcapsule production unit, a fluidized passage for washing and harvesting microcapsules dispensed from the microcapsule production unit and a flow sensor for sizing and counting the microcapsules. In some embodiments, the microencapsulation system may further include a controller configured to simultaneously operate the microcapsule production unit, fluidized passage and flow sensor to process the microcapsules in a continuous manner.

Printed droplet microfluidics for on demand dispensing of picoliter droplets and cells.

Science.gov (United States)

Cole, Russell H; Tang, Shi-Yang; Siltanen, Christian A; Shahi, Payam; Zhang, Jesse Q; Poust, Sean; Gartner, Zev J; Abate, Adam R

2017-08-15

Although the elementary unit of biology is the cell, high-throughput methods for the microscale manipulation of cells and reagents are limited. The existing options either are slow, lack single-cell specificity, or use fluid volumes out of scale with those of cells. Here we present printed droplet microfluidics, a technology to dispense picoliter droplets and cells with deterministic control. The core technology is a fluorescence-activated droplet sorter coupled to a specialized substrate that together act as a picoliter droplet and single-cell printer, enabling high-throughput generation of intricate arrays of droplets, cells, and microparticles. Printed droplet microfluidics provides a programmable and robust technology to construct arrays of defined cell and reagent combinations and to integrate multiple measurement modalities together in a single assay.

Elongation factor P is dispensable in Escherichia coli and Pseudomonas aeruginosa.

Science.gov (United States)

Balibar, Carl J; Iwanowicz, Dorothy; Dean, Charles R

2013-09-01

Elongation factor P (EF-P) is a highly conserved ribosomal initiation factor responsible for stimulating formation of the first peptide bond. Its essentiality has been debated and may differ depending on the organism. Here, we demonstrate that EF-P is dispensable in Escherichia coli and Pseudomonas aeruginosa under laboratory growth conditions. Although knockouts are viable, growth rates are diminished compared with wild-type strains. Despite this cost in fitness, these mutants are not more susceptible to a wide range of antibiotics; including ribosome targeting antibiotics, such as lincomycin, chloramphenicol, and streptomycin, which have been shown previously to disrupt EF-P function in vitro. In Pseudomonas, knockout of efp leads to an upregulation of mexX, a phenotype previously observed with other genetic lesions affecting ribosome function and that can be induced by the treatment with antibiotics affecting protein synthesis.

Addition of pear ester enhances disruption of mating by female codling moth (Lepidoptera: Tortricidae) in walnut orchards treated with meso dispensers

Science.gov (United States)

The success of applying low rates (50 ha-1) of dispensers to achieve disruption of adult communication of codling moth, Cydia pomonella (L)., in walnuts, Juglans regia (L.),was evaluated with several methods. These included cumulative catches of male moths in traps baited with either sex pheromone (...

Effectiveness of an extended period of flashing lights and strategic signage to increase the salience of alcohol-gel dispensers for improving hand hygiene compliance.

Science.gov (United States)

Rashidi, Babak; Li, Aimee; Patel, Rakesh; Harmsen, Irene E; Sabri, Elham; Kyeremanteng, Kwadwo; D'Egidio, Gianni

2016-07-01

Multiple factors affect compliance with hand hygiene, including conspicuity of alcohol-gel dispensers. Previous studies have shown that flashing lights increase hand hygiene compliance; however, the durability of this effect has not been studied. We affixed flashing lights to hand sanitizer dispensers for a total of 6 weeks. Regression analysis was used to compare compliance rates between the beginning and end of the intervention. Our secondary objective was to determine whether compliance rates in cold weather could be improved by adding a sign separated in time and space from the dispensers. Flashing lights improved hand hygiene compliance from 11.8% to 20.7%, and this effect was unchanged over the 6-week study period. Fully charged lights resulted in a greater compliance increase. A preemptive sign did not have a significant effect on hand hygiene rates nor did absolute temperatures. Flashing lights are a simple, inexpensive way of improving hand hygiene. Brighter lights appear to have a greater effect; however, this must be balanced with annoyance in specific settings. Temperature did not have a significant effect; however, this may be because the relationship does not fit a linear model. Other interventions, such as signs, may need to be tailored specifically to individual hospital environments. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Preparation of n-type Bi{sub 2}Te{sub 3} thermoelectric materials by non-contact dispenser printing combined with selective laser melting

Energy Technology Data Exchange (ETDEWEB)

Wu, Keping; Yan, Yonggao; Zhang, Jian; Mao, Yu; Xie, Hongyao; Zhang, Qingjie; Tang, Xinfeng [State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan, Hubei (China); Yang, Jihui [Department of Materials Science and Engineering, University of Washington, Seattle, WA (United States); Uher, Ctirad [Department of Physics, University of Michigan, Ann Arbor, MI (United States)

2017-06-15

The manufacturing cost has been a bottle neck for broader applications of thermoelectric (TE) modules. We have developed a rapid, facile, and low cost method that combines non-contact dispenser printing with selective laser melting (SLM) and we demonstrate it on n-type Bi{sub 2}Te{sub 3}-based materials. Using this approach, single phase n-type Bi{sub 2}Te{sub 2.7}Se{sub 0.3} thin layers with the Seebeck coefficient of -152 μV K{sup -1} at 300 K have been prepared. Assembling such thin layers on top of each other, the performance of thus prepared bulk sample is comparable to Bi{sub 2}Te{sub 3}-based materials fabricated by the conventional techniques. Dispenser printing combined with SLM is a promising manufacturing process for TE materials. (copyright 2017 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

Comparison of medication safety systems in critical access hospitals: Combined analysis of two studies.

Science.gov (United States)

Cochran, Gary L; Barrett, Ryan S; Horn, Susan D

2016-08-01

The role of pharmacist transcription, onsite pharmacist dispensing, use of automated dispensing cabinets (ADCs), nurse-nurse double checks, or barcode-assisted medication administration (BCMA) in reducing medication error rates in critical access hospitals (CAHs) was evaluated. Investigators used the practice-based evidence methodology to identify predictors of medication errors in 12 Nebraska CAHs. Detailed information about each medication administered was recorded through direct observation. Errors were identified by comparing the observed medication administered with the physician's order. Chi-square analysis and Fisher's exact test were used to measure differences between groups of medication-dispensing procedures. Nurses observed 6497 medications being administered to 1374 patients. The overall error rate was 1.2%. The transcription error rates for orders transcribed by an onsite pharmacist were slightly lower than for orders transcribed by a telepharmacy service (0.10% and 0.33%, respectively). Fewer dispensing errors occurred when medications were dispensed by an onsite pharmacist versus any other method of medication acquisition (0.10% versus 0.44%, p = 0.0085). The rates of dispensing errors for medications that were retrieved from a single-cell ADC (0.19%), a multicell ADC (0.45%), or a drug closet or general supply (0.77%) did not differ significantly. BCMA was associated with a higher proportion of dispensing and administration errors intercepted before reaching the patient (66.7%) compared with either manual double checks (10%) or no BCMA or double check (30.4%) of the medication before administration (p = 0.0167). Onsite pharmacist dispensing and BCMA were associated with fewer medication errors and are important components of a medication safety strategy in CAHs. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Studies on the pressed yttrium oxide-tungsten matrix as a possible dispenser cathode material

Energy Technology Data Exchange (ETDEWEB)

Yang, Fan; Wang, Jinshu, E-mail: wangjsh@bjut.edu.cn; Liu, Wei; Liu, Xiang; Zhou, Meiling

2015-01-15

Yttrium oxide was chosen as the secondary emission substance based on calculation results through first principle theory method. A new kind of pressed yttrium oxide-tungsten matrix dispenser cathodes are prepared by a sol–gel method combined with high temperature sintering in dry hydrogen atmosphere. The results show that the growth of the grains is hampered by the pinning effect of Y{sub 2}O{sub 3} distributing uniformly between the tungsten particles, resulting in the formation of small grain size. It is found that Y{sub 2}O{sub 3} improves the secondary electron emission property, i.e., the secondary emission yield increases with the increase of Y{sub 2}O{sub 3} content in the samples. The maximum secondary emission yield δ{sub max} of the cathode with 15% amount of Y{sub 2}O{sub 3} can reach 2.92. Furthermore, the cathode shows a certain thermionic emission performance. The zero field emission current density J{sub 0} of 4.18A/cm{sup 2} has reached at 1050 °C{sub b} for this kind of cathode after being activated at 1200 °C{sub b}, which are much higher than that of rare earth oxide doped molybdenum (REO-Mo) cathode reported in the previous work. - Highlights: • Yttrium oxide was chosen as the secondary emission substance based on first principle calculation result. • A new kind of cathode has been successfully obtained. • Pressed yttrium oxide-tungsten matrix dispenser cathode exhibits good emission properties. • The improvement of the cathode emission can be well explained by the surface analysis results presented in this work.

Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs: a review

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Islam Md Mofizul

2007-10-01

Full Text Available Abstract Reaching hard-to-reach and high-risk injecting drug users (IDUs is one of the most important challenges for contemporary needle syringe programs (NSPs. The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs.

Assessment of the rates and characteristics of the short-term supply of medication (Tider from an integrated healthcare delivery system in the United States

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Delate T

2017-06-01

Full Text Available Objectives: The purpose of this study was to describe the rate of medication short-term supply dispensings (tider, patient and medication characteristics associated with a tider, and costs for tider dispensings in an integrated healthcare delivery system in Colorado, United States. Methods: This was a retrospective study conducted in an integrated healthcare delivery system’s outpatient clinics. All patients who had a prescription dispensed for a study medication at any of the system’s 28 outpatient pharmacies during the first quarter of 2016 were included. A tider was identified as a 3-day supply of a prescription medication that was dispensed at no charge to a patient. The quarterly tider rate and the per member per month (PMPM cost of tiders were estimated. Patient and medication characteristics associated with a tider were assessed. Results: A total of 444,225 study medications were dispensed for 135,907 patients during the study period. There were 3,430 (0.77%, 95%CI 0.75%:0.80% medications dispensed as a tider. The PMPM cost of tider medications and their dispensing fees was USD 0.03. There were 1,092 (0.8% and 134,815 (99.2% patients who did and did not, respectively, have at least one tider dispensed during the study period. Patient characteristics strongly associated with having had a tider dispensed included being older, male, and a Medicare beneficiary. Cardiovascular and neuromuscular medications had the highest rates of tider dispensing. Conclusions: The rate of tider dispensing was relatively low; however, approximately one out of 125 patients had at least one tider. Patients who had a tider were more likely to be older, female, a Medicare beneficiary, and having had a previous tider dispensing and a higher burden of chronic disease. The tider medication was more likely to be a cardiovascular or neuromuscular medication class and more likely to be dispensed on a weekend. The total cost of dispensing a tider appears reasonable

Fascin 1 is dispensable for developmental and tumour angiogenesis

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Yafeng Ma

2013-09-01

The actin bundling protein fascin 1 is not expressed in adult epithelial tissues, but during development it is transiently expressed in many different cell types, and later in adults it is expressed in a subset of immune cells, nervous tissues, endothelial cells, smooth muscle cells and pericytes. In contrast to the wealth of knowledge about the role of fascin 1 in cancer cell migration and invasion, little is known about the involvement of fascin 1 in angiogenesis. We speculated that as angiogenesis involves migration and invasion of tissues by endothelial cells, fascin 1 might have a role in both normal and tumour angiogenesis. Here, we provide evidence that loss of fascin 1 causes relatively minor reductions to angiogenesis during embryonic, postnatal and cancerous development by examining E12.5 hindbrains, postnatal retinas and B16F0 tumour cell allografts in fascin 1-null mice. We also find that in fascin 1 null tissues, endothelial cells display reduced filopodia formation during sprouting. We thus propose that fascin 1 expression promotes angiogenesis via filopodia formation, but is largely dispensable for both normal and tumour angiogenesis.

Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription

Directory of Open Access Journals (Sweden)

Francisco Caamaño

2005-02-01

Full Text Available Objective: To assess the influence of pharmacists' opinions on their dispensing medicines with a «medical prescription only» label without requiring a doctor's prescription. Methods: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a physicians' prescribing practices; b the pharmacist's qualifications to prescribe; c the responsibility of the pharmacist regarding the dispensed drugs; d the customer' qualifications for self-medication; and e the pharmacist's perception of his or her own work. The dependent variable was the pharmacist's demand for a medical prescription for 5 drugs, which in Spain require a prescription. Multiple linear regression models were constructed. Results: The response rate was 98.8%. A total of 65.9% of pharmacists reported dispensing antibiotics without a prescription. This percentage was 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for angiotensin-converting enzyme inhibitors, 13.4% for benzodiazepines, and 84.8% for oral contraceptives. Further results showed that pharmacists with a heavier workload and those who underestimated the physicians' qualifications to prescribe but overestimated their own qualifications to prescribe less frequently demanded medical prescriptions. In contrast, pharmacists who stressed the importance of their duty in rationalizing the consumption of drugs more frequently demanded medical prescriptions. Conclusion: Our results suggest that to increase the quality of dispensing: a the importance of the pharmacist's duty in controlling drug consumption should be stressed; b pharmacies' workload should be optimized; and c perceptions of physicians' prescribing practices among pharmacists should be improved.Objetivo: Evaluar la influencia de las opiniones de los farmacéuticos que no solicitan receta médica para dispensar fármacos que la

Systems and Methods for RFID-Enabled Dispenser

Science.gov (United States)

Fink, Patrick W. (Inventor); Lin, Gregory Y. (Inventor); Kennedy, Timothy F. (Inventor); Ngo, Phong H. (Inventor); Byerly, Diane (Inventor)

2015-01-01

Methods, apparatuses and systems for radio frequency identification (RFID)-enabled information collection are disclosed, including an enclosure, a collector coupled to the enclosure, an interrogator, a processor, and one or more RFID field sensors, each having an individual identification, disposed within the enclosure. In operation, the interrogator transmits an incident signal to the collector, causing the collector to generate an electromagnetic field within the enclosure. The electromagnetic field is affected by one or more influences. RFID sensors respond to the electromagnetic field by transmitting reflected signals containing the individual identifications of the responding RFID sensors to the interrogator. The interrogator receives the reflected signals, measures one or more returned signal strength indications ("RSSI") of the reflected signals and sends the RSSI measurements and identification of the responding RFID sensors to the processor to determine one or more facts about the influences. Other embodiments are also described.

S1P₄ Regulates Passive Systemic Anaphylaxis in Mice but Is Dispensable for Canonical IgE-Mediated Responses in Mast Cells.

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Kulinski, Joseph M; Proia, Richard L; Larson, Elisabeth M; Metcalfe, Dean D; Olivera, Ana

2018-04-25

Mast cells are key players in the development of inflammatory allergic reactions. Cross-linking of the high-affinity receptor for IgE (FcεRI) on mast cells leads to the generation and secretion of the sphingolipid mediator, sphingosine-1-phosphate (S1P) which is able, in turn, to transactivate its receptors on mast cells. Previous reports have identified the expression of two of the five receptors for S1P on mast cells, S1P₁ and S1P₂, with functions in FcεRI-mediated chemotaxis and degranulation, respectively. Here, we show that cultured mouse mast cells also express abundant message for S1P₄. Genetic deletion of S1pr4 did not affect the differentiation of bone marrow progenitors into mast cells or the proliferation of mast cells in culture. A comprehensive characterization of IgE-mediated responses in S1P₄-deficient bone marrow-derived and peritoneal mouse mast cells indicated that this receptor is dispensable for mast cell degranulation, cytokine/chemokine production and FcεRI-mediated chemotaxis in vitro. However, interleukin-33 (IL-33)-mediated enhancement of IgE-induced degranulation was reduced in S1P₄-deficient peritoneal mast cells, revealing a potential negative regulatory role for S1P₄ in an IL-33-rich environment. Surprisingly, genetic deletion of S1pr4 resulted in exacerbation of passive systemic anaphylaxis to IgE/anti-IgE in mice, a phenotype likely related to mast cell-extrinsic influences, such as the high circulating levels of IgE in these mice which increases FcεRI expression and consequently the extent of the response to FcεRI engagement. Thus, we provide evidence that S1P₄ modulates anaphylaxis in an unexpected manner that does not involve regulation of mast cell responsiveness to IgE stimulation.

ASCIZ/ATMIN is dispensable for ATM signaling in response to replication stress.

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Liu, Rui; King, Ashleigh; Hoch, Nicolas C; Chang, Catherine; Kelly, Gemma L; Deans, Andrew J; Heierhorst, Jörg

2017-09-01

The ATM kinase plays critical roles in the response to DNA double-strand breaks, and can also be activated by prolonged DNA replication blocks. It has recently been proposed that replication stress-dependent ATM activation is mediated by ASCIZ (also known as ATMIN, ZNF822), an essential developmental transcription factor. In contrast, we show here that ATM activation, and phosphorylation of its substrates KAP1, p53 and H2AX in response to the replication blocking agent aphidicolin was unaffected in both immortalized and primary ASCIZ/ATMIN-deficient murine embryonic fibroblasts compared to control cells. Similar results were also obtained in human ASCIZ/ATMIN-deleted lymphoma cells. The results demonstrate that ASCIZ/ATMIN is dispensable for ATM activation, and contradict the previously reported dependence of ATM on ASCIZ/ATMIN. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Pharmacy Professionals' Dispensing Practice, Knowledge, and Attitude towards Emergency Contraceptives in Gondar Town, Northwestern Ethiopia: A Cross-Sectional Study

OpenAIRE

Belachew, Sewunet Admasu; Yimenu, Dawit Kumilachew; Gebresillassie, Begashaw Melaku

2017-01-01

Background. Pharmacy professionals, as the most available members of medical team, have an important role in educating patients about the effective and appropriate use of contraceptives. The purpose of this study was to assess pharmacy professionals’ dispensing practice, knowledge, and attitude towards emergency contraceptives use in Gondar town, northwestern Ethiopia. Methods. An institution based cross-sectional study was employed from May 14 to June 14, 2016, on 60 pharmacy professionals, ...

Effects of Televised Direct-to-Consumer Advertising for Varenicline on Prescription Dispensing in the United States, 2006-2009.

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Kim, Yoonsang; Kornfield, Rachel; Shi, Yaru; Vera, Lisa; Daubresse, Matthew; Alexander, G Caleb; Emery, Sherry

2016-05-01

Televised direct-to-consumer advertising (DTCA) for prescription drugs is controversial, especially for tobacco cessation products such as varenicline, given safety concerns that arose only after its market approval. We aim to quantify the extent to which DTCA influenced varenicline use. We linked monthly DTCA television ratings with monthly prescription data from IMS Health's National Prescription Audit across top 75 media markets in 2006-2009. We used Poisson models with Generalized Estimating Equations to analyze effects of exposures to DTCA for both varenicline and nicotine replacement therapies on rate of dispensed varenicline prescriptions among smokers, controlling for population characteristics and varenicline-related events. Varenicline prescriptions increased dramatically following DTCA launch and declined sharply after safety risks were publicized and US Food and Drug Administration (FDA) issued an advisory. DTCA had significant impact on new prescription dispensing in the subsequent month: before the FDA advisory, one additional exposure to varenicline DTCA was associated with a 1.8% (rate ratio [RR] = 1.018 [1.015-1.021]) higher rate of new prescriptions; no effect was observed after the advisory (RR = 1.000 [0.997-1.003]). Prior to the advisory, cross-product effects of nicotine replacement therapy advertising on varenicline prescribing were negligible (RR = 1.002 [0.999-1.004]); after the advisory, effects were positive (RR = 1.015 [1.012-1.019]). DTCA for varenicline had a significant impact on varenicline prescribing when the drug's safety profile was not well characterized, supporting arguments to limit DTCA for newly approved products whose real-world safety is unclear. We examined the fluctuations in varenicline use in association with DTCA for varenicline and other tobacco cessation aids. To our knowledge this is the first study to quantify the effects of televised DTCA for varenicline and other tobacco cessation aids on varenicline

Incidence and cost of medications dispensed despite electronic medical record discontinuation.

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Baranowski, Patrick J; Peterson, Kristin L; Statz-Paynter, Jamie L; Zorek, Joseph A

2015-01-01

To determine the incidence and cost of medications dispensed despite discontinuation (MDDD) of the medications in the electronic medical record within an integrated health care organization. Dean Health System, with medical clinics and pharmacies linked by an electronic medical record, and a shared health plan and pharmacy benefits management company. Pharmacist-led quality improvement project using retrospective chart review. Electronic medical records, pharmacy records, and prescription claims data from patients 18 years of age or older who had a prescription filled for a chronic condition from June 2012 to August 2013 and submitted a claim through the Dean Health Plan were aggregated and cross-referenced to identify MDDD. Descriptive statistics were used to characterize demographics and MDDD incidence. Fisher's exact test and independent samples t tests were used to compare MDDD and non-MDDD groups. Wholesale acquisition cost was applied to each MDDD event. 7,406 patients met inclusion criteria. For 223 (3%) patients with MDDD, 253 independent events were identified. In terms of frequency per category, antihypertensive agents topped the list, followed, in descending order, by anticonvulsants, antilipemics, antidiabetics, and anticoagulants. Nine medications accounted for 59% (150 of 253) of all MDDD events; these included (again in descending order): gabapentin, atorvastatin, simvastatin, hydrochlorothiazide, lisinopril, warfarin, furosemide, metformin, and metoprolol. Mail-service pharmacies accounted for the highest incidence (5.3%) of MDDD, followed by mass merchandisers (4.6%) and small chains (3.9%). The total cost attributable to MDDD was $9,397.74. Development of a technology-based intervention to decrease the incidence of MDDD may be warranted to improve patient safety and decrease health care costs.

Gene disruption reveals a dispensable role for plasmepsin VII in the Plasmodium berghei life cycle.

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Mastan, Babu S; Kumari, Anchala; Gupta, Dinesh; Mishra, Satish; Kumar, Kota Arun

2014-06-01

Plasmepsins (PM), aspartic proteases of Plasmodium, comprises a family of ten proteins that perform critical functions in Plasmodium life cycle. Except VII and VIII, functions of the remaining plasmepsin members have been well characterized. Here, we have generated a mutant parasite lacking PM VII in Plasmodium berghei using reverse genetics approach. Systematic comparison of growth kinetics and infection in both mosquito and vertebrate host revealed that PM VII depleted mutants exhibited no defects in development and progressed normally throughout the parasite life cycle. These studies suggest a dispensable role for PM VII in Plasmodium berghei life cycle. Copyright © 2014 Elsevier B.V. All rights reserved.

Infection prevention and mass vaccination training for U.S. point of dispensing staff and volunteers: a national study.

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Rebmann, Terri; Loux, Travis M; Zink, Thomas K; Swick, Zachary; Wakefield, Mary

2015-03-01

Points of dispensing (PODs) are deployed for medical countermeasure mass dispensing. However, infection prevention and vaccine administration pre-event training offered and just-in-time (JIT) education planned for POD workers have not been assessed. Disaster planners were sent an online questionnaire in 2013. McNemar tests compared training offered to staff versus volunteers and pre-event training versus JIT training. In total, 301 disaster planners participated. The most frequent pre-event training included hand hygiene (59.1% and 28.0%) and personal protective equipment (PPE) selection (52.1% and 24.1%) for staff and volunteers, respectively. Few provided pre-event training on the cold chain technique (14.8% and 5.1%) or smallpox vaccine administration (4.7% and 2.3%) for staff or volunteers. For all topics except smallpox vaccine administration, more staff than volunteers received pre-event training (P training includes hand hygiene (79.8% and 73.5%) and PPE selection (79.4% and 70.0%) to staff and volunteers. For all topics, more JIT education is planned for staff than volunteers (P training is planned than has been given pre-event for all topics (P training is needed on infection prevention and vaccine administration to ensure safe and successful POD deployment. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Fibroblast activation protein is dispensable in the anti-influenza immune response in mice.

Directory of Open Access Journals (Sweden)

Sioh-Yang Tan

Full Text Available Fibroblast activation protein alpha (FAP is a unique dual peptidase of the S9B serine protease family, being capable of both dipeptidyl peptidase and endopeptidase activities. FAP is expressed at low level in healthy adult organs including the pancreas, cervix, uterus, submaxillary gland and the skin, and highly upregulated in embryogenesis, chronic inflammation and tissue remodelling. It is also expressed by cancer-associated stromal fibroblasts in more than 90% of epithelial tumours. FAP has enzymatic and non-enzymatic functions in the growth, immunosuppression, invasion and cell signalling of tumour cells. FAP deficient mice are fertile and viable with no gross abnormality, but little data exist on the role of FAP in the immune system. FAP is upregulated in association with microbial stimulation and chronic inflammation, but its function in infection remains unknown. We showed that major populations of immune cells including CD4+ and CD8+ T cells, B cells, dendritic cells and neutrophils are generated and maintained normally in FAP knockout mice. Upon intranasal challenge with influenza virus, FAP mRNA was increased in the lungs and lung-draining lymph nodes. Nonetheless, FAP deficient mice showed similar pathologic kinetics to wildtype controls, and were capable of supporting normal anti-influenza T and B cell responses. There was no evidence of compensatory upregulation of other DPP4 family members in influenza-infected FAP-deficient mice. FAP appears to be dispensable in anti-influenza adaptive immunity.

State of the art and environmental benefits using methane-hydrogen blends

International Nuclear Information System (INIS)

Faedo, D.

2007-01-01

Hythane is the patented mixture of 15% (by energy content) of hydrogen in CNG: in other proportions the blend is called HCNG. Hydrogen addition to CNG extends the lean burn limit of a natural gas engine, and has the potential to lower the nitrogen oxides emissions and to improve the engine thermal efficiency, with minor hardware changes necessary. This paper reports the benefits of hydrogen to CNG in S.I. engine, and a brief review of the results obtained in this field [it

Integrated waste hydrogen utilization project

International Nuclear Information System (INIS)

Armstrong, C.

2004-01-01

'Full text:' The BC Hydrogen Highway's, Integrated Waste Hydrogen Utilization Project (IWHUP) is a multi-faceted, synergistic collaboration that will capture waste hydrogen and promote its use through the demonstration of 'Hydrogen Economy' enabling technologies developed by Canadian companies. IWHUP involves capturing and purifying a small portion of the 600 kg/hr of by-product hydrogen vented to the atmosphere at the ERCO's electrochemical sodium chlorate plant in North Vancouver, BC. The captured hydrogen will then be compressed so it is suitable for transportation on roadways and can be used as a fuel in transportation and stationary fuel cell demonstrations. In summary, IWHUP invests in the following; Facilities to produce up to 20kg/hr of 99.999% pure 6250psig hydrogen using QuestAir's leading edge Pressure Swing Absorption technology; Ultra high-pressure transportable hydrogen storage systems developed by Dynetek Industries, Powertech Labs and Sacre-Davey Engineering; A Mobile Hydrogen Fuelling Station to create Instant Hydrogen Infrastructure for light-duty vehicles; Natural gas and hydrogen (H-CNG) blending and compression facilities by Clean Energy for fueling heavy-duty vehicles; Ten hydrogen, internal combustion engine (H-ICE), powered light duty pick-up vehicles and a specialized vehicle training, maintenance, and emissions monitoring program with BC Hydro, GVRD and the District of North Vancouver; The demonstration of Westport's H-CNG technology for heavy-duty vehicles in conjunction with local transit properties and a specialized vehicle training, maintenance, and emissions monitoring program; The demonstration of stationary fuel cell systems that will provide clean power for reducing peak-load power demands (peak shaving), grid independence and water heating; A comprehensive communications and outreach program designed to educate stakeholders, the public, regulatory bodies and emergency response teams in the local community, Supported by industry

The C-Terminal Domain of Cernunnos/XLF Is Dispensable for DNA Repair In Vivo▿ †

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Malivert, Laurent; Callebaut, Isabelle; Rivera-Munoz, Paola; Fischer, Alain; Mornon, Jean-Paul; Revy, Patrick; de Villartay, Jean-Pierre

2009-01-01

The core nonhomologous end-joining DNA repair pathway is composed of seven factors: Ku70, Ku80, DNA-PKcs, Artemis, XRCC4 (X4), DNA ligase IV (L4), and Cernunnos/XLF (Cernunnos). Although Cernunnos and X4 are structurally related and participate in the same complex together with L4, they have distinct functions during DNA repair. L4 relies on X4 but not on Cernunnos for its stability, and L4 is required for optimal interaction of Cernunnos with X4. We demonstrate here, using in vitro-generated Cernunnos mutants and a series of functional assays in vivo, that the C-terminal region of Cernunnos is dispensable for its activity during DNA repair. PMID:19103754

Method and apparatus for dispensing small quantities of mercury from evacuated and sealed glass capsules

Science.gov (United States)

Grossman, Mark W.; George, William A.; Pai, Robert Y.

1985-01-01

A technique for opening an evacuated and sealed glass capsule containing a material that is to be dispensed which has a relatively high vapor pressure such as mercury. The capsule is typically disposed in a discharge tube envelope. The technique involves the use of a first light source imaged along the capsule and a second light source imaged across the capsule substantially transversely to the imaging of the first light source. Means are provided for constraining a segment of the capsule along its length with the constraining means being positioned to correspond with the imaging of the second light source. These light sources are preferably incandescent projection lamps. The constraining means is preferably a multiple looped wire support.

Brand versus generic dispensing trend for ciprofloxacin 500 mg, levofloxacin 500 mg, and moxifloxacin 400 mg (oral dosage forms) among pharmacies of Karachi, Pakistan.

Science.gov (United States)

Zehra, Fatima; Naqvi, Atta Abbas; Tasneem, Sumbul; Ahmad, Rizwan; Ahmad, Niyaz; Shamsi, Adnan Zia; Asghar, Naqiya Ali; Khan, Ghufran Ullah

2017-01-01

Pakistan spends 0.7% of its gross domestic product on health. The public sector health-care system provides services to 22% of population thus paving the way for a dominant private sector. Patients in Pakistan mostly pay their medical expenses directly, and 64% of the health expenditures are borne by the household. Expenditure on medicine constitutes 43% of the total household expenditure. A quantitative cross-sectional study was conducted in Karachi, Pakistan, for a month. It was aimed at gathering response from different pharmacies to understand the brand versus generic dispensing trend of ciprofloxacin 500 mg, levofloxacin 500 mg, and moxifloxacin 400 mg oral dosage forms. The study employed convenience sampling and used a survey checklist. The data gathered was entered in SPSS version 22. The mean price per tablet for ciprofloxacin brand and generic was reported at Pakistani Rupees (PKR) 48.44 and PKR 26.85, respectively. The trend for dispensing ciprofloxacin highlighted a split in the market between brand (51%) and generic (49%). For levofloxacin brand and generic, the price per tablet was reported at PKR 36.50 and PKR 36.15 respectively, and despite same price, the market was dominated by generic levofloxacin (92%). Due to a price difference between brand and generic moxifloxacin, i.e., PKR 129.44 and PKR 71.91, respectively, the market was mostly occupied by the generic form (75%). Pricing mechanism must be revisited, and the authorities should take stern actions against any illegitimate price hike. The surging burden of drug expenditure on poorer sections of the society must be addressed by the government on an urgent basis.

Back bombardment for dispenser and lanthanum hexaboride cathodes

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Mahmoud Bakr

2011-06-01

Full Text Available The back bombardment (BB effect limits wide usage of thermionic rf guns. The BB effect induces not only ramping-up of a cathode’s temperature and beam current, but also degradation of cavity voltage and beam energy during a macropulse. This paper presents a comparison of the BB effect for the case of dispenser tungsten-base (DC and lanthanum hexaboride (LaB_{6} thermionic rf gun cathodes. For each, particle simulation codes are used to simulate the BB effect and electron beam dynamics in a thermionic rf gun cathode. A semiempirical equation is also used to investigate the stopping range and deposited heat power of BB electrons in the cathode material. A numerical simulation method is used to calculate the change of the cathode temperature and current density during a single macropulse. This is done by solving two differential equations for the rf gun cavity equivalent circuit and one-dimensional thermal diffusion equation. High electron emission and small beam size are required for generation of a high-brightness electron beam, and so in this work the emission properties of the cathode are taken into account. Simulations of the BB effect show that, for a pulse of 6  μs duration, the DC cathode experiences a large change in the temperature compared with LaB_{6}, and a change in current density 6 times higher. Validation of the simulation results is performed using experimental data for beam current beyond the gun exit. The experimental data is well reproduced using the simulation method.

Catch-slip bonds can be dispensable for motor force regulation during skeletal muscle contraction

Science.gov (United States)

Dong, Chenling; Chen, Bin

2015-07-01

It is intriguing how multiple molecular motors can perform coordinated and synchronous functions, which is essential in various cellular processes. Recent studies on skeletal muscle might have shed light on this issue, where rather precise motor force regulation was partly attributed to the specific stochastic features of a single attached myosin motor. Though attached motors can randomly detach from actin filaments either through an adenosine triphosphate (ATP) hydrolysis cycle or through "catch-slip bond" breaking, their respective contribution in motor force regulation has not been clarified. Here, through simulating a mechanical model of sarcomere with a coupled Monte Carlo method and finite element method, we find that the stochastic features of an ATP hydrolysis cycle can be sufficient while those of catch-slip bonds can be dispensable for motor force regulation.

