Emergency supply of prescription-only medicines to patients by community pharmacists: a mixed methods evaluation incorporating patient, pharmacist and GP perspectives

Objective To evaluate and inform emergency supply of prescription-only medicines by community pharmacists (CPs), including how the service could form an integral component of established healthcare provision to maximise adherence. Design Mixed methods. 4 phases: prospective audit of emergency supply requests for prescribed medicines (October–November 2012 and April 2013); interviews with CPs (February–April 2013); follow-up interviews with patients (April–May 2013); interactive feedback sessions with general practice teams (October–November 2013). Setting 22 community pharmacies and 6 general practices in Northwest England. Participants 27 CPs with experience of dealing with requests for emergency supplies; 25 patients who received an emergency supply of a prescribed medicine; 58 staff at 6 general practices. Results Clinical audit in 22 pharmacies over two 4-week periods reported that 526 medicines were requested by 450 patients. Requests peaked over a bank holiday and around weekends. A significant number of supplies were made during practice opening hours. Most requests were for older patients and for medicines used in long-term conditions. Difficulty in renewing repeat medication (forgetting to order, or prescription delays) was the major reason for requests. The majority of medicines were ‘loaned’ in advance of a National Health Service (NHS) prescription. Interviews with CPs and patients indicated that continuous supply had a positive impact on medicines adherence, removing the need to access urgent care. General practice staff were surprised and concerned by the extent of emergency supply episodes. Conclusions CPs regularly provide emergency supplies to patients who run out of their repeat medication, including during practice opening hours. This may aid adherence. There is currently no feedback loop, however, to general practice. Patient care and interprofessional communication may be better served by the introduction of a formally structured and funded NHS emergency supply service from community pharmacies, with ongoing optimisation of repeat prescribing

The effect of surface tension on free surface flow induced by a point sink in a fluid of finite depth

Solutions are presented to the problem of steady, axisymmetric flow of an inviscid fluid into a point sink. The fluid is of finite depth and has a free surface. Two numerical schemes, a spectral method and an integral equation approach, are implemented to confirm results for the maximum-flow-rate steady solution for each configuration. The effects of surface tension and sink depth are included and constitute the new component of the work. Surface tension has the effect of increasing the maximum flow rate at which steady-state solutions can exist

Spiritual Practices and Dispositional Optimism in an Underprivileged Population

Optimism seems to foster the ability to manage adverse situations better - a finding especially relevant for disadvantaged populations. Employing a unique sample from a small underprivileged village, we study the association between spiritual practices and dispositional optimism. The village belongs to a developing country that is, by far, the most secular country in Latin America: this makes particularly interesting exploring the role of spiritual practices in this context. We find that spiritual practices are positively associated with higher optimism, measured by the Life Orientation Test-Revised (LOT-R): those who practice spirituality, score, on average, 14.4 percentage points higher on the LOT-R than those who do not. And this association seems to be especially robust in the case of the poor and less educated: those with spiritual practices score 20 percentage points higher on the LOT-R. Thus, the role that spiritual practices may play in dispositional optimism in disadvantaged populations deserves more attentio

Spiritual Practices and Dispositional Optimism in an Underprivileged Population

Optimism seems to foster the ability to manage adverse situations better - a finding especially relevant for disadvantaged populations. Employing a unique sample from a small underprivileged village, we study the association between spiritual practices and dispositional optimism. The village belongs to a developing country that is, by far, the most secular country in Latin America: this makes particularly interesting exploring the role of spiritual practices in this context. We find that spiritual practices are positively associated with higher optimism, measured by the Life Orientation Test-Revised (LOT-R): those who practice spirituality, score, on average, 14.4 percentage points higher on the LOT-R than those who do not. And this association seems to be especially robust in the case of the poor and less educated: those with spiritual practices score 20 percentage points higher on the LOT-R. Thus, the role that spiritual practices may play in dispositional optimism in disadvantaged populations deserves more attentio

Twirling and Whirling: Viscous Dynamics of Rotating Elastica

Motivated by diverse phenomena in cellular biophysics, including bacterial flagellar motion and DNA transcription and replication, we study the overdamped nonlinear dynamics of a rotationally forced filament with twist and bend elasticity. Competition between twist injection, twist diffusion, and writhing instabilities is described by a novel pair of coupled PDEs for twist and bend evolution. Analytical and numerical methods elucidate the twist/bend coupling and reveal two dynamical regimes separated by a Hopf bifurcation: (i) diffusion-dominated axial rotation, or twirling, and (ii) steady-state crankshafting motion, or whirling. The consequences of these phenomena for self-propulsion are investigated, and experimental tests proposed.Comment: To be published in Physical Review Letter

Religious Identity, Religious Attendance, and Parental Control

Using a national sample of adolescents aged 10–18 years and their parents (N = 5,117), this article examines whether parental religious identity and religious participation are associated with the ways in which parents control their children. We hypothesize that both religious orthodoxy and weekly religious attendance are related to heightened levels of three elements of parental control: monitoring activities, normative regulations, and network closure. Results indicate that an orthodox religious identity for Catholic and Protestant parents and higher levels of religious attendance for parents as a whole are associated with increases in monitoring activities and normative regulations of American adolescents

Carbon stable isotope analysis of cereal remains as a way to reconstruct water availability: preliminary results

Reconstructing past water availability, both as rainfall and irrigation, is important to answer questions about the way society reacts to climate and its changes and the role of irrigation in the development of social complexity. Carbon stable isotope analysis of archaeobotanical remains is a potentially valuable method for reconstructing water availability. To further define the relationship between water availability and plant carbon isotope composition and to set up baseline values for the Southern Levant, grains of experimentally grown barley and sorghum were studied. The cereal crops were grown at three stations under five different irrigation regimes in Jordan. Results indicate that a positive but weak relationship exists between irrigation regime and total water input of barley grains, but no relationship was found for sorghum. The relationship for barley is site-specific and inter-annual variation was present at Deir ‘Alla, but not at Ramtha and Khirbet as-Samra

Stable carbon Isotope evidence for neolithic and bronze age crop water management in the eastern mediterranean and southwest asia

In a large study on early crop water management, stable carbon isotope discrimination was determined for 275 charred grain samples from nine archaeological sites, dating primarily to the Neolithic and Bronze Age, from the Eastern Mediterranean and Western Asia. This has revealed that wheat (Triticum spp.) was regularly grown in wetter conditions than barley (Hordeum sp.), indicating systematic preferential treatment of wheat that may reflect a cultural preference for wheat over barley. Isotopic analysis of pulse crops (Lens culinaris, Pisum sativum and Vicia ervilia) indicates cultivation in highly varied water conditions at some sites, possibly as a result of opportunistic watering practices. The results have also provided evidence for local land-use and changing agricultural practices