Public health in community pharmacy: a systematic review of pharmacist and consumer views

BACKGROUND The increasing involvement of pharmacists in public health will require changes in the behaviour of both pharmacists and the general public. A great deal of research has shown that attitudes and beliefs are important determinants of behaviour. This review aims to examine the beliefs and attitudes of pharmacists and consumers towards pharmaceutical public health in order to inform how best to support and improve this service. METHODS Five electronic databases were searched for articles published in English between 2001 and 2010. Titles and abstracts were screened by one researcher according to the inclusion criteria. Papers were included if they assessed pharmacy staff or consumer attitudes towards pharmaceutical public health. Full papers identified for inclusion were assessed by a second researcher and data were extracted by one researcher. RESULTS From the 5628 papers identified, 63 studies in 67 papers were included. Pharmacy staff: Most pharmacists viewed public health services as important and part of their role but secondary to medicine related roles. Pharmacists' confidence in providing public health services was on the whole average to low. Time was consistently identified as a barrier to providing public health services. Lack of an adequate counselling space, lack of demand and expectation of a negative reaction from customers were also reported by some pharmacists as barriers. A need for further training was identified in relation to a number of public health services. Consumers: Most pharmacy users had never been offered public health services by their pharmacist and did not expect to be offered. Consumers viewed pharmacists as appropriate providers of public health advice but had mixed views on the pharmacists' ability to do this. Satisfaction was found to be high in those that had experienced pharmaceutical public health. CONCLUSIONS There has been little change in customer and pharmacist attitudes since reviews conducted nearly 10 years previously. In order to improve the public health services provided in community pharmacy, training must aim to increase pharmacists' confidence in providing these services. Confident, well trained pharmacists should be able to offer public health service more proactively which is likely to have a positive impact on customer attitudes and health

PHOTOOXIDATION OF CRUDE PETROLEUM MALTENIC FRACTION IN NATURAL SIMULATED CONDITIONS AND STRUCTURAL ELUCIDATION OF PHOTOPRODUCTS

Photooxidation is an important process in the degradation of petroleum spilled in the marine environment. Most crude oils spilled at sea spread rapidly to form slicks with greatly increased surface area. Thus, a fundamental understanding of the effect of photooxidation on oil is a prerequisite for providing an accurate description of the recent history and potential fate of oil spilled in a marine environment. The present work describes a reliable method for evolution and studies the nature of the photoproducts and composition of the residual hydrocarbons of an oil film over the seawater. The maltenic fraction of Iranian oil was exposed to sunlight with simulated natural conditions as a film of oil over seawater. The effect of ultraviolet illumination on using a variety of techniques including GC/MS and FT-IR was examined. The saturated hydrocarbons were very resistant, but the aromatic hydrocarbons were particularly sensitive to photochemical degradation. Greater size and increasing alkyl substitution increased the sensitivity of aromatic compounds to photooxidation

Transplantation of human chromaffin cells for control of intractable cancer pain

Adrenal medullary chromaffin cells produce high levels of endogenous opioid peptides. Recent data suggest that transplantation injected locally into the spinal subarachnoid space reduced intractable malignant pain. In order to determine the feasibility, the efficacy and the risks of using adrenal medullary tissue for control of irreducible pain, we have developed a transplantation protocol on cancer pain patients selected when they required chronic intrathecal injection of morphine and progressively increasing doses to maintain the level of analgesic effects. At the present time, our clinical trial involves 8 patients. We report here our initial results (mean follow-up: 5 months). The various data collected before and after the intrathecal administration of chromaffin cells included: 1) Pain evaluation over time, with concomitant narcotic intake, 2) CSF sampling through an implanted access port to determine the following biological parameters: biochemical assay for opioid peptides, cell count and phenotyping of lymphocytes, 3) peripheral blood samples for lymphocyte typing. The results confirm the efficacy of adrenal medullary transplantation into spinal CSF for controlling irreducible cancer pain. Complementary intrathecal and oral morphine were totally stopped in 2 cases and stabilized in 5 others. It seems essential to have an important volume of grafted tissue to achieve analgesia with high levels of metenkephalin in CSF. A progressive decrease in metenkephalin release was observed from 2 to 4 months after the transplantation. Two patients with a long-term follow-up (8 and 12 months) needed another intrathecal chromaffin cell graft