Acetyl CoA Carboxylase 2 Is Dispensable for CD8+ T Cell Responses.

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Jang Eun Lee

Full Text Available Differentiation of T cells is closely associated with dynamic changes in nutrient and energy metabolism. However, the extent to which specific metabolic pathways and molecular components are determinative of CD8+ T cell fate remains unclear. It has been previously established in various tissues that acetyl CoA carboxylase 2 (ACC2 regulates fatty acid oxidation (FAO by inhibiting carnitine palmitoyltransferase 1 (CPT1, a rate-limiting enzyme of FAO in mitochondria. Here, we explore the cell-intrinsic role of ACC2 in T cell immunity in response to infections. We report here that ACC2 deficiency results in a marginal increase of cellular FAO in CD8+ T cells, but does not appear to influence antigen-specific effector and memory CD8+ T cell responses during infection with listeria or lymphocytic choriomeningitis virus. These results suggest that ACC2 is dispensable for CD8+ T cell responses.

Influence of transit water flow rate on its dispensation and on inflow through nozzles in pressure pipeline under action of external pressure

Science.gov (United States)

Cherniuk, V. V.; Riabenko, O. A.; Ivaniv, V. V.

2017-12-01

The influence of transit flow rate of water upon operative of the equipped with nozzles pressure pipeline is experimentally investigated. External pressure, which varies in the range of 1465-2295 mm, acted upon the pipeline. The angle β between vectors of velocities of the stream in the pipeline and jets which branch off through nozzles were given the value: 0° ; 45° ; 90° ; 135° ; 180°. The diameter of the pipeline was of D=20.18 mm, the diameter of nozzles d=6.01 mm. The distances between the nozzles were 180 mm, and the number of them 11. The value of the transit flow rate at input into the pipeline varied from 4.05 to 130.20 cm3 / s. The increase in flow rate of the transit flux Qtr caused increase in non-uniformity of distribution of operating heads and increase in flow rate of water along the pipeline over the segment of its dispensation. On the segment of collecting of water, inverse tendency was observed. The number of nozzles through which water became to be dispensed increased with the increase in Qtr.

The cytosolic glyoxalases of Plasmodium falciparum are dispensable during asexual blood-stage development

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Cletus A. Wezena

2017-11-01

Full Text Available The enzymes glyoxalase 1 and 2 (Glo1 and Glo2 are found in most eukaryotes and catalyze the glutathione-dependent conversion of 2-oxoaldehydes to 2-hydroxycarboxylic acids. Four glyoxalases are encoded in the genome of the malaria parasite Plasmodium falciparum, the cytosolic enzymes PfGlo1 and PfcGlo2, the apicoplast enzyme PftGlo2, and an inactive Glo1-like protein that also carries an apicoplast-targeting sequence. Inhibition or knockout of the Plasmodium glyoxalases was hypothesized to lead to an accumulation of 2-oxoaldehydes and advanced glycation end-products (AGE in the host-parasite unit and to result in parasite death. Here, we generated clonal P. falciparum strain 3D7 knockout lines for PFGLO1 and PFcGLO2 using the CRISPR-Cas9 system. Although 3D7Δglo1 knockout clones had an increased susceptibility to external glyoxal, all 3D7Δglo1 and 3D7Δcglo2 knockout lines were viable and showed no significant growth phenotype under standard growth conditions. Furthermore, the lack of PfcGlo2, but not PfGlo1, increased gametocyte commitment in the knockout lines. In summary, PfGlo1 and PfcGlo2 are dispensable during asexual blood-stage development while the loss of PfcGlo2 may induce the formation of transmissible gametocytes. These combined data show that PfGlo1 and PfcGlo2 are most likely not suited as targets for selective drug development.

Microbiological evaluation of hot beverages dispensed by vending machines from the Army barracks of Brigata Meccanizzata Aosta located in Messina

OpenAIRE

Chiara Beninati; Daniele Muscolino; Antonio Panebianco; Alessandro Giuffrida; Filippo Giarratana; Attilio Longo

2013-01-01

The aim of the present study was to evaluate the microbiological quality of hot beverages dispensed by vending machines (VMs). The study was carried out on 203 samples from 15 VMs located in 5 Army barracks in Messina. The samples included: water used for preparation of beverages, swab of water tank, swab of blender machine, chocolate powder, milk powder, cappuccino and chocolate drink (29 samples for each types). All samples were examined for total bacterial count (TBC), coliforms, Escherich...

Dispensação farmacêutica: uma análise de diferentes conceitos e modelos Pharmaceutical dispensing: an analysis of different concepts and models

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Daniela Angonesi

2008-04-01

Full Text Available Apresenta-se uma revisão das definições e metodologias de dispensação elaboradas pelos órgãos públicos reguladores, organizações profissionais e de saúde no Brasil e em outros países e alguns autores brasileiros, sob a perspectiva da contemplação de aspectos técnicos relativos aos medicamentos e a influência da filosofia da atenção farmacêutica. Vários modelos de dispensação consideram os aspectos técnicos relativos aos medicamentos e alguns acrescentam a necessidade de orientação para o uso correto dos medicamentos ou ainda elementos da filosofia da atenção farmacêutica. Mas é necessário rever a definição da dispensação no Brasil para que possam ser criados procedimentos possíveis de serem realizados na prática em uma farmácia comunitária e que cumpram com os objetivos desta atividade farmacêutica.The present article presents a review of the definitions and methodologies of pharmaceutical dispensing elaborated by the regulating authorities, professional and health organizations in Brazil and abroad and also by some Brazilian authors from the perspective of the technical and philosophical aspects involved. Several dispensing models consider the technical aspects related to the medicines and some add the need for orientation with regard to correct use or even elements of the philosophy underlying the pharmacist care model. However, for creating procedures that can be put into practice in a community pharmacy and that meet the purpose of this pharmaceutical activity it is necessary to rethink the concept of pharmaceutical dispensing in Brazil.

Automation systems for radioimmunoassay

International Nuclear Information System (INIS)

Yamasaki, Paul

1974-01-01

The application of automation systems for radioimmunoassay (RIA) was discussed. Automated systems could be useful in the second step, of the four basic processes in the course of RIA, i.e., preparation of sample for reaction. There were two types of instrumentation, a semi-automatic pipete, and a fully automated pipete station, both providing for fast and accurate dispensing of the reagent or for the diluting of sample with reagent. Illustrations of the instruments were shown. (Mukohata, S.)

The cGAS/STING Pathway Detects Streptococcus pneumoniae but Appears Dispensable for Antipneumococcal Defense in Mice and Humans.

Science.gov (United States)

Ruiz-Moreno, Juan Sebastian; Hamann, Lutz; Jin, Lei; Sander, Leif E; Puzianowska-Kuznicka, Monika; Cambier, John; Witzenrath, Martin; Schumann, Ralf R; Suttorp, Norbert; Opitz, Bastian

2018-03-01

Streptococcus pneumoniae is a frequent colonizer of the upper respiratory tract and a leading cause of bacterial pneumonia. The innate immune system senses pneumococcal cell wall components, toxin, and nucleic acids, which leads to production of inflammatory mediators to initiate and control antibacterial defense. Here, we show that the cGAS (cyclic GMP-AMP [cGAMP] synthase)-STING pathway mediates detection of pneumococcal DNA in mouse macrophages to primarily stimulate type I interferon (IFN) responses. Cells of human individuals carrying HAQ TMEM173 , which encodes a common hypomorphic variant of STING, were largely or partly defective in inducing type I IFNs and proinflammatory cytokines upon infection. Subsequent analyses, however, revealed that STING was dispensable for restricting S. pneumoniae during acute pneumonia in mice. Moreover, explorative analyses did not find differences in the allele frequency of HAQ TMEM173 in nonvaccinated pneumococcal pneumonia patients and healthy controls or an association of HAQ TMEM173 carriage with disease severity. Together, our results indicate that the cGAS/STING pathway senses S. pneumoniae but plays no major role in antipneumococcal immunity in mice and humans. Copyright © 2018 American Society for Microbiology.

Policy implementation and financial incentives for nurses in South Africa: a case study on the occupation-specific dispensation

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Duane Blaauw

2013-01-01

Full Text Available Background: In 2007, the South African government introduced the occupation-specific dispensation (OSD, a financial incentive strategy, to attract, motivate, and retain health professionals in the public sector. Implementation commenced with the nursing sector, but there have been unintended negative consequences. Objective: First, to examine implementation of the OSD for nurses using Hogwood and Gunn's framework that outlines ‘perfect implementation’ pre-conditions. Second, to highlight the conditions for the successful implementation of financial incentives. Methods: A qualitative case study design using a combination of a document review and in-depth interviews with 42 key informants. Results: The study found that there were several implementation weaknesses. Only a few of the pre-conditions were met for OSD policy implementation. The information systems required for successful policy implementation, such as the public sector human resource data base and the South African Nursing Council register of specialised nurses were incomplete and inaccurate, thus undermining the process. Insufficient attention was paid to time and resources, dependency relationships, task specification, and communication and coordination. Conclusion: The implementation of financial incentives requires careful planning and management in order to avoid loss of morale and staff grievances.

S1P4 Regulates Passive Systemic Anaphylaxis in Mice but Is Dispensable for Canonical IgE-Mediated Responses in Mast Cells

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Joseph M. Kulinski

2018-04-01

Full Text Available Mast cells are key players in the development of inflammatory allergic reactions. Cross-linking of the high-affinity receptor for IgE (FcεRI on mast cells leads to the generation and secretion of the sphingolipid mediator, sphingosine-1-phosphate (S1P which is able, in turn, to transactivate its receptors on mast cells. Previous reports have identified the expression of two of the five receptors for S1P on mast cells, S1P1 and S1P2, with functions in FcεRI-mediated chemotaxis and degranulation, respectively. Here, we show that cultured mouse mast cells also express abundant message for S1P4. Genetic deletion of S1pr4 did not affect the differentiation of bone marrow progenitors into mast cells or the proliferation of mast cells in culture. A comprehensive characterization of IgE-mediated responses in S1P4-deficient bone marrow-derived and peritoneal mouse mast cells indicated that this receptor is dispensable for mast cell degranulation, cytokine/chemokine production and FcεRI-mediated chemotaxis in vitro. However, interleukin-33 (IL-33-mediated enhancement of IgE-induced degranulation was reduced in S1P4-deficient peritoneal mast cells, revealing a potential negative regulatory role for S1P4 in an IL-33-rich environment. Surprisingly, genetic deletion of S1pr4 resulted in exacerbation of passive systemic anaphylaxis to IgE/anti-IgE in mice, a phenotype likely related to mast cell-extrinsic influences, such as the high circulating levels of IgE in these mice which increases FcεRI expression and consequently the extent of the response to FcεRI engagement. Thus, we provide evidence that S1P4 modulates anaphylaxis in an unexpected manner that does not involve regulation of mast cell responsiveness to IgE stimulation.

Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study.

Science.gov (United States)

Srigley, Jocelyn A; Furness, Colin D; Baker, G Ross; Gardam, Michael

2014-12-01

The Hawthorne effect, or behaviour change due to awareness of being observed, is assumed to inflate hand hygiene compliance rates as measured by direct observation but there are limited data to support this. To determine whether the presence of hand hygiene auditors was associated with an increase in hand hygiene events as measured by a real-time location system (RTLS). The RTLS recorded all uses of alcohol-based hand rub and soap for 8 months in two units in an academic acute care hospital. The RTLS also tracked the movement of hospital hand hygiene auditors. Rates of hand hygiene events per dispenser per hour as measured by the RTLS were compared for dispensers within sight of auditors and those not exposed to auditors. The hand hygiene event rate in dispensers visible to auditors (3.75/dispenser/h) was significantly higher than in dispensers not visible to the auditors at the same time (1.48; p=0.001) and in the same dispensers during the week prior (1.07; pHand hygiene event rates were approximately threefold higher in hallways within eyesight of an auditor compared with when no auditor was visible and the increase occurred after the auditors' arrival. This is consistent with the existence of a Hawthorne effect localised to areas where the auditor is visible and calls into question the accuracy of publicly reported hospital hand hygiene compliance rates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

VEGF-B is dispensable for blood vessel growth but critical for their survival, and VEGF-B targeting inhibits pathological angiogenesis

Science.gov (United States)

Zhang, Fan; Tang, Zhongshu; Hou, Xu; Lennartsson, Johan; Li, Yang; Koch, Alexander W.; Scotney, Pierre; Lee, Chunsik; Arjunan, Pachiappan; Dong, Lijin; Kumar, Anil; Rissanen, Tuomas T.; Wang, Bin; Nagai, Nobuo; Fons, Pierre; Fariss, Robert; Zhang, Yongqing; Wawrousek, Eric; Tansey, Ginger; Raber, James; Fong, Guo-Hua; Ding, Hao; Greenberg, David A.; Becker, Kevin G.; Herbert, Jean-Marc; Nash, Andrew; Yla-Herttuala, Seppo; Cao, Yihai; Watts, Ryan J.; Li, Xuri

2009-01-01

VEGF-B, a homolog of VEGF discovered a long time ago, has not been considered an important target in antiangiogenic therapy. Instead, it has received little attention from the field. In this study, using different animal models and multiple types of vascular cells, we revealed that although VEGF-B is dispensable for blood vessel growth, it is critical for their survival. Importantly, the survival effect of VEGF-B is not only on vascular endothelial cells, but also on pericytes, smooth muscle cells, and vascular stem/progenitor cells. In vivo, VEGF-B targeting inhibited both choroidal and retinal neovascularization. Mechanistically, we found that the vascular survival effect of VEGF-B is achieved by regulating the expression of many vascular prosurvival genes via both NP-1 and VEGFR-1. Our work thus indicates that the function of VEGF-B in the vascular system is to act as a “survival,” rather than an “angiogenic” factor and that VEGF-B inhibition may offer new therapeutic opportunities to treat neovascular diseases. PMID:19369214

A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

OpenAIRE

Stip, Emmanuel; Vincent, Philippe D.; Sablier, Juliette; Guevremont, Catherine; Zhornitsky, Simon; Tranulis, Constantin

2013-01-01

Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5% in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improved AAR...

A randomized-controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

OpenAIRE

Emmanuel eStip; Emmanuel eStip; Emmanuel eStip; Philippe D. Vincent; Philippe D. Vincent; Philippe D. Vincent; Catherine eGuevremont; Simon eZhornitsky; Constantin eTranulis; Constantin eTranulis; Constantin eTranulis; Juliette eSablier; Juliette eSablier

2013-01-01

Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5 % in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improv...

Lyplal1 is dispensable for normal fat deposition in mice

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Rachel A. Watson

2017-12-01

Full Text Available Genome-wide association studies (GWAS have detected association between variants in or near the Lysophospholipase-like 1 (LYPLAL1 locus and metabolic traits, including central obesity, fatty liver and waist-to-hip ratio. LYPLAL1 is also known to be upregulated in the adipose tissue of obese patients. However, the physiological role of LYPLAL1 is not understood. To investigate the function of Lyplal1 in vivo we investigated the phenotype of the Lyplal1tm1a(KOMPWtsi homozygous mouse. Body composition was unaltered in Lyplal1 knockout mice as assessed by dual-energy X-ray absorptiometry (DEXA scanning, both on normal chow and on a high-fat diet. Adipose tissue distribution between visceral and subcutaneous fat depots was unaltered, with no change in adipocyte cell size. The response to both insulin and glucose dosing was normal in Lyplal1tm1a(KOMPWtsi homozygous mice, with normal fasting blood glucose concentrations. RNAseq analysis of liver, muscle and adipose tissue confirmed that Lyplal1 expression was ablated with minimal additional changes in gene expression. These results suggest that Lyplal1 is dispensable for normal mouse metabolic physiology and that despite having been maintained through evolution Lyplal1 is not an essential gene, suggesting possible functional redundancy. Further studies will be required to clarify its physiological role.

Investigation of Influence of Surface Nanoparticle on Emission Properties of Scandia-Doped Dispenser Cathodes

Science.gov (United States)

Zhang, Xizhu; Wang, Jinshu; Wang, Yiman; Liu, Wei; Zhou, Meiling; Gao, Zhiyuan

2013-06-01

The microstructure of a fully activated scandia doped dispenser (SDD) cathode has been studied by scanning electron microscope (SEM). The observation results display that nanoparticles appear at the growth steps and the surface of tungsten grains of the fully activated SDD cathode. To study the influence of the nanoparticles on the emission, the local electric field strengths around the nanoparticles have been calculated by Maxwell 2D code and Comsol. The calculation results show that the local electric field strengths are enhanced by 1.1 to 3.8 times to average value based on different model conditions. The highest field strength is about 1.54 × 105 V/cm at an average field strength of 40 KV/cm, which is related to a space-charge limited (SCL) current density of 100 A/cm2 in the experimental configuration. This implies the field strength is not high enough to cause field emission.

Rac1 in muscle is dispensable for improved insulin action after exercise in mice

DEFF Research Database (Denmark)

Sylow, Lykke; Møller, Lisbeth Liliendal Valbjørn; D'Hulst, Gommaar

2016-01-01

sensitivity in inducible muscle-specific Rac1 knockout (mKO) and wildtype littermate (WT) mice. Prior exercise enhanced whole body insulin sensitivity by 40% in WT mice and rescued the insulin intolerance in Rac1 mKO mice by improving whole body insulin sensitivity by 230%. In agreement, prior exercise...... significantly improved insulin sensitivity by 20% in WT and by 40% in Rac1 mKO soleus muscles. These findings suggest that muscle Rac1 is dispensable for the insulin sensitizing effect of exercise. Moreover, insulin resistance in Rac1 mKO mice can be completely normalized by prior exercise explaining why......Exercise has a potent insulin-sensitivity enhancing effect on skeletal muscle but the intracellular mechanisms that mediate this effect are not well understood. In muscle, Rac1 regulates both insulin- and contraction-stimulated glucose transport and is dysregulated in insulin resistant muscle...

Health care professionals’ perspectives on automated multi-dose drug dispensing

Directory of Open Access Journals (Sweden)

Bardage C

2014-12-01

Full Text Available Background: During the 1980s, manual repackaging of multi-dose medications from pharmacies in Sweden was successively substituted with automated multi-dose drug dispensing (MDD. There are few studies evaluating the consequences of automated MDD with regard to patient safety, and those that investigate this issue are not very extensive. Objectives: To investigate Swedish health care professionals’ perceived experience of automated MDD and its effects on patient adherence and patient safety. Methods: Three questionnaire forms, one for physicians, nurses, and assistant nurses/nursing assistants, were developed based on reviews of the literature and pilot testing of the questions in the intended target groups. The target groups were health professionals prescribing or administrating MDD to patients. A sample (every sixth municipality was drawn from the sampling frame of Swedish municipalities, resulting in 40 municipalities, about 14% of all municipalities in Sweden. Email addresses of general practitioners were obtained from county councils, while the municipalities assisted in getting contact details for nurses, assistant nurses and nursing assistants. A total of 915 questionnaires were distributed electronically to physicians, 515 to nurses, and 4,118 to assistant nurses/nursing assistants. The data were collected in September and October 2012. Results: The response rate among physicians, nurses and assistant nurses/nursing assistants was 31%, 43% and 23%, respectively. The professionals reported that automated MDD reduces duplication of medication, contributes to correct dosages, helps patients take their medication at the right time, and reduces confusion among patients. Fifteen per cent of the physicians and about one-third of the nurses and assistant nurses/nursing assistants reported that generic substitution makes it more difficult for the patient to identify the various medicines available in the sachets. The physicians did, however

SU-F-T-57: Delivered Activity Accuracy of Radium 223 Dichloride Injections, When Being Administrated for Castration Resistant Prostate Cancer, Symptomatic Bone Metastases. The Impact of Residual Activity in the Spent Syringe and Dispensing Accuracy of Ra 223

International Nuclear Information System (INIS)

Jennings, G

2016-01-01

Purpose: To quantify the delivered activity accuracy of Radium 223 dichloride injections, when being administrated for castration – resistant prostate cancer, symptomatic bone metastases. The impact of residual activity in the spent syringe and dispensing accuracy of Ra 223. Methods: The administration is by slow intravenous injection over 1 minute followed by double flushing of the 10 mL syringe and IV with saline. Eighty (80) procedures was used to investigate variations in the activity from the amount prescribed (µCi) = 1.35 × Patient weight Kg. The Activity dispensed into a 10mL syringe using a NIST traceable Capintec CRC-25R Chamber and a cross calibrated capintec CRC-15R to measure activity in the syringe immediately before and after administration Results: The patients weight range from 121Ib to 235lb and doses ranging 74.25 µCi to 144.2 µCi. The deviation of dispensed dose vs Prescribed dose average +2.1% with a range of −1.1% to +5.7%. The Dose measured before administration ranges 79.3 µCi to 154.9 µCi. Deviation from the dispensed dose was show to average +2.9% with a range of −0.8% to +7.3%. The average residual dose post injection was 2.5 µCi or 2.2% of the pre injection activity. Ranging from 0.9 µCi to 6.2 µCi, 0.7% to 5.4% respectively. Subtracting the residual activity from that measured activity before injection and comparing it to prescription dose was shown to have an average variation of +2.7% with a range of −0.8% to 7.4%. Conclusion: The case resulted in the 6.2 µCi maximum residual dose had two syringes. A small, 82.8 µCi activity, case resulted in the 7.4% maximum variation in measures less residual verses prescription dose. The average +2.1 % dispenses activity of Ra 223 over the prescription dosage was seen to counteract the average 2.2% residual dosage found to remain in the syringe

SU-F-T-57: Delivered Activity Accuracy of Radium 223 Dichloride Injections, When Being Administrated for Castration Resistant Prostate Cancer, Symptomatic Bone Metastases. The Impact of Residual Activity in the Spent Syringe and Dispensing Accuracy of Ra 223

Energy Technology Data Exchange (ETDEWEB)

Jennings, G [Marsden Medical Physics Associates, Denville, NJ (United States)

2016-06-15

Purpose: To quantify the delivered activity accuracy of Radium 223 dichloride injections, when being administrated for castration – resistant prostate cancer, symptomatic bone metastases. The impact of residual activity in the spent syringe and dispensing accuracy of Ra 223. Methods: The administration is by slow intravenous injection over 1 minute followed by double flushing of the 10 mL syringe and IV with saline. Eighty (80) procedures was used to investigate variations in the activity from the amount prescribed (µCi) = 1.35 × Patient weight Kg. The Activity dispensed into a 10mL syringe using a NIST traceable Capintec CRC-25R Chamber and a cross calibrated capintec CRC-15R to measure activity in the syringe immediately before and after administration Results: The patients weight range from 121Ib to 235lb and doses ranging 74.25 µCi to 144.2 µCi. The deviation of dispensed dose vs Prescribed dose average +2.1% with a range of −1.1% to +5.7%. The Dose measured before administration ranges 79.3 µCi to 154.9 µCi. Deviation from the dispensed dose was show to average +2.9% with a range of −0.8% to +7.3%. The average residual dose post injection was 2.5 µCi or 2.2% of the pre injection activity. Ranging from 0.9 µCi to 6.2 µCi, 0.7% to 5.4% respectively. Subtracting the residual activity from that measured activity before injection and comparing it to prescription dose was shown to have an average variation of +2.7% with a range of −0.8% to 7.4%. Conclusion: The case resulted in the 6.2 µCi maximum residual dose had two syringes. A small, 82.8 µCi activity, case resulted in the 7.4% maximum variation in measures less residual verses prescription dose. The average +2.1 % dispenses activity of Ra 223 over the prescription dosage was seen to counteract the average 2.2% residual dosage found to remain in the syringe.

Real-World Analysis of Dispensed IUs of Coagulation Factor IX and Resultant Expenditures in Hemophilia B Patients Receiving Standard Half-life Versus Extended Half-life Products and Those Switching from Standard Half-life to Extended Half-life Products.

Science.gov (United States)

Tortella, Bartholomew J; Alvir, José; McDonald, Margaret; Spurden, Dean; Fogarty, Patrick F; Chhabra, Amit; Pleil, Andreas M

2018-01-24

Hemophilia B requires replacement therapy with factor IX (FIX) coagulation products to treat and prevent bleeding episodes. A recently introduced extended half-life (EHL) recombinant FIX replacement product provided the opportunity to compare the amount of dispensed factor and expenditures for EHL treatment compared with a standard half-life (SHL) product. To determine factor international units (IUs) dispensed and expenditures associated with switching from nonacog alfa, the most commonly used SHL replacement product, to eftrenonacog alfa, an EHL FIX replacement product. Two U.S. claims databases were analyzed. A large national specialty pharmacy dispensation claims database was used to identify the number of IUs dispensed and monthly charges for all patients with hemophilia B from April 2015 to June 2016. Truven Health MarketScan Research Databases (January 2010-July 2016) were used to identify IUs and expenditures for patients with claims data for at least 3 months before and after switching from the SHL to the EHL product. Medians for IUs and expenditures are presented to accommodate for skewness of data distribution. The national specialty pharmacy database analysis included 296 patients with moderate or severe hemophilia B (233 on SHL; 94 on EHL). Median monthly factor dispensed was 11% lower (2,142 IU) in the EHL versus SHL cohort over the study period, while individual monthly reductions ranged from 32% to 47% (9,838 IU to 16,514 IU). Using the wholesale acquisition cost, the median per-patient monthly factor expenditures over the 15-month study period were 94% higher ($23,005) for the EHL than for the SHL product. Individual median monthly expenditure differences ranged from 15% ($6,562) to 49% ($19,624). In the Truven database, 14 patients switched from the SHL to the EHL product. The amount of factor dispensed was variable; in the 1-year period before and after the switch from the SHL to the EHL product, mean IUs dispensed decreased by 3,005 IU, while

Solvent removal and spore inactivation directly in dispensing vials with supercritical carbon dioxide and sterilant.

Science.gov (United States)

Howell, Jahna; Niu, Fengui; McCabe, Shannon E; Zhou, Wei; Decedue, Charles J

2012-06-01

A process is described using supercritical carbon dioxide to extract organic solvents from drug solutions contained in 30-mL serum vials. We report drying times of less than 1 h with quantitative recovery of sterile drug. A six-log reduction of three spore types used as biological indicators is achieved with direct addition of peracetic acid to a final concentration of approximately 5 mM (~0.04 %) to the drug solution in the vial. Analysis of two drugs, acetaminophen and paclitaxel, indicated no drug degradation as a result of the treatment. Furthermore, analysis of the processed drug substance showed that no residual peracetic acid could be detected in the final product. We have demonstrated an effective means to simultaneously dry and sterilize active pharmaceutical ingredients from organic solvents directly in a dispensing container.

Weathering and chemical degradation of methyl eugenol and raspberry ketone solid dispensers for detection, monitoring and male annihilation of Bactrocera dorsalis and Bactrocera cucurbitae (Diptera: Tephritidae) in Hawaii

Science.gov (United States)

Solid male lure dispensers containing methyl eugenol (ME) and raspberry ketone (RK), or mixtures of the lures (ME + RK), and dimethyl dichloro-vinyl phosphate (DDVP) were evaluated in AWPM bucket or Jackson traps in commercial papaya (Carica papaya L.) orchards where both oriental fruit fly, Bactroc...

Centrioles initiate cilia assembly but are dispensable for maturation and maintenance in C. elegans.

Science.gov (United States)

Serwas, Daniel; Su, Tiffany Y; Roessler, Max; Wang, Shaohe; Dammermann, Alexander

2017-06-05

Cilia are cellular projections that assemble on centriole-derived basal bodies. While cilia assembly is absolutely dependent on centrioles, it is not known to what extent they contribute to downstream events. The nematode C. elegans provides a unique opportunity to address this question, as centrioles do not persist at the base of mature cilia. Using fluorescence microscopy and electron tomography, we find that centrioles degenerate early during ciliogenesis. The transition zone and axoneme are not completely formed at this time, indicating that cilia maturation does not depend on intact centrioles. The hydrolethalus syndrome protein HYLS-1 is the only centriolar protein known to remain at the base of mature cilia and is required for intraflagellar transport trafficking. Surprisingly, targeted degradation of HYLS-1 after initiation of ciliogenesis does not affect ciliary structures. Taken together, our results indicate that while centrioles are essential to initiate cilia formation, they are dispensable for cilia maturation and maintenance. © 2017 Serwas et al.

Implementation and development of an automated, ultra-high-capacity, acoustic, flexible dispensing platform for assay-ready plate delivery.

Science.gov (United States)

Griffith, Dylan; Northwood, Roger; Owen, Paul; Simkiss, Ellen; Brierley, Andrew; Cross, Kevin; Slaney, Andrew; Davis, Miranda; Bath, Colin

2012-10-01

Compound management faces the daily challenge of providing high-quality samples to drug discovery. The advent of new screening technologies has seen demand for liquid samples move toward nanoliter ranges, dispensed by contactless acoustic droplet ejection. Within AstraZeneca, a totally integrated assay-ready plate production platform has been created to fully exploit the advantages of this technology. This enables compound management to efficiently deliver large throughputs demanded by high-throughput screening while maintaining regular delivery of smaller numbers of compounds in varying plate formats for cellular or biochemical concentration-response curves in support of hit and lead optimization (structure-activity relationship screening). The automation solution, CODA, has the capability to deliver compounds on demand for single- and multiple-concentration ranges, in batch sizes ranging from 1 sample to 2 million samples, integrating seamlessly into local compound and test management systems. The software handles compound orders intelligently, grouping test requests together dependent on output plate type and serial dilution ranges so that source compound vessels are shared among numerous tests, ensuring conservation of sample, reduced labware and costs, and efficiency of work cell logistics. We describe the development of CODA to address the customer demand, challenges experienced, learning made, and subsequent enhancements.

The Histone Methyltransferase Activity of MLL1 Is Dispensable for Hematopoiesis and Leukemogenesis

Directory of Open Access Journals (Sweden)

Bibhu P. Mishra

2014-05-01

Full Text Available Despite correlations between histone methyltransferase (HMT activity and gene regulation, direct evidence that HMT activity is responsible for gene activation is sparse. We address the role of the HMT activity for MLL1, a histone H3 lysine 4 (H3K4 methyltransferase critical for maintaining hematopoietic stem cells (HSCs. Here, we show that the SET domain, and thus HMT activity of MLL1, is dispensable for maintaining HSCs and supporting leukemogenesis driven by the MLL-AF9 fusion oncoprotein. Upon Mll1 deletion, histone H4 lysine 16 (H4K16 acetylation is selectively depleted at MLL1 target genes in conjunction with reduced transcription. Surprisingly, inhibition of SIRT1 is sufficient to prevent the loss of H4K16 acetylation and the reduction in MLL1 target gene expression. Thus, recruited MOF activity, and not the intrinsic HMT activity of MLL1, is central for the maintenance of HSC target genes. In addition, this work reveals a role for SIRT1 in opposing MLL1 function.

PGC-1α is dispensable for exercise-induced mitochondrial biogenesis in skeletal muscle.

Directory of Open Access Journals (Sweden)

Glenn C Rowe

Full Text Available Exercise confers numerous health benefits, many of which are thought to stem from exercise-induced mitochondrial biogenesis (EIMB in skeletal muscle. The transcriptional coactivator PGC-1α, a potent regulator of metabolism in numerous tissues, is widely believed to be required for EIMB. We show here that this is not the case. Mice engineered to lack PGC-1α specifically in skeletal muscle (Myo-PGC-1αKO mice retained intact EIMB. The exercise capacity of these mice was comparable to littermate controls. Induction of metabolic genes after 2 weeks of in-cage voluntary wheel running was intact. Electron microscopy revealed no gross abnormalities in mitochondria, and the mitochondrial biogenic response to endurance exercise was as robust in Myo-PGC-1αKO mice as in wildtype mice. The induction of enzymatic activity of the electron transport chain by exercise was likewise unperturbed in Myo-PGC-1αKO mice. These data demonstrate that PGC-1α is dispensable for exercise-induced mitochondrial biogenesis in skeletal muscle, in sharp contrast to the prevalent assumption in the field.

Surtimiento de recetas a los afiliados al Seguro Popular de Salud de México Dispensing prescriptions to persons affiliated with Popular Health Insurance in Mexico

Directory of Open Access Journals (Sweden)

Francisco Garrido-Latorre

2008-01-01

alta prescripción pero muy bajo costo unitario en los servicios ambulatorios, a expensas de medicamentos de costo más alto y mayor eficacia terapéutica en la atención hospitalaria, que son los de mayor impacto en la economía de los hogares.OBJECTIVE: Measure and compare the percentage of prescriptions fully dispensed to persons with and without Popular Health Insurance (SPS in Spanish who use ambulatory and general hospital services associated with the Mexico State Health Services (SESA in Spanish, and taking into account insurance status. SESA user satisfaction was also measured with respect to access to medication. MATERIAL AND METHODS: Information for the study was taken from four surveys of SESA ambulatory and hospital units that included probabilistic samples with state representativity. Samples of ambulatory units were selected by stratification according to level of care and association to the SPS service network. RESULTS: The findings indicate that the percentage of prescriptions fully dispensed in SESA ambulatory units has improved, reaching approximately 90%, especially among those units offering services to persons affiliated with SPS. Nevertheless, these percentages continue to be lower than those of ambulatory units associated with social security institutions. Percentages of prescriptions fully dispensed have also improved in SESA hospital units, but continue to be relatively low. In nearly all states, as the percentage of prescriptions fully dispensed has increased, user satisfaction with access to medication has also improved. CONCLUSIONS: In 2006 more than 50% of the states had high levels of fully dispensed prescriptions among persons with SPS (>90%. The more significant problem exists among hospitals, since only 44% of users who received a prescription in SESA hospitals in 2006 had their prescriptions fully dispensed. This finding requires a review of SPS medication policies, which have favored highly prescribed low-cost medications at

Subcutaneous inguinal white adipose tissue is responsive to, but dispensable for, the metabolic health benefits of exercise.

