Asthma management by New Zealand pharmacists: a pharmaceutical care demonstration project

Background: Pharmaceutical care services became recognized in New Zealand in the mid-1990s, albeit with limited evidence of the acceptability and effectiveness of the model. An asthma-specific pharmaceutical care service was trialled in southern New Zealand, based on a 'problem-action-outcome' method, with pharmacists adopting a patient-centred, outcome-focused approach with multidisciplinary consultation. Objective: To report on the implementation and outcomes of a specialist asthma service offered by community pharmacists. Design: Pharmacists in five pharmacies, servicing predominantly rural, established clientele, received training in the asthma service and research documentation. Ten patients per pharmacy were recruited in each year (years 1 and 2) of the study. The patients were entered into the study in cohorts of five per pharmacy twice yearly, with year 2 mirroring year 1. The phase-in design minimized the impact on the pharmacists. The patients acted as their own controls. All patients received individualized care and had approximately monthly consultations with the pharmacist, with clinical and quality of life (QoL) monitoring. Results: A total of 100 patients were recruited. On average, 4.3 medication-related problems were identified per patient; two-thirds of them were compliance-related. The most common interventions were revision of patients' asthma action plans, referral and medication counselling. Clinical outcomes included reduced bronchodilator use and improved symptom control in around two-thirds of patients. Asthma-specific QoL changes were more positive and correlated well with clinical indicators. Conclusion: Further research is warranted to integrate this service into daily practice. Clinical outcomes were generally positive and supported by QoL indicators. Characteristics of New Zealand practice and this sample of pharmacies may limit the generalizability of these findings.

Discussions on grain refinement of magnesium alloys by carbon inoculation

Carbon inoculation has no effect on magnesium alloys that do not contain aluminium. The hypothesis proposed in a recent article [Scripta Materialia 49 (2003) 1129] that segregation of carbon plays a major role in the grain refinement of magnesium alloys by carbon inoculation is inconsistent with many of the observed facts. The Al4C3 or Al-C-O hypothesis, which is supported by experimental observations, is still the most reasonable mechanism proposed to date for the grain refinement of magnesium alloys by carbon inoculation. (C) 2004 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Preparation and anode property of Pt-CeO2 electrodes supported on carbon black for direct methanol fuel cell applications

A platinum (Pt) on pure ceria (CeO2) supported by carbon black (CB) anode was synthesized using a combined process of precipitation and coimpregnation methods. The electrochemical activity of methanol oxidation reaction on synthesized Pt-CeO2/CB anodes was investigated by cyclic voltammetry and chronoamperometry experimentation. To improve the anode property on Pt-CeO2/CB, the influence of particle morphology and particle size on anode properties was examined. The morphology and particle size of the pure CeO2 particles could be controlled by changing the preparation conditions. The anode properties (i.e., peak current density and onset potential for methanol oxidation) were improved by using nanosize CeO2 particles. This indicates that a larger surface area and higher activity on the surface of CeO2 improve the anode properties. The influence of particle morphology of CeO2 on anode properties was not very large. The onset potential for methanol oxidation reaction on Pt-CeO2/CB, which consisted of CeO2 with a high surface area, was shifted to a lower potential compared with that on the anodes, which consisted of CeO2 with a low surface area. The onset potential on Pt-CeO2/CB at 60 degrees C became similar to that on the commercially available Pt-Ru/carbon anode. We suggest that the rate-determining steps of the methanol oxidation reaction on Pt-CeO2/CB and commercially available Pt-Ru/carbon anodes are different, which accounts for the difference in performance. In the reaction mechanism on Pt-CeO2/CB, we conclude that the released oxygen species from the surface of CeO2 particles contribute to oxidation of adsorbed CO species on the Pt surface. This suggests that the anode performance of the Pt-CeO2/CB anode would lead to improvements in the operation of direct methanol fuel cells at 80 degrees C by the enhancement of diffusion of oxygen species created from the surface of nanosized CeO2 particles. Therefore, we conclude that fabrication of nanosized CeO2 with a high surface area is a key factor for development of a high-quality Pt-CeO2/CB anode in direct methanol fuel cells.