Evaluation of a hospital-based community liaison pharmacy service in Northern Ireland

Objective: To evaluate the impact of a hospital based community liaison pharmacy service on a range of outcomes in patients aged more than 55 years and taking more than 3 prescribed drugs, who had been admitted to the medical unit of a district general hospital in Northern Ireland.

Influence of drugs, demographics and medical history on hospital readmission of elderly patients - A predictive model

Objective: To investigate factors that influence hospital readmissions of elderly patients and to construct a robust hospital readmissions predictive model.

Prescribing Practices and Polypharmacy in Kitovu Hospital, Uganda.

This audit of prescribing practices explores recent trends at Kitovu Hospital, Uganda. The average number of drugs prescribed per patient was 2.89 ± 0.11, of which 1.79±0.09 were generics and 0.69±0.06 antibiotics. No injections were prescribed. Patient essential drug knowledge was 100% while the adequacy of labelling was 0%. The number of drugs prescribed correlated positively with patient age, was greater for female patients, similar for doctors and clinical officers but greater in medical (3.30±0.15, n=50) than surgical (2.48±0.13, n=50) outpatient clinics. The mean consultation time was 6.56 min and 10.25 min per patient in medical and surgical outpatient clinics respectively. The patient essential knowledge indicators were greatly improved but only modest reduction in polypharmacy was evident compared to the Ugandan Pharmaceutical Sector national survey of 2002. Antibiotic prescription was high and generic prescribing was found to be low. Policy changes are required to enhance rational drug use in the health sector in Uganda.

Accounting, Regulation and Profitability: The Case of PFI Hospital Refinancing

The refinancing of PFI (Private Finance Initiative) projects represents one of the most contentious aspects of Public Private Partnerships (PPPs) in the UK. The negative publicity associated with UK PFI refinancing deals is associated with several factors, including, evidence of massive private sector profit making, the failure of private sector financiers to share refinancing profits and, lastly, private sector frustration of adequate regulatory intervention in this area. Utilising a dynamic model of capital market and state interaction, this paper explains these outcomes as a function of effective private sector lobbying of bureaucratic state agencies to alter the structure of accounting, accountability and regulation with the goal of securing favourable profit and risk outcomes. These dynamics are illustrated with reference to the history of UK PFI refinancing and a case study of one of the projects where these gains reached extreme levels.

UV-activated photocatalyst films and inks for cleaning tarnished metals

A simple UV-activated, TiO2-based film or ink for removing thin oxide or sulfide layers from metal surfaces by reductive photocatalysis is described.

Simple method for the rapid simultaneous screening of photocatalytic activity over multiple positions of self-cleaning films

An intelligent ink, previously shown to be capable of rapidly assessing photocatalytic activity, was simply applied via a felt-pen onto a commercially available piece of Activ (TM) self-cleaning glass. The ink, comprising of redox dye resazurin and the sacrificial electron donor glycerol within an aqueous hydroxy ethyl cellulose (HEC) polymer media, was photocatalytically degraded in a two-step process. The key initial stage was the photo-reductive conversion of resazurin to resorufin, whereby a colour change from blue to pink occurred. The latter stage was the subsequent photo-reduction of the resorufin, where a slower change from pink to colourless was seen. Red and green components of red-green-blue colour extracted from flat-bed scanner digital images of resazurin ink coated photocatalytic films at intervals during the photocatalysis reaction were inversely proportional to the changes seen via UV-visible absorption spectroscopy and indicative of reaction kinetics. A 3 x 3 grid of intelligent ink was drawn onto a piece of Activ (TM) and a glass blank. The photocatalysis reaction was monitored solely by flat-bed digital scanning. Red-green-blue values of respective positions on the grid were extracted using a custom-built program entitled RGB Extractor (c). The program was capable of extracting a number of 5 x 5 pixel averages of red-green-blue components simultaneously. Allocation of merely three coordinates allowed for the automatic generation of a grid, with scroll-bars controlling the number of positions to be extracted on the grid formed. No significant change in red and green components for any position on the glass blank was observed; however, the Activ (TM) film displayed a homogenous photo-reduction of the dye, reaching maxima in red and minima in green components in 23 +/- 3 and 14 +/- 2 min, respectively. A compositionally graded N-doped titania film synthesised in house via a combinatorial APCVD reaction was also photocatalytically tested by this method where 247 positions on a 13 x 19 grid were simultaneously analysed. The dramatic variation in photocatalysis observed was rapidly quantified for all positions (2-3 hours) allowing for correlations to be made between thicknesses and N : Ti% compositions attained from Swanepoel and WDX analysis, respectively. N incorporation within this system was found to be detrimental to film activity for the photocatalysis reaction of intelligent ink under 365 nm light.

Method of rapid assessment of photocatalytic activities of self-cleaning films

An ink, comprising the redox dye resazurin (Rz) and the sacrificial electron donor glycerol, is shown to be capable of the rapid assessment of the photocatalytic activities of self-cleaning films. In the key initial stage of photocatalysis the ink changes from blue to pink. Prolonged irradiation bleaches the ink and eventually mineralizes it. The kinetics of the initial photoinduced color change is studied as a function of UV irradiance, [glycerol], [Rz], and temperature. The results reveal an apparent approximate quantum yield of 3.5 x 10(-3) and an initial rate, r(i), which increases with [glycerol] and decreases with [Rz]. It is proposed that the reduction of Rz, dispersed throughout the thick (ca. 590 nm) indicator film, may take place either via the diffusion of the dye molecules in the ink film to the surface of the underlying semiconductor layer and their subsequent reaction with photogenerated electrons and/or via the diffusion of alpha-hydroxyalkyl radicals, produced by the oxidation of the glycerol by photogenerated holes, or hydroxy radicals, away from the surface of the semiconductor into the ink film and their subsequent reaction with the dye molecules therein. The decrease in r(i) with [Rz] appears to be due to dimer formation, with the latter impeding the reduction process. The activation energy for the initial color-change process is low, ca. 9.1 +/- 0.1 kJ mol(-1) and not unlike many other photocatalytic processes. The initial rate of dye reduction appears to be directly related to the rate of destruction of stearic acid. The ink can be applied by spin-coating, stamping, or writing, using a felt-tip pen. The efficacy of such an ink for assessing the photocatalytic activity of any photocatalytic film, including those employed on commercial self-cleaning glasses, tiles, and paving stones, is discussed briefly.

Simultaneous monitoring of the destruction of stearic acid and generation of carbon dioxide by self-cleaning semiconductor photocatalytic films

The destruction of stearic acid (SA), the SA test, is a popular approach used to evaluate the activities of photocatalytic films. The destruction of SA via semiconductor photocatalysis is monitored simultaneously, using FT-IR spectroscopy, via the disappearance of SA and the appearance of CO2, Sol-gel and P25 films of titania are used as the semiconductor photocatalytic self-cleaning films. A conversion factor is used of 9.7 x 1015 molecules of SA cm(-2) 1 Cru-1 integrated areas of the peaks in the Fr-IR of SA over the range 2700-3000 cm(-1), which is three times that reported previously by others. As the SA disappeared the concomitant amount of CO2 generated was > 90% that expected throughout the photomineralisation process for the sol-gel titania film. In contrast, the slightly more active, and scattering, P25 fitania films generated CO2 levels that dipped as low as 69% during the course of the photoreaction, but eventually recovered to congruent to 100% that expected based on the amount of SA present. The importance of these results with respect to SA test and the evaluation of new and existing self-cleaning films are discussed briefly. (c) 2006 Elsevier B.V. All rights reserved.