Science.gov (United States)

Peppler, Willem T; Townsend, Logan K; Knuth, Carly M; Foster, Michelle T; Wright, David C

2018-01-01

Exercise training has robust effects on subcutaneous inguinal white adipose tissue (iWAT), characterized by a shift to a brown adipose tissue (BAT)-like phenotype. Consistent with this, transplantation of exercise-trained iWAT into sedentary rodents activates thermogenesis and improves glucose homeostasis, suggesting that iWAT metabolism may contribute to the beneficial effects of exercise. However, it is yet to be determined if adaptations in iWAT are necessary for the beneficial systemic effects of exercise. To test this, male C57BL/6 mice were provided access to voluntary wheel running (VWR) or remained as a cage control (SED) for 11 nights after iWAT removal via lipectomy (LIPX) or SHAM surgery. We found that SHAM and LIPX mice with access to VWR ran similar distances and had comparable reductions in body mass, increased food intake, and increased respiratory exchange ratio (RER). Further, VWR improved indexes of glucose homeostasis and insulin tolerance in both SHAM and LIPX mice. The lack of effect of LIPX in the response to VWR was not explained by compensatory increases in markers of mitochondrial biogenesis and thermogenesis in skeletal muscle, epididymal white adipose tissue, or interscapular brown adipose tissue. Together, these data demonstrate that mice with and without iWAT have comparable adaptations to VWR, suggesting that iWAT may be dispensable for the metabolic health benefits of exercise.

"This is not a drill": Activation of a student-led influenza vaccination point of dispensing.

Science.gov (United States)

Adams, Lavonne M; Canclini, Sharon; Tillman, Kelle

2018-04-13

To describe activation of a Point of dispensing (POD) in response to an influenza outbreak, highlighting the use of a student-led model. Faculty, staff, and students of Harris College of Nursing and Health Sciences, Texas Christian University (TCU), as well as those located in its primary building. In response to an August 2017 influenza outbreak, a vaccination clinic was conducted for a target population through POD activation. The larger campus community was served through provision of additional doses by the Texas Christian University Health Center and the annual October student-led vaccination clinic. Eleven additional cases were diagnosed after vaccinations began. One hundred percent of the targeted population was vaccinated (n = 824), with an additional 127 participants vaccinated (others working in the building where POD held also vaccinated). This was the first time POD activation had occurred on campus in response to an outbreak.

77 FR 47043 - Work Group on Measuring Systems for Electric Vehicle Fueling

Science.gov (United States)

2012-08-07

... Systems for Electric Vehicle Fueling AGENCY: National Institute of Standards and Technology, Commerce... electric vehicle fuel. There is no cost for participating in the Work Group. No proprietary information... and sell electricity dispensed as a vehicle fuel) and to ensure that the prescribed methodologies and...

TMEM45A Is Dispensable for Epidermal Morphogenesis, Keratinization and Barrier Formation.

Directory of Open Access Journals (Sweden)

Aurélie Hayez

Full Text Available TMEM45A gene encodes an initially uncharacterized predicted transmembrane protein. We previously showed that this gene is highly expressed in keratinocytes where its expression correlates with keratinization, suggesting a role in normal epidermal physiology. To test this hypothesis, we generated TMEM45A knockout mice and found that these mice develop without any evident phenotype. The morphology of the epidermis assessed by histology and by labelling differentiation markers in immunofluorescence was not altered. Toluidine blue permeability assay showed that the epidermal barrier develops normally during embryonic development. We also showed that depletion of TMEM45A in human keratinocytes does not alter their potential to form in vitro 3D-reconstructed epidermis. Indeed, epidermis with normal morphogenesis were generated from TMEM45A-silenced keratinocytes. Their expression of differentiation markers quantified by RT-qPCR and evidenced by immunofluorescence labelling as well as their barrier function estimated by Lucifer yellow permeability were similar to the control epidermis. In summary, TMEM45A gene expression is dispensable for epidermal morphogenesis, keratinization and barrier formation. If this protein plays a role in the epidermis, its experimental depletion can possibly be compensated by other proteins in the two experimental models analyzed in this study.

Maintaining Microclimates during Nanoliter Chemical Dispensations Using Custom-Designed Source Plate Lids.

Science.gov (United States)

Foley, Bryan J; Drozd, Ashley M; Bollard, Mary T; Laspina, Denise; Podobedov, Nikita; Zeniou, Nicholas; Rao, Anjali S; Andi, Babak; Jackimowicz, Rick; Sweet, Robert M; McSweeney, Sean; Soares, Alexei S

2016-02-01

A method is described for using custom snap-on lids to protect chemicals in microtiter plates from evaporation and contamination. The lids contain apertures (diameter 1.5, 1.0, or 0.5 mm) through which the chemical building blocks can be transferred. The lid with 0.5 mm apertures was tested using a noncontact acoustic liquid handler; the 1.0 and 1.5 mm lids were tested using two tip-based liquid handlers. All of the lids reduced the rate at which solvents evaporated to room air, and greatly reduced the rate of contamination by water and oxygen from room air. In steady-state measurements, the lids reduced the rate of evaporation of methanol, 1-hexene, and water by 33% to 248%. In cycled experiments, the contamination of aqueous solvent with oxygen was reduced below detectability and the rate at which DMSO engorged atmospheric water was reduced by 81%. Our results demonstrate that the lids preserve the integrity of air-sensitive reagents during the time needed for different types of liquid handlers to perform dispensations. Controlling degradation and evaporation of chemical building blocks exposed to the atmosphere is increasingly useful as the reagent volume is reduced by advances in liquid handling technology, such as acoustic droplet ejection. © 2015 Society for Laboratory Automation and Screening.

Measurement of semiochemical release rates with a dedicated environmental control system

Science.gov (United States)

Heping Zhu; Harold W. Thistle; Christopher M. Ranger; Hongping Zhou; Brian L. Strom

2015-01-01

Insect semiochemical dispensers are commonly deployed under variable environmental conditions over a specified period. Predictions of their longevity are hampered by a lack of methods to accurately monitor and predict how primary variables affect semiochemical release rate. A system was constructed to precisely determine semiochemical release rates under...

Flux through the tetrahydrodipicolinate succinylase pathway is dispensable for L-lysine production in Corynebacterium glutamicum.

Science.gov (United States)

Shaw-Reid, C A; McCormick, M M; Sinskey, A J; Stephanopoulos, G

1999-03-01

The N-succinyl-LL-diaminopimelate desuccinylase gene (dapE) in the four-step succinylase branch of the L-lysine biosynthetic pathway of Corynebacterium glutamicum was disrupted via marker-exchange mutagenesis to create a mutant strain that uses only the one-step meso-diaminopimelate dehydrogenase branch to overproduce lysine. This mutant strain grew and utilized glucose from minimal medium at the same rate as the parental strain. In addition, the dapE- strain produced lysine at the same rate as its parent strain. Transformation of the parental and dapE- strains with the amplified meso-diaminopimelate dehydrogenase gene (ddh) on a plasmid did not affect lysine production in either strain, despite an eightfold amplification of the activity of the enzyme. These results indicate that the four-step succinylase pathway is dispensable for lysine overproduction in shake-flask culture. In addition, the one-step meso-diaminopimelate dehydrogenase pathway does not limit lysine flux in Corynebacterium under these conditions.

A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia.

Science.gov (United States)

Stip, Emmanuel; Vincent, Philippe D; Sablier, Juliette; Guevremont, Catherine; Zhornitsky, Simon; Tranulis, Constantin

2013-01-01

Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5% in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill(®) improved AAR of schizophrenic patients. Furthermore, we compared AAR obtained by the DoPill(®) and the BARS, in order to verify whether the DoPill(®) provides reliable assessment of medication adherence. The DoPill(®) is a smart pill dispenser that beeps and flashes at the appropriate time of the day. Each of its 28 compartments is covered by a plastic lamina that, when taken off, sends a signal to the pharmacist. Patients were randomized to the DoPill(®) or treatment as usual groups for 6 weeks. The BARS was used as a reference measure. Forty-six percent of patients were deemed to be non-adherent with antipsychotic medication. The mean AAR was 67% after 6 weeks. DoPill(®) recorded better AAR than some of those found in the literature and were lower than the BARS estimate we found. These results suggest that DoPill(®) is a valid tool that provides more reliable and objective data for the clinician about their patient's adherence, than existing assessment tools like the BARS. Furthermore, the device may help patients successfully manage their medication regimen.

Impact of rheumatoid arthritis in the public health system in Santa Catarina, Brazil: a descriptive and temporal trend analysis from 1996 to 2009

Directory of Open Access Journals (Sweden)

Rafael Kmiliauskis Santos Gomes

Full Text Available ABSTRACT Introduction: There are few studies that carried out a descriptive and trend analysis based on available data from the Unified Health System (SUS between pre- and post-free dispensing of pharmacological treatment of rheumatoid arthritis (RA from the perspective of the public health system, in terms of the direct cost of the disease among adults and elderly residents of the State of Santa Catarina, Brazil. This study aims to characterize the direct cost of medical and surgical procedures before and after the dispensing of drugs in this state. Methods: This is a time series-type study with a cross-sectional survey of data from the Hospital (SIH and Outpatient (SIA Information System of SUS during the period from 1996 to 2009. Results: Between 1996 and 2009, the total expenditure for hospital- and outpatient pharmacological treatment of rheumatoid arthritis was R$ 26,659,127.20. After the dispensing of drug treatment by SUS a decrease of 36% in the number of hospital admissions was observed; however, an increase of 19% in clinical procedures was noted. Conclusion: During the observed period, a reduction in the number of hospital admissions for both clinical and orthopedic surgical procedures related to this disease was observed. Nevertheless, there was an increase in the cost of medical admissions.

Efficacy of Various Chemical Disinfectants on Biofilms Formed in Spacecraft Potable Water System Component

Science.gov (United States)

Wong, Willy; Garcia, Veronica; Castro, Victoria; Ott, Mark; Duane

2009-01-01

As the provision of potable water is critical for successful habitation of the International Space Station (ISS), life support systems were installed in December 2008 to recycle both humidity from the atmosphere and urine to conserve available water in the vehicle. Pre-consumption testing from the dispensing needle at the Potable Water Dispenser (PWD) indicated that bacterial concentrations exceeded the current ISS specifications of 50 colony forming units (CFU) per ml. Subsequent investigations revealed that a corrugated stainless steel flex hose upstream of the dispensing needle in the PWD was filled with non-sterile water and left at room temperature for over one month before launch. To simulate biofilm formation that was suspected in the flight system, sterile flex hoses were seeded with a consortium of bacterial isolates previously recovered from other ISS water systems, which included Ralstonia pickettii, Burkholderia multivorans, Caulobacter vibrioides., and Cupriavidus pauculus. After 5 days of incubation, these hoses were challenged with various chemical disinfectants including hydrogen peroxide, colloidal silver, and buffered pH solutions to determine the ability of the disinfectants to decrease and maintain bacterial concentrations below ISS specifications. Disinfection efficacy over time was measured by collecting daily heterotrophic plate counts following exposure to the disinfectants. A single flush with either 6% hydrogen peroxide solution or a mixture of 3% hydrogen peroxide and 400 ppb colloidal silver effectively reduced the bacterial concentrations to less than 1 CFU/ml for a period of up to 2 months. Testing results indicated that hydrogen peroxide and mixtures of hydrogen peroxide and colloidal silver have tremendous potential as alternative disinfectants for ISS water systems.

Efficacy of various chemical disinfectants on biofilms formed in spacecraft potable water system components.

Science.gov (United States)

Wong, Wing C; Dudinsky, Lynn A; Garcia, Veronica M; Ott, Charlie M; Castro, Victoria A

2010-07-01

As the provision of potable water is critical for successful habitation of the International Space Station (ISS), life support systems were installed in December 2008 to recycle both humidity from the atmosphere and urine to conserve available water in the Station. In-flight pre-consumption testing from the dispensing needle at the Potable Water Dispenser (PWD) indicated that bacterial concentrations exceeded the current ISS specifications of 50 colony-forming units (CFU) ml(-1). Subsequent investigations revealed that a corrugated stainless steel flex hose upstream of the dispensing needle in the PWD was filled with nonsterile water and left at room temperature for more than 1 month before launch. To simulate biofilm formation that was suspected in the flight system, sterile flex hoses were seeded with a consortium of bacterial isolates previously recovered from other ISS water systems, including Ralstonia pickettii, Burkholderia multivorans, Caulobacter vibrioides, and Cupriavidus pauculus. After incubation for 5 days, the hoses were challenged with various chemical disinfectants including hydrogen peroxide (H2O2), colloidal silver, and buffered pH solutions to determine the ability of the disinfectants to decrease and maintain bacterial concentrations below ISS specifications. The disinfection efficacy over time was measured by collecting daily heterotrophic plate counts after exposure to the disinfectants. A single flush with either 6% H2O2 solution or a mixture of 3% H2O2 and 400 ppb colloidal silver effectively reduced the bacterial concentrations to <1 CFU ml(-1) for a period of up to 3 months.

Automated spike preparation system for Isotope Dilution Mass Spectrometry (IDMS)

International Nuclear Information System (INIS)

Maxwell, S.L. III; Clark, J.P.

1990-01-01

Isotope Dilution Mass Spectrometry (IDMS) is a method frequently employed to measure dissolved, irradiated nuclear materials. A known quantity of a unique isotope of the element to be measured (referred to as the ''spike'') is added to the solution containing the analyte. The resulting solution is chemically purified then analyzed by mass spectrometry. By measuring the magnitude of the response for each isotope and the response for the ''unique spike'' then relating this to the known quantity of the ''spike'', the quantity of the nuclear material can be determined. An automated spike preparation system was developed at the Savannah River Site (SRS) to dispense spikes for use in IDMS analytical methods. Prior to this development, technicians weighed each individual spike manually to achieve the accuracy required. This procedure was time-consuming and subjected the master stock solution to evaporation. The new system employs a high precision SMI Model 300 Unipump dispenser interfaced with an electronic balance and a portable Epson HX-20 notebook computer to automate spike preparation

Implementation of measurement methods over the process of cleaning and disinfection of cooling equipment and dispensing of beer in keg of type 'Fast Chiller', installed at points of sale

International Nuclear Information System (INIS)

Matus Ramirez, Adrian Francisco

2014-01-01

The Cerveceria de Costa Rica has launched a project to improve the controls over the process of cleaning and disinfection of dispensing equipments in keg beer of type 'fast chiller' installed at points of sale. The development of some methods have been used to verify the effectiveness of the procedure. The study of the initial situation of the company has been the starting point of the project. One study, updating and summarizing has performed of maintenance manual used by technicians responsible for performing cleaning of equipments. The selection and evaluation at laboratory level has been made of the container used to hold 30 mL dose of disinfectant with which the equipments maintenance is performed. Additional controls have been specifically established to ensure food quality CO 2 that was used to dislodge the keg beer. A specification sheet has been prepared containing the necessary parameters to product quality is preserved by contact with the gas. A method of reception of cylinders in the plant has been standardized to ensure that they meet specifications. The most important phase of the project has been the implementation of the use of bioluminescence tests, to determine whether the process of cleaning and disinfection has been effective. The critical control points have been selected and standardized for testing the detection of adenosine triphosphate (ATP), then the training of personnel. A number of documents and specifications have been standardized in different control procedures, a specification sheet of ingredient for CO 2 and different registers that are expected to establish an effective control mechanism to ensure customer satisfaction by consuming a quality beverage. Monitor the records that are generated has been the recommendation to ensure that all outlets is served a product without alterations by contamination present in the dispensing system. (author) [es

Impact of alternative interventions on changes in generic dispensing rates.

Science.gov (United States)

O'Malley, A James; Frank, Richard G; Kaddis, Atheer; Rothenberg, Barbara M; McNeil, Barbara J

2006-10-01

To evaluate the effectiveness of four alternative interventions (member mailings, advertising campaigns, free generic drug samples to physicians, and physician financial incentives) used by a major health insurer to encourage its members to switch to generic drugs. Using claim-level data from Blue Cross Blue Shield of Michigan, we evaluated the success of four interventions implemented during 2000-2003 designed to increase the use of generic drugs among its members. Around 13 million claims involving seven important classes of drugs were used to assess the effectiveness of the interventions. For each intervention a control group was developed that most closely resembled the corresponding intervention group. Logistic regression models with interaction effects between the treatment group (intervention versus control) and the status of the intervention (active versus not active) were used to evaluate if the interventions had an effect on the generic dispensing rate (GDR). Because the mail order pharmacy was considered more aggressive at converting prescriptions to generics, separate generic purchasing models were fitted to retail and mail order claims. In secondary analyses separate models were also fitted to claims involving a new condition and claims refilled for preexisting conditions. The interventions did not appear to increase the market penetration of generic drugs for either retail or mail order claims, or for claims involving new or preexisting conditions. In addition, we found that the ratio of copayments for brand name to generic drugs had a large positive effect on the GDR. The interventions did not appear to directly influence the GDR. Financial incentives expressed to consumers through benefit designs have a large influence on their switching to generic drugs and on the less-costly mail-order mode of purchase.

Microbial quality of soft drinks served by the dispensing machines in fast food restaurants and convenience stores in Griffin, Georgia, and surrounding areas.

Science.gov (United States)

Park, Yoen Ju; Chen, Jinru

2009-12-01

This study was undertaken to evaluate the microbial quality of the soft drinks served by fast food restaurants and gas station convenience stores in Griffin, GA, and surrounding areas. The soft drinks were collected from the dispensing machines in 8 fast food restaurants or gas station convenience stores in 2005 (n = 25) and in 10 fast food restaurants or gas station convenience stores in 2006 (n = 43) and 2007 (n = 43). One hundred milliliters of each soft drink was filtered through a hydrophobic grid membrane filter. The remaining portion of the soft drink was kept at room temperature for 4 h before sampling in order to mimic the possible holding time between purchase and consumption. The membrane filters were sampled for total aerobic bacteria, Enterobacteriaceae, lactic acid bacteria, and yeasts and molds. The microbial counts in the 2006 samples were numerically higher than the counts in the 2007 samples except for the average lactic acid bacteria counts, and were either significantly or numerically higher than the counts in the 2005 samples. Soft drinks sampled after the 4-h holding period had relatively higher counts than those sampled initially, with a few exceptions. Some soft drinks had over 4 log CFU/100 ml of total aerobic bacteria, Enterobacteriaceae, lactic acid bacteria, and yeast and mold cells. The study revealed the microbial quality of soft drinks served by dispensing machines in Griffin, GA, and surrounding areas, emphasizing the importance of effective sanitizing practice in retail settings.

Identification of vital and dispensable sulfur utilization factors in the Plasmodium apicoplast.

Directory of Open Access Journals (Sweden)

Joana M Haussig

Full Text Available Iron-sulfur [Fe-S] clusters are ubiquitous and critical cofactors in diverse biochemical processes. They are assembled by distinct [Fe-S] cluster biosynthesis pathways, typically in organelles of endosymbiotic origin. Apicomplexan parasites, including Plasmodium, the causative agent of malaria, harbor two separate [Fe-S] cluster biosynthesis pathways in the their mitochondrion and apicoplast. In this study, we systematically targeted the five nuclear-encoded sulfur utilization factors (SUF of the apicoplast [Fe-S] cluster biosynthesis pathway by experimental genetics in the murine malaria model parasite Plasmodium berghei. We show that four SUFs, namely SUFC, D, E, and S are refractory to targeted gene deletion, validating them as potential targets for antimalarial drug development. We achieved targeted deletion of SUFA, which encodes a potential [Fe-S] transfer protein, indicative of a dispensable role during asexual blood stage growth in vivo. Furthermore, no abnormalities were observed during Plasmodium life cycle progression in the insect and mammalian hosts. Fusion of a fluorescent tag to the endogenous P. berghei SUFs demonstrated that all loci were accessible to genetic modification and that all five tagged SUFs localize to the apicoplast. Together, our experimental genetics analysis identifies the key components of the SUF [Fe-S] cluster biosynthesis pathway in the apicoplast of a malarial parasite and shows that absence of SUFC, D, E, or S is incompatible with Plasmodium blood infection in vivo.

A randomized-controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

Directory of Open Access Journals (Sweden)

Emmanuel eStip

2013-08-01

Full Text Available Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR is about 49.5 % in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improved AAR of schizophrenic patients. Furthermore, we compared AAR obtained by the DoPill® and the BARS, in order to verify whether the DoPill® provides reliable assessment of medication adherence. Methods: The DoPill® is a smart pill dispenser that beeps and flashes at the appropriate time of the day. Each of its 28 compartments is covered by a plastic lamina that, when taken off, sends a signal to the pharmacist. Patients were randomized to the DoPill® or Treatment As Usual group (TAU for six weeks. The BARS was used as a reference measure. Results: Forty-six percent of patients were deemed to be non-adherent with antipsychotic medication. The mean AAR was 67 % after six weeks. DoPill® recorded better AAR than some of those found in the literature and were lower than the BARS estimate we found. Conclusion: These results suggest that DoPill® is a valid tool that provides more reliable and objective data for the clinician about their patient’s adherence, than existing assessment tools like the BARS. Furthermore, the device may help patients successfully manage their medication regimen.

Microbiological evaluation of hot beverages dispensed by vending machines from the Army barracks of Brigata Meccanizzata Aosta located in Messina

Directory of Open Access Journals (Sweden)

Chiara Beninati

2013-04-01

Full Text Available The aim of the present study was to evaluate the microbiological quality of hot beverages dispensed by vending machines (VMs. The study was carried out on 203 samples from 15 VMs located in 5 Army barracks in Messina. The samples included: water used for preparation of beverages, swab of water tank, swab of blender machine, chocolate powder, milk powder, cappuccino and chocolate drink (29 samples for each types. All samples were examined for total bacterial count (TBC, coliforms, Escherichia coli, enterococci, Pseudomonas aeruginosa, Staphylococcus aureus, Clostri - dium perfringens, Aeromonas spp., Salmonella spp. and Listeria monocytogenes. For the water samples the colony count (CC at 22°C and at 37°C was made. The average values of CC at 22°C and at 37°C were of 10.86x10²±8.72x10² CFU/mL and of 21.72x10²±16.44x10² CFU/mL, respectively. P. aeruginosa, coliform bacteria, S. aureus, E. coli and molds were detected from water. The TBC ranged from 176 CFU/g (±275.2 for chocolate powder to 294.8±69.4 CFU/g for milk powder. S. aureus and molds were isolated from milk powder, while coliforms, E. coli and S. aureus were observed in chocolate powder. The average TBC for hot beverages ranged from 34.32x10³±97.77x10³ CFU/mL for cappuccino to 36.59x10³±10.47x104 CFU/mL for chocolate drink. Coliforms, E. coli, enterococci and molds were detected from cappuccino, while enterococci and molds were observed in chocolate drink. The microbiological characteristics of the water and powders, hygiene, and the periodic cleaning of machines, influenced the microbiological quality of the hot beverages dispensed by VMs.

p62/SQSTM1 is required for Parkin-induced mitochondrial clustering but not mitophagy; VDAC1 is dispensable for both

Science.gov (United States)

Narendra, Derek P; Kane, Lesley A; Hauser, David N; Fearnley, Ian M

2010-01-01

Mitochondria sustain damage with aging, and the resulting mitochondrial dysfunction has been implicated in a number of diseases including parkinson disease. We recently demonstrated that the E3 ubiquitin ligase Parkin, which is linked to recessive forms of parkinsonism, causes a dramatic increase in mitophagy and a change in mitochondrial distribution, following its translocation from the cytosol to mitochondria. Investigating how Parkin induces these changes may offer insight into the mechanisms that lead to the sequestration and elimination of damaged mitochondria. We report that following Parkin's translocation from the cytosol to mitochondria, Parkin (but not a pathogenic mutant) promotes the K63-linked polyubiquitination of mitochondrial substrate(s) and recruits the ubiquitin- and LC3-binding protein, p62/SQSTM1, to mitochondria. After its recruitment, p62/SQSTM1 mediates the aggregation of dysfunctional mitochondria through polymerization via its PB1 domain, in a manner analogous to its aggregation of polyubiquitinated proteins. Surprisingly and in contrast to what has been recently reported for ubiquitin-induced pexophagy and xenophagy, p62 appears to be dispensable for mitophagy. Similarly, mitochondrial-anchored ubiquitin is sufficient to recruit p62 and promote mitochondrial clustering, but does not promote mitophagy. Although VDAC1 (but not VDAC2) is ubiquitinated following mitochondrial depolarization, we find VDAC1 cannot fully account for the mitochondrial K63-linked ubiquitin immunoreactivity observed following depolarization, as it is also observed in VDAC1/3−/− mouse embryonic fibroblasts. Additionally, we find VDAC1 and VDAC3 are dispensable for the recruitment of p62, mitochondrial clustering and mitophagy. These results demonstrate that mitochondria are aggregated by p62, following its recruitment by Parkin in a VDAC1-independent manner. They also suggest that proteins other than p62 are likely required for mitophagy downstream of Parkin

Catalysts, systems and methods to reduce NOX in an exhaust gas stream

Science.gov (United States)

Castellano, Christopher R.; Moini, Ahmad; Koermer, Gerald S.; Furbeck, Howard

2010-07-20

Catalysts, systems and methods are described to reduce NO.sub.x emissions of an internal combustion engine. In one embodiment, an emissions treatment system for an exhaust stream is provided having an SCR catalyst comprising silver tungstate on an alumina support. The emissions treatment system may be used for the treatment of exhaust streams from diesel engines and lean burn gasoline engines. An emissions treatment system may further comprise an injection device operative to dispense a hydrocarbon reducing agent upstream of the catalyst.

Aurora B is dispensable for megakaryocyte polyploidization, but contributes to the endomitotic process.

Science.gov (United States)

Lordier, Larissa; Chang, Yunhua; Jalil, Abdelali; Aurade, Frédéric; Garçon, Loïc; Lécluse, Yann; Larbret, Frédéric; Kawashima, Toshiyuki; Kitamura, Toshio; Larghero, Jérôme; Debili, Najet; Vainchenker, William

2010-09-30

Polyploidization of megakaryocytes (MKs), the platelet precursors, occurs by endomitosis, a mitotic process that fails at late stages of cytokinesis. Expression and function of Aurora B kinase during endomitosis remain controversial. Here, we report that Aurora B is normally expressed during the human MK endomitotic process. Aurora B localized normally in the midzone or midbody during anaphase and telophase in low ploidy megakaryocytes and in up to 16N rare endomitotic MKs was observed. Aurora B was also functional during cytokinesis as attested by phosphorylation of both its activation site and MgcRacGAP, its main substrate. However, despite its activation, Aurora B did not prevent furrow regression. Inhibition of Aurora B by AZD1152-HQPA decreased cell cycle entry both in 2N to 4N and polyploid MKs and induced apoptosis mainly in 2N to 4N cells. In both MK classes, AZD1152-HQPA induced p53 activation and retinoblastoma hypophosphorylation. Resistance of polyploid MKs to apoptosis correlated to a high BclxL level. Aurora B inhibition did not impair MK polyploidization but profoundly modified the endomitotic process by inducing a mis-segregation of chromosomes and a mitotic failure in anaphase. This indicates that Aurora B is dispensable for MK polyploidization but is necessary to achieve a normal endomitotic process.

Mpl expression on megakaryocytes and platelets is dispensable for thrombopoiesis but essential to prevent myeloproliferation.

Science.gov (United States)

Ng, Ashley P; Kauppi, Maria; Metcalf, Donald; Hyland, Craig D; Josefsson, Emma C; Lebois, Marion; Zhang, Jian-Guo; Baldwin, Tracey M; Di Rago, Ladina; Hilton, Douglas J; Alexander, Warren S

2014-04-22

Thrombopoietin (TPO) acting via its receptor, the cellular homologue of the myeloproliferative leukemia virus oncogene (Mpl), is the major cytokine regulator of platelet number. To precisely define the role of specific hematopoietic cells in TPO-dependent hematopoiesis, we generated mice that express the Mpl receptor normally on stem/progenitor cells but lack expression on megakaryocytes and platelets (Mpl(PF4cre/PF4cre)). Mpl(PF4cre/PF4cre) mice displayed profound megakaryocytosis and thrombocytosis with a remarkable expansion of megakaryocyte-committed and multipotential progenitor cells, the latter displaying biological responses and a gene expression signature indicative of chronic TPO overstimulation as the underlying causative mechanism, despite a normal circulating TPO level. Thus, TPO signaling in megakaryocytes is dispensable for platelet production; its key role in control of platelet number is via generation and stimulation of the bipotential megakaryocyte precursors. Nevertheless, Mpl expression on megakaryocytes and platelets is essential to prevent megakaryocytosis and myeloproliferation by restricting the amount of TPO available to stimulate the production of megakaryocytes from the progenitor cell pool.

Flow and heat transfer in water based liquid film fluids dispensed with graphene nanoparticles

Science.gov (United States)

Zuhra, Samina; Khan, Noor Saeed; Khan, Muhammad Altaf; Islam, Saeed; Khan, Waris; Bonyah, Ebenezer

2018-03-01

The unsteady flow and heat transfer characteristics of electrically conducting water based thin liquid film non-Newtonian (Casson and Williamson) nanofluids dispensed with graphene nanoparticles past a stretching sheet are considered in the presence of transverse magnetic field and non-uniform heat source/sink. Embedding the graphene nanoparticles effectively amplifies the thermal conductivity of Casson and Williamson nanofluids. Ordinary differential equations together with the boundary conditions are obtained through similarity variables from the governing equations of the problem, which are solved by the HAM (Homotopy Analysis Method). The solution is expressed through graphs and illustrated which show the influences of all the parameters. The convergence of the HAM solution for the linear operators is obtained. Favorable comparison with previously published research paper is performed to show the correlation for the present work. Skin friction coefficient and Nusselt number are presented through Tables and graphs which show the validation for the achieved results demonstrating that the thin liquid films results from this study are in close agreement with the results reported in the literature. Results achieved by HAM and residual errors are evaluated numerically, given in Tables and also depicted graphically which show the accuracy of the present work.

The effect of pharmacist-provided non-dispensing services on patient outcomes, health service utilisation and costs in low- and middle-income countries.

Science.gov (United States)

Pande, Sami; Hiller, Janet E; Nkansah, Nancy; Bero, Lisa

2013-02-28

The role of pharmacists has expanded beyond dispensing and packaging over the past two decades, and now includes ensuring rational use of drugs, improving clinical outcomes and promoting health status by working with the public and other healthcare professionals. To examine the effect of pharmacist-provided non-dispensing services on patient outcomes, health service utilisation and costs in low- and middle-income countries. Studies were identified by electronically searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (February 2010), MEDLINE (1949 to February 2010), Scopus (1960 to March 2010) and International Pharmaceutical Abstracts (1970 to January 2010) databases. An update of this review is currently ongoing. The search was re-run September 2012 and the potentially relevant studies are awaiting classification. Randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted time series analyses comparing 1. pharmacist-provided non-dispensing services targeted at patients versus (a) the same services provided by other healthcare professionals, (b) the same services provided by untrained health workers, and (c) usual care; and 2. pharmacist-provided non-dispensing services targeted at healthcare professionals versus (a) the same services provided by other healthcare professionals, (b) the same services provided by untrained health workers, and (c) usual care in low- and middle-income countries. The research sites must have been located in low or middle income countries according to World Bank Group 2009 at the time of the study, regardless of the location or the origin of the researchers. Two authors independently reviewed studies for inclusion in the review. Two review authors independently extracted data for each study. Risk of bias of the included studies was also assessed independently by two authors. Twelve studies comparing pharmacist-provided services versus usual

Mouse Panx1 Is Dispensable for Hearing Acquisition and Auditory Function.

Science.gov (United States)

Zorzi, Veronica; Paciello, Fabiola; Ziraldo, Gaia; Peres, Chiara; Mazzarda, Flavia; Nardin, Chiara; Pasquini, Miriam; Chiani, Francesco; Raspa, Marcello; Scavizzi, Ferdinando; Carrer, Andrea; Crispino, Giulia; Ciubotaru, Catalin D; Monyer, Hannah; Fetoni, Anna R; M Salvatore, Anna; Mammano, Fabio

2017-01-01

Panx1 forms plasma membrane channels in brain and several other organs, including the inner ear. Biophysical properties, activation mechanisms and modulators of Panx1 channels have been characterized in detail, however the impact of Panx1 on auditory function is unclear due to conflicts in published results. To address this issue, hearing performance and cochlear function of the Panx1 -/- mouse strain, the first with a reported global ablation of Panx1 , were scrutinized. Male and female homozygous ( Panx1 -/-), hemizygous ( Panx1 +/-) and their wild type (WT) siblings ( Panx1 +/+) were used for this study. Successful ablation of Panx1 was confirmed by RT-PCR and Western immunoblotting in the cochlea and brain of Panx1 -/- mice. Furthermore, a previously validated Panx1-selective antibody revealed strong immunoreactivity in WT but not in Panx1 -/- cochleae. Hearing sensitivity, outer hair cell-based "cochlear amplifier" and cochlear nerve function, analyzed by auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) recordings, were normal in Panx1 +/- and Panx1 -/- mice. In addition, we determined that global deletion of Panx1 impacts neither on connexin expression, nor on gap-junction coupling in the developing organ of Corti. Finally, spontaneous intercellular Ca 2+ signal (ICS) activity in organotypic cochlear cultures, which is key to postnatal development of the organ of Corti and essential for hearing acquisition, was not affected by Panx1 ablation. Therefore, our results provide strong evidence that, in mice, Panx1 is dispensable for hearing acquisition and auditory function.

Plasma processes inside dispenser hollow cathodes

International Nuclear Information System (INIS)

Mikellides, Ioannis G.; Katz, Ira; Goebel, Dan M.; Polk, James E.; Jameson, Kristina K.

2006-01-01

A two-dimensional fluid model of the plasma and neutral gas inside dispenser orificed hollow cathodes has been developed to quantify plasma processes that ultimately determine the life of the porous emitters inserted in these devices. The model self-consistently accounts for electron emission from the insert as well as for electron and ion flux losses from the plasma. Two cathodes, which are distinctively different in size and operating conditions, have been simulated numerically. It is found that the larger cathode, with outer tube diameter of 1.5 cm and orifice diameter of 0.3 cm, establishes an effective emission zone that spans approximately the full length of the emitter when operated at a discharge current of 25 A and a flow rate of 5.5 sccm. The net heating of the emitter is caused by ions that are produced by ionization of the neutral gas inside the tube and are then accelerated by the sheath along the emitter. The smaller cathode, with an outer diameter of 0.635 cm and an orifice diameter of 0.1 cm, does not exhibit the same operational characteristics. At a flow rate of 4.25 sccm and discharge current of 12 A, the smaller cathode requires 4.5 times the current density near the orifice and operates with more than 6 times the neutral particle density compared to the large cathode. As a result, the plasma particle density is almost one order of magnitude higher compared to the large cathode. The plasma density in this small cathode is high enough such that the Debye length is sufficiently small to allow 'sheath funneling' into the pores of the emitter. By accessing areas deeper into the insert material, it is postulated that the overall emission of electrons is significantly enhanced. The maximum emission current density is found to be about 1 A/mm 2 in the small cathode, which is about one order of magnitude higher than attained in the large cathode. The effective emission zone in the small cathode extends to about 15% of the emitter length only, and the

Impact of rheumatoid arthritis in the public health system in Santa Catarina, Brazil: a descriptive and temporal trend analysis from 1996 to 2009.

Science.gov (United States)

Gomes, Rafael Kmiliauskis Santos; Pires, Fabio Antero; Nobre, Moacyr Roberto Cuce; Marchi, Mauricio Felippi de Sá; Rickli, Jennifer Cristina Kozechen

There are few studies that carried out a descriptive and trend analysis based on available data from the Unified Health System (SUS) between pre- and post-free dispensing of pharmacological treatment of rheumatoid arthritis (RA) from the perspective of the public health system, in terms of the direct cost of the disease among adults and elderly residents of the State of Santa Catarina, Brazil. This study aims to characterize the direct cost of medical and surgical procedures before and after the dispensing of drugs in this state. This is a time series-type study with a cross-sectional survey of data from the Hospital (SIH) and Outpatient (SIA) Information System of SUS during the period from 1996 to 2009. Between 1996 and 2009, the total expenditure for hospital- and outpatient pharmacological treatment of rheumatoid arthritis was R$ 26,659,127.20. After the dispensing of drug treatment by SUS a decrease of 36% in the number of hospital admissions was observed; however, an increase of 19% in clinical procedures was noted. During the observed period, a reduction in the number of hospital admissions for both clinical and orthopedic surgical procedures related to this disease was observed. Nevertheless, there was an increase in the cost of medical admissions. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

Partial dispensability of Djp1's J domain in peroxisomal protein import in Saccharomyces cerevisiae results from genetic redundancy with another class II J protein, Caj1.

Science.gov (United States)

Dobriyal, Neha; Tripathi, Prerna; Sarkar, Susrita; Tak, Yogesh; Verma, Amit K; Sahi, Chandan

2017-05-01

J proteins are obligate co-chaperones of Hsp70s. Via their signature J domain, all J proteins interact with their partner Hsp70s and stimulate their weak ATPase activity, which is vital for Hsp70 functions. The dependency of J proteins on their J domain is such that mutations in critical amino acids in the J domain often results into a null phenotype for a particular J protein. Here, we show that the J domain of Djp1, a cytosolic J protein important for peroxisomal protein import in Saccharomyces cerevisiae, is partially dispensable. A complete deletion of Djp1 J domain resulted into only partial loss in peroxisomal protein import function. Instead, the C-terminal domain of Djp1 was found to be essential for proper localization of the peroxisomal targeted GFP-PTS1. Furthermore, we show that Caj1, another cytosolic J protein, also has some role in peroxisomal protein import. Caj1 was found to be partially redundant with Djp1 as cells lacking both Djp1 and Caj1 resulted into a much more severe defect in GFP-PTS1 localization. Based on these results, we propose that dispensability of J domains could be attributed to genetic redundancy between different J proteins sharing common structural topology and cellular localization.

The Quality of Selected Essential Medicines Sold in Accredited Drug Dispensing Outlets and Pharmacies in Tanzania.

Science.gov (United States)

Kaale, Eliangiringa; Manyanga, Vicky; Chambuso, Mhina; Liana, Jafary; Rutta, Edmund; Embrey, Martha; Layloff, Thomas; Johnson, Keith

2016-01-01

The purpose of this study was to investigate the quality of a select group of medicines sold in accredited drug dispensing outlets (ADDOs) and pharmacies in different regions of Tanzania as part of an in-depth cross-sectional assessment of community access to medicines and community use of medicines. We collected 242 samples of amoxicillin trihydrate, artemether-lumefantrine (ALu), co-trimoxazole, ergometrine maleate, paracetamol, and quinine from selected ADDOs and pharmacies in Mbeya, Morogoro, Singida, and Tanga regions. The analysis included physical examination and testing with validated analytical techniques. Assays for eight of nine products were conducted using high-performance thin-layer chromatography (HPTLC). For ALu tablets, we used a two-tiered approach, where tier 1 was a semi-quantitative Global Pharma Health Fund-Minilab® method and tier 2 was high-performance liquid chromatography (HPLC) as described in The International Pharmacopoeia's monograph for artemether-lumefantrine. The physical examination of samples revealed no defects in the solid and oral liquid dosage forms, but unusual discoloration in an injectable solution, ergometrine maleate. For ALu, the results showed that of 38 samples, 31 (81.6%) passed tier 1 testing and 7 (18.4%) gave inconclusive drug content results. The inconclusive ALu samples were submitted for tier 2 testing and all met the quality standards. The pass rate using the HPTLC and TLC/HPLC assays was 93.8%; the failures were the ergometrine maleate samples purchased from both ADDOs and pharmacies. The disintegration testing of the solid dosage forms was conducted in accordance with US Pharmacopeia monographs. Only two samples of paracetamol, 1.2% of the solid dosage forms, failed to comply to standards. The study revealed a high overall rate of 92.6% of samples that met the quality standards. Although the overall failure rate was 7.4%, it is important to note that this was largely limited to one product and likely due to

The Quality of Selected Essential Medicines Sold in Accredited Drug Dispensing Outlets and Pharmacies in Tanzania.

Directory of Open Access Journals (Sweden)

Eliangiringa Kaale

Full Text Available The purpose of this study was to investigate the quality of a select group of medicines sold in accredited drug dispensing outlets (ADDOs and pharmacies in different regions of Tanzania as part of an in-depth cross-sectional assessment of community access to medicines and community use of medicines.We collected 242 samples of amoxicillin trihydrate, artemether-lumefantrine (ALu, co-trimoxazole, ergometrine maleate, paracetamol, and quinine from selected ADDOs and pharmacies in Mbeya, Morogoro, Singida, and Tanga regions. The analysis included physical examination and testing with validated analytical techniques. Assays for eight of nine products were conducted using high-performance thin-layer chromatography (HPTLC. For ALu tablets, we used a two-tiered approach, where tier 1 was a semi-quantitative Global Pharma Health Fund-Minilab® method and tier 2 was high-performance liquid chromatography (HPLC as described in The International Pharmacopoeia's monograph for artemether-lumefantrine.The physical examination of samples revealed no defects in the solid and oral liquid dosage forms, but unusual discoloration in an injectable solution, ergometrine maleate. For ALu, the results showed that of 38 samples, 31 (81.6% passed tier 1 testing and 7 (18.4% gave inconclusive drug content results. The inconclusive ALu samples were submitted for tier 2 testing and all met the quality standards. The pass rate using the HPTLC and TLC/HPLC assays was 93.8%; the failures were the ergometrine maleate samples purchased from both ADDOs and pharmacies. The disintegration testing of the solid dosage forms was conducted in accordance with US Pharmacopeia monographs. Only two samples of paracetamol, 1.2% of the solid dosage forms, failed to comply to standards. The study revealed a high overall rate of 92.6% of samples that met the quality standards. Although the overall failure rate was 7.4%, it is important to note that this was largely limited to one product and

Mating Disruption of the Navel Orangeworm (Lepidoptera: Pyralidae) Using Widely Spaced, Aerosol Dispensers: Is the Pheromone Blend the Most Efficacious Disruptant?

Science.gov (United States)

Higbee, Bradley S; Burks, Charles S; Cardé, Ring T

2017-10-01

The navel orangeworm, Amyelois transitella (Walker) (Lepidoptera: Pyralidae), is a key pest of almonds and pistachios and is sometimes controlled using mating disruption as part of a program of integrated management. The formulation used has a single, nonattractive compound [(11Z,13Z)-hexadecadienal] as the active ingredient that is emitted from timed aerosol dispensers. This study compared this nonattractive, single-compound formulation with two aerosol formulations also containing two additional compounds [(11Z,13Z)-hexadecadien-1-ol and (3Z,6Z,9Z,12Z,15Z)-tricosapentaene] that are found in the pheromone glands, and that in combination with the aldehyde are attractive in wind-tunnel and field-attraction trials. An experiment in pistachios found 97% to 99% suppression of males captured in female-baited traps and 82-93% suppression of mating in sentinel females. Both assays revealed a trend to greater suppression by the more complete pheromone formulations. In almonds, where the abundance of navel orangeworm was lower, all three formulations suppressed males captured in traps and mating in sentinel females by >99%. Each of the formulations significantly reduced damage to Nonpareil almonds. In almonds, there were no significant differences among the formulations in disruption of sexual communication or in damage. These findings suggest that it may be possible to make mating disruption more cost-effective and to achieve higher levels of mating disruption by using attractive aerosol formulations to reduce the number of dispenser per ha. Such a formulation, however, would be more expensive to register in the United States than pheromones meeting the definition of straight-chain lepidopteran pheromone, including the currently used aldehyde-only formulation. Published by Oxford University Press on behalf of Entomological Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

AMPKγ3 is dispensable for skeletal muscle hypertrophy induced by functional overload.

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Riedl, Isabelle; Osler, Megan E; Björnholm, Marie; Egan, Brendan; Nader, Gustavo A; Chibalin, Alexander V; Zierath, Juleen R

2016-03-15

Mechanisms regulating skeletal muscle growth involve a balance between the activity of serine/threonine protein kinases, including the mammalian target of rapamycin (mTOR) and 5'-AMP-activated protein kinase (AMPK). The contribution of different AMPK subunits to the regulation of cell growth size remains inadequately characterized. Using AMPKγ3 mutant-overexpressing transgenic Tg-Prkag3(225Q) and AMPKγ3-knockout (Prkag3(-/-)) mice, we investigated the requirement for the AMPKγ3 isoform in functional overload-induced muscle hypertrophy. Although the genetic disruption of the γ3 isoform did not impair muscle growth, control sham-operated AMPKγ3-transgenic mice displayed heavier plantaris muscles in response to overload hypertrophy and underwent smaller mass gain and lower Igf1 expression compared with wild-type littermates. The mTOR signaling pathway was upregulated with functional overload but unchanged between genetically modified animals and wild-type littermates. Differences in AMPK-related signaling pathways between transgenic, knockout, and wild-type mice did not impact muscle hypertrophy. Glycogen content was increased following overload in wild-type mice. In conclusion, our functional, transcriptional, and signaling data provide evidence against the involvement of the AMPKγ3 isoform in the regulation of skeletal muscle hypertrophy. Thus, the AMPKγ3 isoform is dispensable for functional overload-induced muscle growth. Mechanical loading can override signaling pathways that act as negative effectors of mTOR signaling and consequently promote skeletal muscle hypertrophy. Copyright © 2016 the American Physiological Society.

Controlled Substance Reconciliation Accuracy Improvement Using Near Real-Time Drug Transaction Capture from Automated Dispensing Cabinets.

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Epstein, Richard H; Dexter, Franklin; Gratch, David M; Perino, Michael; Magrann, Jerry

2016-06-01

Accurate accounting of controlled drug transactions by inpatient hospital pharmacies is a requirement in the United States under the Controlled Substances Act. At many hospitals, manual distribution of controlled substances from pharmacies is being replaced by automated dispensing cabinets (ADCs) at the point of care. Despite the promise of improved accountability, a high prevalence (15%) of controlled substance discrepancies between ADC records and anesthesia information management systems (AIMS) has been published, with a similar incidence (15.8%; 95% confidence interval [CI], 15.3% to 16.2%) noted at our institution. Most reconciliation errors are clerical. In this study, we describe a method to capture drug transactions in near real-time from our ADCs, compare them with documentation in our AIMS, and evaluate subsequent improvement in reconciliation accuracy. ADC-controlled substance transactions are transmitted to a hospital interface server, parsed, reformatted, and sent to a software script written in Perl. The script extracts the data and writes them to a SQL Server database. Concurrently, controlled drug totals for each patient having care are documented in the AIMS and compared with the balance of the ADC transactions (i.e., vending, transferring, wasting, and returning drug). Every minute, a reconciliation report is available to anesthesia providers over the hospital Intranet from AIMS workstations. The report lists all patients, the current provider, the balance of ADC transactions, the totals from the AIMS, the difference, and whether the case is still ongoing or had concluded. Accuracy and latency of the ADC transaction capture process were assessed via simulation and by comparison with pharmacy database records, maintained by the vendor on a central server located remotely from the hospital network. For assessment of reconciliation accuracy over time, data were collected from our AIMS from January 2012 to June 2013 (Baseline), July 2013 to April 2014

RIG-I self-oligomerization is either dispensable or very transient for signal transduction.

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Jade Louber

Full Text Available Effective host defence against viruses depends on the rapid triggering of innate immunity through the induction of a type I interferon (IFN response. To this end, microbe-associated molecular patterns are detected by dedicated receptors. Among them, the RIG-I-like receptors RIG-I and MDA5 activate IFN gene expression upon sensing viral RNA in the cytoplasm. While MDA5 forms long filaments in vitro upon activation, RIG-I is believed to oligomerize after RNA binding in order to transduce a signal. Here, we show that in vitro binding of synthetic RNA mimicking that of Mononegavirales (Ebola, rabies and measles viruses leader sequences to purified RIG-I does not induce RIG-I oligomerization. Furthermore, in cells devoid of endogenous functional RIG-I-like receptors, after activation of exogenous Flag-RIG-I by a 62-mer-5'ppp-dsRNA or by polyinosinic:polycytidylic acid, a dsRNA analogue, or by measles virus infection, anti-Flag immunoprecipitation and specific elution with Flag peptide indicated a monomeric form of RIG-I. Accordingly, when using the Gaussia Luciferase-Based Protein Complementation Assay (PCA, a more sensitive in cellula assay, no RIG-I oligomerization could be detected upon RNA stimulation. Altogether our data indicate that the need for self-oligomerization of RIG-I for signal transduction is either dispensable or very transient.

Mouse Panx1 Is Dispensable for Hearing Acquisition and Auditory Function

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Veronica Zorzi

2017-11-01

Full Text Available Panx1 forms plasma membrane channels in brain and several other organs, including the inner ear. Biophysical properties, activation mechanisms and modulators of Panx1 channels have been characterized in detail, however the impact of Panx1 on auditory function is unclear due to conflicts in published results. To address this issue, hearing performance and cochlear function of the Panx1−/− mouse strain, the first with a reported global ablation of Panx1, were scrutinized. Male and female homozygous (Panx1−/−, hemizygous (Panx1+/− and their wild type (WT siblings (Panx1+/+ were used for this study. Successful ablation of Panx1 was confirmed by RT-PCR and Western immunoblotting in the cochlea and brain of Panx1−/− mice. Furthermore, a previously validated Panx1-selective antibody revealed strong immunoreactivity in WT but not in Panx1−/− cochleae. Hearing sensitivity, outer hair cell-based “cochlear amplifier” and cochlear nerve function, analyzed by auditory brainstem response (ABR and distortion product otoacoustic emission (DPOAE recordings, were normal in Panx1+/− and Panx1−/− mice. In addition, we determined that global deletion of Panx1 impacts neither on connexin expression, nor on gap-junction coupling in the developing organ of Corti. Finally, spontaneous intercellular Ca2+ signal (ICS activity in organotypic cochlear cultures, which is key to postnatal development of the organ of Corti and essential for hearing acquisition, was not affected by Panx1 ablation. Therefore, our results provide strong evidence that, in mice, Panx1 is dispensable for hearing acquisition and auditory function.

Hospital medication errors in a pharmacovigilance system in Colombia

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Jorge Enrique Machado-Alba

2015-11-01

Full Text Available Objective: this study analyzes the medication errors reported to a pharmacovigilance system by 26 hospitals for patients in the healthcare system of Colombia. Methods: this retrospective study analyzed the medication errors reported to a systematized database between 1 January 2008 and 12 September 2013. The medication is dispensed by the company Audifarma S.A. to hospitals and clinics around Colombia. Data were classified according to the taxonomy of the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP. The data analysis was performed using SPSS 22.0 for Windows, considering p-values < 0.05 significant. Results: there were 9 062 medication errors in 45 hospital pharmacies. Real errors accounted for 51.9% (n = 4 707, of which 12.0% (n = 567 reached the patient (Categories C to I and caused harm (Categories E to I to 17 subjects (0.36%. The main process involved in errors that occurred (categories B to I was prescription (n = 1 758, 37.3%, followed by dispensation (n = 1 737, 36.9%, transcription (n = 970, 20.6% and administration (n = 242, 5.1%. The errors in the administration process were 45.2 times more likely to reach the patient (CI 95%: 20.2–100.9. Conclusions: medication error reporting systems and prevention strategies should be widespread in hospital settings, prioritizing efforts to address the administration process.

Productive performance of Nile tilapia (Oreochromis niloticus fed at different frequencies and periods with automatic dispenser

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R.M.R. Sousa

2012-02-01

Full Text Available The performance of Nile tilapia (Oreochromis niloticus raised in cages furnished with an automatic dispenser, supplied at different frequencies (once per hour and once every two hours and periods (daytime, nighttime and both was evaluated. Eighteen 1.0m³ cages were placed into a 2000m² pond, two meters deep with a 5% water exchange. One hundred and seventy tilapias, with initial weight of 16.0±4.9g, were dispersed into each 1m³ cage and the feed ration was adjusted every 21 days with biometry. Data was collected from March to July (autumn and winter. Significant difference to final weight (P<0.05 among treatments was observed. The increase in feeding frequency improves the productive performance of Nile tilapias in cages and permitted better management of the food. The better feed conversion rate for high feeding frequency (24 times day-1 can result in saving up to 360kg of food for each ton of fish produced, increasing the economic sustenance for tilapia culture and suggesting less environmental pollution.

Aerial release of Rhinoncomimus latipes (Coleoptera: Curculionidae) to control Persicaria perfoliata (Polygonaceae) using an unmanned aerial system.

Science.gov (United States)

Park, Yong-Lak; Gururajan, Srikanth; Thistle, Harold; Chandran, Rakesh; Reardon, Richard

2018-01-01

Rhinoncomimus latipes (Coleoptera: Curculionidae) is a major biological control agent against the invasive plant Persicaria perfoliata. Release of R. latipes is challenging with the current visit-and-hand release approach because P. perfoliata shows a high degree of patchiness in the landscape, possesses recurved barbs on its stems, and often spreads into hard-to-access areas. This 3-year study developed and evaluated unmanned aerial systems (UAS) for precise aerial release of R. latipes to control P. perfoliata. We have developed two UAS (i.e. quad-rotor and tri-rotor) and an aerial release system to disseminate R. latipes. These include pods containing R. latipes and a dispenser to accommodate eight pods. Results of field tests to evaluate the systems showed no significant (P > 0.05) effects on survivorship and feeding ability of R. latipes after aerial release. Our study demonstrates the potential of UAS for precision aerial release of biological control agents to control invasive plants. The aerial deployment systems we have developed, including both pods and a dispenser, are low cost, logistically practical, and effective with no negative effects on aerially released R. latipes. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Mast cells are dispensable in a genetic mouse model of chronic dermatitis.

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Sulcova, Jitka; Meyer, Michael; Guiducci, Eva; Feyerabend, Thorsten B; Rodewald, Hans-Reimer; Werner, Sabine

2015-06-01

Chronic inflammatory skin diseases, such as atopic dermatitis, affect a large percentage of the population, but the role of different immune cells in the pathogenesis of these disorders is largely unknown. Recently, we found that mice lacking fibroblast growth factor receptor 1 (Fgfr1) and Fgfr2 (K5-R1/R2 mice) in the epidermis have a severe impairment in the epidermal barrier, which leads to the development of a chronic inflammatory skin disease that shares many features with human atopic dermatitis. Using Fgfr1-/Fgfr2-deficient mice, we analyzed the consequences of the loss of mast cells. Mast cells accumulated and degranulated in the skin of young Fgfr1-/Fgfr2-deficient mice, most likely as a consequence of increased expression of the mast cell chemokine Ccl2. The increase in mast cells occurred before the development of histological abnormalities, indicating a functional role of these cells in the inflammatory skin phenotype. To test this hypothesis, we mated the Fgfr1-/Fgfr2-deficient mice with mast cell-deficient CreMaster mice. Surprisingly, loss of mast cells did not or only mildly affect keratinocyte proliferation, epidermal thickness, epidermal barrier function, accumulation and activation of different immune cells, or expression of different proinflammatory cytokines in the skin. These results reveal that mast cells are dispensable for the development of chronic inflammation in response to a defect in the epidermal barrier. Copyright © 2015 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study.

Science.gov (United States)

Franklin, Bryony Dean; O'Grady, Kara; Donyai, Parastou; Jacklin, Ann; Barber, Nick

2007-08-01

To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Before-and-after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Closed-loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Prescribing errors were identified in 3.8% of 2450 medication orders pre-intervention and 2.0% of 2353 orders afterwards (pMedical staff required 15 s to prescribe a regular inpatient drug pre-intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre-intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; chi(2) test). A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.

Impact of Pharmacists’ Religious and Personal Beliefs in Dispensing Contraceptives

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Anna Krupa

2016-10-01

Full Text Available Background: Until recently, pharmacies were not permitted to dispense any emergency contraceptives to women to prevent pregnancy. No legal statutes existed under which pharmacists with religious, moral or ethical objections could refuse to fill a prescription for contraceptives, nor were there direct guidelines describing the pharmacist’s professional obligations. Objectives: The purpose of this study is to explore the frequency of cases in which pharmacists have refused, due to their personal beliefs, to provide counsel regarding contraceptives or have refused to refer to a patient to a different pharmacist or healthcare provider. This study will compare and contrast the differences between independent pharmacies and chain pharmacies (i.e. time spent, location, most common recommended contraception. Finally, this study will compare the results evident between male pharmacists and female pharmacists. Method: Quantitative method employed uses two interview questions directed to pharmacists: (1 “I am moving in with my fiancée/boyfriend next month and I have never used contraceptives. What are my options?” (2 “If I use a condom and it breaks, do I have any choices to prevent pregnancy after the fact?” The survey was conducted in two locations, the greater Philadelphia area and Hershey, PA. The survey was conducted through face-to-face interactions with pharmacists, either employed at independent pharmacy or at a chain pharmacy. Data collected from each pharmacist included number of approximate age/gender; minutes spent in each consultation with a patient; the kind of privacy provided during the consultation; and the referrals given, if any. Results: Fifty (50 pharmacists were interviewed. No pharmacist indicated that counseling would be denied, although one (1 pharmacist refused to counsel on Plan B and four (4 pharmacists referred the interviewer to a doctor immediately, indicating that all medications require a prescription. Two (2

Metrological and operational performance of measuring systems used in vehicle compressed natural gas filling stations

Energy Technology Data Exchange (ETDEWEB)

Velosa, Jhonn F.; Abril, Henry; Garcia, Luis E. [CDT de GAS (Venezuela). Gas Technological Development Center Corporation

2008-07-01

Corporation CDT GAS financially supported by the Colombian government through COLCIENCIAS, carried out a study aimed at designing, developing and implementing in Colombia a calibration and metrological verification 'specialized service' for gas meters installed at dispensers of filling stations using compressed natural gas. The results permitted the identification of improving opportunities (in measuring systems, equipment and devices used to deliver natural gas) which are focused on achieving the highest security and reliability of trading processes of CNG for vehicles. In the development of the first stage of the project, metrological type variables were initially considered, but given the importance of the measuring system and its interaction with the various elements involving gas supply to the filling station, the scope of the work done included aspects related to the operational performance, that is, those influencing the security of the users and the metrological performance of the measuring system. The development of the second stage counted on the collaboration of national companies from the sector of CNG for vehicles, which permitted the carrying out of multiple calibrations to the measuring systems installed in the CNG dispensers, thus achieving, in a concrete way, valid and reliable technological information of the implemented procedures. (author)

GM-CSF Controls Nonlymphoid Tissue Dendritic Cell Homeostasis but Is Dispensable for the Differentiation of Inflammatory Dendritic Cells

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Greter, Melanie; Helft, Julie; Chow, Andrew; Hashimoto, Daigo; Mortha, Arthur; Agudo-Cantero, Judith; Bogunovic, Milena; Gautier, Emmanuel L.; Miller, Jennifer; Leboeuf, Marylene; Lu, Geming; Aloman, Costica; Brown, Brian D.; Pollard, Jeffrey W.; Xiong, Huabao; Randolph, Gwendalyn J.; Chipuk, Jerry E.; Frenette, Paul S.; Merad, Miriam

2012-01-01

SUMMARY GM-CSF (Csf-2) is a critical cytokine for the in vitro generation of dendritic cells (DCs) and is thought to control the development of inflammatory DCs and resident CD103+ DCs in some tissues. Here we showed that in contrast to the current understanding, Csf-2 receptor acts in the steady state to promote the survival and homeostasis of nonlymphoid tissue-resident CD103+ and CD11b+ DCs. Absence of Csf-2 receptor on lung DCs abrogated the induction of CD8+ T cell immunity after immunization with particulate antigens. In contrast, Csf-2 receptor was dispensable for the differentiation and innate function of inflammatory DCs during acute injuries. Instead, inflammatory DCs required Csf-1 receptor for their development. Thus, Csf-2 is important in vaccine-induced CD8+ T cell immunity through the regulation of nonlymphoid tissue DC homeostasis rather than control of inflammatory DCs in vivo. PMID:22749353

Putative oncogene Brachyury (T) is essential to specify cell fate but dispensable for notochord progenitor proliferation and EMT.

Science.gov (United States)

Zhu, Jianjian; Kwan, Kin Ming; Mackem, Susan

2016-04-05

The transcription factor Brachyury (T) gene is expressed throughout primary mesoderm (primitive streak and notochord) during early embryonic development and has been strongly implicated in the genesis of chordoma, a sarcoma of notochord cell origin. Additionally, T expression has been found in and proposed to play a role in promoting epithelial-mesenchymal transition (EMT) in various other types of human tumors. However, the role of T in normal mammalian notochord development and function is still not well-understood. We have generated an inducible knockdown model to efficiently and selectively deplete T from notochord in mouse embryos. In combination with genetic lineage tracing, we show that T function is essential for maintaining notochord cell fate and function. Progenitors adopt predominantly a neural fate in the absence of T, consistent with an origin from a common chordoneural progenitor. However, T function is dispensable for progenitor cell survival, proliferation, and EMT, which has implications for the therapeutic targeting of T in chordoma and other cancers.

From 32 ounces to zero: a medical geographic study of dispensing a cultivated batch of "plum" cannabis flowers to medical marijuana patients in Washington State.

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Aggarwal, Sunil K; Carter, Gregory T; Zumbrunnen, Craig; Morrill, Richard; Sullivan, Mark; Mayer, Jonathan D

2013-01-01

The medicinal use of cannabis is a growing phenomenon in the U.S. predicated on the success of overcoming specific spatial challenges and establishing particular human-environment relationships. This article takes a medical geographic "snapshot" of an urban site in Washington State where qualifying chronically ill and debilitated patients are delivered locally produced botanical cannabis for medical use. Using interview, survey, and observation, this medical geographic research project collected information on the social space of the particular delivery site and tracked the production cost, reach, and health value of a 32-ounce batch of strain-specific medical cannabis named "Plum" dispensed over a four-day period. A convenience sample of 37 qualifying patients delivered this batch of cannabis botanical medicine was recruited and prospectively studied with survey instruments. Results provide insight into patients' self-rated health, human-plant relationships, and travel-to-clinic distances. An overall systematic geographic understanding of the medical cannabis delivery system gives a grounded understanding of the lengths that patients and care providers go, despite multiple hurdles, to receive and deliver treatment with botanical cannabis that relieves diverse symptoms and improves health-related quality-of-life.

Relative accuracy and availability of an Irish National Database of dispensed medication as a source of medication history information: observational study and retrospective record analysis.

LENUS (Irish Health Repository)

Grimes, T

2013-01-27

WHAT IS KNOWN AND OBJECTIVE: The medication reconciliation process begins by identifying which medicines a patient used before presentation to hospital. This is time-consuming, labour intensive and may involve interruption of clinicians. We sought to identify the availability and accuracy of data held in a national dispensing database, relative to other sources of medication history information. METHODS: For patients admitted to two acute hospitals in Ireland, a Gold Standard Pre-Admission Medication List (GSPAML) was identified and corroborated with the patient or carer. The GSPAML was compared for accuracy and availability to PAMLs from other sources, including the Health Service Executive Primary Care Reimbursement Scheme (HSE-PCRS) dispensing database. RESULTS: Some 1111 medication were assessed for 97 patients, who were median age 74 years (range 18-92 years), median four co-morbidities (range 1-9), used median 10 medications (range 3-25) and half (52%) were male. The HSE-PCRS PAML was the most accurate source compared to lists provided by the general practitioner, community pharmacist or cited in previous hospital documentation: the list agreed for 74% of the medications the patients actually used, representing complete agreement for all medications in 17% of patients. It was equally contemporaneous to other sources, but was less reliable for male than female patients, those using increasing numbers of medications and those using one or more item that was not reimbursable by the HSE. WHAT IS NEW AND CONCLUSION: The HSE-PCRS database is a relatively accurate, available and contemporaneous source of medication history information and could support acute hospital medication reconciliation.

Infrastructure of pharmacies of the primary health care in the Brazilian Unified Health System: Analysis of PNAUM - Services data.

Science.gov (United States)

Leite, Silvana Nair; Manzini, Fernanda; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mário; Farias, Mareni Rocha

2017-11-13

To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). Information on 1,175 pharmacies/dispensing units were gathered from direct observation and assessment of dispensing units installations conducted by trained researchers who used a standardized form. The analyzed variables refer to the physical structure of pharmacies or medicine dispensing units of the health units under research. The pharmacy area was greater than 14 m2 in 40.3% of the sampled units, highlighting those from Midwest (56.9%) and Southeast (56.2%) regions and those of Northeast, with only 23.3%. About 80.2% units had waiting rooms with chairs for patients, 31.8% of them had dispensing areas inferior to 5m2, while in 46.2% these areas were superior to 10m2. Bars were found in service counters in 23.8% of health units, thus separating the patient from the professional; 44.1% had internet access. In most units, the area of medicine storage had no refrigerator or freezer for their exclusive storage and 13.7% had a specific room for pharmaceutical consultation. Aiming at achieving care humanization and improving working conditions for professionals, the structuring of the environment of pharmacy services is necessary. This would contribute to the better qualification of pharmacy services, comprising more than medicine delivery. Data on the Northeast region indicated less favorable conditions to the development of adequate dispensing services. Based on the panorama pointed out, we suggest the expansion of stimulus concerning the physical structure of pharmaceutical services, considering regional specificities.

