Drinking to excess and the tipping point: An international study of alcohol intoxication in 61,000 people

BackgroundPeople who drink alcohol often seek to manage their intake in order to maximise the pleasurable effects, such as feelings of sociability and relaxation, without reaching their ‘tipping point’, where they feel out of control, or unwell. This paper aimed to explore three stages of intoxication; feeling the effects; being as drunk as you would like to be; and reaching the tipping point (feeling more drunk than you want to be) in a large international sample.MethodsThe Global Drug Survey (GDS) is an annual, cross-sectional, online survey of drug use. This paper draws on data from 61,043 respondents (63.7% male) from 21 countries who took part in GDS2015 collected in November 2014 to January 2015. Respondents reported their usual type of drink; how many drinks they would require to reach each stage of intoxication and how frequently they reached each stage. Alongside socio-demographic measures, they also completed the Alcohol Use Disorders Identification Test (AUDIT).ResultsMale respondents reported consuming 87.55 gm to be as drunk as they want to be and female respondents reported 70.16 gm, on average. The tipping point was reached at 138.65 gm for male respondents and 106.54 gm for female respondents. Overall 20.3% reported reaching their tipping point at least once a month. Being male, aged under 25 and at higher risk for alcohol use disorder was associated with reporting reaching the tipping point more frequently.ConclusionsThe amount of alcohol being consumed to reach a desired point of intoxication is much higher than the maximum daily, and sometimes weekly, amount recommended by country guidelines. Encouraging people to avoid reaching their tipping point may be a useful intervention point alongside better communication of low risk drinking guidelines.     

Evaluation of patient perspective of point of care testing and medication: Dispensing by community pharmacists for Streptococcus pyogenes and influenza

BackgroundRecent state-level legislation allows pharmacies to implement protocols for the testing and treatment of influenza and group A streptococcal pharyngitis infections, which may improve access.ObjectivesThis study evaluated patient perspectives on testing and treatment of influenza or streptococcal pharyngitis infections in the pharmacy and evaluated patient acceptance, willingness to seek testing, and willingness to pay.MethodsThis study used a cross-sectional paper survey administered at the community pharmacy after receiving a coronavirus disease 2019 vaccine. The survey consisted of multiple choice and rank order. Surveys were anonymous and returned after completion before leaving the pharmacy. Survey data were entered into an Excel database for analysis.ResultsThere were a total of 152 respondents. Most of them were older than the age of 50 years and female. Most (89%) have a primary care provider (PCP) and their preferred location for testing was their PCP or a walk-in, quick care setting. More than half of the respondents stated that they would use the pharmacy as a source for testing and treatment for streptococcal pharyngitis infections and influenza. Half of the respondents pay an office copay visit of less than $15 and 29% pay $25-$50 per visit. The majority of respondents (62%) were willing to pay $25 or more out of pocket for testing.ConclusionAlthough the pharmacy was not the preferred site for testing, more than half of the respondents stated that they would use the pharmacy for testing and treatment. Most respondents’ willingness to pay was more than their copayments for office visits, suggesting some may value the convenience of testing and treatment at the pharmacy.     

Quantum dot induced acute changes in lung mechanics are mouse strain dependent

Abstract

Introduction: Concerns have been raised regarding occupational exposure to engineered nanomaterials (ENMs). Potential impacts on lung function from inhalation exposures are of concern as the lung is a sensitive ENM target in animals. Epidemiological data suggest that occupational exposure to ENMs may impact respiratory and cardiovascular health. Quantum dots (QDs) are ENMs with outstanding semiconductor and fluorescent properties with uses in biomedicine and electronics. QDs are known to induce inflammation and cytotoxicity in rodents and high dose exposures impact lung function 2 weeks after exposure. However, effects of mouse strain and the temporality of QD effects on lung function at more occupationally relevant doses have not been well-established.

