Public Sector Debt Dynamics: The Persistence and Sources of Shocks to Debt in Ten EU Countries

We document that, at business cycle frequencies, fluctuations in nominal variables, such as aggregate price levels and nominal interest rates, are substantially more synchronized across countries than fluctuations in real output. To the extent that domestic nominal variables are largely determined by domestic monetary policy, this might seem surprising. We ask if a parsimonious international business cycle model can account for this aspect of cross-country aggregate fluctuations. It can. Due to spillovers of technology shocks across countries, expected future responses of national central banks to fluctuations in domestic output and inflation generate movements in current prices and interest rates that are synchronized across countries even when output is not. Even modest spillovers produce cross-country correlations such as those in the data.International business cycles, prices, interest rates.

Tunable Assembly of Gold Nanorods in Polymer Solutions to Generate Controlled Nanostructured Materials

Gold nanorods grafted with short chain polymers are assembled into controlled open structures using polymer-induced depletion interactions and structurally characterized using small angle x-ray scattering. When the nanorod diameter is smaller than the radius of gyration of the depletant polymer, the depletion interaction depends solely on the correlation length of the polymer solution and not directly on the polymer molecular weight. As the polymer concentration increases, the stronger depletion interactions increasingly compress the grafted chains and push the gold nanorods closer together. By contrast, other structural characteristics such as the number of nearest neighbors and fractal dimension exhibit a non-monotonic dependence on polymer concentration. These parameters are maximal at intermediate concentrations, which are attributed to a crossover from reaction-limited to diffusion-limited aggregation. The control over structural properties of anisotropic nanoscale building blocks demonstrated here will be beneficial to designing and producing materials \emph{in situ} with specific direction-dependent nanoscale properties and provides a crucial route for advances in additive manufacturing

Keeping prisoners out of prison: the role of higher education in keeping Aboriginal Australians out of our prison system

An effective way to keep people out of prison is to stop prisoners from reoffending. In Australia, 77% of Aboriginal prisoners have been under sentence previously, as compared to around 50% for non-Aboriginal Australians. Many who end up in prison have had little opportunity to engage with education or have had negative schooling experiences. This is particularly true of Aboriginal prisoners who are half as likely to finish year 12 as non-Aboriginal Australians. With encouragement and support, these people may take the opportunity to engage with education during incarceration. This paper reports on an Australian-government-funded project, Making the Connection which facilitates participation in digital higher education in prisons with a view to reducing recidivism, particularly for Aboriginal Australians. Participation in education can help those incarcerated to develop critical thinking skills, digital literacies and the capacity for self-reflection. In addition, it promotes the prospects for employment on release and promotes positive connection to community and families. This helps reduce the risk of reoffending upon release, by equipping people with the cognitive tools to engage constructively with families, communities and an increasingly digital society. Most correctional jurisdictions prohibit the use of the internet by prisoners, yet most universities are increasingly reliant on the online provision of programs. This often results in the further marginalisation of those who are already marginalised, including prisoners. The Making the Connection project is developing internet-independent digital technologies and a suite of higher education programs that will enable Aboriginal and non-Aboriginal prisoners to engage with higher education

Behaviours that contribute to pharmacist professionalism: a scoping review

OBJECTIVES: Clearly understanding and describing professional behaviours of pharmacists allows the profession, researchers and policy-makers to observe and monitor the professionalism of pharmacists, and design interventions to improve it where needed. The primary objective of this review was to identify which behaviours are discussed to contribute to professionalism in registered pharmacists in peer-reviewed literature. The secondary objective was to review the identified behaviours using a behavioural specification framework to understand how they are expressed. DESIGN: A scoping literature review was conducted. DATA SOURCES: An electronic database search of Scopus, Embase, PsycINFO, PsychArticles, Emcare and Medline limited to articles published in English from 1 January 2000 to 21 October 2022 was conducted. ELIGIBILITY CRITERIA: Eligible articles contributed behaviourally relevant content with reference to registered pharmacists’ professionalism. DATA EXTRACTION AND SYNTHESIS: Extracted behaviourally relevant content was subject to researcher’s familiarisation, then deductive coding to one of two overarching definitions of technical or non-technical behaviour. Data were then inductively coded through assignment of a descriptive code to identify categories of professional behaviour within these two overarching types of behaviour. RESULTS: Seven articles were identified and included in the final analysis. From the extracted behaviourally relevant content, 18 categories of behaviours were identified. All articles identified behaviours in categories titled ‘establishes effective relationships’ and ‘complies with regulations codes and operating procedures’. Identified behaviours were often broadly described and merged with descriptions of influences on them and broader outcomes that they contribute to. CONCLUSIONS: Behaviours described to contribute to pharmacists’ professionalism in the literature are broad and non-specific