RNA-Interference Components Are Dispensable for Transcriptional Silencing of the Drosophila Bithorax-Complex

KAUST Repository

Cernilogar, Filippo M.

2013-06-13

Background:Beyond their role in post-transcriptional gene silencing, Dicer and Argonaute, two components of the RNA interference (RNAi) machinery, were shown to be involved in epigenetic regulation of centromeric heterochromatin and transcriptional gene silencing. In particular, RNAi mechanisms appear to play a role in repeat induced silencing and some aspects of Polycomb-mediated gene silencing. However, the functional interplay of RNAi mechanisms and Polycomb group (PcG) pathways at endogenous loci remains to be elucidated.Principal Findings:Here we show that the endogenous Dicer-2/Argonaute-2 RNAi pathway is dispensable for the PcG mediated silencing of the homeotic Bithorax Complex (BX-C). Although Dicer-2 depletion triggers mild transcriptional activation at Polycomb Response Elements (PREs), this does not induce transcriptional changes at PcG-repressed genes. Moreover, Dicer-2 is not needed to maintain global levels of methylation of lysine 27 of histone H3 and does not affect PRE-mediated higher order chromatin structures within the BX-C. Finally bioinformatic analysis, comparing published data sets of PcG targets with Argonaute-2-bound small RNAs reveals no enrichment of these small RNAs at promoter regions associated with PcG proteins.Conclusions:We conclude that the Dicer-2/Argonaute-2 RNAi pathway, despite its role in pairing sensitive gene silencing of transgenes, does not have a role in PcG dependent silencing of major homeotic gene cluster loci in Drosophila. © 2013 Cernilogar et al.

Theoretical study for heterojunction surface of NEA GaN photocathode dispensed with Cs activation

Science.gov (United States)

Xia, Sihao; Liu, Lei; Wang, Honggang; Wang, Meishan; Kong, Yike

2016-09-01

For the disadvantages of conventional negative electron affinity (NEA) GaN photocathodes activated by Cs or Cs/O, new-type NEA GaN photocathodes with heterojunction surface dispensed with Cs activation are investigated based on first-principle study with density functional theory. Through the growth of an ultrathin n-type GaN cap layer on p-type GaN emission layer, a p-n heterojunction is formed on the surface. According to the calculation results, it is found that Si atoms tend to replace Ga atoms to result in an n-type doped cap layer which contributes to the decreasing of work function. After the growth of n-type GaN cap layer, the atom structure near the p-type emission layer is changed while that away from the surface has no obvious variations. By analyzing the E-Mulliken charge distribution of emission surface with and without cap layer, it is found that the positive charge of Ga and Mg atoms in the emission layer decrease caused by the cap layer, while the negative charge of N atom increases. The conduction band moves downwards after the growth of cap layer. Si atom produces donor levels around the valence band maximum. The absorption coefficient of GaN emission layer decreases and the reflectivity increases caused by n-type GaN cap layer.

Flow and heat transfer in water based liquid film fluids dispensed with graphene nanoparticles

Directory of Open Access Journals (Sweden)

Samina Zuhra

2018-03-01

Full Text Available The unsteady flow and heat transfer characteristics of electrically conducting water based thin liquid film non-Newtonian (Casson and Williamson nanofluids dispensed with graphene nanoparticles past a stretching sheet are considered in the presence of transverse magnetic field and non-uniform heat source/sink. Embedding the graphene nanoparticles effectively amplifies the thermal conductivity of Casson and Williamson nanofluids. Ordinary differential equations together with the boundary conditions are obtained through similarity variables from the governing equations of the problem, which are solved by the HAM (Homotopy Analysis Method. The solution is expressed through graphs and illustrated which show the influences of all the parameters. The convergence of the HAM solution for the linear operators is obtained. Favorable comparison with previously published research paper is performed to show the correlation for the present work. Skin friction coefficient and Nusselt number are presented through Tables and graphs which show the validation for the achieved results demonstrating that the thin liquid films results from this study are in close agreement with the results reported in the literature. Results achieved by HAM and residual errors are evaluated numerically, given in Tables and also depicted graphically which show the accuracy of the present work. Keywords: Graphene nanoparticles, MHD, Casson and Williamson nanofluids, Stretching sheet, Skin friction coefficient, Nusselt number, Residual errors, Homotopy Analysis Method

The proline-histidine-rich CDK2/CDK4 interaction region of C/EBPalpha is dispensable for C/EBPalpha-mediated growth regulation in vivo

DEFF Research Database (Denmark)

Porse, Bo Torben; Pedersen, Thomas Askov; Hasemann, Marie Sigurd

2006-01-01

The C/EBPalpha transcription factor regulates growth and differentiation of several tissues during embryonic development. Several hypotheses as to how C/EBPalpha inhibits cellular growth in vivo have been derived, mainly from studies of tissue culture cells. In fetal liver it has been proposed......, carrying a modified cebpa allele lacking amino acids 180 to 194, were born at the Mendelian ratio, reached adulthood, and displayed no apparent adverse phenotypes. When fetal livers from the DeltaPHR mice were analyzed for their expression of cell cycle markers, bromodeoxyuridine incorporation, cyclin...... is dispensable for proper embryonic development of, and cell cycle control in, the liver. Surprisingly, control experiments performed in C/EBPalpha null fetal livers yielded similar results....

An Analytic Hierarchy Process-based Method to Rank the Critical Success Factors of Implementing a Pharmacy Barcode System.

Science.gov (United States)

Alharthi, Hana; Sultana, Nahid; Al-Amoudi, Amjaad; Basudan, Afrah

2015-01-01

Pharmacy barcode scanning is used to reduce errors during the medication dispensing process. However, this technology has rarely been used in hospital pharmacies in Saudi Arabia. This article describes the barriers to successful implementation of a barcode scanning system in Saudi Arabia. A literature review was conducted to identify the relevant critical success factors (CSFs) for a successful dispensing barcode system implementation. Twenty-eight pharmacists from a local hospital in Saudi Arabia were interviewed to obtain their perception of these CSFs. In this study, planning (process flow issues and training requirements), resistance (fear of change, communication issues, and negative perceptions about technology), and technology (software, hardware, and vendor support) were identified as the main barriers. The analytic hierarchy process (AHP), one of the most widely used tools for decision making in the presence of multiple criteria, was used to compare and rank these identified CSFs. The results of this study suggest that resistance barriers have a greater impact than planning and technology barriers. In particular, fear of change is the most critical factor, and training is the least critical factor.

78 FR 44016 - Exclusion of Orphan Drugs for Certain Covered Entities Under 340B Program

Science.gov (United States)

2013-07-23

... used. Once a hospital is enrolled in 340B, it may change its decision to purchase all orphan drugs... alternative system to tracking each discounted drug through the purchasing and dispensing process. (59 FR... the purchasing and dispensing process, to prove compliance. If an alternate system of tracking is...

76 FR 69709 - 36(b)(1) Arms Sales Notification

Science.gov (United States)

2011-11-09

... central electronics unit and system control unit. Images will be displayed in the aircraft real-time, and... ``short'' aircraft. 2. The AN/ALE-47 Counter-Measures Dispensing System (CMDS) is an integrated, threat... tailored to the immediate aircraft and threat environment may be dispensed using one of four operational...

Development of new portable miniaturize solid phase microextraction of silver-APDC complex using micropipette tip in-syringe system couple with electrothermal atomic absorption spectrometry

Science.gov (United States)

Naeemullah; Kazi, Tasneem Gul; Afridi, Hassan Imran; Shah, Faheem; Arain, Sadaf Sadia; Arain, Salma Aslam; Panhwar, Abdul Haleem; Arain, Mariam Shahzadi; Samoon, Muhammad Kashif

2016-02-01

An innovative and simple miniaturized solid phase microextraction (M-SPME) method, was developed for preconcentration and determination of silver(I) in the fresh and waste water samples. For M-SPME, a micropipette tip packed with activated carbon cloth (ACC) as sorbent, in a syringe system. The size, morphology and elemental composition of ACC before and after adsorption of analyte have been characterized by scanning electron microscopy and energy dispersive spectroscopy. The sample solution treated with a complexing reagent, ammonium pyrrolidine dithiocarbamate (APDC), was drawn into the syringe filled with ACC and dispensed manually for 2 to 10 aspirating/dispensing cycle. Then the Ag- complex sorbed on the ACC in micropipette was quantitatively eluted by drawing and dispensing of different concentrations of acids for 2 to 5 aspirating/dispensing cycles. The extracted Ag ions with modifier were injected directly into the electrothermal atomic absorption spectrometry for analysis. The influence of different variables on the extraction efficiency, including the concentration of ligand, pH, sample volume, eluent type, concentration and volume was investigated. Validity and accuracy of the developed method was checked by the standard addition method. Reliability of the proposed methodology was checked by the relative standard deviation (%RSD), which was found to be < 5%. Under the optimized experimental variables, the limits of detection (LOD) and enhancement factors (EF), were obtained to be 0.86 ng L- 1 and 120, respectively. The proposed method was successfully applied for the determination of trace levels of silver ions in fresh and waste water samples.

Development of new portable miniaturize solid phase microextraction of silver-APDC complex using micropipette tip in-syringe system couple with electrothermal atomic absorption spectrometry.

Science.gov (United States)

Naeemullah; Kazi, Tasneem Gul; Afridi, Hassan Imran; Shah, Faheem; Arain, Sadaf Sadia; Arain, Salma Aslam; Panhwar, Abdul Haleem; Arain, Mariam Shahzadi; Samoon, Muhammad Kashif

2016-02-05

An innovative and simple miniaturized solid phase microextraction (M-SPME) method, was developed for preconcentration and determination of silver(I) in the fresh and waste water samples. For M-SPME, a micropipette tip packed with activated carbon cloth (ACC) as sorbent, in a syringe system. The size, morphology and elemental composition of ACC before and after adsorption of analyte have been characterized by scanning electron microscopy and energy dispersive spectroscopy. The sample solution treated with a complexing reagent, ammonium pyrrolidine dithiocarbamate (APDC), was drawn into the syringe filled with ACC and dispensed manually for 2 to 10 aspirating/dispensing cycle. Then the Ag- complex sorbed on the ACC in micropipette was quantitatively eluted by drawing and dispensing of different concentrations of acids for 2 to 5 aspirating/dispensing cycles. The extracted Ag ions with modifier were injected directly into the electrothermal atomic absorption spectrometry for analysis. The influence of different variables on the extraction efficiency, including the concentration of ligand, pH, sample volume, eluent type, concentration and volume was investigated. Validity and accuracy of the developed method was checked by the standard addition method. Reliability of the proposed methodology was checked by the relative standard deviation (%RSD), which was found to be <5%. Under the optimized experimental variables, the limits of detection (LOD) and enhancement factors (EF), were obtained to be 0.86 ng L(-1) and 120, respectively. The proposed method was successfully applied for the determination of trace levels of silver ions in fresh and waste water samples. Copyright © 2015 Elsevier B.V. All rights reserved.

Yap1 is dispensable for self-renewal but required for proper differentiation of mouse embryonic stem (ES) cells.

Science.gov (United States)

Chung, HaeWon; Lee, Bum-Kyu; Uprety, Nadima; Shen, Wenwen; Lee, Jiwoon; Kim, Jonghwan

2016-04-01

Yap1 is a transcriptional co-activator of the Hippo pathway. The importance of Yap1 in early cell fate decision during embryogenesis has been well established, though its role in embryonic stem (ES) cells remains elusive. Here, we report that Yap1 plays crucial roles in normal differentiation rather than self-renewal of ES cells. Yap1-depleted ES cells maintain undifferentiated state with a typical colony morphology as well as robust alkaline phosphatase activity. These cells also retain comparable levels of the core pluripotent factors, such as Pou5f1 and Sox2, to the levels in wild-type ES cells without significant alteration of lineage-specific marker genes. Conversely, overexpression of Yap1 in ES cells promotes nuclear translocation of Yap1, resulting in disruption of self-renewal and triggering differentiation by up-regulating lineage-specific genes. Moreover, Yap1-deficient ES cells show impaired induction of lineage markers during differentiation. Collectively, our data demonstrate that Yap1 is a required factor for proper differentiation of mouse ES cells, while remaining dispensable for self-renewal. © 2016 The Authors.

Characteristics of good quality pharmaceutical services common to community pharmacies and dispensing general practices.

Science.gov (United States)

Grey, Elisabeth; Harris, Michael; Rodham, Karen; Weiss, Marjorie C

2016-10-01

In the United Kingdom, pharmaceutical services can be delivered by both community pharmacies (CPs) and dispensing doctor practices (DPs). Both must adhere to minimum standards set out in NHS regulations; however, no common framework exists to guide quality improvement. Previous phases of this research had developed a set of characteristics indicative of good pharmaceutical service provision. To ask key stakeholders to confirm, and rank the importance of, a set of characteristics of good pharmaceutical service provision. A two-round Delphi-type survey was conducted in south-west England and was sent to participants representing three stakeholder groups: DPs, CPs and patients/lay members. Participants were asked to confirm, and rank, the importance of these characteristics as representing good quality pharmaceutical services. Thirty people were sent the first round survey; 22 participants completed both rounds. Median ratings for the 23 characteristics showed that all were seen to represent important aspects of pharmaceutical service provision. Participants' comments highlighted potential problems with the practicality of the characteristics. Characteristics relating to patient safety were deemed to be the most important and those relating to public health the least important. A set of 23 characteristics for providing good pharmaceutical services in CPs and DPs was developed and attained approval from a sample of stakeholders. With further testing and wider discussion, it is hoped that the characteristics will form the basis of a quality improvement tool for CPs and DPs. © 2016 Royal Pharmaceutical Society.

The impact of a closed‐loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before‐and‐after study

Science.gov (United States)

Franklin, Bryony Dean; O'Grady, Kara; Donyai, Parastou; Jacklin, Ann; Barber, Nick

2007-01-01

Objectives To assess the impact of a closed‐loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Design, setting and participants Before‐and‐after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Intervention Closed‐loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Main outcome measures Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Results Prescribing errors were identified in 3.8% of 2450 medication orders pre‐intervention and 2.0% of 2353 orders afterwards (pMedical staff required 15 s to prescribe a regular inpatient drug pre‐intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre‐intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; χ2 test). Conclusions A closed‐loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication‐related tasks increased. PMID:17693676

Iodine generator for reclaimed water purification

Science.gov (United States)

Wynveen, R. A.; Powell, J. D.; Schubert, F. H. (Inventor)

1977-01-01

The system disclosed is for controlling the iodine level in a water supply in a spacecraft. It includes an iodine accumulator which stores crystalline iodine, an electrochemical valve to control the input of iodine to the drinking water and an iodine dispenser. A pump dispenses fluid through the iodine dispenser and an iodine sensor to a potable water tank storage. The iodine sensor electronically detects the iodine level in the water, and through electronic means, produces a correction current control. The correction current control operates the electro-chemical iodine valve to release iodine from the iodine accumulator into the iodine dispenser.

Sialylation of lipooligosaccharides is dispensable for the virulence of Haemophilus ducreyi in humans.

Science.gov (United States)

Spinola, Stanley M; Li, Wei; Fortney, Kate R; Janowicz, Diane M; Zwickl, Beth; Katz, Barry P; Munson, Robert S

2012-02-01

Sialylated glycoconjugates on the surfaces of mammalian cells play important roles in intercellular communication and self-recognition. The sialic acid preferentially expressed in human tissues is N-acetylneuraminic acid (Neu5Ac). In a process called molecular mimicry, many bacterial pathogens decorate their cell surface glycolipids with Neu5Ac. Incorporation of Neu5Ac into bacterial glycolipids promotes bacterial interactions with host cell receptors called Siglecs. These interactions affect bacterial adherence, resistance to serum killing and phagocytosis, and innate immune responses. Haemophilus ducreyi, the etiologic agent of chancroid, expresses lipooligosaccharides (LOS) that are highly sialylated. However, an H. ducreyi sialyltransferase (lst) mutant, whose LOS contain reduced levels of Neu5Ac, is fully virulent in human volunteers. Recently, a second sialyltransferase gene (Hd0053) was discovered in H. ducreyi, raising the possibility that Hd0053 compensated for the loss of lst during human infection. CMP-Neu5Ac is the obligate nucleotide sugar donor for all bacterial sialyltransferases; LOS derived from an H. ducreyi CMP-Neu5Ac synthetase (neuA) mutant has no detectable Neu5Ac. Here, we compared an H. ducreyi neuA mutant to its wild-type parent in several models of pathogenesis. In human inoculation experiments, the neuA mutant formed papules and pustules at rates that were no different than those of its parent. When grown in media with and without Neu5Ac supplementation, the neuA mutant and its parent had similar phenotypes in bactericidal, macrophage uptake, and dendritic cell activation assays. Although we cannot preclude a contribution of LOS sialylation to ulcerative disease, these data strongly suggest that sialylation of LOS is dispensable for H. ducreyi pathogenesis in humans.

THE ORIGINS OF THE CASHLESS SOCIETY: CASH DISPENSERS, DIRECT TO ACCOUNT PAYMENTS AND THE DEVELOPMENT OF ON-LINE REAL-TIME NETWORKS, C.1965-1985

Directory of Open Access Journals (Sweden)

Bernardo Bátiz-Lazo

2014-07-01

Full Text Available This article explores the technological choices made at the dawn of the massification of retail finance. We describe and analyze the early development of electronic banking and the foundations of the cashless society through the experiences of organizations with similar governance in two different competitive environments — Swedish and British savings banks. We document how the adoption of direct-to-account wage deposits and the subsequent deployment of networks of cash dispensers interacted with the adoption of on-line real-time (OLRT computing, and distinguish on- line and OLRT communication as distinct stages in the evolution of computer networks. We emphasize the role of middle managers in the selection of alternative technologies and show how delivering a cashless society proved more difficult than anticipated.

Effects of a direct refill program for automated dispensing cabinets on medication-refill errors.

Science.gov (United States)

Helmons, Pieter J; Dalton, Ashley J; Daniels, Charles E

2012-10-01

The effects of a direct refill program for automated dispensing cabinets (ADCs) on medication-refill errors were studied. This study was conducted in designated acute care areas of a 386-bed academic medical center. A wholesaler-to-ADC direct refill program, consisting of prepackaged delivery of medications and bar-code-assisted ADC refilling, was implemented in the inpatient pharmacy of the medical center in September 2009. Medication-refill errors in 26 ADCs from the general medicine units, the infant special care unit, the surgical and burn intensive care units, and intermediate units were assessed before and after the implementation of this program. Medication-refill errors were defined as an ADC pocket containing the wrong drug, wrong strength, or wrong dosage form. ADC refill errors decreased by 77%, from 62 errors per 6829 refilled pockets (0.91%) to 8 errors per 3855 refilled pockets (0.21%) (p error type detected before the intervention was the incorrect medication (wrong drug, wrong strength, or wrong dosage form) in the ADC pocket. Of the 54 incorrect medications found before the intervention, 38 (70%) were loaded in a multiple-drug drawer. After the implementation of the new refill process, 3 of the 5 incorrect medications were loaded in a multiple-drug drawer. There were 3 instances of expired medications before and only 1 expired medication after implementation of the program. A redesign of the ADC refill process using a wholesaler-to-ADC direct refill program that included delivery of prepackaged medication and bar-code-assisted refill significantly decreased the occurrence of ADC refill errors.

COMBUSTION AND PERFORMANCE CHARACTERISTICS OF A SMALL SPARK IGNITION ENGINE FUELLED WITH HCNG

OpenAIRE

A. SONTHALIA; C. RAMESHKUMAR; U. SHARMA; A. PUNGANUR; S. ABBAS

2015-01-01

Due to environmental concerns and fossil fuel depletion, large scale researches were carried out involving the use of natural gas in internal combustion engines. Natural gas is a clean burning fuel that is available from large domestic natural reserve. When it is used as a fuel in SI engines, it reduces emissions to meet EURO-III norms with carburettors and EURO-IV norms with manifold injection. Countries like India with fewer natural fossil fuel reserves depend heavily on oil imported fro...

Radioisotope heaters for spacecraft life support systems

International Nuclear Information System (INIS)

Shivers, R.W.; Murray, R.W.

1974-01-01

Future manned space flight requires the sanitary collection and disposal of biological wastes to minimize microbial contamination hazard. The recovery and reuse of water from such wastes are also necessary to reduce the weight of vehicles at launching and resupply logistics. The development and test of an engineering model, i.e. the completely integrated waste management-water system using radioisotopes for thermal energy, are described. This is capable of collecting and processing the wastes from four men during 180-day simulated space mission. The sub-systems include collection of feces, trash and urine, water reclamation, the storage, heating and dispensing of the water, and the disposal of feces, urine residue and other non-metallic waste material by incineration. (Mori, K.)

Dnmt1 activity is dispensable in δ-cells but is essential for α-cell homeostasis.

Science.gov (United States)

Damond, Nicolas; Thorel, Fabrizio; Kim, Seung K; Herrera, Pedro L

2017-07-01

In addition to β-cells, pancreatic islets contain α- and δ-cells, which respectively produce glucagon and somatostatin. The reprogramming of these two endocrine cell types into insulin producers, as observed after a massive β-cell ablation in mice, may help restoring a functional β-cell mass in type 1 diabetes. Yet, the spontaneous α-to-β and δ-to-β conversion processes are relatively inefficient in adult animals and the underlying epigenetic mechanisms remain unclear. Several studies indicate that the conserved chromatin modifiers DNA methyltransferase 1 (Dnmt1) and Enhancer of zeste homolog 2 (Ezh2) are important for pancreas development and restrict islet cell plasticity. Here, to investigate the role of these two enzymes in α- and δ-cell development and fate maintenance, we genetically inactivated them in each of these two cell types. We found that loss of Dnmt1 does not enhance the conversion of α- or δ-cells toward a β-like fate. In addition, while Dnmt1 was dispensable for the development of these two cell types, we noticed a gradual loss of α-, but not δ-cells in adult mice. Finally, we found that Ezh2 inactivation does not enhance α-cell plasticity, and, contrary to what is observed in β-cells, does not impair α-cell proliferation. Our results indicate that both Dnmt1 and Ezh2 play distinct roles in the different islet cell types. Copyright © 2017 Elsevier Ltd. All rights reserved.

Myogenin regulates exercise capacity but is dispensable for skeletal muscle regeneration in adult mdx mice.

Directory of Open Access Journals (Sweden)

Eric Meadows

Full Text Available Duchenne muscular dystrophy (DMD is the most prevalent inherited childhood muscle disorder in humans. mdx mice exhibit a similar pathophysiology to the human disorder allowing for an in-depth investigation of DMD. Myogenin, a myogenic regulatory factor, is best known for its role in embryonic myogenesis, but its role in adult muscle maintenance and regeneration is still poorly understood. Here, we generated an mdx:Myog(flox/flox mouse harboring a tamoxifen-inducible Cre recombinase transgene, which was used to conditionally delete Myog during adult life. After tamoxifen treatment, three groups of mice were created to study the effects of Myog deletion: mdx:Myog(flox/flox mice (mdx, Myog(flox/flox mice (wild-type, and mdx:Myog(floxΔ/floxΔ:Cre-ER mice (mdx:Myog-deleted. mdx:Myog-deleted mice exhibited no adverse phenotype and behaved normally. When run to exhaustion, mdx:Myog-deleted mice demonstrated an enhanced capacity for exercise compared to mdx mice, running nearly as far as wild-type mice. Moreover, these mice showed the same signature characteristics of muscle regeneration as mdx mice. Unexpectedly, we found that myogenin was dispensable for muscle regeneration. Factors associated with muscle fatigue, metabolism, and proteolysis were significantly altered in mdx:Myog-deleted mice, and this might contribute to their increased exercise capacity. Our results reveal novel functions for myogenin in adult muscle and suggest that reducing Myog expression in other muscle disease models may partially restore muscle function.

Alternative Manufacturing Concepts for Solid Oral Dosage Forms From Drug Nanosuspensions Using Fluid Dispensing and Forced Drying Technology.

Science.gov (United States)

Bonhoeffer, Bastian; Kwade, Arno; Juhnke, Michael

2018-03-01

Flexible manufacturing technologies for solid oral dosage forms with a continuous adjustability of the manufactured dose strength are of interest for applications in personalized medicine. This study explored the feasibility of using microvalve technology for the manufacturing of different solid oral dosage form concepts. Hard gelatin capsules filled with excipients, placebo tablets, and polymer films, placed in hard gelatin capsules after drying, were considered as substrates. For each concept, a basic understanding of relevant formulation parameters and their impact on dissolution behavior has been established. Suitable matrix formers, present either on the substrate or directly in the drug nanosuspension, proved to be essential to prevent nanoparticle agglomeration of the drug nanoparticles and to ensure a fast dissolution behavior. Furthermore, convection and radiation drying methods were investigated for the fast drying of drug nanosuspensions dispensed onto polymer films, which were then placed in hard gelatin capsules. Changes in morphology and in drug and matrix former distribution were observed for increasing drying intensity. However, even fast drying times below 1 min could be realized, while maintaining the nanoparticulate drug structure and a good dissolution behavior. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Porous solid backbone impregnation for electrochemical energy conversion systems

KAUST Repository

Boulfrad, Samir; Jabbour, Ghassan

2013-01-01

An apparatus and method for impregnating a porous solid backbone. The apparatus may include a platform for holding a porous solid backbone, an ink jet nozzle configured to dispense a liquid solution onto the porous solid backbone, a positioning mechanism configured to position the ink jet nozzle proximate to a plurality of locations of the porous solid backbone, and a control unit configured to control the positioning mechanism to position the ink jet nozzle proximate to the plurality of locations and cause the ink jet nozzle to dispense the liquid solution onto the porous solid backbone.

Porous solid backbone impregnation for electrochemical energy conversion systems

KAUST Repository

Boulfrad, Samir

2013-09-19

An apparatus and method for impregnating a porous solid backbone. The apparatus may include a platform for holding a porous solid backbone, an ink jet nozzle configured to dispense a liquid solution onto the porous solid backbone, a positioning mechanism configured to position the ink jet nozzle proximate to a plurality of locations of the porous solid backbone, and a control unit configured to control the positioning mechanism to position the ink jet nozzle proximate to the plurality of locations and cause the ink jet nozzle to dispense the liquid solution onto the porous solid backbone.

SYSTEM OF PRECISE DOSING OF COAGULANT IN THE PULVERIZING AERATOR POWERED BY WIND USING FUZZY LOGIC

Directory of Open Access Journals (Sweden)

Andrzej Osuch

2017-06-01

Full Text Available One of the methods used to support land restoration lakes is the method of pulverizing aeration. Use of aerators powered exclusively by wind improves the condition of reservoirs, while not compromising the environment. The pulverizing aeration process drive is windy on the water aeration zone near bottom, while removing harmful gases anaerobic metabolism. Aerators of this type due to the unique method of operation also enable dosing of inactivation coagulants with oxygenated water to the depths of the lake. Mileage coagulant dosing can be made dependent on the speed of the wind, which has an impact on the performance of his work, because with the increase of wind speed dispensing valve coagulants should be stronger open. One of the methods for assessing the state of lakes is to measure water transparency. The softer visibility, the most likely state of the water is better. Dosage of coagulant so you can make the transparency of the water. Similarly, with increasing transparency water dispensing valve should be more covered up. Control of the drain valve dispenser coagulant can be simultaneously dependent on two factors. The study was designed method of control drain valve dispenser coagulant using fuzzy inference.

Evaluation of pharmacists' services for dispensing emergency contraceptive pills in Delhi, India: A mystery shopper study

Directory of Open Access Journals (Sweden)

Pikee Saxena

2016-01-01

Full Text Available Background: Although emergency contraceptive pills are available over the counter, the quality of consultation, including key areas of contraceptive counseling and prevention of sexually transmitted infections (STI, has not been well documented. Objective: To evaluate actual pharmacist services while dispensing emergency contraception through a mystery shopper technique. Material and Methods: This cross-sectional study was conducted in 81 pharmacies situated in Delhi by 4 trained mystery shoppers posed as customers over a period of 6 months. Results: None of the pharmacists asked about the time lapsed since last unprotected sexual intercourse or last menstrual period before deciding the eligibility of the customer. The majority were unclear about side effects associated with emergency contraception (78.57% or with anticipated changes in menstrual flow (78.57%; 85.71% did not know whether subsequent unprotected intercourse would be protected. Only 15.71% counseled shoppers regarding risk of STI on asking leading questions and 88.5% did not provide any contraceptive advice. Conclusion: There is a huge gap in the technical knowledge and mindset of the pharmacists when it comes to checking for the eligibility of the client and providing advice regarding use of regular contraception and barrier for protection from STI, which needs to be addressed in order to realize the full benefit of making emergency contraceptive pills available over the counter.

Comparison of Test Procedures and Energy Efficiency Criteria in Selected International Standards and Labeling Programs for Clothes Washers, Water Dispensers, Vending Machines and CFLs

Energy Technology Data Exchange (ETDEWEB)

Fridley, David; Zheng, Nina; Zhou, Nan

2010-06-01

Since the late 1970s, energy labeling programs and mandatory energy performance standards have been used in many different countries to improve the efficiency levels of major residential and commercial equipment. As more countries and regions launch programs covering a greater range of products that are traded worldwide, greater attention has been given to harmonizing the specific efficiency criteria in these programs and the test methods for measurements. For example, an international compact fluorescent light (CFL) harmonization initiative was launched in 2006 to focus on collaboration between Australia, China, Europe and North America. Given the long history of standards and labeling programs, most major energy-consuming residential appliances and commercial equipment are already covered under minimum energy performance standards (MEPS) and/or energy labels. For these products, such as clothes washers and CFLs, harmonization may still be possible when national MEPS or labeling thresholds are revised. Greater opportunity for harmonization exists in newer energy-consuming products that are not commonly regulated but are under consideration for new standards and labeling programs. This may include commercial products such as water dispensers and vending machines, which are only covered by MEPS or energy labels in a few countries or regions. As China continues to expand its appliance standards and labeling programs and revise existing standards and labels, it is important to learn from recent international experiences with efficiency criteria and test procedures for the same products. Specifically, various types of standards and labeling programs already exist in North America, Europe and throughout Asia for products in China's 2010 standards and labeling programs, namely clothes washers, water dispensers, vending machines and CFLs. This report thus examines similarities and critical differences in energy efficiency values, test procedure specifications and

A Novel Robot of Manufacturing Space Solar Cell Arrays

Directory of Open Access Journals (Sweden)

Wu Yuexin

2008-11-01

Full Text Available This paper presents a novel robot employed to manufacture space solar cell arrays. First of all including the mechanical configuration and control system, the architecture of the robot is described. Then the flow velocity field of adhesive in the dispensing needles is acquired based on hydrodynamics. The accurate section form model of adhesive dispensed on the solar cells is obtained, which is essential for the robot to control the uniformity of dispensing adhesive. Finally the experiment validates the feasibility and reliability of the robot system. The application of robots instead of manual work in manufacturing space solar cell arrays will enhance the development of space industry.

A Novel Robot of Manufacturing Space Solar Cell Arrays

Directory of Open Access Journals (Sweden)

Wu Yuexin

2007-03-01

Full Text Available This paper presents a novel robot employed to manufacture space solar cell arrays. First of all including the mechanical configuration and control system, the architecture of the robot is described. Then the flow velocity field of adhesive in the dispensing needles is acquired based on hydrodynamics. The accurate section form model of adhesive dispensed on the solar cells is obtained, which is essential for the robot to control the uniformity of dispensing adhesive. Finally the experiment validates the feasibility and reliability of the robot system. The application of robots instead of manual work in manufacturing space solar cell arrays will enhance the development of space industry.

Seasonal abundance of the navel orangeworm, Amyelois transitella, in figs and the effect of peripheral aerosol dispensers on sexual communication.

Science.gov (United States)

Burks, Charles S; Brandl, David G

2004-01-01

We used flight traps baited with unmated female navel orangeworm Amyelois transitella (Walker) (Lepidoptera: Pyralidae) to examine, over two growing seasons, seasonal changes in the abundance of males in fig orchards and the impact of release of 48 mg per ha per day of the pheromone component (Z,Z)-11,13-hexadecadienal from peripherally-located timed-release dispensers on the ability of males to find unmated females within 16-ha treatment plots. Material was placed out and mating disruption was commenced at the beginning of April in the first year, and at the beginning of July the second year. This technique effectively prevented males from finding females in female-baited traps placed throughout the plot. Navel orangeworm abundance was high in figs during the first and third flight, but lower in June and July during the second flight. Since Calimyrna figs are not susceptible to attack by navel orangeworm until mid-to-late July, these findings suggest that materials cost can be reduced by beginning treatment later. Implications for insect pest management in figs and other California crops are discussed.

SCD1 Expression is dispensable for hepatocarcinogenesis induced by AKT and Ras oncogenes in mice.

