Outcome measurement and service evaluation - a note on research design.

The purpose of this research note is to demonstrate how an individualised quality of life instrument could be adapted to provide a more accurate estimate of the impact of a social service on a person’s quality of life. An increase in quality of life between the start and end of a service is often taken as an indication that the service impacted positively on quality of life. The modifications to the quality of life instrument suggested in this paper show that this assumption is not always accurate and should be questioned directly.

Design, characterisation and preliminary clinical evaluation of a novel mucoadhesive topical formulation containing tetracycline for the treatment of periodontal disease

This study describes the formulation, characterisation and preliminary clinical evaluation of mucoadhesive, semi-solid formulations containing hydroxyethylcellulose (HEC, 1-5%, w/w), polyvinylpyrrolidine (PVP, 2 or 3%, w/w), poly carbophil (PC, 1 or 3%, w/w) and tetracycline (5%, w/w, as the hydrochloride). Each formulation was characterised in terms of drug release, hardness, compressibility, adhesiveness (using a texture analyser in texture profile analysis mode), syringeability (using a texture analyser in compression mode) and adhesion to a mucin disc (measured as a detachment force using the texture analyser in tensile mode). The release exponent for the formulations ranged from 0.78+/-0.02 to 1.27+/-0.07, indicating that drug release was non-diffusion controlled. Increasing the concentrations of each polymeric component significantly increased the time required for 10 and 30% release of the original mass of tetracycline, due to both increased viscosity and, additionally, the unique swelling properties of the formulations. Increasing concentrations of each polymeric component also increased the hardness, compressibility, adhesiveness, syringeability and mucoadhesion of the formulations. The effects on product hardness, compressibility and syringeability may be due to increased product viscosity and, hence, increased resistance to compression. Similarly, the effects of these polymers on adhesiveness/mucoadhesion highlight their mucoadhesive nature and, importantly, the effects of polymer state (particularly PC) on these properties. Thus, in formulations where the neutralisation of PC was maximally suppressed, adhesiveness and mucoadhesion were also maximal. Interestingly, statistical interactions were primarily observed between the effects of HEC and PC on drug release, mechanical and mucoadhesive properties. These were explained by the effects of HEC on the physical state of PC, namely swollen or unswollen. In the preliminary clinical evaluation, a formulation was selected that offered an appropriate balance of the above physical properties and contained 3% HEC, 3% PVP and 1% PC, in addition to tetracycline 5% (as the hydrochloride). The clinical efficacy of this (test) formulation was compared to an identical tetracycline-devoid (control) formulation in nine periodontal pockets (greater than or equal to 5 mm depth). One week following administration of the test formulation, there was a significant improvement in periodontal health as identified by reduced numbers of sub-gingival microbial pathogens. Therefore, it can be concluded that, when used in combination with mechanical plaque removal, the tetracycline-containing semi-solid systems described in this study would augment such therapy by enhancing the removal of pathogens, thus improving periodontal health. (C) 2000 Elsevier Science B.V. All rights reserved.

Application of Heuristic Evaluation Method by Universal Design Experts

This study highlights how heuristic evaluation as a usability evaluation method can feed into current building design practice to conform to universal design principles. It provides a definition of universal usability that is applicable to an architectural design context. It takes the seven universal design principles as a set of heuristics and applies an iterative sequence of heuristic evaluation in a shopping mall, aiming to achieve a cost-effective evaluation process. The evaluation was composed of three consecutive sessions. First, five evaluators from different professions were interviewed regarding the construction drawings in terms of universal design principles. Then, each evaluator was asked to perform the predefined task scenarios. In subsequent interviews, the evaluators were asked to re-analyze the construction drawings. The results showed that heuristic evaluation could successfully integrate universal usability into current building design practice in two ways: (i) it promoted an iterative evaluation process combined with multi-sessions rather than relying on one evaluator and on one evaluation session to find the maximum number of usability problems, and (ii) it highlighted the necessity of an interdisciplinary ad hoc committee regarding the heuristic abilities of each profession. A multi-session and interdisciplinary heuristic evaluation method can save both the project budget and the required time, while ensuring a reduced error rate for the universal usage of the built environments.