Pharmacists’ use of guidelines for the supply of non-prescription medicines: a cross-sectional survey

Objectives: Guidelines support best practice for healthcare practice. In Australia, some non-prescription medicines are only accessible after consultation with a pharmacist and are known as Pharmacist Only medicines. Guidelines for providing some Pharmacist Only medicines are available, however, it is currently unknown if and how these guidelines are used in practice.// The objective was to characterise pharmacists’, intern pharmacists and pharmacy students’ use of guidelines for Pharmacist Only medicines.// Methods: A cross-sectional electronic survey of Australian registered pharmacists, intern pharmacists and pharmacy students was administered in July 2020. Questions explored the participants’ use of Pharmacist Only medicine guidelines (available both in print and online; available online only) in the preceding 12 months. Data were analysed descriptively (i.e. frequencies, percentages).// Key findings: In total, 574 eligible respondents completed the survey. Overall, 396 (69%) reported accessing the online and in-print guidelines in the previous 12 months with 185 (33%) accessing online-only guidelines. The guideline on emergency contraception was used the most out of all guidelines in the past 12 months (278, 48%). Overall, respondents reported accessing guidelines to update knowledge, check their practice reflected best practice and content familiarisation. Respondents’ reasons for not accessing guidelines were due to respondents stating they did not need the information or that they had previously accessed the guidelines more than 12 months ago. These reasons varied between respondent groups.// Conclusions: Access and use of the Pharmacist Only medicines guidelines varied between pharmacists, interns and students. Further understanding of the influences of the use of these guidelines will help inform professional bodies on how best to develop guidelines to increase consistent use in practice and implement interventions to increase use./

Use of a reference text by pharmacists, intern pharmacists and pharmacy students: a national cross-sectional survey

Background: Reference texts assist pharmacists by addressing knowledge gaps and enabling evidence-based decisions when providing patient care. It is unknown whether reference text utilisation patterns differ between pharmacists, intern pharmacists and pharmacy students. To describe and compare the self-reported use and perceptions of a reference text, namely the national formulary, by pharmacists, intern pharmacists and pharmacy students. // Methods: Registered pharmacists, intern pharmacists and pharmacy students living in Australia were surveyed in July 2020. The survey was electronic and self-administered. Questions considered self-reported use of a specific reference text in the preceding 12 months. // Key findings: There were 554 eligible responses out of 774 who commenced the survey: 430 (78%) pharmacists, 45 (8%) intern pharmacists and 79 (14%) pharmacy students. Most participants (529/554, 96%) reported historical use of the text, though pharmacists were significantly less likely than intern pharmacists and students to use it frequently (52/422, 12% versus 16/43, 37% versus 23/76, 30%, P < 0.001). Pharmacists (44%, 177/404) reported using the text as a tool to resolve a situation when providing a service or patient care (177/404, 44%) or as a teaching resource (150/404, 38%). In contrast, intern pharmacists and students most commonly use these to familiarise themselves with the contents (30/43, 70%; 46/76, 61%) or update their knowledge (34/43, 79%; 53/76, 70%). // Conclusions: Access and use patterns varied significantly across career stages. A broader understanding of the use of reference texts may help develop interventions to optimise the content and usability. Varying usage patterns across the groups may inform the tailoring of texts for future use

A surface-stabilized ozonide triggers bromide oxidation at the aqueous solution-vapour interface

Oxidation of bromide in aqueous environments initiates the formation of molecular halogen compounds, which is important for the global tropospheric ozone budget. In the aqueous bulk, oxidation of bromide by ozone involves a [Br•OOO−] complex as intermediate. Here we report liquid jet X-ray photoelectron spectroscopy measurements that provide direct experimental evidence for the ozonide and establish its propensity for the solution-vapor interface. Theoretical calculations support these findings, showing that water stabilizes the ozonide and lowers the energy of the transition state at neutral pH. Kinetic experiments confirm the dominance of the heterogeneous oxidation route established by this precursor at low, atmospherically relevant ozone concentrations. Taken together, our results provide a strong case of different reaction kinetics and mechanisms of reactions occurring at the aqueous phase-vapor interface compared with the bulk aqueous phase