Directory of Open Access Journals (Sweden)

Lei Li

Full Text Available Increased de novo lipogenesis is one of the major metabolic events in cancer. In human hepatocellular carcinoma (HCC, de novo lipogenesis has been found to be increased and associated with the activation of AKT/mTOR signaling. In mice, overexpression of an activated form of AKT results in increased lipogenesis and hepatic steatosis, ultimately leading to liver tumor development. Hepatocarcinogenesis is dramatically accelerated when AKT is co-expressed with an oncogenic form of N-Ras. SCD1, the major isoform of stearoyl-CoA desaturases, catalyzing the conversion of saturated fatty acids (SFA into monounsaturated fatty acids (MUFA, is a key enzyme involved in de novo lipogenesis. While many studies demonstrated the requirement of SCD1 for tumor cell growth in vitro, whether SCD1 is necessary for tumor development in vivo has not been previously investigated. Here, we show that genetic ablation of SCD1 neither inhibits lipogenesis and hepatic steatosis in AKT-overexpressing mice nor affects liver tumor development in mice co-expressing AKT and Ras oncogenes. Molecular analysis showed that SCD2 was strongly upregulated in liver tumors from AKT/Ras injected SCD1(-/- mice. Noticeably, concomitant silencing of SCD1 and SCD2 genes was highly detrimental for the growth of AKT/Ras cells in vitro. Altogether, our study provides the evidence, for the first time, that SCD1 expression is dispensable for AKT/mTOR-dependent hepatic steatosis and AKT/Ras-induced hepatocarcinogenesis in mice. Complete inhibition of stearoyl-CoA desaturase activity may be required to efficiently suppress liver tumor development.

Assessment of Closed Point-of-Dispensing (POD) Preparedness in St. Louis County, Missouri, 2012-2016.

Science.gov (United States)

Rebmann, Terri; Anthony, John; Loux, Travis M; Mulroy, Julia; Sitzes, Rikki

Little is known about closed point-of-dispensing (POD) site preparedness-especially how these entities progress in their preparedness efforts over time. The purpose of this study was to assess the preparedness of a closed POD network. Between 2012 and 2016, 30% to 50% of POD entities in the St. Louis County region were assessed each year, for a total of 138 site evaluations from 62 entities. The assessment tool included 41 components of closed POD preparedness, each scored either 0 = not met or 1 = met. POD preparedness scores could range from 0 to 41. Chi-square tests were conducted to compare the percentage of entities that had each preparedness indicator. A multilevel linear model with a random intercept for each agency was used to model longitudinal changes in closed POD preparedness. POD preparedness scores were higher in 2016 than in 2012 (31.5 vs. 26.5, t = 14.3, p trend in preparedness, and, on average, entities met only 65.4% of the preparedness indicators. Only a third of entities reported hosting a POD exercise at least once every 2 years (32.3%, n = 20). From the multilevel regression, determinants of better POD preparedness include having been assessed more often, employing a business continuity expert, and not being a long-term care agency. Closed POD entities should continue to work toward better preparedness, to better ensure successful deployment. Findings from this study indicate that more frequent assessments likely enhance preparedness at closed POD entities.

Use of Strychnos Nux-Vomica (Azraqi) Seeds in Unani System of Medicine: Role of Detoxification

OpenAIRE

Akbar, Seema; Khan, Shamshad A; Masood, Akbar; Iqbal, M

2010-01-01

Some plants used in Unani system of medicine are toxic, even deadly poisonous. The drugs having such plants as their components are detoxified before they are dispensed to the patients. One such drug, capsule Hudar, has Strychnos nux-vomica L. (Azraqi) seeds as one of its components and is very effectively used to elevate blood pressure. Ancient manuscripts describe many methods of its detoxification. It has been found that the detoxification processes studied reduce the strychnine content, a...

Prescribing quality for older people in Norwegian nursing homes and home nursing services using multidose dispensed drugs.

Science.gov (United States)

Halvorsen, Kjell H; Granas, Anne Gerd; Engeland, Anders; Ruths, Sabine

2012-09-01

To examine and compare the quality of drug prescribing for older patients in nursing homes and home nursing services. Cross-sectional study comprising 11,254 patients aged ≥ 65 years in nursing homes (n = 2986) and home nursing services (n = 8268). Potentially inappropriate medications were identified by using the Norwegian General Practice criteria and drug-drug interactions through a Norwegian Web-based tool. The impact of care setting on exposure to selected drug groups, potentially inappropriate medications, and drug interactions was calculated, adjusting for patients' age, gender, and number of drugs used. Patients in nursing homes and home nursing services used on average 5.7 (SD = 2.6) multidose dispensed regular drugs. Twenty-six percent used at least one potentially inappropriate medication, 31% in nursing homes and 25% in home nursing services, p nursing homes (18%) and home nursing services (9%), p nursing homes, more patients in home nursing services used cardiovascular drugs and fewer patients used psychotropic drugs. Altogether, 8615 drug-drug interactions were identified in 55% of patients, 48% in nursing homes and 57% in home nursing services, p quality of drug prescribing in nursing homes compared with home nursing services. Explanations as to why these differences exist need to be further explored. Copyright © 2011 John Wiley & Sons, Ltd.

A New Concept of a Drug Delivery System with Improved Precision and Patient Safety Features

Directory of Open Access Journals (Sweden)

Florian Thoma

2014-12-01

Full Text Available This paper presents a novel dosing concept for drug delivery based on a peristaltic piezo-electrically actuated micro membrane pump. The design of the silicon micropump itself is straight-forward, using two piezoelectrically actuated membrane valves as inlet and outlet, and a pump chamber with a piezoelectrically actuated pump membrane in-between. To achieve a precise dosing, this micropump is used to fill a metering unit placed at its outlet. In the final design this metering unit will be made from a piezoelectrically actuated inlet valve, a storage chamber with an elastic cover membrane and a piezoelectrically actuated outlet valve, which are connected in series. During a dosing cycle the metering unit is used to adjust the drug volume to be dispensed before delivery and to control the actually dispensed volume. To simulate the new drug delivery concept, a lumped parameter model has been developed to find the decisive design parameters. With the knowledge taken from the model a drug delivery system is designed that includes a silicon micro pump and, in a first step, a silicon chip with the storage chamber and two commercial microvalves as a metering unit. The lumped parameter model is capable to simulate the maximum flow, the frequency response created by the micropump, and also the delivered volume of the drug delivery system.

Cyclic di-adenosine monophosphate (c-di-AMP) is required for osmotic regulation in Staphylococcus aureus but dispensable for viability in anaerobic conditions.

Science.gov (United States)

Zeden, Merve S; Schuster, Christopher F; Bowman, Lisa; Zhong, Qiyun; Williams, Huw D; Gründling, Angelika

2018-03-02

Cyclic di-adenosine monophosphate (c-di-AMP) is a recently discovered signaling molecule important for the survival of Firmicutes, a large bacterial group that includes notable pathogens such as Staphylococcus aureus However, the exact role of this molecule has not been identified. dacA , the S. aureus gene encoding the diadenylate cyclase enzyme required for c-di-AMP production, cannot be deleted when bacterial cells are grown in rich medium, indicating that c-di-AMP is required for growth in this condition. Here, we report that an S. aureus dacA mutant can be generated in chemically defined medium. Consistent with previous findings, this mutant had a severe growth defect when cultured in rich medium. Using this growth defect in rich medium, we selected for suppressor strains with improved growth to identify c-di-AMP-requiring pathways. Mutations bypassing the essentiality of dacA were identified in alsT and opuD, encoding a predicted amino acid and osmolyte transporter, the latter of which we show here to be the main glycine betaine-uptake system in S. aureus. Inactivation of these transporters likely prevents the excessive osmolyte and amino acid accumulation in the cell, providing further evidence for a key role of c-di-AMP in osmotic regulation. Suppressor mutations were also obtained in hepS, hemB, ctaA, and qoxB, coding proteins required for respiration. Furthermore, we show that dacA is dispensable for growth in anaerobic conditions. Together, these findings reveal an essential role for the c-di-AMP signaling network in aerobic, but not anaerobic, respiration in S. aureus . © 2018 by The American Society for Biochemistry and Molecular Biology, Inc.

Bioprinting of a mechanically enhanced three-dimensional dual cell-laden construct for osteochondral tissue engineering using a multi-head tissue/organ building system

International Nuclear Information System (INIS)

Shim, Jin-Hyung; Lee, Jung-Seob; Cho, Dong-Woo; Kim, Jong Young

2012-01-01

The aim of this study was to build a mechanically enhanced three-dimensional (3D) bioprinted construct containing two different cell types for osteochondral tissue regeneration. Recently, the production of 3D cell-laden structures using various scaffold-free cell printing technologies has opened up new possibilities. However, ideal 3D complex tissues or organs have not yet been printed because gel-state hydrogels have been used as the principal material and are unable to maintain the desired 3D structure due to their poor mechanical strength. In this study, thermoplastic biomaterial polycaprolactone (PCL), which shows relatively high mechanical properties as compared with hydrogel, was used as a framework for enhancing the mechanical stability of the bioprinted construct. Two different alginate solutions were then infused into the previously prepared framework consisting of PCL to create the 3D construct for osteochondral printing. For this work, a multi-head tissue/organ building system (MtoBS), which was particularly designed to dispense thermoplastic biomaterial and hydrogel having completely different rheology properties, was newly developed and used to bioprint osteochondral tissue. It was confirmed that the line width, position and volume control of PCL and alginate solutions were adjustable in the MtoBS. Most importantly, dual cell-laden 3D constructs consisting of osteoblasts and chondrocytes were successfully fabricated. Further, the separately dispensed osteoblasts and chondrocytes not only retained their initial position and viability, but also proliferated up to 7 days after being dispensed. (paper)

Bioprinting of a mechanically enhanced three-dimensional dual cell-laden construct for osteochondral tissue engineering using a multi-head tissue/organ building system

Science.gov (United States)

Shim, Jin-Hyung; Lee, Jung-Seob; Kim, Jong Young; Cho, Dong-Woo

2012-08-01

The aim of this study was to build a mechanically enhanced three-dimensional (3D) bioprinted construct containing two different cell types for osteochondral tissue regeneration. Recently, the production of 3D cell-laden structures using various scaffold-free cell printing technologies has opened up new possibilities. However, ideal 3D complex tissues or organs have not yet been printed because gel-state hydrogels have been used as the principal material and are unable to maintain the desired 3D structure due to their poor mechanical strength. In this study, thermoplastic biomaterial polycaprolactone (PCL), which shows relatively high mechanical properties as compared with hydrogel, was used as a framework for enhancing the mechanical stability of the bioprinted construct. Two different alginate solutions were then infused into the previously prepared framework consisting of PCL to create the 3D construct for osteochondral printing. For this work, a multi-head tissue/organ building system (MtoBS), which was particularly designed to dispense thermoplastic biomaterial and hydrogel having completely different rheology properties, was newly developed and used to bioprint osteochondral tissue. It was confirmed that the line width, position and volume control of PCL and alginate solutions were adjustable in the MtoBS. Most importantly, dual cell-laden 3D constructs consisting of osteoblasts and chondrocytes were successfully fabricated. Further, the separately dispensed osteoblasts and chondrocytes not only retained their initial position and viability, but also proliferated up to 7 days after being dispensed.

Perceptions of nurse educators regarding the implementation of the occupational specific dispensation at a selected nursing college in Limpopo Province

Directory of Open Access Journals (Sweden)

M.D. Netshiswinzhe Mcur

2015-06-01

Full Text Available The aim of this study was to explore and describe the perceptions of nurses regarding the implementation of the occupation-specific dispensation (OSD in a selected nursing college in Limpopo province. A qualitative approach was used with a purposive sampling method for the selection of 12 voluntary participants who had worked for more than five years and been subjected to the implementation of OSD. In-depth interviews were conducted and data analysed according to Tesch's method. The perceptions of nurse educators were shared through participants' responses to a central research question. Participants expressed different responses, both positive and negative. The findings of this study demonstrated: high expectations, unfair treatment in relation to the implementation, and reactions to introduction of OSD. Participants also identified envisaged ways of improving the situation through the identification of ways to correct the problems. This study recommended that management ensure that nurse educators' remuneration packages are competitive with those of similar professions in the clinical setting. Recognition of nurse educators' additional qualifications, long-service experiences and rural allowance reviews in nursing education should be taken into consideration urgently.

Nursing perception of the impact of automated dispensing cabinets on patient safety and ergonomics in a teaching health care center.

Science.gov (United States)

Rochais, Elise; Atkinson, Suzanne; Guilbeault, Mélanie; Bussières, Jean-François

2014-04-01

To evaluate how nursing staff felt about the impact of automated dispensing cabinets (ADCs) on the safe delivery of health care and workplace ergonomics. To identify the main issues involved in the use of this technology and to describe the corrective measures implemented. Cross-sectional descriptive study with quantitative and qualitative components. A questionnaire that consisted of 33 statements about ADC was distributed from May 24 to June 3, 2011. A total of 172 (46%) of 375 nurses completed the questionnaire. Nursing staff considered the introduction of ADC made their work easier (level of agreement of 90%), helped to safely provide patients with care (91%), and helped to reduce medication incidents/accidents (81%). Nursing staff was particularly satisfied by the narcotic drugs management with the ADCs. Nursing staff were not satisfied with the additional delays in the preparation and administration of a medication dose and the inability to prevent a medication from being administered when stopped on the medication administration record (48%). The nursing staff members were satisfied with the use of ADC and believed it made their work easier, promoted safe patient care, and were perceived to reduce medication incidents/accidents.

Optimization of mass-production conditions for tritium breeder pebbles based on slurry droplet wetting method

Energy Technology Data Exchange (ETDEWEB)

Park, Yi-Hyun, E-mail: yhpark@nfri.re.kr [National Fusion Research Institute, Daejeon (Korea, Republic of); Min, Kyung-Mi; Ahn, Mu-Young; Cho, Seungyon; Lee, Young-Min [National Fusion Research Institute, Daejeon (Korea, Republic of); Park, Sang-Jin; Danish, Rehan; Lim, Chul-Hwan; Jo, Yong-Dae [IVT Co., Ltd., Daegu (Korea, Republic of)

2016-11-01

Highlights: • An automatic dispensing system was developed to improve uniformity and production rate of breeder pebbles. • The production rate of this system for Li{sub 2}TiO{sub 3} pebble was estimated at 50 kg/year. • The optimization of dispensing and sintering conditions for the mass-production of Li{sub 2}TiO{sub 3} pebble was conducted. • Integrity of Li{sub 2}TiO{sub 3} pebble was able to be ensured during mass-production process, especially during batch process. - Abstract: Lithium metatitanate (Li{sub 2}TiO{sub 3}) is being considered as tritium breeding material for solid-type breeding blanket, which are used in pebble-bed form. The total amount of Li{sub 2}TiO{sub 3} pebbles in Helium Cooled Ceramic Reflector (HCCR) Test Blanket Module (TBM) is approximately 80 kg. Furthermore, DEMO reactor requires a great deal of breeder pebbles. Therefore, the development of mass-production system for breeder pebbles is necessary. The slurry droplet wetting method was adopted in the mass-production process for Li{sub 2}TiO{sub 3} pebbles, which had been developed in Korea. In this method, an automatic slurry dispensing system is one of the key apparatuses because the uniformity of pebbles and production rate are able to be improved. The system was successfully manufactured, which was consisted of a dispensing unit for instillation of Li{sub 2}TiO{sub 3} slurry, a glycerin bath for hardening of droplets, and an automatic maintaining unit for constant distance between syringe needle and glycerin surface. The production rate of this system for Li{sub 2}TiO{sub 3} pebble was estimated at 50 kg/year. In this study, it was investigated that the effect of dispensing and sintering conditions on the mass-production of Li{sub 2}TiO{sub 3} pebbles.

An analysis of the utilisation and expenditure of medicines dispensed for the management of severe asthma.

LENUS (Irish Health Repository)

McGowan, B

2009-03-01

There are approximately 6,300 people in Ireland with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD) and with a fast growing elderly population the incidence of COPD is likely to increase. This study examines the prescribing patterns of medicines dispensed for the management Asthma\\/COPD in patients over the age of 35 years using the HSE-Primary Care Reimbursement Services (PCRS) prescribing databases. The HSE-PCRS pharmacy claims data, which covers all those over 70 years of age and means tested for those less than 70 years, was analysed for the years 2005\\/2006. Approximately 26,548 (17.9%) of patients who were prescribed a respiratory drug received inhaled short-acting beta2 agonists in combination with a regular standard-dose inhaled corticosteroid. A further 5,044 (3.4%) were also prescribed a regular inhaled long-acting beta2 agonist (salmeterol or formoterol). A total of 2506 patients (6.2%) on combination therapy were co-prescribed four different anti-asthmatic treatments inclusive of oral prednisolone. A small proportion of the patients prescribed a respiratory drug were co-prescribed nicotine replacement therapy (n = 5177, 3.5%). In total there were 9,728 (6.2%) patients prescribed a mucolytic drug in combination with a respiratory drug and the rate of co-prescribing with antibiotics was 22%. COPD is a debilitating disease that is primarily caused by smoking and is therefore largely preventable. The HSE-PCRS pharmacy claims data is a valuable tool for helping to assess the burden of this disease in the Irish context.

β-Hemolysin/cytolysin of Group B Streptococcus enhances host inflammation but is dispensable for establishment of urinary tract infection.

Directory of Open Access Journals (Sweden)

Ritwij Kulkarni

Full Text Available Group B Streptococcus (GBS; Streptococcus agalactiae is a major human pathogen that disproportionately affects neonates and women in the peripartum period and is an emerging cause of infection in older adults. The primary toxin of GBS, β-hemolysin/cytolysin (βH/C, has a well-defined role in the pathogenesis of invasive disease, but its role in urinary tract infection (UTI is unknown. Using both in vitro and in vivo models, we analyzed the importance of βH/C in GBS uropathogenesis. There were no significant differences in bacterial density from the bladders or kidneys from mice infected with wild-type or isogenic βH/C-deficient GBS, and competitive indices from co-infection experiments were near 1. Thus, βH/C is dispensable for the establishment of GBS-UTI. However, βH/C-sufficient GBS induced a more robust proinflammatory cytokine response in cultured bladder epithelial cells and in the urinary tracts of infected mice. Given the near ubiquity of βH/C-expressing strains in epidemiologic studies and the importance of local inflammation in dictating outcomes and sequelae of UTI, we hypothesize that βH/C-driven inflammatory signaling may be important in the clinical course of GBS-UTI.

Time-to-impact estimation in passive missile warning systems

Science.gov (United States)

Şahıngıl, Mehmet Cihan

2017-05-01

A missile warning system can detect the incoming missile threat(s) and automatically cue the other Electronic Attack (EA) systems in the suit, such as Directed Infrared Counter Measure (DIRCM) system and/or Counter Measure Dispensing System (CMDS). Most missile warning systems are currently based on passive sensor technology operating in either Solar Blind Ultraviolet (SBUV) or Midwave Infrared (MWIR) bands on which there is an intensive emission from the exhaust plume of the threatening missile. Although passive missile warning systems have some clear advantages over pulse-Doppler radar (PDR) based active missile warning systems, they show poorer performance in terms of time-to-impact (TTI) estimation which is critical for optimizing the countermeasures and also "passive kill assessment". In this paper, we consider this problem, namely, TTI estimation from passive measurements and present a TTI estimation scheme which can be used in passive missile warning systems. Our problem formulation is based on Extended Kalman Filter (EKF). The algorithm uses the area parameter of the threat plume which is derived from the used image frame.

Spot test kit for explosives detection

Science.gov (United States)

Pagoria, Philip F; Whipple, Richard E; Nunes, Peter J; Eckels, Joel Del; Reynolds, John G; Miles, Robin R; Chiarappa-Zucca, Marina L

2014-03-11

An explosion tester system comprising a body, a lateral flow membrane swab unit adapted to be removeably connected to the body, a first explosives detecting reagent, a first reagent holder and dispenser operatively connected to the body, the first reagent holder and dispenser containing the first explosives detecting reagent and positioned to deliver the first explosives detecting reagent to the lateral flow membrane swab unit when the lateral flow membrane swab unit is connected to the body, a second explosives detecting reagent, and a second reagent holder and dispenser operatively connected to the body, the second reagent holder and dispenser containing the second explosives detecting reagent and positioned to deliver the second explosives detecting reagent to the lateral flow membrane swab unit when the lateral flow membrane swab unit is connected to the body.

Air Pollution and Dispensed Medications for Asthma, and Possible Effect Modifiers Related to Mental Health and Socio-Economy: A Longitudinal Cohort Study of Swedish Children and Adolescents.

Science.gov (United States)

Oudin, Anna; Bråbäck, Lennart; Oudin Åström, Daniel; Forsberg, Bertil

2017-11-16

It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the association between air pollution exposure and asthma, and effect modification by mental health and by socio-economic status (as markers of a stressful environment). All individuals under 18 years of age in four Swedish counties during 2007 to 2010 (1.2 million people) were included. The outcome was defined as dispensing at least two asthma medications during follow up. We linked data on NO₂ from an empirical land use regression to data from national registers on outcome and potential confounders. Data was analyzed with logistic regression. There was an odds ratio (OR) of 1.02 (95% Confidence Interval (CI: 1.01-1.03) for asthma associated with a 10 µg·m -3 increase in NO₂. The association only seemed to be present in areas where NO₂ was higher than 15 µg·m -3 with an OR of 1.09 (95% CI: 1.07-1.12), and the association seemed stronger in children with parents with a high education, OR = 1.05 (95% CI: 1.02-1.09) and OR = 1.04 (95% CI: 1.01-1.07) in children to mothers and father with a high education, respectively. The association did not seem to depend on medication history of psychiatric disorders. There was weak evidence for the association between air pollution and asthma to be stronger in neighborhoods with higher education levels. In conclusion, air pollution was associated with dispensed asthma medications, especially in areas with comparatively higher levels of air pollution, and in children to parents with high education. We did not observe support for our hypothesis that stressors linked to socio-economy or mental health problems would increase susceptibility to the effects of air pollution on the development of asthma.

PS-022 Complex automated medication systems reduce medication administration error rates in an acute medical ward

DEFF Research Database (Denmark)

Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

2017-01-01

Background Medication errors have received extensive attention in recent decades and are of significant concern to healthcare organisations globally. Medication errors occur frequently, and adverse events associated with medications are one of the largest causes of harm to hospitalised patients...... cabinet, automated dispensing and barcode medication administration; (2) non-patient specific automated dispensing and barcode medication administration. The occurrence of administration errors was observed in three 3 week periods. The error rates were calculated by dividing the number of doses with one...

Interpreting Popov criteria in Lure´ systems with complex scaling stability analysis

Science.gov (United States)

Zhou, J.

2018-06-01

The paper presents a novel frequency-domain interpretation of Popov criteria for absolute stability in Lure´ systems by means of what we call complex scaling stability analysis. The complex scaling technique is developed for exponential/asymptotic stability in LTI feedback systems, which dispenses open-loop poles distribution, contour/locus orientation and prior frequency sweeping. Exploiting the technique for alternatively revealing positive realness of transfer functions, re-interpreting Popov criteria is explicated. More specifically, the suggested frequency-domain stability conditions are conformable both in scalar and multivariable cases, and can be implemented either graphically with locus plotting or numerically without; in particular, the latter is suitable as a design tool with auxiliary parameter freedom. The interpretation also reveals further frequency-domain facts about Lure´ systems. Numerical examples are included to illustrate the main results.

A simple automated system for appetitive conditioning of zebrafish in their home tanks.

Science.gov (United States)

Doyle, Jillian M; Merovitch, Neil; Wyeth, Russell C; Stoyek, Matthew R; Schmidt, Michael; Wilfart, Florentin; Fine, Alan; Croll, Roger P

2017-01-15

We describe here an automated apparatus that permits rapid conditioning paradigms for zebrafish. Arduino microprocessors were used to control the delivery of auditory or visual stimuli to groups of adult or juvenile zebrafish in their home tanks in a conventional zebrafish facility. An automatic feeder dispensed precise amounts of food immediately after the conditioned stimuli, or at variable delays for controls. Responses were recorded using inexpensive cameras, with the video sequences analysed with ImageJ or Matlab. Fish showed significant conditioned responses in as few as 5 trials, learning that the conditioned stimulus was a predictor of food presentation at the water surface and at the end of the tank where the food was dispensed. Memories of these conditioned associations persisted for at least 2days after training when fish were tested either as groups or as individuals. Control fish, for which the auditory or visual stimuli were specifically unpaired with food, showed no comparable responses. This simple, low-cost, automated system permits scalable conditioning of zebrafish with minimal human intervention, greatly reducing both variability and labour-intensiveness. It will be useful for studies of the neural basis of learning and memory, and for high-throughput screening of compounds modifying those processes. Copyright © 2016 Elsevier B.V. All rights reserved.

The univocal identification and safe dispensation of medicinal products across Europe – challenges and solution proposal

Directory of Open Access Journals (Sweden)

Stroetmann, Karl A.

2017-12-01

Full Text Available Problem: The Smart Open Services for European Patients (epSOS the exchange of electronic Patient Summaries and ePrescriptions between selected member states of the European Union (EU. This project basically solved the ‘communication’ or message transfer problem. However, it encountered a serious ‘delivery’ problem: the safe dispensation of a medicinal product noted in a prescription from a given country by a retail pharmacist in another country. The reason for this was that the specified medicine could in many instances not univocally be identified – the same name may identify a product with a different active ingredient, or the product with identical composition may carry a different name in the other country. If the prescribed medicine had not been authorised for marketing in the other country, information on its attributes may not be available. This rendered dispensation by the pharmacist impossible, even where substitution would, in principle, be allowed and possible.Objectives: This paper reports on the goal, activities and achievements of the openMedicine project towards development of a digital solution and its implementation to meet this identification and the resulting delivery challenge. European-wide and cross-Atlantic endeavours to enhance pharmacovigilance by being able to match adverse event reports filed under different drug names which provide, however, for the same active ingredient(s were developed upon. And the need for and benefits of being able to trace for clinical purposes, e.g. the longer-term treatment with the same active ingredient, even when the name of the prescribed medicine changed several times, were explored.Methodological approach: The openMedicine project was funded by the European Commission (EC on behalf of member states to analyse this European-wide problem. Work benefitted from the epSOS project and work by the European Medicines Agency (EMA, the USA Federal Drug Agency (FDA, and standard

MEDICATION SYSTEM ANALYSIS OF AN UNIVERSITY HOSPITAL IN THE STATE OF GOIÁS

Directory of Open Access Journals (Sweden)

Ana Elisa Bauer de Camargo Silva

2004-04-01

Full Text Available The medication errors can bring serious consequences to patients, professionals andhealthcare institutions, they have multiple causes, amongst them failures related to theprofessionals and related to the medication system. This study’s objective was to identify and toanalyse the medication system process, its failures in order to propose improvement actions to thehospital. This exploratory descriptive study took place in the medical clinical unit and in thepharmacy of a general and university hospital of the state of Goiás, after approval of theCommittee of the Ethics of the correspondent hospital. The sample included: (first phase apharmacist, (third phase 40 professionals divided into 12 resident physicians (30%, 20 nursingprofessionals (50%, 8 pharmacy team members (20%; 294 patient charts were also used. Thedata was collected in 2002 and consisted of an interview with the professional in charge of themedication system, and non-participant observation of the environment and actions of theprofessionals and the academic people, interviews with the professionals and patient chartanalysis. The professionals were asked to sign on the “Free Will Participation Agreement”. It waspossible based on the data collected to describe the following processes: handwriting medicationprescription using carbon paper, individually dose dispensing and that the nursing professional whoadministrates the drug is not the same that prepares it in the clinical unit. The results based on the21 days of observation of the drug prescription, dispensing and administration processes were: theenvironment is the main problem in the prescription (75% and dispensing (30,6% processes, it isa noisy place and interruptions frequently occur; safety failures during the technique and inadvancedrug preparation appeared in the top (46,8% in the preparation process. The datacollection also allowed to build a chart of the 60 steps from drug prescription to monitoring. Theresults from

Regulación de la dispensación de medicamentos y su efecto en el consumo de antibióticos en Venezuela Regulations governing the dispensing of medications and their effect on antibiotic consumption in Venezuela

Directory of Open Access Journals (Sweden)

Phenélope Rivas

2011-12-01

antibiotics with the highest consumption were penicillins and first-generation cephalosporins, aminoglycosides, diami-nopyridine-sulfonamides, and tetracyclines. Total consumption in the categories of antibiotics with unregulated dispensing was twice as high as in the categories with regulated sales, both before and after introduction of the regulation. CONCLUSIONS: There were no statistically significant differences in antibiotic consumption with regulated or unregulated dispensing, either before or after the introduction of measures regulating the dispensing of antibiotics.

Interoperability among Future Miniature Munition/Stores and Dispensing Systems

National Research Council Canada - National Science Library

Provenza, Jerry

2001-01-01

...) is in the early stages of development by the services. The initial versions of these stores will range primarily from 100 to 350 pounds, with variants for attack of fixed, re-locatable, and mobile targets...

Association between medication supplies and healthcare costs in older adults from an urban healthcare system.

Science.gov (United States)

Stroupe, K T; Murray, M D; Stump, T E; Callahan, C M

2000-07-01

The amount of medication dispensed to older adults for the treatment of chronic disease must be balanced carefully. Insufficient medication supplies lead to inadequate treatment of chronic disease, whereas excessive supplies represent wasted resources and the potential for toxicity. We used an electronic medical record system to determine the distribution of medications supplied to older urban adults and to examine the correlations of these distributions with healthcare costs and use. A cross-sectional study using data acquired over 3 years (1994-1996). A tax-supported urban public healthcare system consisting of a 300-bed hospital, an emergency department, and a network of community-based ambulatory care centers. Patients were >60 years of age and had at least one prescription refill and at least two ambulatory visits or one hospitalization during the 3-year period. Focusing on 12 major categories of drugs used to treat chronic diseases, we determined the amounts and direct costs of these medications dispensed to older adult patients. Amounts of medications that were needed by patients to medicate themselves adequately were compared with the medication supply actually dispensed considering all sources of care (primary, emergency, and inpatient). We calculated the excess drug costs attributable to oversupply of medication (>120% of the amount needed) and the drug cost reduction caused by undersupply of medication (120% of the supply needed. The total direct cost of targeted medications for 3 years was $1.96 million or, on average, $654,000 annually. During the 3-year period, patients receiving >120% of their needed medications had excess direct medication costs of $279,084 or $144 per patient, whereas patients receiving <80% of drugs needed had reduced medication costs of $423,438 or $634 per patient. Multivariable analyses revealed that both under- and over-supplies of medication were associated with a greater likelihood of emergency department visits and hospital

Conventional CD11chigh Dendritic Cells Are Important for T Cell Priming during the Initial Phase of Plasmodium yoelii Infection, but Are Dispensable at Later Time Points.

Science.gov (United States)

Ueffing, Kristina; Abberger, Hanna; Westendorf, Astrid M; Matuschewski, Kai; Buer, Jan; Hansen, Wiebke

2017-01-01

Dendritic cells (DCs) are highly specialized antigen-presenting cells that orchestrate adaptive immune responses to pathogens. During malaria infection pro- and anti-inflammatory T cell responses have to be tightly balanced to ensure parasite clearance without induction of severe immune pathologies. However, the precise role of CD11c high DCs in this process is still discussed controversially. Here, we demonstrate that long-term depletion of conventional CD11c high DCs in Plasmodium yoelii ( P. yoelii )-infected diphtheria toxin (DT)-treated RosaiDTR/CD11c-cre mice interferes with the activation of CD8 + and CD4 + T cells as well as CD4 + Foxp3 + regulatory T cells at early time points during infection. Moreover, systemic levels of the pro-inflammatory cytokines IFN-γ and TNF-α were decreased in P. yoelii -infected mice deficient for CD11c high DCs compared to infected RosaiDTR controls. To further elucidate the importance of CD11c high DCs during the later phase of infection, we treated RosaiDTR/CD11c-cre and control mice with DT only from day 4 of P. yoelii infection onward. Strikingly, this approach had no impact on the activation and IFN-γ production of CD4 + and CD8 + effector T cells. These results indicate that CD11c high DCs play a crucial role in eliciting effector T cell responses during the initial phase, but are dispensable during ongoing infection with P. yoelii .

Conventional CD11chigh Dendritic Cells Are Important for T Cell Priming during the Initial Phase of Plasmodium yoelii Infection, but Are Dispensable at Later Time Points

Directory of Open Access Journals (Sweden)

Kristina Ueffing

2017-10-01

Full Text Available Dendritic cells (DCs are highly specialized antigen-presenting cells that orchestrate adaptive immune responses to pathogens. During malaria infection pro- and anti-inflammatory T cell responses have to be tightly balanced to ensure parasite clearance without induction of severe immune pathologies. However, the precise role of CD11chigh DCs in this process is still discussed controversially. Here, we demonstrate that long-term depletion of conventional CD11chigh DCs in Plasmodium yoelii (P. yoelii-infected diphtheria toxin (DT-treated RosaiDTR/CD11c-cre mice interferes with the activation of CD8+ and CD4+ T cells as well as CD4+Foxp3+ regulatory T cells at early time points during infection. Moreover, systemic levels of the pro-inflammatory cytokines IFN-γ and TNF-α were decreased in P. yoelii-infected mice deficient for CD11chigh DCs compared to infected RosaiDTR controls. To further elucidate the importance of CD11chigh DCs during the later phase of infection, we treated RosaiDTR/CD11c-cre and control mice with DT only from day 4 of P. yoelii infection onward. Strikingly, this approach had no impact on the activation and IFN-γ production of CD4+ and CD8+ effector T cells. These results indicate that CD11chigh DCs play a crucial role in eliciting effector T cell responses during the initial phase, but are dispensable during ongoing infection with P. yoelii.