Objective: We evaluated the impact of QD exposure on respiratory mechanics in C57BL/6J and A/J mice. Previous work found a greater initial inflammatory response to QD exposure in A/J mice compared to C57BL/6J mice. Thus, we hypothesized that A/J mice would be more sensitive to QD-induced effects on lung mechanics.

Methods: C57BL/6J and A/J mice were exposed to 6?μg/kg Cd equivalents of amphiphilic polymer-coated Cd/Se core, ZnS shell QDs via oropharyngeal aspiration. Lung mechanics were measured using forced oscillation, and inflammation was characterized by neutrophils and cytokines in bronchoalveolar lavage fluid.

Results: Both strains showed signs of QD-induced acute lung inflammation. However, lung mechanics were impacted by QD exposure in A/J mice only.

Conclusions: Our findings suggest that susceptibility to QDs and similar ENM-induced changes in lung function may depend at least in part on genetic background.     

阻生第三磨牙生长方向与牙根数目关系的探讨

目的对临床拔除的1035颗阻生第三磨牙的生长方向（阻生类型）与牙根数目的关系进行分析与探讨。方法记录1035颗阻生第三磨牙拔除前阻生类型（生长方向）和拔除后牙根数目。结果阻生类型中,下颌以近中阻生最多见（50．559／6）,其次为垂直阻生（45．05％）,远中阻生最少（4．40％）;上颌以颊向阻生最多见（60．12％）,其次为垂直阻生（35．58％）,腭向阻生和远中阻生最少。下颌牙根数目有四类：两根（60．99％）、融合根（34．62％）、多根（3．859／6）和单根（0．55％）;上颌牙根数目有五类：融合根（56．44％）、三根（20．25％）、两根（17．79％）、四根（4．29％）和单根（1．23％）。下颌近中阻生、垂直阻生和远中阻生中两根比率、融合根比率分别为64．13％、33．70％,59．75％、32．93％,37．50％、62．50％。上颌颊向阻生、垂直阻生、腭向阻生和远中阻生中融合根比率分别为56．12％、56．9％、50％、66．67％。结论阻生第三磨牙的牙根数目与生长方向（阻生类型）有关,这一结果对临床顺利拔除阻生第三磨牙有重要指导意义。     

Pharmacy Access to Sterile Syringes for Injection Drug Users: Attitudes of Participants in a Syringe Exchange Program

ObjectiveTo examine attitudes of participants of a van-based syringe exchange program (SEP) toward the hypothetical prospect of pharmacy-based syringe access.DesignOne-time, cross-sectional survey.SettingBaltimore, Maryland.Participants206 injection drug users who participate in the Baltimore SEP.InterventionsFace-to-face interviews.Main Outcome MeasuresLocation preferred for obtaining syringes, drug and syringe use, past experience with pharmacies, and willingness to pay.ResultsThe sample was 67% men, 95% African American, and 95% unemployed; mean age was 39.8 years. A total of 19% of respondents had bought syringes at a pharmacy during the prior six months. Some 37% reported having been turned down when asking for syringes at a pharmacy, most commonly due to lack of identification to prove diabetic status (50%). If legal restrictions were lifted, 92% of respondents would obtain syringes from pharmacies, and would be willing to pay a mean price of $0.80 (median = $1.00) per syringe. Women were more likely than men to report the intention to switch from van-based SEP to pharmacy (57% versus 38%, p = .045).ConclusionIf current legal restrictions were lifted, pharmacies would be a viable syringe source appealing particularly to women, suggesting gender-specific access issues that should be addressed. The per-syringe price that study participants would be willing to pay exceeds typical retail prices, suggesting that pharmacists could charge enough per syringe to recoup operational costs.     