A randomised study of rituximab and belimumab sequential therapy in PR3 ANCA-associated vasculitis (COMBIVAS): design of the study protocol

Background: Sequential B cell-targeted immunotherapy with BAFF antagonism (belimumab) and B cell depletion (rituximab) may enhance B cell targeting in ANCA-associated vasculitis (AAV) through several mechanisms. Methods: Study design: COMBIVAS is a randomised, double-blind, placebo-controlled trial designed to assess the mechanistic effects of sequential therapy of belimumab and rituximab in patients with active PR3 AAV. The recruitment target is 30 patients who meet the criteria for inclusion in the per-protocol analysis. Thirty-six participants have been randomised to one of the two treatment groups in a 1:1 ratio: either rituximab plus belimumab or rituximab plus placebo (both groups with the same tapering corticosteroid regimen), and recruitment is now closed (final patient enrolled April 2021). For each patient, the trial will last for 2 years comprising a 12-month treatment period followed by a 12-month follow-up period. Participants: Participants have been recruited from five of seven UK trial sites. Eligibility criteria were age ≥ 18 years and a diagnosis of AAV with active disease (newly diagnosed or relapsing disease), along with a concurrent positive test for PR3 ANCA by ELISA. Interventions: Rituximab 1000 mg was administered by intravenous infusions on day 8 and day 22. Weekly subcutaneous injections of 200 mg belimumab or placebo were initiated a week before rituximab on day 1 and then weekly through to week 51. All participants received a relatively low prednisolone (20 mg/day) starting dose from day 1 followed by a protocol-specified corticosteroid taper aiming for complete cessation by 3 months. Outcomes: The primary endpoint of this study is time to PR3 ANCA negativity. Key secondary outcomes include change from baseline in naïve, transitional, memory, plasmablast B cell subsets (by flow cytometry) in the blood at months 3, 12, 18 and 24; time to clinical remission; time to relapse; and incidence of serious adverse events. Exploratory biomarker assessments include assessment of B cell receptor clonality, B cell and T cell functional assays, whole blood transcriptomic analysis and urinary lymphocyte and proteomic analysis. Inguinal lymph node and nasal mucosal biopsies have been performed on a subgroup of patients at baseline and month 3. Discussion: This experimental medicine study provides a unique opportunity to gain detailed insights into the immunological mechanisms of belimumab-rituximab sequential therapy across multiple body compartments in the setting of AAV. Trial registration: ClinicalTrials.gov NCT03967925. Registered on May 30, 2019

Perceptions and expectations of health professionals regarding hospital pharmacy services and the roles of hospital pharmacists: A qualitative systematic review and meta-synthesis

BackgroundPharmacists have become increasingly integrated within the interprofessional hospital team as their scope of practice expanded in recent decades. However, limited research has explored how the roles of hospital pharmacists are perceived by other health professionals. Aim/Objective(s)To identify what is known about the perceptions of hospital pharmacists' roles and hospital pharmacy services held by non-pharmacist health professionals. MethodsA systematic literature search was conducted in August 2022 in MEDLINE, Embase, and CINAHL to identify peer-reviewed articles published between 2011 and 2022. Title/abstract and full-text screening, by two independent reviewers, identified eligible articles. Inclusion criteria included qualitative studies in hospital settings that reported perceptions regarding the roles of hospital pharmacists held by non-pharmacist health professionals. Data were extracted using a standardised extraction tool. Collated qualitative data underwent inductive thematic analysis by two independent investigators to identify codes, which were reconciled and merged into over-arching themes through a consensus process. Findings were assessed to measure confidence using the GRADE-CERQual criteria. ResultsThe search resulted in 14,718 hits. After removing duplicates, 10,551 studies underwent title/abstract screening. Of these, 515 underwent full-text review, and 36 were included for analysis. Most studies included perceptions held by medical or nursing staff. Hospital pharmacists were perceived as valuable, competent and supportive. At an organisational level, the roles of hospital pharmacists were perceived to benefit hospital workflow and improve patient safety. Roles contributing to all four domains of the World Health Organization's Strategic Framework of the Global Patient Safety Challenge were recognised. Highly-valued roles include medication reviews, provision of drug information, and education for health professionals. ConclusionThis review describes the roles hospital pharmacists performed within the interprofessional team, as reported by non-pharmacist health professionals internationally. Multidisciplinary perceptions and expectations of these roles may guide the prioritisation and optimisation of hospital pharmacy services.This work was supported by the Australian Government - KL and SK the Research Training Program Scholarships