Using an action research process in pharmacy practice research—A cooperative project between university and internship pharmacies

BackgroundAction research (AR) is a common research-based methodology useful for development and organizational changes in health care when participant involvement is key. However, AR is not widely used for research in the development of pharmaceutical care services in pharmacy practice.ObjectivesTo disseminate the experience from using AR methodology to develop cognitive services in pharmacies by describing how the AR process was conducted in a specific study, and to describe the outcome for participants.MethodsThe study was conducted over a 3-year period and run by a steering group of researchers, pharmacy students, and preceptors. The study design was based on AR methodology. The following data production methods were used to describe and evaluate the AR model: documentary analysis, qualitative interviews, and questionnaires.ResultsExperiences from using AR methodology and the outcome for participants are described. A set of principles was followed while the study, called the Pharmacy-University study, was being conducted. These principles are considered useful for designing future AR studies. Outcome for participating pharmacies was registered for staff-oriented and patient-oriented activities. Outcome for students was practice as project leaders and enhancement of clinical pharmacy-based skills. Outcome for researchers and the steering group conducting the study was in-depth knowledge of the status of pharmacies in giving advice to patient groups, and effective learning methods for students.ConclusionDeveloping and implementing cognitive pharmaceutical services (CPS) involves wide-reaching changes that require the willingness of pharmacy and staff as well as external partners. The use of AR methodology creates a platform that supports raising the awareness and the possible inclusion of these partners. During this study, a set of tools was developed for use in implementing CPS as part of AR.     

Air pollution, oxidative damage to DNA, and carcinogenesis

There is growing concern that air pollution exposure increases the risk of lung cancer. The mechanism of action is related to particle-induced oxidative stress and oxidation of DNA. Humans exposed to urban air with vehicle emissions have elevated levels of oxidized guanine bases in blood cells and urine. Animal experimental studies show that pulmonary and gastrointestinal exposure is associated with elevated levels of oxidized guanines in the lung and other organs. Collectively, there is evidence indicating that exposure to traffic-related air pollution particles is associated with oxidative damage to DNA and this might be associated with increased risk of cancer.     

Prognosis of subacute low back pain patients according to pain response

Centralization of referred pain or failure to centralize has in earlier studies been shown to be a predictor of low back pain prognosis. Research suggests that there are differences in how males and females experience pain. The aim of this study was to evaluate the outcome after 1 year, and to evaluate the prognostic value of the pain response in a mechanical test at the first consultation at a spine clinic, and the influence of gender, in order to identify patients with especially high risk of chronicity. The patients in this study were low back pain patients, included consecutively from a spine clinic in Northern Denmark. The criteria for entering this spine clinic were neck or low back pain with radiating symptoms and a duration of 4–26 weeks, without satisfactory improvement after treatment in the primary care system. The 793 patients were categorised into four subgroups according to their pain response in a mechanical test performed at the initial examination: centralization, non-lasting centralization, peripheralization and no effect. The patients were instructed in doing specific exercises according to the test results. The four subgroups were compared after 1 year with regard to changes in back and leg pain, disability and return-to-work status. The statistical evaluation was undertaken for the study group as a whole and stratified according to gender. A significant improvement in all outcome measures was found in all the subgroups, among both men and women. There were no systematic or statistically significant differences in the prognosis between the four subgroups of patients. The proportion of Centralizers in this study was 18%. The mechanical test at baseline is important for deciding the subject-specific exercises, but when treated according to test results, the prognostic value of the test seems limited. The project is approved by the Regional Scientific Ethical Committee.     

Use of monoclonal antibodies for the typing of malignant lymphomas in routinely processed biopsy samples

Eight antibodies (UCHL1 (CD45RO), MT1 (CD43), MT2 (CD45R), 4KB5 (CD45R), MB1 (CD45R), MB2, L26 (CD20) and LN1 (CDw75)) have been examined for reactivity with routine specimens of normal and hyperplastic lymphoid organs (n = 6), non-Hodgkin's lymphomas (n = 62), Hodgkin's disease (n = 27) and non-lymphoid malignancies (n = 9). In normal and hyperplastic lymphoid organs, UCHL1 and MT1 stained predominantly T cells; 4KB5, MB1, MB2, L26 and LN1 stained predominantly B cells; and MT2 reacted with a subset of B and T cells. The lineage of the neoplastic cells was correctly identified in 24 of 28 (86%) peripheral T-cell lymphomas; and in 31 of 35 (88%) B-cell malignancies. In two cases of lymphocyte-predominant Hodgkin's disease, the Hodgkin's and Reed-Sternberg (H&RS) cells were 4KB5+, L26+ and/or LN1+. The H&Rs cells in nodular sclerosis and mixed cellularity Hodgkin's disease were positive with 4KB5 in 17 of 25 cases. Antibodies UCHL1, MT1, MB1, MB2, L26 and LN1 also labelled some H&RS cells, but in a much smaller proportion of the cases. In three of nine non-lymphoid neoplasms, UCHL1 and MB2 showed a staining of the neoplastic cells, but the staining was cytoplasmic rather than membrane-associated. The remaining antibodies were unreactive with the non-lymphoid malignancies. It is concluded that many non-Hodgkin's lymphomas can be typed in routine specimens, and that antibodies UCHL1, MT1, L26 and LN1 are especially useful in this respect. The antibodies do not provide a means of distinguishing between non-Hodgkin's lymphomas and Hodgkin's disease.