Direct 3D cell-printing of human skin with functional transwell system.

Science.gov (United States)

Kim, Byoung Soo; Lee, Jung-Seob; Gao, Ge; Cho, Dong-Woo

2017-06-06

Three-dimensional (3D) cell-printing has been emerging as a promising technology with which to build up human skin models by enabling rapid and versatile design. Despite the technological advances, challenges remain in the development of fully functional models that recapitulate complexities in the native tissue. Moreover, although several approaches have been explored for the development of biomimetic human skin models, the present skin models based on multistep fabrication methods using polydimethylsiloxane chips and commercial transwell inserts could be tackled by leveraging 3D cell-printing technology. In this paper, we present a new 3D cell-printing strategy for engineering a 3D human skin model with a functional transwell system in a single-step process. A hybrid 3D cell-printing system was developed, allowing for the use of extrusion and inkjet modules at the same time. We began by revealing the significance of each module in engineering human skin models; by using the extrusion-dispensing module, we engineered a collagen-based construct with polycaprolactone (PCL) mesh that prevented the contraction of collagen during tissue maturation; the inkjet-based dispensing module was used to uniformly distribute keratinocytes. Taking these features together, we engineered a human skin model with a functional transwell system; the transwell system and fibroblast-populated dermis were consecutively fabricated by using the extrusion modules. Following this process, keratinocytes were uniformly distributed onto the engineered dermis by the inkjet module. Our transwell system indicates a supportive 3D construct composed of PCL, enabling the maturation of a skin model without the aid of commercial transwell inserts. This skin model revealed favorable biological characteristics that included a stabilized fibroblast-stretched dermis and stratified epidermis layers after 14 days. It was also observed that a 50 times reduction in cost was achieved and 10 times less medium was

Non-prescription dispensing of emergency oral contraceptives: Recommendations from the German Federal Chamber of Pharmacists [Bundesapothekerkammer

Directory of Open Access Journals (Sweden)

Schulz M

2016-09-01

Full Text Available Background: Emergency hormonal contraceptives (EHC are contraceptives used to prevent unintended pregnancy following unprotected sexual intercourse (USI or contraceptive failure. The EHCs available without a prescription include medicines containing levonorgestrel (LNG in more than 80 countries and, recently, based on an EU-switch ellaOne®, which contains ulipristal acetate (UPA. EHCs work by stopping or delaying ovulation. Those containing LNG can be used up to 72 hours after USI or contraceptive failure, while UPA can be used up to 120 hours. In the context of the UPA implementation process, Germany switched LNG to non-prescription status as well. Objectives: To develop recommendations, a protocol, and a continuing education program for pharmacists to assure quality when giving advice and dispensing EHCs in community pharmacies without a medical prescription. Methods: The recommendations were developed by an iterative process of drafting, recognizing, and discussing comments and proposals for amendments as well a seeking agreement with a number of stakeholders such as the Federal Ministry of Health (BMG, Federal Institute for Drugs and Medical Devices (BfArM, Federal Chamber of Physicians (BÄK, Drug Commission of German Physicians (AkdÄ, professional organizations/associations of gynaecologists, pharmaceutical OTC-industry as well as government-controlled, private, and church-based organizations and centres providing advice on sex education and family planning. Results: The recommendations were eventually endorsed by the BMG in consultation with the BfArM. Conclusions: The recommendations were made public, published in the professional journal and used in an uncounted number of continuing education programs based on the curriculum and provided by the State Chambers of Pharmacists.

High-level Gpr56 expression is dispensable for the maintenance and function of hematopoietic stem and progenitor cells in mice

Directory of Open Access Journals (Sweden)

Tata Nageswara Rao

2015-05-01

Full Text Available Blood formation by hematopoietic stem cells (HSCs is regulated by a still incompletely defined network of general and HSC-specific regulators. In this study, we analyzed the role of G-protein coupled receptor 56 (Gpr56 as a candidate HSC regulator based on its differential expression in quiescent relative to proliferating HSCs and its common targeting by core HSC regulators. Detailed expression analysis revealed that Gpr56 is abundantly expressed by HSPCs during definitive hematopoiesis in the embryo and in the adult bone marrow, but its levels are reduced substantially as HSPCs differentiate. However, despite enriched expression in HSPCs, Gpr56-deficiency did not impair HSPC maintenance or function during steady-state or myeloablative stress-induced hematopoiesis. Gpr56-deficient HSCs also responded normally to physiological and pharmacological mobilization signals, despite the reported role of this GPCR as a regulator of cell adhesion and migration in neuronal cells. Moreover, Gpr56-deficient bone marrow engrafted with equivalent efficiency as wild-type HSCs in primary recipients; however, their reconstituting ability was reduced when subjected to serial transplantation. These data indicate that although GPR56 is abundantly and selectively expressed by primitive HSPCs, its high level expression is largely dispensable for steady-state and regenerative hematopoiesis.

AMP-activated protein kinase regulates lymphocyte responses to metabolic stress but is largely dispensable for immune cell development and function.

Science.gov (United States)

Mayer, Alice; Denanglaire, Sébastien; Viollet, Benoit; Leo, Oberdan; Andris, Fabienne

2008-04-01

AMP-activated protein kinase (AMPK), a phylogenetically conserved serine/threonine protein kinase, represents an energy sensor able to adapt cellular metabolism in response to nutritional environmental variations. TCR stimulation activates AMPK, a regulatory event that is known to stimulate ATP-producing processes, possibly in anticipation of the increased energetic needs associated with cell division and expression of effector function. Taking advantage of the selective expression of the AMPKalpha1 catalytic subunit in lymphoid cells, we have analyzed the in vitro and in vivo capacity of lymphocytes lacking AMPK activity (AMPKalpha1-KO cells) to respond to metabolic stress and to initiate and sustain an immune response. AMPKalpha1-KO cells displayed increasing sensitivity to energetic stress in vitro, and were found unable to maintain adequate ATP levels in response to ATP synthase inhibition. These cells were, however, able to respond to antigen stimulation in vitro, as shown by optimal proliferation and cytokine production. Similarly, AMPKalpha1-KO mice were fully immunocompetent in vivo and displayed normal cell proliferation, humoral, cytotoxic and delayed-type hypersensitivity (DTH) responses following antigen injection. In conclusion, AMPK represents an important enzyme allowing lymphocytes to resist a mild energy crisis in vitro, but is largely dispensable for activation and expression of effector function in response to antigen stimulation.

IL-22 is mainly produced by IFNγ-secreting cells but is dispensable for host protection against Mycobacterium tuberculosis infection.

Directory of Open Access Journals (Sweden)

Jochen Behrends

Full Text Available Anti-inflammatory treatment of autoimmune diseases is associated with an increased risk of reactivation tuberculosis (TB. Besides interleukin (IL-17A, IL-22 represents a classical T helper (TH17 cytokine and shares similar pathological effects in inflammatory diseases such as psoriasis or arthritis. Whereas IL-17A supports protective immune responses during mycobacterial infections, the role of IL-22 after infection with Mycobacterium tuberculosis (Mtb is yet poorly characterized. Therefore, we here characterize the cell types producing IL-22 and the protective function of this cytokine during experimental TB in mice. Like IL-17A, IL-22 is expressed early after infection with Mtb in an IL-23-dependent manner. Surprisingly, the majority of IL-22-producing cells are not positive for IL-17A but have rather functional characteristics of interferon-gamma-producing TH1 cells. Although we found minor differences in the number of naive and central memory T cells as well as in the frequency of TH1 and polyfunctional T cells in mice deficient for IL-22, the absence of IL-22 does not affect the outcome of Mtb infection. Our study revealed that although produced by TH1 cells, IL-22 is dispensable for protective immune responses during TB. Therefore, targeting of IL-22 in inflammatory disease may represent a therapeutic approach that does not incur the danger of reactivation TB.

Self-Cleaning Coatings and Materials for Decontaminating Field-Deployable Land and Water-Based Optical Systems

Science.gov (United States)

Ryan, Robert; Underwood, Lauren; Holekamp, Kara; May, George; Spiering, Bruce; Davis, Bruce

2011-01-01

This technology exploits the organic decomposition capability and hydrophilic properties of the photocatalytic material titanium dioxide (TiO2), a nontoxic and non-hazardous substance, to address contamination and biofouling issues in field-deployed optical sensor systems. Specifically, this technology incorporates TiO2 coatings and materials applied to, or integrated as a part of, the optical surfaces of sensors and calibration sources, including lenses, windows, and mirrors that are used in remote, unattended, ground-based (land or maritime) optical sensor systems. Current methods used to address contamination or biofouling of these optical surfaces in deployed systems are costly, toxic, labor intensive, and non-preventative. By implementing this novel technology, many of these negative aspects can be reduced. The functionality of this innovative self-cleaning solution to address the problem of contamination or biofouling depends on the availability of a sufficient light source with the appropriate spectral properties, which can be attained naturally via sunlight or supplemented using artificial illumination such as UV LEDs (light emitting diodes). In land-based or above-water systems, the TiO2 optical surface is exposed to sunlight, which catalyzes the photocatalytic reaction, facilitating both the decomposition of inorganic and organic compounds, and the activation of superhydrophilic properties. Since underwater optical surfaces are submerged and have limited sunlight exposure, supplementary UV light sources would be required to activate the TiO2 on these optical surfaces. Nighttime operation of land-based or above-water systems would require this addition as well. For most superhydrophilic self-cleaning purposes, a rainwater wash will suffice; however, for some applications an attached rainwater collector/ dispenser or other fresh water dispensing system may be required to wash the optical surface and initiate the removal of contaminates. Deployment of this

Carbon dioxide is a powerful inducer of monokaryotic hyphae and spore development in Cryptococcus gattii and carbonic anhydrase activity is dispensable in this dimorphic transition.

Science.gov (United States)

Ren, Ping; Chaturvedi, Vishnu; Chaturvedi, Sudha

2014-01-01

Cryptococcus gattii is unique among human pathogenic fungi with specialized ecological niche on trees. Since leaves concentrate CO2, we investigated the role of this gaseous molecule in C. gattii biology and virulence. We focused on the genetic analyses of β-carbonic anhydrase (β-CA) encoded by C. gattii CAN1 and CAN2 as later is critical for CO2 sensing in a closely related pathogen C. neoformans. High CO2 conditions induced robust development of monokaryotic hyphae and spores in C. gattii. Conversely, high CO2 completely repressed hyphae development in sexual mating. Both CAN1 and CAN2 were dispensable for CO2 induced morphogenetic transitions. However, C. gattii CAN2 was essential for growth in ambient air similar to its reported role in C. neoformans. Both can1 and can2 mutants retained full pathogenic potential in vitro and in vivo. These results provide insight into C. gattii adaptation for arboreal growth and production of infectious propagules by β-CA independent mechanism(s).

Electron-optical system of 200 kV gun for the VEPP-5 preinjector

International Nuclear Information System (INIS)

Akimov, V.E.; Kazarezov, I.V.; Tiunov, M.A.

2004-01-01

The electron gun with a new electron-optical system to match project parameters of the VEPP-5 preinjector is described. The gun produces the current with 10 A amplitude, pulse duration 2...3 ns at half-height and electron energy 200 keV. The gun has a dispenser cathode 20 mm in diameter and 100 mm spherical radius. The current control is performed by means of molybdenum equipotential grid with the cell size 0.4 centre dot 0.4 mm and optical transparency of about 0.68. The experimental results obtained are in good agreement with project parameters

Processing a difficult urethane elastomer system

International Nuclear Information System (INIS)

Gillespie, T.J.

1977-01-01

A detailed study of an adiprene/butanediol/trimethylolpropane elastomer system and the associated production process was performed to assess the importance of various processing factors on the physical properties of the system. Results indicated that control of the curing cycle, material ratio, moisture in the curing agent and elastomer, mixing, and vacuum level was necessary. Sufficient control of the manual process could not be obtained to eliminate significant physical property variability. An automatic metering, mixing and dispensing machine was purchased for laboratory evaluation. After modification, including the addition of a high shear vacuum type mixer, and with close vacuum and temperature control, material property variability was still at an unacceptable level. A tracer agent was introduced into the curing agent system to assess the distribution of the curing agent in the elastomer. Machine evaluation using the tracer agent indicated that distribution of the curing agent in the elastomer was very poor is spite of the high shear mixing configuration. The addition of an oscillating motion to the mixing configuration. The addition of an oscillating motion to the mixing system significantly improved curing agent distribution and eliminated material property variability problems. 16 figures, 3 tables

Designing an automated blood fractionation system.

Science.gov (United States)

McQuillan, Adrian C; Sales, Sean D

2008-04-01

UK Biobank will be collecting blood samples from a cohort of 500 000 volunteers and it is expected that the rate of collection will peak at approximately 3000 blood collection tubes per day. These samples need to be prepared for long-term storage. It is not considered practical to manually process this quantity of samples so an automated blood fractionation system is required. Principles of industrial automation were applied to the blood fractionation process leading to the requirement of developing a vision system to identify the blood fractions within the blood collection tube so that the fractions can be accurately aspirated and dispensed into micro-tubes. A prototype was manufactured and tested on a range of human blood samples collected in different tube types. A specially designed vision system was capable of accurately measuring the position of the plasma meniscus, plasma/buffy coat interface and the red cells/buffy coat interface within a vacutainer. A rack of 24 vacutainers could be processed in blood fractionation system offers a solution to the problem of processing human blood samples collected in vacutainers in a consistent manner and provides a means of ensuring data and sample integrity.

Medication errors in outpatient care in Colombia, 2005-2013.

Science.gov (United States)

Machado-Alba, Jorge E; Moncada, Juan Carlos; Moreno-Gutiérrez, Paula Andrea

2016-06-03

Medication errors outside the hospital have been poorly studied despite representing an important threat to patient safety. To describe the characteristics of medication errors in outpatient dispensing pharmacists reported in a pharmaco-surveillance system between 2005 and 2013 in Colombia. We conducted a descriptive study by reviewing and categorizing medication error reports from outpatient pharmacy services to a national medication dispensing company between January, 2005 and September, 2013. Variables considered included: process involved (administration, dispensing, prescription and transcription), wrong drug, time delay for the report, error type, cause and severity. The analysis was conducted in the SPSS® software, version 22.0. A total of 14,873 medication errors were reviewed, of which 67.2% in fact occurred, 15.5% reached the patient and 0.7% caused harm. Administration (OR=93.61, CI 95%: 48.510-180.655, perrors (OR=5.64; CI 95%: 3.488-9.142, perror reaching the patient. It is necessary to develop surveillance systems for medication errors in ambulatory care, focusing on the prescription, transcription and dispensation processes. Special strategies are needed for the prevention of medication errors related to anti-infective drugs.

Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England.

Science.gov (United States)

Lichtner, Valentina; Hibberd, Ralph; Cornford, Tony

2016-01-01

Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.

Strengthening Service Delivery with ICT based Monitoring and Reporting Systems: The CSIR’s Municipal Services Corrective Action Request and Report System (CARRS)

CSIR Research Space (South Africa)

Maponya, Goodhope S

2016-10-01

Full Text Available In the advent of the democratic dispensation, government crafted and implemented new strategies and programmes that would ensure that everyone had equal access to basic services. However, many studies show that there are still significant gaps...

Future Autonomous Robotic Systems in the Pacific Theater

Science.gov (United States)

2015-05-06

areas to inform the friendly units behind of what potential threats lurk within. Once secure supply routes are established, driverless vehicles can...developing new ARS, from driverless vehicles to handheld medical devices that dispense personal diagnoses, tailored to that individual’s medical

77 FR 19425 - Prescription Drugs Not Administered During Treatment; Update to Administrative Cost for Calendar...

Science.gov (United States)

2012-03-30

... using VA's managerial cost accounting system. Under this accounting system, the national average... the professional activity of reviewing and dispensing a prescription. Based on this accounting system...

Maryfield Nursing Home, Farnablake East, Athenry, Galway.

LENUS (Irish Health Repository)

Hammond, Lisa

2012-09-09

Background Oral anticancer medicines (OAM) facilitate transfer of cancer care into the community, where safeguards developed in hospitals that control their prescribing, dispensing and administration may not exist. Objective To determine if the systems of prescribing and dispensing OAM in Ireland facilitate clinical verification of the prescription, thereby ensuring treatment is tailored and appropriate for the patient. Setting Randomly selected community pharmacies in Ireland and all Irish hospitals with cancer services. Method A questionnaire was sent to a random selection of Irish community pharmacists. A different questionnaire was sent to all Irish hospitals treating cancer patients. One hundred OAM prescriptions were retrospectively reviewed, to assess the information presented and the potential barriers to a community pharmacist performing a clinical verification of the prescription. Main outcome measure Community pharmacist survey: problems experienced when dispensing OAM and risk factors identified with the current system. Hospital pharmacist survey: proportion of hospitals that clinically verify prescriptions for parenteral versus oral anticancer medicines and associated policies. OAM prescription review: proportion of OAM prescriptions that contained sufficient information for a community pharmacist to clinically verify the prescription and safely dispense the medication. Results Sixty-four percent of community pharmacist respondents felt they did not have enough information available to them to safely dispense these prescriptions, and 74 % felt that patients are at risk with the current Irish system of prescribing and dispensing OAM. Irish hospitals do not have systems to ensure that all OAM prescriptions are clinically verified by a pharmacist. Seventeen different agents were prescribed on the prescriptions reviewed. The information provided to the community pharmacist would have allowed them to clinically verify 7 % of the OAM prescriptions

Transonic Experimental Research Facility

Data.gov (United States)

Federal Laboratory Consortium — The Transonic Experimental Research Facility evaluates aerodynamics and fluid dynamics of projectiles, smart munitions systems, and sub-munitions dispensing systems;...

Visitor characteristics and alcohol-based hand sanitizer dispenser locations at the hospital entrance: Effect on visitor use rates.

Science.gov (United States)

Hobbs, Mary A; Robinson, Susan; Neyens, David M; Steed, Connie

2016-03-01

Hospital visitors' hand hygiene (HH) is an important aspect of preventing health care-associated infections, but little is known about visitors' use of alcohol-based hand sanitizers (AHS). The study aim was to examine if use of AHS is influenced by visitor characteristics and the location of AHS within the lobby of a large hospital. An observational study was conducted with AHS placed in 3 different locations. The data included visitor characteristics and if AHS were used. The results suggest that visitors are 5.28 times (95% confidence interval [CI], 3.68-7.82) more likely to use AHS when dispensers are located in the middle of the lobby with limited landmarks or barriers, 1.35 times more likely to use the AHS in the afternoon compared with the morning, or when they are younger visitors (adjusted odds ratio, 1.47; 95% CI, 1.09-1.97). Individuals in a group are more likely (adjusted odds ratio, 1.39; 95% CI, 1.06-1.84) to use AHS. In addition to location, time of day, and age, there is a group effect that results in visitors being more likely to use AHS when in a group. The increased use related to groups may serve as a mechanism to encourage visitor HH. The results suggest future research opportunities to investigate the effect of group dynamics and social pressure on visitor AHS use and to identify strategies for improving visitor HH. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Notch3 is dispensable for thymocyte β-selection and Notch1-induced T cell leukemogenesis.

Directory of Open Access Journals (Sweden)

Sara Suliman

Full Text Available Notch1 (N1 signaling induced by intrathymic Delta-like (DL ligands is required for T cell lineage commitment as well as self-renewal during "β-selection" of TCRβ⁺CD4⁻CD8⁻ double negative 3 (DN3 T cell progenitors. However, over-expression of the N1 intracellular domain (ICN1 renders N1 activation ligand-independent and drives leukemic transformation during β-selection. DN3 progenitors also express Notch3 (N3 mRNA, and over-expression of ligand-independent mutant N3 (ICN3 influences β-selection and drives T cell leukemogenesis. However, the importance of ligand-activated N3 in promoting β-selection and ICN1-induced T cell leukemogenesis has not been examined. To address these questions we generated mice lacking functional N3. We confirmed that DN3 progenitors express N3 protein using a N3-specific antibody. Surprisingly however, N3-deficient DN3 thymocytes were not defective in generating DP thymocytes under steady state conditions or in more stringent competition assays. To determine if N3 co-operates with N1 to regulate β-selection, we generated N1;N3 compound mutants. However, N3 deficiency did not exacerbate the competitive defect of N1⁺/⁻ DN3 progenitors, demonstrating that N3 does not compensate for limiting N1 during T cell development. Finally, N3 deficiency did not attenuate T cell leukemogenesis induced by conditional expression of ICN1 in DN3 thymocytes. Importantly, we showed that in contrast to N1, N3 has a low binding affinity for DL4, the most abundant intrathymic DL ligand. Thus, despite the profound effects of ectopic ligand-independent N3 activation on T cell development and leukemogenesis, physiologically activated N3 is dispensable for both processes, likely because N3 interacts poorly with intrathymic DL4.

Microparticle analysis system and method

Science.gov (United States)

Morrison, Dennis R. (Inventor)

2007-01-01

A device for analyzing microparticles is provided which includes a chamber with an inlet and an outlet for respectively introducing and dispensing a flowing fluid comprising microparticles, a light source for providing light through the chamber and a photometer for measuring the intensity of light transmitted through individual microparticles. The device further includes an imaging system for acquiring images of the fluid. In some cases, the device may be configured to identify and determine a quantity of the microparticles within the fluid. Consequently, a method for identifying and tracking microparticles in motion is contemplated herein. The method involves flowing a fluid comprising microparticles in laminar motion through a chamber, transmitting light through the fluid, measuring the intensities of the light transmitted through the microparticles, imaging the fluid a plurality of times and comparing at least some of the intensities of light between different images of the fluid.

Integrated system for error prevention in process of drugs used in oncology

International Nuclear Information System (INIS)

Soriano Garcia, Jorge L; Lima Perez, Mayte; Gonzalez Gonzalez, Joaquin; Batista Albuerne, Noyde; Rodriguez Lopez, Roberto; Garcia Dieguez, Robin; Gonzalez Duennas, Marta; Ugando, Elizabeth

2007-01-01

Medication mistakes in case of chemotherapy or adjuvant treatment used in any stage of drug application process: prescription, transcription, preparation, dispense or administration, are a frequent cause of side effects of antineoplastic drugs. (Author)

Effects of mating disruption treatments on navel orangeworm (Lepidoptera: Pyralidae) sexual communication and damage in almonds and pistachios.

Science.gov (United States)

Higbee, Bradley S; Burks, Charles S

2008-10-01

Two experiments in 2003 examined the effects of different ways of dispensing the principal sex pheromone component on sexual communication among and crop damage by the navel orangeworm, Amyelois transitella (Walker) (Lepidoptera: Pyralidae) in Nonpareil almonds and pistachios. A third experiment in 2004 compared the effect on navel orangeworm damage to several almond varieties using one of these dispensing systems by itself or with phosmet, phosmet alone, and an untreated control. Additional data are presented estimating release rates from timed aerosol release devices (PuffersNOW, Suterra LLC, Bend, OR) and hand-applied membrane dispensers. In 2003, puffers placed peripherally around 16-ha blocks, evenly spaced Puffers, and hand-applied dispensers reduced males captured in virgin-baited traps by > or = 95% and mating in sentinel females by > or = 69%, with evenly placed Puffers showing greater reduction of males captured and females mated compared with the other dispensing systems. Mating disruption with gridded Puffers or hand-applied devices in almonds resulted in an approximately 37% reduction of navel orangeworm damage (not significant), whereas peripheral Puffers resulted in a 16% reduction of navel orangeworm damage to almonds. In pistachios neither peripheral nor gridded Puffers reduced navel orangeworm damage, whereas insecticide reduced damage by 56%. In 2004, Puffers alone, insecticide alone, and both in combination significantly reduced navel orangeworm damage in Nonpareil almonds. In other, later harvested varieties, the insecticide treatments reduced damage, whereas the mating disruption treatment alone did not. We discuss application of these findings to management of navel orangeworm in these two crops.

High capacity argon extraction and purification system. [Suitable for age estimation of rocks

Energy Technology Data Exchange (ETDEWEB)

Balogh, K; Morik, Gy [Magyar Tudomanyos Akademia Atommag Kutato Intezete, Debrecen

1979-01-01

A high capacity metal-glass argon extraction and purification system has been developed for K/Ar dating of geologic materials. A set of samples can be loaded simultaneously and degassed in turn in the system by high frequency induction heating in a molybdenum crucible. The argon purification is carried out by titanium sponge, molecular sieve, copper oxide and glass and charcoal filled traps cooled by liquid nitrogen. The /sup 38/Ar spike and the atmospheric argon used for calibrating the mass spectrometer are dispensed by a gas-pipette system. 80-120 minutes after starting the degassing of the sample, the purified argon can be introduced into the mass spectrometer; the gettering materials regenerate in 1-5 hours, thus 1-3 samples may be analysed a day. The atmospheric argon inflow during an experimental process is less than 5x10/sup -8/ cc STP.

Future expectations for Japanese pharmacists as compared to the rest of the world

OpenAIRE

井上, 裕; 森田, 夕貴; 滝川, 茉由; 高尾, 浩一; 金本, 郁男; 杉林, 堅次

2015-01-01

It is important to share information about other countries' pharmacists to optimize cross-border medical cooperation. This paper examines the dispensing systems and the work done by pharmacists in the United Kingdom, Germany, France, Thailand, and Malaysia so as to compare these countries' medical practices and develop a cohesive vision for the future of Japanese pharmacists. All five of the countries have dispensing assistants. Pharmacists in Japan have duties of inventory control, drug disp...

Indigenous development of automated metallographic sample preparation system

International Nuclear Information System (INIS)

Kulkarni, A.P.; Pandit, K.M.; Deshmukh, A.G.; Sahoo, K.C.

2005-01-01

Surface preparation of specimens for Metallographic studies on irradiated material involves a lot of remote handling of radioactive material by skilled manpower. These are laborious and man-rem intensive activities and put limitations on number of samples that can be prepared for the metallographic studies. To overcome these limitations, automated systems have been developed for surface preparation of specimens in PIE division. The system includes (i) Grinding and polishing stations (ii) Water jet cleaning station (iii) Ultrasonic cleaning stations (iv) Drying station (v) Sample loading and unloading station (vi) Dispenser for slurries and diluents and (vii) Automated head for movement of the sample holder disc from one station to other. System facilities the operator for programming/changing sequence of the sample preparations including remote changing of grinding/polishing discs from the stations. Two such systems have been installed and commissioned in Hot Cell for PIE Division. These are being used for preparation of irradiated samples from nuclear fuels and structural components. This development has increased the throughput of metallography work and savings in terms of (man-severts) radiation exposure to operators. This presentation will provide details of the challenges in undertaking this developmental work. (author)

Integrated water and waste management system for future spacecraft

Science.gov (United States)

Ingelfinger, A. L.; Murray, R. W.

1974-01-01

Over 200 days of continuous testing have been completed on an integrated waste management-water recovery system developed by General Electric under a jointly funded AEC/NASA/AF Contract. The 4 man system provides urine, feces, and trash collection; water reclamation; storage, heating and dispensing of the water; storage and disposal of the feces and urine residue and all of other nonmetallic waste material by incineration. The heat required for the 1200 deg F purification processes is provided by a single 420-w radioisotope heater. A second 836-w radioisotope heater supplemented by 720 w of electrical heat provides for distillation and water heating. Significant test results are no pre-or-post treatment, greater than 98 per cent potable water recovery, approximately 95 per cent reduction in solids weight and volume, all outflows are sterile with the water having no bacteria or virus, and the radioisotope capsule radiation level is only 7.9 mrem/hr unshielded at 1 m (neutrons and gamma).

Targeting herpesvirus reliance of the chemokine system

DEFF Research Database (Denmark)

Rosenkilde, Mette M; Kledal, Thomas N

2006-01-01

the infection. However, since both virus and host exist, the organisms struggle must reach an ecological equilibrium. Among the best-studied interactions between viruses and the host immune system are those between herpesviruses and their hosts. Herpesviruses are known to devote a significant part...... of their large genomes on immuno-modulatory genes, some encoding chemokines or chemokine receptors. These genes, which may be dispensable for viral replication in vitro, are highly important for viral growth in vivo, for viral dissemination and disease progression. Indeed, all beta and gamma-herpesviruses have...... chemokine receptors seems to be their constitutive activity. The biological function of the constitutive activity is still unclear, but it has become clear that the receptors are involved in important parts of the viral lifecycle in vivo, and that the receptor signaling is involved in gamma-herpesvirus...

Prenatal exposure to systemic antibacterials and overweight and obesity in Danish schoolchildren

DEFF Research Database (Denmark)

Mor, A; Antonsen, S; Kahlert, J

2015-01-01

BACKGROUND/OBJECTIVE: Prenatal exposure to antibacterials may permanently dysregulate fetal metabolic patterns via epigenetic pathways or by altering maternal microbiota. We examined the association of prenatal exposure to systemic antibacterials with overweight and obesity in schoolchildren...... admissions during pregnancy. We defined overweight and obesity among the children using standard age- and sex-specific cutoffs. We computed sex-specific adjusted prevalence ratios (aPRs) of overweight and obesity associated with exposure to prenatal antibacterials, adjusting for maternal age at delivery....... SUBJECTS/METHODS: We conducted a prevalence study among Danish schoolchildren aged 7-16 years using data from routine school anthropometric evaluations conducted during 2002-2013. Prenatal exposure to antibacterials was ascertained by using maternal prescription dispensations and infection-related hospital...

Usefulness of pharmacy dispensing records in the evaluation of adherence to antiretroviral therapy in Brazilian children and adolescents.

Science.gov (United States)

Ernesto, Aline Santarem; Lemos, Renata Muller Banzato Pinto de; Huehara, Maria Ivone; Morcillo, André Moreno; Dos Santos Vilela, Maria Marluce; Silva, Marcos Tadeu Nolasco da

2012-01-01

Adherence, which is crucial to the success of antiretroviral therapy (HAART), is currently a major challenge in the care of children and adolescents living with HIV/AIDS. To evaluate the prevalence of nonadherence to HAART using complementary instruments in a cohort of children and adolescents with HIV/AIDS followed in a reference service in Campinas, Brazil. The level of adherence of 108 patients and caregivers was evaluated by an adapted standardized questionnaire and pharmacy dispensing records (PDR). Non-adherence was defined as a drug intake lower than 95% (on 24-hour or seven-day questionnaires), or as an interval of 38 days or more for pharmacy refills. The association between adherence and clinical, immunological, virological, and psychosocial characteristics was assessed by multivariate analysis. Non-adherence prevalence varied from 11.1% (non-adherent in three instruments), 15.8% (24-hour self-report), 27.8% (seven-day self-report), 45.4% (PDR), and 56.3% (at least one of the outcomes). 24-hour and seven-day self-reports, when compared to PDR, showed low sensitivity (29% and 43%, respectively) but high specificity (95% and 85%, respectively). In multivariate analysis, medication intolerance, difficulty of administration by caregiver, HAART intake by the patient, lower socioeconomical class, lack of virological control, missed appointments in the past six months, and lack of religious practice by caregiver were significantly associated with non-adherence. A high prevalence of HAART non-adherence was observed in the study population, and PDR was the most sensitive of the tested instruments. The instruments employed were complementary in the identification of non-adherence. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

Usefulness of pharmacy dispensing records in the evaluation of adherence to antiretroviral therapy in Brazilian children and adolescents

Directory of Open Access Journals (Sweden)

Aline Santarem Ernesto

Full Text Available INTRODUCTION: Adherence, which is crucial to the success of antiretroviral therapy (HAART, is currently a major challenge in the care of children and adolescents living with HIV/AIDS. OBJECTIVE: To evaluate the prevalence of nonadherence to HAART using complementary instruments in a cohort of children and adolescents with HIV/AIDS followed in a reference service in Campinas, Brazil. METHODS: The level of adherence of 108 patients and caregivers was evaluated by an adapted standardized questionnaire and pharmacy dispensing records (PDR. Non-adherence was defined as a drug intake lower than 95% (on 24-hour or seven-day questionnaires, or as an interval of 38 days or more for pharmacy refills. The association between adherence and clinical, immunological, virological, and psychosocial characteristics was assessed by multivariate analysis. RESULTS: Non-adherence prevalence varied from 11.1% (non-adherent in three instruments, 15.8% (24-hour self-report, 27.8% (seven-day self-report, 45.4% (PDR, and 56.3% (at least one of the outcomes. 24-hour and seven-day self-reports, when compared to PDR, showed low sensitivity (29% and 43%, respectively but high specificity (95% and 85%, respectively. In multivariate analysis, medication intolerance, difficulty of administration by caregiver, HAART intake by the patient, lower socioeconomical class, lack of virological control, missed appointments in the past six months, and lack of religious practice by caregiver were significantly associated with non-adherence. CONCLUSION: A high prevalence of HAART non-adherence was observed in the study population, and PDR was the most sensitive of the tested instruments. The instruments employed were complementary in the identification of non-adherence.