基于T>MIC简易数学模型对二室模型的拓展适用性探讨美罗培南给药方案

目的 考察T>MIC简易数学模型对二室模型的适用性,简化T>MIC计算过程,并据此探讨美罗培南给药方案。方法 以美罗培南的推荐剂量和静脉输注时间分别为0.5 h与3 h设计6种临床常用方案（0.5 g/次 q8 h 0.5 h、0.5 g/次 q8 h 3 h、1.0 g/次 q8 h 0.5 h、1.0 g/次q8 h 3 h、2.0 g/次q8 h 0.5 h、2.0 g/次q8 h 3 h）,各方案分别与美罗培南对临床常见致病菌的4种MIC敏感性折点（0.5、1、2、4 μg/ml）组合形成不同的T>MIC,每种方案的T>MIC又可根据简易模型和二室模型计算,结果形成不同方案下的T>MIC对子,T>MIC差异采用配对样本t检验,考察简易数学模型的拓展适用性。并根据简易模型计算T>MIC%,以其达到40%~100%探讨美罗培南对不同细菌感染的给药方案。结果与结论 简易模型可替代二室模型计算T>MIC,根据该模型从理论上可方便快捷地对美罗培南给药方案进行初判和模拟优化。     

食物嵌塞的病因与疗效分析

目的 探索食物嵌塞的病因与治疗方法, 为临床防治食物嵌塞提供参考。方法 选择临床确诊的食物嵌塞患者500 例, 详细询问病史与发病原因, 针对不同病因给予不同方法的治疗。2年后随访治疗效果, 总结临床资料并进行统计学分析。结果 食物嵌塞多发生于35～65岁, 以垂直型嵌塞为主, 原因以龋损﹑牙周炎﹑不良充填及修复体等造成牙齿邻面接触关系和咬合关系不正常多见。拔牙、冠修复与充填的治疗有效率较高, 分别为100.00%、89.03%和88.20%。结论 对于食物嵌塞患者, 应针对不同病因采取不同治疗方法, 以免引起严重并发症, 导致牙齿缺失。     

Patterns and Perceptions of Dextromethorphan Use in Adult Members of an Online Dextromethorphan Community

Abstract

Dextromethorphan (DXM) is a widely available antitussive that has, at elevated dose levels, euphoric and dissociative effects. This article presents the reported patterns and preferences of DXM use, and perceptions of DXM use among adult members of an online DXM community. Analyses were conducted of quantitative and qualitative responses from nine female and 43 male individuals, aged 18–63 years old. All respondents reported illegal and DXM drug use, beginning, on average, at 15.7 and 17.1 years of age, respectively. The majority of respondents first heard about DXM online or from a friend, preferred to use DXM alone, ingested substances concurrently with DXM to modify its effects, had not been to an emergency room or arrested because of their DXM use, and used DXM for its dissociative and mind-altering effects. DXM was perceived as safe and in no need of further regulation with only 14% of respondents mentioning DXM’s addictive qualities. Findings from this sample of adult DXM users reveal a sophisticated subculture in which users report using DXM specifically to induce changes to their mental state and use a variety of substances to modify or enhance DXM’s effects.     

An analysis of which anti-osteoporosis therapeutic regimen would improve compliance in a population of elderly adults

ABSTRACT

Objective: Although medications to prevent osteoporotic fractures have been proven to be effective, compliance to these therapies is generally poor. Therapeutic regimens for different anti-osteoporotic medications differ widely and it is currently unknown which regimen would be most preferred by patients.

Research design and methods: We conducted a large, population-based study to discern which therapeutic attributes would be most preferable to a population representative of the age and sex distribution of patients with osteoporosis.

Results: Our study sample was restricted to persons aged 55 years and over and comprised 2485 individuals (mean age of 64.5 years). The study population was predominantly female (90.3%) and two-thirds of the respondents reported current daily medication use. Nearly half (45%) of the study population preferred to take medications daily, while one in five preferred weekly therapy and 30% preferred monthly therapy (?p < 0.0001 for between proportion comparisons). When given the option of choosing between three different medication regimen scenarios, those subjects not currently using anti-osteoporotic medications preferred a theoretical regimen which was daily and did not involve subsequent fasting and maintaining an upright posture.

