Pharmacists subjected to disciplinary action: Characteristics and risk factors

Abstract Objective To establish whether there are any characteristics of pharmacists that predict their likelihood of being subjected to disciplinary action. Methods The setting was the Royal Pharmaceutical Society of Great Britain's Disciplinary Committee. One hundred and seventeen pharmacists, all of whom had been referred to the Disciplinary Committee, were matched with a quota sample of 580 pharmacists who had not been subjected to disciplinary action but that matched the disciplined pharmacists on a set of demographic factors (gender, country of residence, year of registration). Frequency analysis and regression analysis were used to compare the two groups of pharmacists in terms of sector of work, ethnicity, age and country of training. Descriptive statistics were also obtained from the disciplined pharmacists to further explore characteristics of disciplinary cases and those pharmacists who undergo them. Key findings While a number of characteristics appeared to increase the likelihood of a pharmacist being referred to the disciplinary committee, only one of these – working in a community pharmacy – was statistically significant. Professional misconduct accounted for a greater proportion of referrals than did clinical malpractice, and approximately one-fifth of pharmacists who went before the Disciplinary Committee had previously been disciplined by the Society. Conclusions This study provides initial evidence of pharmacist characteristics that are associated with an increased risk of being disciplined, based upon the data currently available. It is recommended that follow-up work is carried out using a more extensive dataset in order to confirm the statistical trends identified here. </jats:sec

The interaction of Indian monsoon depressions with northwesterly mid-level dry intrusions

Monsoon depressions (MDs) bring substantial monsoon rainfall to northern and central India. These events usually form over the Bay of Bengal and travel across northern India toward Pakistan. Using European Centre for Medium-Range Weather Forecasting Interim Reanalysis, an MD tracking algorithm, and an objective identification method, we find that about 40% of MDs interact with northerly intrusions of dry desert air masses as the MDs traverse the subcontinent. MD interactions with dry intrusions are often preceded by positive potential vorticity anomalies on the subtropical jet and low level anticyclonic anomalies over the north Arabian Sea. Dry intrusions nearly halve the precipitation rate in the southwest quadrant of MDs, where MDs rain the most. However, dry intrusions increase the rainfall rate near the MD center. Similarly, ascent is reduced west of the MD center and enhanced at the MD center, especially in the upper troposphere. The reduced ascent west of MD centers is likely attributable to changes in vertical shear reducing differential cyclonic vorticity advection. Dry intrusions slightly reduce MDs’ propagation speed. For the mid-upper level vortex, this can be explained by anomalous westerlies reducing propagation by adiabatic advection. For the lower tropospheric vortex, it is likely that reduced diabatic generation of PV plays a role in slowing propagation, along with reduced adiabatic advection

Mapping ground instability in areas of geotechnical infrastructure using satellite InSAR and Small UAV Surveying: a case study in Northern Ireland

Satellite Interferometric Synthetic Aperture Radar (InSAR), geological data and Small Unmanned Aerial Vehicle (SUAV) surveying was used to enhance our understanding of ground movement at five areas of interest in Northern Ireland. In total 68 ERS-1/2 images 1992–2000 were processed with the Small Baseline Subset (SBAS) InSAR technique to derive the baseline ground instability scenario of key areas of interest for five stakeholders: TransportNI, Northern Ireland Railways, Department for the Economy, Arup, and Belfast City Council. These stakeholders require monitoring of ground deformation across either their geotechnical infrastructure (i.e., embankments, cuttings, engineered fills and earth retaining structures) or assessment of subsidence risk as a result of abandoned mine workings, using the most efficient, cost-effective methods, with a view to minimising and managing risk to their businesses. The InSAR results provided an overview of the extent and magnitude of ground deformation for a 3000 km2 region, including the key sites of the disused salt mines in Carrickfergus, the Belfast–Bangor railway line, Throne Bend and Ligoniel Park in Belfast, Straidkilly and Garron Point along the Antrim Coast Road, plus other urbanised areas in and around Belfast. Tailored SUAV campaigns with a X8 airframe and generation of very high resolution ortho-photographs and a 3D surface model via the Structure from Motion (SfM) approach at Maiden Mount salt mine collapse in Carrickfergus in 2016 and 2017 also demonstrate the benefits of very high resolution surveying technologies to detect localised deformation and indicators of ground instabilit