Novel nanoscale pheromone dispenser for more accurate evaluation of Grapholita molesta (Lepidoptera: Tortricidae) attract-and-kill strategies in the laboratory.

Science.gov (United States)

Czarnobai De Jorge, Bruna; Bisotto-de-Oliveira, Ricardo; Pereira, Cláudio Nunes; Sant'Ana, Josué

2017-09-01

Nanotechnology has recently allowed the production of formulations for controlled release of active ingredients. In the present study, the electrospinning technique was used to produce nanoscale dispensers for attract-and-kill strategies. Non-woven nanofibres containing insecticide (cypermethrin) and (E)-8,(Z)-8-dodecenyl acetate and (Z)-8-dodecanol (0.87 mg L -1 ), the main components of Grapholita molesta (Lepidoptera: Tortricidae) (Busck) pheromone, were evaluated in laboratory experiments. Male electroantennographic (EAG) responses and mortality (tarsal-contact and attract-and-kill behavioural cages) bioassays were performed for nanofibres (with and without insecticide) exposed for different periods (21, 42, 63 and 84 days) in controlled and non-exposed conditions. There were no significant differences in G. molesta male EAG responses based on the time of exposure within treatments. Nanofibres with pheromone only and with pheromone plus insecticide elicited equal EAG responses. Mortality in tarsal-contact bioassays was greater than 87% after exposure for 84 days. In the attract-and-kill bioassays, mortality ranged from 28.4 to 56.6%, although no difference was observed on insect mortalities over time (24, 48 and 72 h). Incorporation of cypermethrin in nanofibres did not interfere with G. molesta attractiveness. Both aspects of the strategy, the attractant and killing effects, were recorded using innovative nanofibres, and long-term effects suggest a controlled release of pheromone and insecticide. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

The last half-repeat of transcription activator-like effector (TALE) is dispensable and thereby TALE-based technology can be simplified.

Science.gov (United States)

Zheng, Chong-Ke; Wang, Chun-Lian; Zhang, Xiao-Ping; Wang, Fu-Jun; Qin, Teng-Fei; Zhao, Kai-Jun

2014-09-01

To activate the expression of host genes that contribute to pathogen growth, pathogenic Xanthomonas bacteria inject their transcription activator-like effectors (TALEs) into plant cells and the TALEs bind to target gene promoters by the central repeat region consisting of near-perfect 34-amino-acid repeats (34-aa repeats). Based on the recognition codes between the 34-aa repeats and the targeted nucleotides, TALE-based technologies, such as designer TALEs (dTALEs) and TALE nucleases (TALENs), have been developed. Amazingly, every natural TALE invariantly has a truncated last half-repeat (LHR) at the end of the 34-aa repeats. Consequently, all the reported dTALEs and TALENs also harbour their LHRs. Here, we show that the LHRs in dTALEs are dispensable for the function of gene activation by both transient expression assays in Nicotiana benthamiana and gene-specific targeting in the rice genome, indicating that TALEs might originate from a single progenitor. In the light of this finding, we demonstrate that dTALEs can be constructed through two simple steps. Moreover, the activation strengths of dTALEs lacking the LHR are comparable with those of dTALEs harbouring the LHR. Our results provide new insights into the origin of natural TALEs, and will facilitate the simplification of the design and assembly of TALE-based tools, such as dTALEs and TALENs, in the near future. © 2014 BSPP AND JOHN WILEY & SONS LTD.

On-Orbit Quantitative Real-Time Gene Expression Analysis Using the Wetlab-2 System

Science.gov (United States)

Parra, Macarena; Jung, Jimmy; Almeida, Eduardo; Boone, Travis; Tran, Luan; Schonfeld, Julie

2015-01-01

NASA Ames Research Center's WetLab-2 Project enables on-orbit quantitative Reverse Transcriptase PCR (qRT-PCR) analysis without the need for sample return. The WetLab-2 system is capable of processing sample types ranging from microbial cultures to animal tissues dissected on-orbit. The project developed a RNA preparation module that can lyse cells and extract RNA of sufficient quality and quantity for use as templates in qRT-PCR reactions. Our protocol has the advantage of using non-toxic chemicals and does not require alcohols or other organics. The resulting RNA is dispensed into reaction tubes that contain all lyophilized reagents needed to perform qRT-PCR reactions. System operations require simple and limited crew actions including syringe pushes, valve turns and pipette dispenses. The project selected the Cepheid SmartCycler (TradeMark), a Commercial-Off-The-Shelf (COTS) qRT-PCR unit, because of its advantages including rugged modular design, low power consumption, rapid thermal ramp times and four-color multiplex detection. Single tube multiplex assays can be used to normalize for RNA concentration and integrity, and to study multiple genes of interest in each module. The WetLab-2 system can downlink data from the ISS to the ground after a completed run and uplink new thermal cycling programs. The ability to conduct qRT-PCR and generate results on-orbit is an important step towards utilizing the ISS as a National Laboratory facility. Specifically, the ability to get on-orbit data will provide investigators with the opportunity to adjust experimental parameters in real time without the need for sample return and re-flight. On orbit gene expression analysis can also eliminate the confounding effects on gene expression of reentry stresses and shock acting on live cells and organisms or the concern of RNA degradation of fixed samples and provide on-orbit gene expression benchmarking prior to sample return. Finally, the system can also be used for analysis of

Qualitative analysis of multi-disciplinary round-table discussions on the acceleration of benefits and data analytics through hospital electronic prescribing (ePrescribing) systems.

Science.gov (United States)

Cresswell, Kathrin; Coleman, Jamie; Smith, Pam; Swainson, Charles; Slee, Ann; Sheikh, Aziz

2016-07-04

Electronic systems that facilitate prescribing, administration and dispensing of medicines (ePrescribing systems) are at the heart of international efforts to improve the safety, quality and efficiency of medicine management. Considering the initial costs of procuring and maintaining ePrescribing systems, there is a need to better understand how to accelerate and maximise the financial benefits associated with these systems. We sought to investigate how different sectors are approaching the realisation of returns on investment from ePrescribing systems in U.K. hospitals and what lessons can be learned for future developments and implementation strategies within healthcare settings. We conducted international, multi-disciplinary, round-table discussions with 21 participants from different backgrounds including policy makers, healthcare organisations, academic researchers, vendors and patient representatives. The discussions were audio-recorded, transcribed and then thematically analysed with the qualitative analysis software NVivo10. There was an over-riding concern that realising financial returns from ePrescribing systems was challenging. The underlying reasons included substantial fixed costs of care provision, the difficulties in radically changing the medicines management process and the lack of capacity within NHS hospitals to analyse and exploit the digital data being generated. Any future data strategy should take into account the need to collect and analyse local and national data (i.e. within and across hospitals), setting comparators to measure progress (i.e. baseline measurements) and clear standards guiding data management so that data are comparable across settings. A more coherent national approach to realising financial benefits from ePrescribing systems is needed as implementations progress and the range of tools to collect information will lead to exponential data growth. The move towards more sophisticated closed-loop systems that integrate

Qualitative analysis of multi-disciplinary round-table discussions on the acceleration of benefits and data analytics through hospital electronic prescribing (ePrescribing systems

Directory of Open Access Journals (Sweden)

Kathrin Cresswell

2016-07-01

Full Text Available Background: Electronic systems that facilitate prescribing, administration and dispensing of medicines (ePrescribing systems are at the heart of international efforts to improve the safety, quality and efficiency of medicine management. Considering the initial costs of procuring and maintaining ePrescribing systems, there is a need to better understand how to accelerate and maximise the financial benefits associated with these systems. Objectives: We sought to investigate how different sectors are approaching the realisation of returns on investment from ePrescribing systems in U.K. hospitals and what lessons can be learned for future developments and implementation strategies within healthcare settings. Methods: We conducted international, multi-disciplinary, round-table discussions with 21 participants from different backgrounds including policy makers, healthcare organisations, academic researchers, vendors and patient representatives. The discussions were audio-recorded, transcribed and then thematically analysed with the qualitative analysis software NVivo10. Results: There was an over-riding concern that realising financial returns from ePrescribing systems was challenging. The underlying reasons included substantial fixed costs of care provision, the difficulties in radically changing the medicines management process and the lack of capacity within NHS hospitals to analyse and exploit the digital data being generated. Any future data strategy should take into account the need to collect and analyse local and national data (i.e. within and across hospitals, setting comparators to measure progress (i.e. baseline measurements and clear standards guiding data management so that data are comparable across settings. Conclusions: A more coherent national approach to realising financial benefits from ePrescribing systems is needed as implementations progress and the range of tools to collect information will lead to exponential data growth. The

Notch activation is dispensable for D, L-sulforaphane-mediated inhibition of human prostate cancer cell migration.

Directory of Open Access Journals (Sweden)

Eun-Ryeong Hahm

Full Text Available D, L-Sulforaphane (SFN, a synthetic racemic analog of broccoli constituent L-sulforaphane, is a highly promising cancer chemopreventive agent with in vivo efficacy against chemically-induced as well as oncogene-driven cancer in preclinical rodent models. Cancer chemopreventive effect of SFN is characterized by G(2/M phase cell cycle arrest, apoptosis induction, and inhibition of cell migration and invasion. Moreover, SFN inhibits multiple oncogenic signaling pathways often hyperactive in human cancers, including nuclear factor-κB, Akt, signal transducer and activator of transcription 3, and androgen receptor. The present study was designed to determine the role of Notch signaling, which is constitutively active in many human cancers, in anticancer effects of SFN using prostate cancer cells as a model. Exposure of human prostate cancer cells (PC-3, LNCaP, and/or LNCaP-C4-2B to SFN as well as its naturally-occurring thio-, sulfinyl-, and sulfonyl-analogs resulted in cleavage (activation of Notch1, Notch2, and Notch4, which was accompanied by a decrease in levels of full-length Notch forms especially at the 16- and 24-hour time points. The SFN-mediated cleavage of Notch isoforms was associated with its transcriptional activation as evidenced by RBP-Jk-, HES-1A/B- and HEY-1 luciferase reporter assays. Migration of PC-3 and LNCaP cells was decreased significantly by RNA interference of Notch1 and Notch2, but not Notch4. Furthermore, SFN-mediated inhibition of PC-3 and LNCaP cell migration was only marginally affected by knockdown of Notch1 and Notch2. Strikingly, SFN administration to Transgenic Adenocarcinoma of Mouse Prostate transgenic mice failed to increase levels of cleaved Notch1, cleaved Notch2, and HES-1 proteins in vivo in prostatic intraepithelial neoplasia, well-differentiated carcinoma or poorly-differentiated prostate cancer lesions. These results indicate that Notch activation is largely dispensable for SFN-mediated inhibition of cell

Comparative Rates of Mortality and Serious Adverse Effects Among Commonly Prescribed Opioid Analgesics.

Science.gov (United States)

Murphy, David L; Lebin, Jacob A; Severtson, Stevan G; Olsen, Heather A; Dasgupta, Nabarun; Dart, Richard C

2018-03-26

The epidemic of prescription opioid overdose and mortality parallels the dispensing rates of prescription opioids, and the availability of increasingly potent opioid analgesics. The common assumption that more potent opioid analgesics are associated with higher rates of adverse outcomes has not been adequately substantiated. We compared the rate of serious adverse events among commonly prescribed opioid analgesics of varying potency. Serious adverse events (SAEs; defined as death, major medical effect, or hospitalization) resulting from exposure to tablets containing seven opioid analgesics (oxycodone, hydrocodone, morphine, hydromorphone, oxymorphone, tapentadol, and tramadol) captured by the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS ® ) System Poison Center Program were evaluated from 2010 through 2016. Rates of SAEs were adjusted for availability through outpatient dispensing data and regressed on morphine milligram equivalents (MME). There were 19,480 cases of SAE during the 7-year study period. Hydrocodone and oxycodone contributed to 77% of SAE cases. Comparing rates of outcome by relative potency, a hierarchy was observed with hydromorphone (8.02 SAEs/100 kg) and tapentadol (0.27 SAE/100 kg) as the highest and lowest rates, reflecting a 30-fold difference among individual opioid products. SAE rate and potency were related linearly-SAEs increased 2.04 per 100 kg drug dispensed for each 1-unit rise in MME (p = 0.004). Linear regression of SAE/100 kg drug dispensed and drug potency identified that MME comprised 96% of the variation observed. In contrast, potency did not explain variation seen using other study denominators (prescriptions dispensed, dosage units dispensed, and the number of individuals filling a prescription). Potency of a prescription opioid analgesic demonstrates a significant, highly positive linear relationship with exposures resulting in SAEs per 100 kg drug dispensed reported to poison centers

Radioactive gas-containing polymeric capsule

International Nuclear Information System (INIS)

Winchell, H.S.; Lewis, R.E.

1975-01-01

A disposable ventilation study system for dispensing a single patient dosage of gaseous radioisotopes to patients for pulmonary function studies is disclosed. A gas impermeable capsule encloses the gaseous radioisotope and is stored within a radioactivity shielding body of valve means which shears the capsule to dispense the radioisotope to the patient. A breathing bag receives the patient's exhalation of the radioisotope and permits rebreathing of the radioisotope by the patient. 18 claims, 7 drawing figures

Technical issues and conservation conditions of medicines in the primary health care of the Brazilian Unified Health System

Science.gov (United States)

Costa, Ediná Alves; Araújo, Patrícia Sodré; Pereira, Marcelo Tavares; Souto, Ana Cristina; Souza, Gisélia Santana; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Alvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

2017-01-01

ABSTRACT OBJECTIVE To characterize the technical issues and conditions of medicines conservation in Primary Health Care of Brazilian regions, responsible for pharmacy/dispensing unit profile; environmental, storage, and dose fractioning conditions; inventory control and waste management; fire and electrical failure safety items; transportation problems; advertising regulation; and pharmacovigilance. METHODS This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (National Survey on Access, Use and Promotion of Rational Use of Medicines – Services)–, a cross-sectional and exploratory study, of evaluative nature, consisting of an information survey within a representative sample of municipalities, stratified by Brazilian regions, which constitute the study domains, and a sample of Primary Health Care services. Pharmaceutical services (PS) were directly observed with photographic record and face-to-face interviews with those responsible for the dispensing of medicines and over the telephone with those responsible for pharmaceutical services. Data were processed with the SPSS® software version 21. RESULTS The investigated dimensions showed relevant deficiencies and inequalities between the regions, generally more favorable in the Southeast and Midwest regions and weaker in the Northeast and North regions. We verified non-compliance with technical requirements and conditions essential to the conservation of medicines, which may interfere with the maintenance of stability and, thus, on their quality, efficacy, and safety. The regulation of advertising/promotion of medicines is still incipient and there is some progress in the structuring of mechanisms regarding pharmacovigilance. CONCLUSIONS The sanitary situation of medicines in Brazilian Primary Health Care is alarming due to the violation of the specific sanitary legislation for dispensing establishments and due to a wide range of

Specific concentration evaluation of 16% carbamide peroxide compounded at dispensing pharmacies Avaliação da concentração específica do peróxido de carbamida a 16% produzido em farmácias de manipulação

Directory of Open Access Journals (Sweden)

Juliana Maria Habith Martin

2007-12-01

Full Text Available The aim of this work was to evaluate the concentration of carbamide peroxide compounded at different dispensing pharmacies. Immediate concentration analysis was made of bleaching gels dispensed by specialized pharmacies, and of a commercially available gel (control group (n = 20. The carbamide peroxide concentration was determined by titration and the results were analyzed statistically by the Kruskal-Wallis test. The commercial bleaching agent (control group and one of the gels from the pharmacies presented the best mean concentration values, close to 16%. In conclusion, the concentration of the manipulated and industrialized carbamide peroxide gels presented concentration values differing from 16%.O objetivo deste trabalho foi avaliar a concentração do peróxido de carbamida manipulado em diferentes farmácias de manipulação. Foram utilizados géis clareadores manipulados em farmácias especializadas e um industrializado (grupo controle (n = 20 com análise de concentração imediata. A concentração do peróxido de carbamida foi obtida por titulometria e os resultados foram submetidos a análise estatística pelo teste de Kruskal-Wallis. Como resultado, o agente clareador (controle e um dos produtos manipulados em farmácia apresentaram as melhores médias de concentração, próximas a 16%. Pode-se concluir que a concentração do peróxido de carbamida manipulado e dos industrializados apresentaram valores de concentração diferentes de 16%.

Automated and electronically assisted hand hygiene monitoring systems: a systematic review.

Science.gov (United States)

Ward, Melissa A; Schweizer, Marin L; Polgreen, Philip M; Gupta, Kalpana; Reisinger, Heather S; Perencevich, Eli N

2014-05-01

Hand hygiene is one of the most effective ways to prevent transmission of health care-associated infections. Electronic systems and tools are being developed to enhance hand hygiene compliance monitoring. Our systematic review assesses the existing evidence surrounding the adoption and accuracy of automated systems or electronically enhanced direct observations and also reviews the effectiveness of such systems in health care settings. We systematically reviewed PubMed for articles published between January 1, 2000, and March 31, 2013, containing the terms hand AND hygiene or hand AND disinfection or handwashing. Resulting articles were reviewed to determine if an electronic system was used. We identified 42 articles for inclusion. Four types of systems were identified: electronically assisted/enhanced direct observation, video-monitored direct observation systems, electronic dispenser counters, and automated hand hygiene monitoring networks. Fewer than 20% of articles identified included calculations for efficiency or accuracy. Limited data are currently available to recommend adoption of specific automatic or electronically assisted hand hygiene surveillance systems. Future studies should be undertaken that assess the accuracy, effectiveness, and cost-effectiveness of such systems. Given the restricted clinical and infection prevention budgets of most facilities, cost-effectiveness analysis of specific systems will be required before these systems are widely adopted. Published by Mosby, Inc.

Investment in hydrogen tri-generation for wastewater treatment plants under uncertainties

Science.gov (United States)

Gharieh, Kaveh; Jafari, Mohsen A.; Guo, Qizhong

2015-11-01

In this article, we present a compound real option model for investment in hydrogen tri-generation and onsite hydrogen dispensing systems for a wastewater treatment plant under price and market uncertainties. The ultimate objective is to determine optimal timing and investment thresholds to exercise initial and subsequent options such that the total savings are maximized. Initial option includes investment in a 1.4 (MW) Molten Carbonate Fuel Cell (MCFC) fed by mixture of waste biogas from anaerobic digestion and natural gas, along with auxiliary equipment. Produced hydrogen in MCFC via internal reforming, is recovered from the exhaust gas stream using Pressure Swing Adsorption (PSA) purification technology. Therefore the expansion option includes investment in hydrogen compression, storage and dispensing (CSD) systems which creates additional revenue by selling hydrogen onsite in retail price. This work extends current state of investment modeling within the context of hydrogen tri-generation by considering: (i) Modular investment plan for hydrogen tri-generation and dispensing systems, (ii) Multiple sources of uncertainties along with more realistic probability distributions, (iii) Optimal operation of hydrogen tri-generation is considered, which results in realistic saving estimation.

The Canonical Immediate Early 3 Gene Product pIE611 of Mouse Cytomegalovirus Is Dispensable for Viral Replication but Mediates Transcriptional and Posttranscriptional Regulation of Viral Gene Products.

Science.gov (United States)

Rattay, Stephanie; Trilling, Mirko; Megger, Dominik A; Sitek, Barbara; Meyer, Helmut E; Hengel, Hartmut; Le-Trilling, Vu Thuy Khanh

2015-08-01

Transcription of mouse cytomegalovirus (MCMV) immediate early ie1 and ie3 is controlled by the major immediate early promoter/enhancer (MIEP) and requires differential splicing. Based on complete loss of genome replication of an MCMV mutant carrying a deletion of the ie3-specific exon 5, the multifunctional IE3 protein (611 amino acids; pIE611) is considered essential for viral replication. Our analysis of ie3 transcription resulted in the identification of novel ie3 isoforms derived from alternatively spliced ie3 transcripts. Construction of an IE3-hemagglutinin (IE3-HA) virus by insertion of an in-frame HA epitope sequence allowed detection of the IE3 isoforms in infected cells, verifying that the newly identified transcripts code for proteins. This prompted the construction of an MCMV mutant lacking ie611 but retaining the coding capacity for the newly identified isoforms ie453 and ie310. Using Δie611 MCMV, we demonstrated the dispensability of the canonical ie3 gene product pIE611 for viral replication. To determine the role of pIE611 for viral gene expression during MCMV infection in an unbiased global approach, we used label-free quantitative mass spectrometry to delineate pIE611-dependent changes of the MCMV proteome. Interestingly, further analysis revealed transcriptional as well as posttranscriptional regulation of MCMV gene products by pIE611. Cytomegaloviruses are pathogenic betaherpesviruses persisting in a lifelong latency from which reactivation can occur under conditions of immunosuppression, immunoimmaturity, or inflammation. The switch from latency to reactivation requires expression of immediate early genes. Therefore, understanding of immediate early gene regulation might add insights into viral pathogenesis. The mouse cytomegalovirus (MCMV) immediate early 3 protein (611 amino acids; pIE611) is considered essential for viral replication. The identification of novel protein isoforms derived from alternatively spliced ie3 transcripts prompted

Cross-sectional study of the dispensation of synthetic anorectic drugs in community pharmacies in the city of Cruz Alta - State of Rio Grande do Sul

Directory of Open Access Journals (Sweden)

Marcieli Maria Navarini

2014-12-01

Full Text Available Obesity is defined as the excess adipose tissue in the body. Drugs responsible for inhibiting the appetite are called anorectics or appetite suppressants. Sibutramine, fenproporex and amfepramone belongs to this class, and are capable of causing physical or psychological dependence. The aim of this study was to evaluate the frequency of prescriptions for appetite suppressants in community pharmacies at Cruz Alta, State of Rio Grande do Sul, Brazil. The sales of fenproporex, amfepramone and sibutramine in the months of September, October and November 2010 and April, May and June 2011 were compared. It was observed that the most commonly dispensed anorectic in the three community pharmacies analyzed was sibutramine. In the months of September, October and November 2010, consumption was higher, with sibutramine achieving 40.3% of overall sales, amfepramone 21% and, finally, fenproporex, 7.9%. The consumption of appetite suppressants was more prevalent in females, who represented 82% of total. The results suggested the existence of high consumption of anorectics, possibly related to the current concern with aesthetic standards, which emphasizes the importance of strict control over the marketing of these substances.

An investigation into the prescribing of analgesics

African Journals Online (AJOL)

system drugs that analgesics comprised; proportion of patients using combination analgesics; cost of analgesics. Results. On average, 83.3% of all .... nervous system drugs were the most frequently dispensed therapeutic type, accounting on.

Role of β1 integrins and bacterial adhesins for Yop injection into leukocytes in Yersinia enterocolitica systemic mouse infection.

Science.gov (United States)

Deuschle, Eva; Keller, Birgit; Siegfried, Alexandra; Manncke, Birgit; Spaeth, Tanja; Köberle, Martin; Drechsler-Hake, Doreen; Reber, Julia; Böttcher, Ralph T; Autenrieth, Stella E; Autenrieth, Ingo B; Bohn, Erwin; Schütz, Monika

2016-02-01

Injection of Yersinia outer proteins (Yops) into host cells by a type III secretion system is an important immune evasion mechanism of Yersinia enterocolitica (Ye). In this process Ye invasin (Inv) binds directly while Yersinia adhesin A (YadA) binds indirectly via extracellular matrix (ECM) proteins to β1 integrins on host cells. Although leukocytes turned out to be an important target of Yop injection by Ye, it was unclear which Ye adhesins and which leukocyte receptors are required for Yop injection. To explain this, we investigated the role of YadA, Inv and β1 integrins for Yop injection into leukocytes and their impact on the course of systemic Ye infection in mice. Ex vivo infection experiments revealed that adhesion of Ye via Inv or YadA is sufficient to promote Yop injection into leukocytes as revealed by a β-lactamase reporter assay. Serum factors inhibit YadA- but not Inv-mediated Yop injection into B and T cells, shifting YadA-mediated Yop injection in the direction of neutrophils and other myeloid cells. Systemic Ye mouse infection experiments demonstrated that YadA is essential for Ye virulence and Yop injection into leukocytes, while Inv is dispensable for virulence and plays only a transient and minor role for Yop injection in the early phase of infection. Ye infection of mice with β1 integrin-depleted leukocytes demonstrated that β1 integrins are dispensable for YadA-mediated Yop injection into leukocytes, but contribute to Inv-mediated Yop injection. Despite reduced Yop injection into leukocytes, β1 integrin-deficient mice exhibited an increased susceptibility for Ye infection, suggesting an important role of β1 integrins in immune defense against Ye. This study demonstrates that Yop injection into leukocytes by Ye is largely mediated by YadA exploiting, as yet unknown, leukocyte receptors. Copyright © 2015. Published by Elsevier GmbH.

A Prospective Randomized Trial on the Effect of Using an Electronic Monitoring Drug Dispensing Device to Improve Adherence and Compliance.

Science.gov (United States)

Henriksson, Jarmo; Tydén, Gunnar; Höijer, Jonas; Wadström, Jonas

2016-01-01

Outcome after renal transplantation depends on patient compliance and adherence for early detection of complications and identification of intervention opportunities. Compliance describes the degree to which patients follow medical advice and take their medications. Adherence has been defined as the extent to which a patients' behavior coincides with clinical prescriptions. Patients were randomized 7 to 14 days after transplantation into groups with (n = 40) and without (n = 40) an electronic medication dispenser (EMD). The EMD, which was used for the 1-year study period, recorded the date and time the patient took their medications and was monitored via a web-based application. Patients were monitored for 1 year regarding outpatient follow-up visits, emergency hospitalizations, renal biopsies, rejection episodes, renal function, and blood concentration of medications. Compliance in the intervention group was 97.8% (the control group was not assessed). Number of missed doses varied significantly by weekday (P = 0.033); patients were most likely to miss doses on Saturdays and Thursdays. Patients missed a total of 11 follow-up visits. During the study, 92 biopsies were performed on 55 patients (intervention group: 32 [17]; control group, 60 [38]). Biopsy-verified rejection was three times more common among controls (13 patients vs. 4; P = 0.054, not significant). Average P-creatinine level was slightly lower in the intervention group than the control group (131 vs. 150 μmol/L, not significant), whereas mean tacrolimus was similar (7.32 vs. 7.22 ng/mL, n.s.). The EMD is associated with high compliance, and there are also indications of a lower rejection rate.

Greek National E-Prescribing System: Preliminary Results of a Tool for Rationalizing Pharmaceutical Use and Cost.

Science.gov (United States)

Polyzos, Nikolaos; Kastanioti, Catherine; Zilidis, Christos; Mavridoglou, George; Karakolias, Stefanos; Litsa, Panagiota; Menegakis, Valantis; Kani, Chara

2016-10-01

In Greece, due to the ongoing economic crisis a number of measures aiming at rationalising expenditure implemented. A new e-prescribing system, under a unified healthcare fund was the main pillar of these reforms focus on monitoring and auditing prescribing patterns. Main objective of this study was to document the Greek experience with the new national e-prescribing system. We analyse the dispensed prescriptions over the period 2013-2014, stratified into four levels: therapeutic subgroup, patent status, physician's specialty and geographical region. Data analysis offered a comprehensive insight into pharmaceutical expenditure over the timeframe and revealed discrepancies regarding composition of spending, brand-generic substitution within certain therapeutic subgroups, physicians' prescribing behaviour based on medical specialty, therapeutic subgroup as well as regional per capita measures. E-prescribing system is a valuable tool providing sound information to health policymakers in order to monitor and rationalize pharmaceutical expenditure, in value and volume terms.

The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study.

Science.gov (United States)

Harvey, Jasmine; Avery, Anthony J; Waring, Justin; Barber, Nick

2012-12-20

approaches community pharmacies used to appropriate procedures in practice. These were 'technically oriented', 'improvising' or 'socially oriented'. We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools.

Operating experience with power-equalising drive systems for ploughs. Betriebserfahrungen mit leistungsausgleichenden Antriebssystemen fuer Hobelanlagen

Energy Technology Data Exchange (ETDEWEB)

Kaci, M.V. (DMT-Gesellschaft fuer Forschung und Pruefung mbH (Germany). Inst. fuer Vortrieb und Gewinnung); Klimek, K.H. (Ruhrkohle Niederrhein AG (Germany))

1991-11-14

Further development of ploughs and the available technology enable the application of stripping in deposits, which did not permit efficient plough operation in the past. Power equalisation between the drives is certainly the optimum solution for some of the applications with internal power consumption. However, it has emerged that the simple transition from the passive hydraulic to the active electrical system with use of the same gear is not the best method. Hence the idea of upgrading a plough gear with integrated overload protection to a load equalising gear was conceived. This system is known as S 15 UeL with LA 15 and conforms to the standardization efforts of Ruhrkohle AG. If the advantages of active power equalisation are dispensed with, the PL 15-S (Safesydor) can be used with ideally integrated overload protection. (orig.).

Disposal of radioactive waste

International Nuclear Information System (INIS)

Critchley, R.J.; Swindells, R.J.

1984-01-01

A method and apparatus for charging radioactive waste into a disposable steel drum having a plug type lid. The drum is sealed to a waste dispenser and the dispenser closure and lid are withdrawn into the dispenser in back-to-back manner. Before reclosing the dispenser the drum is urged closer to it so that on restoring the dispenser closure to the closed position the lid is pressed into the drum opening

Automation of radioimmunoassay

International Nuclear Information System (INIS)

Yamaguchi, Chisato; Yamada, Hideo; Iio, Masahiro

1974-01-01

Automation systems for measuring Australian antigen by radioimmunoassay under development were discussed. Samples were processed as follows: blood serum being dispensed by automated sampler to the test tube, and then incubated under controlled time and temperature; first counting being omitted; labelled antibody being dispensed to the serum after washing; samples being incubated and then centrifuged; radioactivities in the precipitate being counted by auto-well counter; measurements being tabulated by automated typewriter. Not only well-type counter but also position counter was studied. (Kanao, N.)

What Can We Learn About the Processes of Regulation of Tuberculosis Medicines From the Experiences of Health Policy and System Actors in India, Tanzania, and Zambia?

Directory of Open Access Journals (Sweden)

Kabir Sheikh

2016-07-01

Full Text Available Background: The unregulated availability and irrational use of tuberculosis (TB medicines is a major issue of public health concern globally. Governments of many low- and middle-income countries (LMICs have committed to regulating the quality and availability of TB medicines, but with variable success. Regulation of TB medicines remains an intractable challenge in many settings, but the reasons for this are poorly understood. The objective of this paper is to elaborate processes of regulation of quality and availability of TB medicines in three LMICs – India, Tanzania, and Zambia – and to understand the factors that constrain and enable these processes. Methods: We adopted the action-centred approach of policy implementation analysis that draws on the experiences of relevant policy and health system actors in order to understand regulatory processes. We drew on data from three case studies commissioned by the World Health Organization (WHO, on the regulation of TB medicines in India, Tanzania, and Zambia. Qualitative research methods were used, including in-depth interviews with 89 policy and health system actors and document review. Data were organized thematically into accounts of regulators’ authority and capacity; extent of policy implementation; and efficiency, transparency, and accountability. Results: In India, findings included the absence of a comprehensive policy framework for regulation of TB medicines, constraints of authority and capacity of regulators, and poor implementation of prescribing and dispensing norms in the majority private sector. Tanzania had a policy that restricted import, prescribing and dispensing of TB medicines to government operators. Zambia procured and dispensed TB medicines mainly through government services, albeit in the absence of a single policy for restriction of medicines. Three cross-cutting factors emerged as crucially influencing regulatory processes - political and stakeholder support for

System to determine leaf photosynthetic activity by means of 14CO2

International Nuclear Information System (INIS)

Fernandez Gonzalez, J.

1977-01-01

A method to determine leaf photosynthetic activity is described. 14 CO 2 labeled air is produced from 14 CO 3 Ba and stored in a poliethylene balloon and supplied by means of an automatic dispenser to a perspex chamber inside of which is the leaf. (author) [es

aculty of Pharmacy, Muhirnbili University College of Health Sciences

African Journals Online (AJOL)

The quality of pharmacy practice provided by dispensers in private pharmacies was studied. Parameters used include levels of education of the dispensers, access to health information, knowledge and practice regarding dispensing of drugs to patients, and disposal of expired drugs. A total of 150 dispensers selected from ...

77 FR 75499 - Reasonable Charges for Medical Care or Services; V3.12, 2013 Calendar Year Update and National...

Science.gov (United States)

2012-12-20

... administered during treatment. The administrative cost is determined annually using VA's managerial cost accounting system. Under this accounting system, the national average administrative cost is determined by... of reviewing and dispensing a prescription. Based on the accounting system, VA will determine the...