Comparing outpatient oral antibiotic use in Germany and the Netherlands from 2012 to 2016.

PURPOSE: Overuse of antibiotics is of concern, but may differ between European countries. This study compares outpatient use of oral antibiotics between Germany (DE) and the Netherlands (NL). METHODS: For DE, we used the DAPI database with information on dispensings at the expense of the Statutory Health Insurance Funds from > 80% of community pharmacies. For NL, data were obtained from the Dutch Foundation for Pharmaceutical Statistics. Use of oral antibiotics was estimated as defined daily doses per 1000 inhabitants per day (DID), except for age comparisons as packages per 1000 inhabitants annually. National time trends were assessed with linear regression, stratified for the major antibiotic classes, and individual substances. RESULTS: From 2012 to 2016, outpatient antibiotic use was lower in NL than in DE (9.64 vs 14.14 DID in 2016) and non-significantly decreased slightly over time in both countries. In DE, dispensings of oral antibiotics to children were higher compared with NL for the age groups 2 to 5 (2.0-fold in 2016) and 6 to 14 years (2.7-fold in 2016). Use of cephalosporins was very low in NL (0.02 DID in 2016), but the second most frequently dispensed class in DE (2.95 DID in 2016). CONCLUSION: From 2012 to 2016, outpatient use of oral antibiotics was lower in NL than in DE. Differences were primarily observed in the age groups 2 to 5 and 6 to 14 years, although the recommendations of evidence-based guidelines in both countries were in agreement

Development of a maturity matrix to assess organizational readiness of community pharmacies for implementation of guideline recommendations in diabetes care

ObjectivesPharmaceutical care for people with diabetes mellitus type 2 (DMT2) has been described in professional guidelines. To apply their recommendations, organizational changes are needed. We aimed to describe, for the first time, the development of a maturity matrix for community pharmacy teams (MM-CP) to assess organizational readiness in implementing the guideline recommendations on pharmaceutical DMT2 care.MethodsMM-CP development was conducted in a systematic consensus process with pharmacists from existing working groups. In three meetings with preparatory assignments, mutually exclusive domains were chosen for the DMT2 guideline implementation. After determining the growth steps, the resulting matrix cells were filled with examples of the organizational implementation activities. To explore the generalizability of domains and growth steps, two other working groups for “medication surveillance” and “multidose drug dispensing” guidelines were consulted.Key findingsA five-by-five matrix was developed using the domains “personalized care,” “teamwork,” “information systems and data exchange,” “external collaboration,” and “education and research” on the horizontal axis, and the growth steps “being aware and motivated,” “being able to,” “performing, evaluating and improving,” and “innovating” on the vertical axis. The MM-CP cells were filled with examples to implement the core recommendations of the DMT2 guideline. The matrix is to be used by pharmacy teams as a formative instrument.ConclusionsThe MM-CP is ready for use by community pharmacy teams for self-assessing their organizational readiness. However, further research is required to evaluate its potential in stimulating targeted improvement during the implementation of the DMT2-guideline recommendations in community pharmacies.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Treatise on Invertebrate Paleontology, Part W, conodonts, conoidal shells, worms, trace fossils: comments and additions

18 p., 21 fig.http://paleo.ku.edu/contributions.htm

Evaporative gold nanorod assembly on chemically stripe-patterned gradient surfaces

Experimentally we explore the potential of using pre-defined motion of a receding contact line to control the deposition of nanoparticles from suspension. Stripe-patterned wettability gradients are employed, which consist of alternating hydrophilic and hydrophobic stripes with increasing macroscopic surface energy. Nanoparticle suspensions containing nanorods and nanospheres are deposited onto these substrates and left to dry. After moving over the pattern and evaporation of the solvent, characteristic nanoparticle deposits are found. The liquid dynamics has a pronounced effect on the spatial distribution. Nanoparticles do not deposit on the hydrophobic regions; there is high preference to deposit on the wetting stripes. Moreover, the fact that distributed nanoparticle islands are formed suggests that the receding of the contact line occurs in a stick-slip like fashion. Furthermore, the formation of liquid bridges covering multiple stripes during motion of the droplet over the patterns is modeled. We discuss their origin and show that the residue after drying, containing both nanoparticles and the stabilizing surfactant, also resembles such dynamics. Finally, zooming into individual islands reveals that highly selective phase separation occurs based on size and shape of the nanoparticle