Conclusions: Our data suggest that compliance with osteoporotic medications could be improved if patients are able to choose a therapeutic regimen best suited to their particular needs. The majority of subjects preferred a drug which was taken daily and with minimal inconvenience, rather than a weekly drug with slightly more inconvenience. Given that most physicians currently prescribe anti-osteoporotic therapy as a weekly regimen, at the time of diagnosis physicians should ascertain which regimen would be most preferable to patients prior to initiating therapy.     

Professional Use of Social Media by Pharmacists

Background:A recent trend among health care professionals is the use of social media for professional purposes. These rapidly expanding media allow for timely and efficient access to health information, but they also carry the potential for increased liability. There is a paucity of research detailing how health care professionals, specifically pharmacists, use social media.Objective:To characterize the use of social media by pharmacists in the Canadian province of Alberta and to identify independent determinants of and perceived barriers to using social media for professional purposes.Methods:Data for this mixed-methods study were collected by an online survey in March and April 2014. Alberta pharmacists were invited to participate via e-mail distributed by 2 professional organizations.Results:The survey had 273 respondents. Of these, 226 (82.8%) stated that they had a social media account for either personal or professional purposes, and 138 (61.1%) of these reported using social media for professional purposes, although most respondents used social media predominantly for personal reasons. The most commonly reported social media applications were Facebook and Twitter, accessed primarily via smartphones. Of the 273 respondents, 206 (75.5%) had a Facebook account, and 101 (49.0%) of these used Facebook to some extent for professional purposes. Twitter users (104 [38.1%] of respondents) had a higher rate of professional utilization (57/104 [54.8%]). The most commonly identified barrier to using social media for professional purposes was concern over liability. Positive predictors of use of social media for professional purposes included younger age and fewer years of professional experience. Participants perceived the most beneficial aspect of social media (in professional terms) as connecting with pharmacist colleagues.Conclusion:More than 80% of pharmacists in Alberta reported that they had a social media account, and over half of them reported using their accounts for professional purposes. Although Facebook had a higher reported rate of utilization in general, a greater proportion of respondents reported using Twitter for professional purposes. Individuals and organizations seeking to expand their professional social media presence should focus on Twitter.     

Quantifying and characterising multi-compartment compliance aid provision

BackgroundMedication compliance aids (MCAs) to support adherence lack evidence for cost-effectiveness yet a 2001 survey in England estimated 100,000 patients receiving an MCA whilst living in their home.Objective(s): To obtain a contemporary estimate of MCA provision by community pharmacies in England and describe factors influencing pharmacist decision-making regarding MCA initiation.MethodsA stratified random sample of two community pharmacies per county (n = 40) in England were surveyed by telephone and a more detailed postal survey sent to participants expressing an interest. Data were collected to determine magnitude of MCA provision and, professional and administrative factors influencing initiation were reported as percentage (95% confidence interval) respondents reporting a factor.ResultsAn estimated 273,529 MCAs are filled by community pharmacies in England with a median (IQR) of 20(10, 50) MCAs per pharmacy per month provided for patients living in their home. Practitioners' judgement of appropriateness for MCA initiation was reported by 51.3 ± 11% as the primary factor influencing decision-making relative to 16.3 ± 8% and 20 ± 8.8% reporting patient's and carer's opinion respectively. Some form of assessment tool was reported by 13 ± 7.3% respondents.Postal survey respondents (n = 31) indicated that decision-making regarding MCA initiation was often or always affected by suitability of medication for dispensing in an MCA by 58% ± 17% of respondents; 74.2% ± 15.4% and 53.3% ± 17.9% of respondents’ decision-making was never or rarely affected by the risk of adverse events and reduced patient autonomy arising from an MCA respectively.ConclusionsProvision of MCAs by pharmacies in England has more than doubled in the past decade. Beyond considering the practicalities of whether an MCA is suitable for a patient, there is limited evidence of pharmacists considering patient choice or risk of adverse events arising from sudden increased adherence prior to initiation.     