On the structure and dynamics of Indian monsoon depressions

ERA-Interim reanalysis data from the past 35 years have been used with a newly-developed feature tracking algorithm to identify Indian monsoon depressions originating in or near the Bay of Bengal. These were then rotated, centralised and combined to give a fully three-dimensional 106-depression composite structure – a considerably larger sample than any previous detailed study on monsoon depressions and their structure. Many known features of depression structure are confirmed, particularly the existence of a maximum to the southwest of the centre in rainfall and other fields, and a westward axial tilt in others. Additionally, the depressions are found to have significant asymmetry due to the presence of the Himalayas; a bimodal mid-tropospheric potential vorticity core; a separation into thermally cold- (~–1.5K) and neutral- (~0K) cores near the surface with distinct properties; and that the centre has very large CAPE and very small CIN. Variability as a function of background state has also been explored, with land/coast/sea, diurnal, ENSO, active/break and Indian Ocean Dipole contrasts considered. Depressions are found to be markedly stronger during the active phase of the monsoon, as well as during La Niña. Depressions on land are shown to be more intense and more tightly constrained to the central axis. A detailed schematic diagram of a vertical cross-section through a composite depression is also presented, showing its inherent asymmetric structure

Whole-Genome Sequencing-Based Characterization of 100 Listeria monocytogenes Isolates Collected from Food Processing Environments over a Four-Year Period

Listeria monocytogenes is frequently found in foods and processing facilities, where it can persist, creating concerns for the food industry. Its ability to survive under a wide range of environmental conditions enhances the potential for cross-contamination of the final food products, leading to possible outbreaks of listeriosis. In this study, whole-genome sequencing (WGS) was applied as a tool to characterize and track 100 L. monocytogenes isolates collected from three food processing environments. These WGS data from environmental and food isolates were analyzed to (i) assess the genomic diversity of L. monocytogenes, (ii) identify possible source(s) of contamination, cross-contamination routes, and persistence, (iii) detect absence/presence of antimicrobial resistance-encoding genes, (iv) assess virulence genotypes, and (v) explore in vivo pathogenicity of selected L. monocytogenes isolates carrying different virulence genotypes. The predominant L. monocytogenes sublineages (SLs) identified were SL101 (21%), SL9 (17%), SL121 (12%), and SL5 (12%). Benzalkonium chloride (BC) tolerance-encoding genes were found in 62% of these isolates, a value that increased to 73% among putative persistent subgroups. The most prevalent gene was emrC followed by bcrABC, qacH-Tn6188, and qacC. The L. monocytogenes major virulence factor inlA was truncated in 31% of the isolates, and only one environmental isolate (L. monocytogenes CFS086) harbored all major virulence factors, including Listeria pathogenicity island 4 (LIPI-4), which has been shown to confer hypervirulence. A zebrafish embryo infection model showed a low (3%) embryo survival rate for all putatively hypervirulent L. monocytogenes isolates assayed. Higher embryo survival rates were observed following infection with unknown virulence potential (20%) and putatively hypovirulent (53 to 83%) L. monocytogenes isolates showing predicted pathogenic phenotypes inferred from virulence genotypes

A two-arm parallel-group individually randomised prison pilot study of a male remand alcohol intervention for self-efficacy enhancement:The APPRAISE study protocol

Introduction The prevalence of at-risk drinking is far higher among those in contact with the criminal justice system (73%) than the general population (35%). However, there is little evidence on the effectiveness of alcohol brief interventions (ABIs) in reducing risky drinking among those in the criminal justice system, including the prison system and, in particular, those on remand. Building on earlier work, A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE) is a pilot study designed to assess the feasibility and acceptability of an ABI, delivered to male prisoners on remand. The findings of APPRAISE should provide the information required to design a future definitive randomised controlled trial (RCT). Methods and analysis APPRAISE will use mixed methods, with two linked phases, across two prisons in the UK, recruiting 180 adult men on remand: 90 from Scotland and 90 from England. Phase I will involve a two-arm, parallel-group, individually randomised pilot study. The pilot evaluation will provide data on the likely impact of A two-arm parallel group individually randomised Prison Pilot study of a male Remand Alcohol Intervention for Self-efficacy Enhancement (APPRAISE), which will be used to inform a future definitive multicentre RCT. Phase II will be a process evaluation assessing how the ABI has been implemented to explore the change mechanisms underpinning the ABI (figure 1) and to assess the context within which the ABI is delivered. Ethics and dissemination The APPRAISE protocol has been approved by the East of Scotland Research Ethics Committee (19/ES/0068), National Offender Management System (2019-240), Health Board Research and Development (2019/0268), Scottish Prison Service research and ethics committee, and by the University of Edinburgh’s internal ethics department. The findings will be disseminated via peer-reviewed journal publications, presentations at local, national and international conferences, infographics and shared with relevant stakeholders through meetings and events.Additional co-authors: Jeremy Bray, Jennifer Ferguson, Arun Sondhi, Kieran Lynch, Jessica Rees, Dorothy Newbury-Birc