Efficacy of Gluma Desensitizer® on dentin hypersensitivity in periodontally treated patients Eficácia do Gluma Desensitizer® sobre hipersensibilidade dentinária em pacientes periodontalmente tratados

The aim of this double-blind, controlled, split-mouth designed clinical trial was to assess the effect of a single application of Gluma Desensitizer® on alleviating dentin hypersensitivity. Twelve subjects entered the study and ten completed the protocol. Each subject had two teeth treated: one with Gluma Desensitizer® according to the manufacturer's instructions and one with water. The assessment of pain was performed with the VAS (Visual Analogue Scale), after tactile (probe), thermal (cold blast of water) and thermal/evaporative (cold blast of air) stimuli at baseline, immediately after treatment, after 1 week and after 4 weeks. The mean VAS values for the test and control teeth were compared by the paired t test (alpha = 0.05). Repeated measurements ANOVA was used to compare the different experimental times. The results showed that for test teeth, at baseline, mean VAS values were 1.76 (&plusmn; 2.82), 7.10 (&plusmn; 2.10) and 4.75 (&plusmn; 2.65), and, after 4 weeks, the mean values were 1.70 (&plusmn; 2.31), 5.50 (&plusmn; 3.30) and 4.61 (&plusmn; 3.14), respectively for probe, water and air stimuli. For the control teeth, at baseline, the mean VAS values were 1.86 (&plusmn; 2.92), 6.61 (&plusmn; 2.31) and 4.08 (&plusmn; 2.91) and, after 4 weeks, 2.66 (&plusmn; 3.07), 6.32 (&plusmn; 2.94) e 4.76 (&plusmn; 3.26).There were no statistically significant differences between test and control teeth at any time. No intra-group differences were demonstrated either. It was concluded that Gluma Desensitizer® had no effect on hypersensitive teeth from periodontally treated patients for a period up to 4 weeks.<br>O objetivo deste estudo clínico duplo-cego, controlado, de boca-dividida foi avaliar o efeito de uma aplicação única do Gluma Desensitizer® no alívio da hipersensibilidade dentinária. Doze sujeitos participaram do estudo, sendo que destes dez completaram o estudo. Cada um dos participantes teve dois dentes tratados, um com o Gluma Desensitizer®, de acordo com as orientações do fabricante, e o outro com água. Para a avaliação da dor foi utilizada a EVA (Escala Visual Analógica), após os estímulos táctil (sonda), térmico (jato de água frio) e térmico/evaporativo (jato de ar frio) no início do experimento, imediatamente após o tratamento, uma e quatro semanas após. Os valores médios encontrados na EVA foram comparados pelo teste-t pareado (alfa = 0,05). Para os diferentes tempos experimentais utilizou-se ANOVA para medidas repetidas. Os resultados mostram que, no início do tratamento, os valores médios foram de 1,76 (&plusmn; 2,82), 7,10 (&plusmn; 2,10) e 4,75 (&plusmn; 2,65) para os dentes teste e, após quatro semanas, os valores médios foram de 1,70 (&plusmn; 2,31), 5,50 (&plusmn; 3,30) e 4,61 (&plusmn; 3,14) respectivamente para os estímulos sonda, água e ar. Para os dentes controle, no início do tratamento, os valores médios segundo a EVA foram de 1,86 (&plusmn; 2,92), 6,61 (&plusmn; 2,31) e 4,08 (&plusmn; 2,91) e, após 4 semanas, 2,66 (&plusmn; 3,07), 6,32 (&plusmn; 2,94) e 4,76 (&plusmn; 3,26). Não ocorreram diferenças estatisticamente significativas entre os dentes teste e controle em nenhum dos tempos experimentais. Também não ocorreram diferenças intragrupo. Concluímos que o Gluma Desensitizer® não tem efeito sobre a hipersensibilidade dentinária de pacientes periodontalmente tratados num período de até quatro semanas