Design and Evaluation of a "Pharmacists in Schools" Community Outreach Programme: A Pilot Study.

Aims: To design, evaluate and pilot a novel programme that would allow school children to become “pharmacists for the day”,encouraging them to recognise the importance of science, to contribute to the Department of Health‟s Building the Community Partnership strategy and University Outreach to the community and to provide undergraduate pharmacy students with teaching experience and an opportunity to build their CV.

Methods: Concept and formulation development, branding work,schools visits,questionnaires and semi-structured interviews.

Results: Suitable formulations were developed and prepared by school children on visits to their schools. The children seemed to enjoy the experience and their teachers gave both positive and constructive feedback. Pharmacy undergraduate students felt they had gained valuable experience that will benefit their future careers.

Conclusion: The Pharmacists in Schools outreach programme has now been successfully piloted and launched and will now be fully implemented in 20 schools in the local community.

Design and evaluation of tinnitus synthesis methods: From spectral to spatial matching

Purpose
This study was designed to investigate methods to help patients suffering from unilateral tinnitus synthesizing an auditory replica of their tinnitus.

Materials and methods
Two semi-automatic methods (A and B) derived from the auditory threshold of the patient and a method (C) combining a pure tone and a narrow band-pass noise centred on an adjustable frequency were devised and rated on their likeness over two test sessions. A third test evaluated the stability over time of the synthesized tinnitus replica built with method C, and its proneness to merge with the patient's tinnitus. Patients were then asked to try and control the lateralisation of this single percept through the adjustment of the tinnitus replica level.

Results
The first two tests showed that seven out of ten patients chose the tinnitus replica built with method C as their preferred one. The third test, performed on twelve patients, revealed pitch tuning was rather stable over a week interval. It showed that eight patients were able to consistently match the central frequency of the synthesized tinnitus (presented to the contralateral ear) to their own tinnitus, which leaded to a unique tinnitus percept. The lateralisation displacement was consistent across patients and revealed an average range of 29dB to obtain a full lateral shift from the ipsilateral to the contralateral side.

Conclusions
Although spectrally simpler than the semi-automatic methods, method C could replicate patients' tinnitus, to some extent. When a unique percept between synthesized tinnitus and patients' tinnitus arose, lateralisation of this percept was achieved.

Ecological coherence in marine reserve network design: an empirical evaluation of sequential site selection using genetic structure

Ecological coherence is a multifaceted conservation objective that includes some potentially conflicting concepts. These concepts include the extent to which the network maximises diversity (including genetic diversity) and the extent to which protected areas interact with non-reserve locations. To examine the consequences of different selection criteria, the preferred location to complement protected sites was examined using samples taken from four locations around each of two marine protected areas: Strangford Lough and Lough Hyne, Ireland. Three different measures of genetic distance were used: FST, Dest and a measure of allelic dissimilarity, along with a direct assessment of the total number of alleles in different candidate networks. Standardized site scores were used for comparisons across methods and selection criteria. The average score for Castlehaven, a site relatively close to Lough Hyne, was highest, implying that this site would capture the most genetic diversity while ensuring highest degree of interaction between protected and unprotected sites. Patterns around Strangford Lough were more ambiguous, potentially reflecting the weaker genetic structure around this protected area in comparison to Lough Hyne. Similar patterns were found across species with different dispersal capacities, indicating that methods based on genetic distance could be used to help maximise ecological coherence in reserve networks. ⺠Ecological coherence is a key component of marine protected area network design. ⺠Coherence contains a number of competing concepts. ⺠Genetic information from field populations can help guide assessments of coherence. ⺠Average choice across different concepts of coherence was consistent among species. ⺠Measures can be combined to compare the coherence of different network designs.

EVALUATION OF A FOAM BUFFER TARGET DESIGN FOR SPATIALLY UNIFORM ABLATION OF LASER-IRRADIATED PLASMAS

Experimental observations are presented demonstrating that the use of a gold-coated foam layer on the surface of a laser-driven target substantially reduces its hydrodynamic breakup during the acceleration phase. The data suggest that this results from enhanced thermal smoothing during the early-time imprint stage of the interaction. The target's kinetic energy and the level of parametric instability growth are shown to remain essentially unchanged from that of a conventionally driven target.