Impact of a debate on pharmacy students' views of online pharmacy practice

Objectives To evaluate the impact of a debate on pharmacy students' perceptions, using online pharmacy practice as the debate topic. Methods This is a quasi‐experimental interrupted time‐series study. A 60 min debate was organized as a lunchtime meeting. A four‐category Likert scale questionnaire (fully agree, partially agree, partially disagree, fully disagree) measured the debate participants' level of agreement with 25 statements (main issues associated with online pharmacy) in the pre‐phase (before the debate), post‐phase 1 (after the debate) and post‐phase 2 (6 months after the debate). One hundred and seventy‐seven students were recruited (response rate of 100% in the pre‐phase and post‐phase 1, 31% in post‐phase 2). Four questions measured the perceptions of the students on this pedagogical technique. Key findings The overall proportion of respondents in favour of online pharmacy practice showed little variation among the three phases. However, on average (mean ± SD) 43 ± 8% of the respondents changed their opinion, 21 ± 7% reversed their opinion, 22 ± 4% nuanced their opinion and 1 ± 1% radically changed their opinion. Respectively 98% (post‐phase 1) and 96% (post‐phase 2) of the respondents were of the opinion that debate was a very useful teaching formula in their pharmacist training and 79 and 66% thought debate significantly changed their opinion of the issue. Conclusions Few data have been collected on the use of debates as part of healthcare professional training. The impact of a debate on how pharmacy students feel about online pharmacy practice is described.     

Analysis of growth factor expression in affected and unaffected muscles of oculo-pharyngeal muscular dystrophy (OPMD) patients: A pilot study

Oculo-pharyngeal muscular dystrophy (OPMD) is characterised by progressive eyelid drooping (ptosis) and difficulties with swallowing (dysphagia). In order to determine the role of growth factors, cytokines and chemokines in the physiopathology of muscle disease we have compared the level of expression of 174 factors in both the affected (cricopharyngeal) and non-affected (sternocleidomastoid) muscles of 8 OPMD patients by means of antibody arrays. Despite an important inter-individual variability the expression of sixty factors was found to be persistently different between affected and non-affected muscles. Many of the differentially expressed factors in our study are known to be involved in the formation of fibrosis in both the liver and the lung, indicating the possibility that treatments such as those used in hepatic fibrosis may have a beneficial effect in OPMD patients.     

Influence of Array Interspacing on the Force Required for Successful Microneedle Skin Penetration: Theoretical and Practical Approaches

Insertion behaviour of microneedle (MN) arrays depends upon the mechanical properties of the skin and, MN geometry and distribution in an array. In addressing this issue, this paper studies MN array insertion mechanism into skin and provides a simple quantitative basis to relate the insertion force with distance between two MNs. The presented framework is based on drawing an analogy between a beam on an elastic foundation and mechanism of needle insertion, where insertion force is separated into different components.A theoretical analysis indicates that insertion force decreases as interspacing increases. For a specified skin type, insertion force decreased from 0.029 to 0.028 N/MN when interspacing at MN tip was increased from 50 μm (350 μm at MN base) to 150 μm (450 μm at MN base).However, dependence of insertion force seems to decrease as the interspacing is increased beyond 150 μm. To assess the validity of the proposed model, a series of experiments was carried out to determine the force required for skin insertion of MN. Experiments performed at insertion speed of 0.5 and 1.0 mm/s yielded insertion force values of 0.030 and 0.0216 N, respectively, for 30 μm interspacing at MN base (330 μm interspacing at tip) and 0.028 and 0.0214 N, respectively, for 600 μm interspacing at MN base (900 μm interspacing at tip). Results from theoretical analysis and finite element modelling agree well with experimental results, which show MN interspacing only begins to affect insertion force at low interspacing (< 150 μm interspacing at MN base). This model provides a framework for optimising MN devices, and should aid development of suitable application method and determination of force for reliable insertion into skin.     

Clinical review: Bedside lung ultrasound in critical care practice

Lung ultrasound can be routinely performed at the bedside by intensive care unit physicians and may provide accurate information on lung status with diagnostic and therapeutic relevance. This article reviews the performance of bedside lung ultrasound for diagnosing pleural effusion, pneumothorax, alveolar-interstitial syndrome, lung consolidation, pulmonary abscess and lung recruitment/derecruitment in critically ill patients with acute lung injury.     

Computed tomography assessment of exogenous surfactant-induced lung reaeration in patients with acute lung injury

Introduction  

Previous randomized trials failed to demonstrate a decrease in mortality of patients with acute lung injury treated by exogenous surfactant. The aim of this prospective randomized study was to evaluate the effects of exogenous porcine-derived surfactant on pulmonary reaeration and lung tissue in patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS).