Kinetic temperature of massive star-forming molecular clumps measured with formaldehyde IV. The ALMA view of N113 and N159W in the LMC

We mapped the kinetic temperature structure of two massive star-forming regions, N113 and N159W, in the Large Magellanic Cloud (LMC). We have used ~1.′′6 (~0.4 pc) resolution measurements of the para-H2CO JKaKc = 303–202, 322–221, and 321–220 transitions near 218.5 GHz to constrain RADEX non local thermodynamic equilibrium models of the physical conditions. The gas kinetic temperatures derived from the para-H2CO line ratios 322–221/303–202 and 321–220/303–202 range from 28 to 105 K in N113 and 29 to 68 K in N159W. Distributions of the dense gas traced by para-H2CO agree with those of the 1.3 mm dust and Spitzer 8.0 μm emission, but they do not significantly correlate with the Hα emission. The high kinetic temperatures (Tkin ≳ 50 K) of the dense gas traced by para-H2CO appear to be correlated with the embedded infrared sources inside the clouds and/or young stellar objects in the N113 and N159W regions. The lower temperatures (Tkin < 50 K) were measured at the outskirts of the H2CO-bearing distributions of both N113 and N159W. It seems that the kinetic temperatures of the dense gas traced by para-H2CO are weakly affected by the external sources of the Hα emission. The non thermal velocity dispersions of para-H2CO are well correlated with the gas kinetic temperatures in the N113 region, implying that the higher kinetic temperature traced by para-H2CO is related to turbulence on a ~0.4 pc scale. The dense gas heating appears to be dominated by internal star formation activity, radiation, and/or turbulence. It seems that the mechanism heating the dense gas of the star-forming regions in the LMC is consistent with that in Galactic massive star-forming regions located in the Galactic plane

Ideal and actual involvement of community pharmacists in health promotion and prevention: a cross-sectional study in Quebec, Canada

<p>Abstract</p> <p>Background</p> <p>An increased interest is observed in broadening community pharmacists' role in public health. To date, little information has been gathered in Canada on community pharmacists' perceptions of their role in health promotion and prevention; however, such data are essential to the development of public-health programs in community pharmacy. A cross-sectional study was therefore conducted to explore the perceptions of community pharmacists in urban and semi-urban areas regarding their ideal and actual levels of involvement in providing health-promotion and prevention services and the barriers to such involvement.</p> <p>Methods</p> <p>Using a five-step modified Dillman's tailored design method, a questionnaire with 28 multiple-choice or open-ended questions (11 pages plus a cover letter) was mailed to a random sample of 1,250 pharmacists out of 1,887 community pharmacists practicing in Montreal (Quebec, Canada) and surrounding areas. It included questions on pharmacists' ideal level of involvement in providing health-promotion and preventive services; which services were actually offered in their pharmacy, the employees involved, the frequency, and duration of the services; the barriers to the provision of these services in community pharmacy; their opinion regarding the most appropriate health professionals to provide them; and the characteristics of pharmacists, pharmacies and their clientele.</p> <p>Results</p> <p>In all, 571 out of 1,234 (46.3%) eligible community pharmacists completed and returned the questionnaire. Most believed they should be very involved in health promotion and prevention, particularly in smoking cessation (84.3%); screening for hypertension (81.8%), diabetes (76.0%) and dyslipidemia (56.9%); and sexual health (61.7% to 89.1%); however, fewer respondents reported actually being very involved in providing such services (5.7% [lifestyle, including smoking cessation], 44.5%, 34.8%, 6.5% and 19.3%, respectively). The main barriers to the provision of these services in current practice were lack of: time (86.1%), coordination with other health care professionals (61.1%), staff or resources (57.2%), financial compensation (50.8%), and clinical tools (45.5%).</p> <p>Conclusions</p> <p>Although community pharmacists think they should play a significant role in health promotion and prevention, they recognize a wide gap between their ideal and actual levels of involvement. The efficient integration of primary-care pharmacists and pharmacies into public health cannot be envisioned without addressing important organizational barriers.</p