Effect of Methionine Supplementation During Late Gestation in Beef Females

Some amino acids are known to be essential to cattle and effect protein availability to the animal, especially during gestation when nutrient requirements are higher. Methionine is found to be one of the most limiting in low quality forage diets. Two 3-yr studies were performed to evaluate the impact of methionine supplementation during late gestation on intake, body weight, average daily gain, and subsequent calf performance in primiparous and multiparous females. In exp 1, 120 artificially inseminated pregnancy heifers were placed in a Calan gate feeding system (n=40/yr) and assigned 1 of 3 treatments during late gestation and fed ad libitum grass hay with either: no supllement, 2 lbs. distillers based supplement with 1 oz of rumen protected methionine. In exp 2, multiparous cows on upland winter range were fed 1 of 5 treatments; no supplement, ad libitum meadow hay, 1 lb. of a distiller\u27s based cube, 2 lb. of a distiller\u27s based cube, or 2 lb. of a distiller\u27s based cube plus 1 oz of a rumen protected methionine. Body weight, body condition score, reproductive responses, and subequent calf performance were recorded in both studies. No differences were observed in calving performance or progeny carcass characteristics in either experiment in response to methionine supplementation, so it may not be a necessary supplementation strategy

Hierarchy of adhesion forces in patterns of photoreactive surface layers

Precise control of surface properties including electrical characteristics, wettability, and friction is a prerequisite for manufacturing modern organic electronic devices. The successful combination of bottom up approaches for aligning and orienting the molecules and top down techniques to structure the substrate on the nano and micrometer scale allows the cost efficient fabrication and integration of future organic light emitting diodes and organic thin film transistors. One possibility for the top down patterning of a surface is to utilize different surface free energies or wetting properties of a functional group. Here, we used friction force microscopy (FFM) to reveal chemical patterns inscribed by a photolithographic process into a photosensitive surface layer. FFM allowed the simultaneous visualization of at least three different chemical surface terminations. The underlying mechanism is related to changes in the chemical interaction between probe and film surface.Comment: 11 pages, 5 figures The following article has been submitted to Journal of Chemical Physics. After it is published, it will be found at http://jcp.aip.org

Is keV ion induced pattern formation on Si(001) caused by metal impurities?

We present ion beam erosion experiments performed in ultra high vacuum using a differentially pumped ion source and taking care that the ion beam hits the Si(001) sample only. Under these conditions no ion beam patterns form on Si for angles below 45 degrees with respect to the global surface normal using 2 keV Kr ions and fluences of 2 x 10^22 ions/m^2. In fact, the ion beam induces a smoothening of preformed patterns. Simultaneous sputter deposition of stainless steel in this angular range creates a variety of patterns, similar to those previously ascribed to clean ion beam induced destabilization of the surface profile. Only for grazing incidence with incident angles between 60 degrees and 83 degrees pronounced ion beam patterns form. It appears that the angular dependent stability of Si(001) against pattern formation under clean ion beam erosion conditions is related to the angular dependence of the sputtering yield, and not primarily to a curvature dependent yield as invoked frequently in continuum theory models.Comment: 15 pages, 7 figures. This is an author-created, un-copyedited version of an article published in Nanotechnology. IOP Publishing Ltd is not responsible for any errors or omissions in this version of the manuscript or any version derived from i

Dark Current in Superconducting RF Photoinjectors Measurements and Mitigation

Unwanted beam can cause beam losses and may produce acute or chronic damages of the accelerator. Furthermore it can considerably disturb experiments or increase its back ground. The operation of the superconducting RF photo gun at the ELBE accelerator has delivered the first experimental information on that topic. It was found, that dark current is an important issue, similar to that normal conducting RF photo injectors. In the presentation the measurement of dark current, its properties and analysis will be shown and we will discuss ways for mitigation, especially the construction of a dark current kicke