The influence of COVID-19 related psychological and demographic variables on the effectiveness of e-learning among health care students in the southern region of Saudi Arabia

BackgroundE-learning is a modern and flexible mode of education and is being used as an alternative to conventional mode of education during the ongoing COVID-19 pandemic. However evidence suggests that effectiveness of e-learning is influenced by many prevailing factors.MethodsA cross sectional study aimed to evaluate health care students’ perception towards implementation of e-learning was conducted for a period of 4 months, from April 2020 to July 2020. Research instrument consisted of a self-designed, qualitative questionnaire with three domains was validated using field pretest method and administered among health care students of King Khalid University using social media platforms. Chi square test was used to estimate the effect of e-learning on various domains whereas linear regression analysis was used to find the association between subjects’ characteristics to overall domain scores. P value < 0.05 was considered significant.ResultsAmong 254 respondents 59.8% were males and 96.5% respondents were staying with their families.10.2% reported medically imposed quarantine for one or more family members. 59.8% reported that the online classes were commenced too early. 63.4% of the respondents reported that they had no previous experience. Poor network connectivity (32.3%) and unawareness about online platforms (29.9%), poor audio/video qualities (26.3%) were found as major barriers. Psychological stress, discipline of study, living status and quarantine history had a remarkable impact on the effectiveness of online education.ConclusionHealth care students are still cynical and are yet to embrace e-learning fully. Psychological distress, technical issues in association with accessibility, inexperience and unpreparedness were found to be main barriers that limited student acceptance of e-learning.     

Patent Evaluation: Amphiphilic peptides as novel antibacterial agents

Novelty: Amphiphilic peptides (ion channel-forming peptides) are claimed as antibiotics. They may be used to inhibit or prevent growth of microbial and other infections. They can be used in combination with various antibiotic agents.

Biology: Antibacterial activity of nine peptides was assayed against three bacterial cultures. MIC values were 4 to > 256 μg/ml for S. aureus, 4 to 256 μg/ml for E. aeruginosa, and 4 to 256 μ/ml for E. coli. Bacterial cell concentrations were 1-5 × 10⁵ CFUs/ml. MIC for the preferred peptide was 4, 8 and 32 μg/ml, for the microorganisms, respectively.

Chemistry: The peptides may be produced by standard techniques such as solid protein synthesis or genetic manipulation and obtained in substantially pure form. DNA encoding the proteins may also be provided and expressed from suitable organisms. The preferred peptide comprises 16 amino acids.     

U.S. publication trends in social and administrative pharmacy: Implications for promotion and tenure

BackgroundThere is no consensus on the preferred approach to assess journal quality. Procedures previously used include journal acceptance or rejection policies, impact factors, number of subscribers, citation counts, whether the articles were refereed or not, and journals cited in books within the discipline. This study built on the work of previous authors by using a novel approach to assess journal quality in social and administrative pharmacy (SAdP).ObjectivesTo determine U.S. SAdP faculty perceptions of prestigious journals for their research, SAdP faculty perceptions of prestigious journals by their promotion and tenure (P&;T) committees, and current research trends in SAdP.MethodsA census of U.S. colleges and schools of pharmacy was conducted using an e-mailed survey and an open-ended approach requiring respondents to list their preferred journals.ResultsSeventy-nine SAdP faculty reported that the 5 most prestigious journals were JAMA, New England Journal of Medicine, Health Affairs, Health Services Research, and Medical Care. These journals were selected because respondents wished to seek broad readership.ConclusionsResults of this study can be used as a guide by U.S. SAdP faculty and P&;T committees to assess the quality of publications by pharmacy administration faculty with the caveat being that pharmacy versus nonpharmacy journals will be chosen based on the fit of the article with the audience.