Assessment of global cardiovascular risk and risk factors in Portugal according to the SCORE® model

Abstract Background/objective Cardiovascular diseases (CVD) are the leading cause of mortality in European countries. This study aimed at estimating the 10-year risk of fatal CVD in Portuguese adults and to assess the prevalence of major cardiovascular risk factors, according to the SCORE® risk prediction system. Subjects and methods A cross-sectional survey was carried out in 60 community pharmacies (CP) from October 2005 to January 2006 in a sample of CP users (=40 and =65 years). Data were collected by patient interviews using a structured questionnaire applied by a trained pharmacist. Results A total of 1,043 individuals were enrolled in the study (participation rate: 91%). The mean age was 53.7 years (SD: 7.1) with a ratio men/women of 0.68. The average risk in the sample was 1.94 (minimum 0, maximum 28, SD?=2.69). About 20% of the studied adults were at high risk, of which 39.4% were asymptomatic. CV risk was significantly higher in the oldest age group and in men (p?<?0.05). The prevalence of main CV risk factors was: hypertension-54.8%; hypercholesterolemia-63.1%, diabetes-13.4%; smoking-10.4% and obesity–29.0%. About 1/3 of those asked had family history of premature CVD. Mean values of biochemical and clinical parameters were: systolic blood pressure (mmHg): 134.8?±?19.7; diastolic blood pressure (mmHg): 81.0?±?11.4; total cholesterol (mg/dl): 193.8?±?34.6; body mass index (kg/m2): 28.0?±?4.5. Conclusions According to SCORE®, about one-fifth of the individuals was classified as high risk, and 7.7% was asymptomatic. CV risk was significantly higher in the oldest age group (55–65 years old) and in men (p?<?0.05). These results show a high prevalence of some risk factors, particularly hypertension and hypercholesterolemia

Cardiovascular risk screening program in Australian community pharmacies

Objective: To assess the suitability of Australian community pharmacies as cardiovascular disease risk profile screening centres and evaluate whether community pharmacists can play an important role in detecting, educating and referring screened individuals at high risk of cardiovascular disease. Setting 14 Australian community pharmacies. Method: Opportunistic cardiovascular disease risk profiling for members of the public aged greater than 30 years with no existing cardiovascular diseases was performed. All major cardiovascular risk factors were measured. Exercise habits, existing conditions and therapy, and family history were also assessed. The results were used to calculate each subject’s 10-year risk of developing cardiovascular events, based on Framingham Risk Equations (New Zealand tables). Each subject’s knowledge of cardiovascular risk factors was assessed using a multiple-choice questionnaire. Written educational materials and verbal counselling were provided. Referral to a doctor for further assessment was recommended as appropriate. The screened individuals were followed up via mailed out questionnaire. A random sample of individuals at elevated risk was phoned to assess for outcomes of the screening and referral process. Main outcome measures Risk of developing cardiovascular disease and knowledge of cardiovascular risk factors. Results: A total of 655 individuals (71.4% female) were screened for cardiovascular disease risk factors. Ages ranged from 30 to 90 years (median: 54 years) and 14.2% were smokers. Of the individuals screened, 28.1% had a 10-year risk of developing cardiovascular disease greater than 15%, including 6.9% who had a 10-year risk above 30%. The median calculated 10-year risk of developing cardiovascular disease was 9.5%. Approximately one-third of the individuals had elevated blood pressure, and almost two-thirds were either overweight or obese. The mean total serum cholesterol was 5.31 mmol/l, with 40% of individuals having a level above 5.5 mmol/l and 20% having a high-density lipoprotein cholesterol level below 1.0 mmol/l. There was a statistically significant improvement in the knowledge of cardiovascular disease risk factors at follow-up. Almost half of the contacted high-risk subjects reported lifestyle changes or started drug therapy following re-testing by their general practitioner. Conclusion: A pharmacy-based cardiovascular disease risk profile screening and education program has the potential to identify and refer many undiagnosed individuals at high risk of cardiovascular events, and help contain the burden of heart disease