What is the new medicines use review ‘patient survey’ attempting to capture in the context of existing patient satisfaction with pharmacy questionnaires and a new conceptual framework?

The community pharmacy service medicines use review (MUR) was introduced in 2005 ‘to improve patient knowledge, concordance and use of medicines’ through a private patient–pharmacist consultation. The MUR presents a fundamental change in community pharmacy service provision. While traditionally pharmacists are dispensers of medicines and providers of medicines advice, and patients as recipients, the MUR considers pharmacists providing consultation-type activities and patients as active participants. The MUR facilitates a two-way discussion about medicines use. Traditional patient–pharmacist behaviours transform into a new set of behaviours involving the booking of appointments, consultation processes and form completion, and the physical environment of the patient–pharmacist interaction moves from the traditional setting of the dispensary and medicines counter to a private consultation room. Thus, the new service challenges traditional identities and behaviours of the patient and the pharmacist as well as the environment in which the interaction takes place. In 2008, the UK government concluded there is at present too much emphasis on the quantity of MURs rather than on their quality.[1] A number of plans to remedy the perceived imbalance included a suggestion to reward ‘health outcomes’ achieved, with calls for a more focussed and scientific approach to the evaluation of pharmacy services using outcomes research. Specifically, the UK government set out the main principal research areas for the evaluation of pharmacy services to include ‘patient and public perceptions and satisfaction’as well as ‘impact on care and outcomes’. A limited number of ‘patient satisfaction with pharmacy services’ type questionnaires are available, of varying quality, measuring dimensions relating to pharmacists’ technical competence, behavioural impressions and general satisfaction. For example, an often cited paper by Larson[2] uses two factors to measure satisfaction, namely ‘friendly explanation’ and ‘managing therapy’; the factors are highly interrelated and the questions somewhat awkwardly phrased, but more importantly, we believe the questionnaire excludes some specific domains unique to the MUR. By conducting patient interviews with recent MUR recipients, we have been working to identify relevant concepts and develop a conceptual framework to inform item development for a Patient Reported Outcome Measure questionnaire bespoke to the MUR. We note with interest the recent launch of a multidisciplinary audit template by the Royal Pharmaceutical Society of Great Britain (RPSGB) in an attempt to review the effectiveness of MURs and improve their quality.[3] This template includes an MUR ‘patient survey’. We will discuss this ‘patient survey’ in light of our work and existing patient satisfaction with pharmacy questionnaires, outlining a new conceptual framework as a basis for measuring patient satisfaction with the MUR. Ethical approval for the study was obtained from the NHS Surrey Research Ethics Committee on 2 June 2008. References 1. Department of Health (2008). Pharmacy in England: Building on Strengths – Delivering the Future. London: HMSO. www. official-documents.gov.uk/document/cm73/7341/7341.pdf (accessed 29 September 2009). 2. Larson LN et al. Patient satisfaction with pharmaceutical care: update of a validated instrument. JAmPharmAssoc 2002; 42: 44–50. 3. Royal Pharmaceutical Society of Great Britain (2009). Pharmacy Medicines Use Review – Patient Audit. London: RPSGB. http:// qi4pd.org.uk/index.php/Medicines-Use-Review-Patient-Audit. html (accessed 29 September 2009).

A narrow band pulsed eddy current instrument for materials testing

The principles of operation of an experimental prototype instrument known as J-SCAN are described along with the derivation of formulae for the rapid calculation of normalized impedances; the structure of the instrument; relevant probe design parameters; digital quantization errors; and approaches for the optimization of single frequency operation. An eddy current probe is used As the inductance element of a passive tuned-circuit which is repeatedly excited with short impulses. Each impulse excites an oscillation which is subject to decay dependent upon the values of the tuned-circuit components: resistance, inductance and capacitance. Changing conditions under the probe that affect the resistance and inductance of this circuit will thus be detected through changes in the transient response. These changes in transient response, oscillation frequency and rate of decay, are digitized, and then normalized values for probe resistance and inductance changes are calculated immediately in a micro processor. This approach coupled with a minimum analogue processing and maximum of digital processing has advantages compared with the conventional approaches to eddy current instruments. In particular there are: the absence of an out of balance condition and the flexibility and stability of digital data processing.

A thermally stable tension meter for atmospheric soundings using kites

Kites offer considerable potential as wind speed sensors—a role distinct from their traditional use as instrument-carrying platforms. In the sensor role, wind speed is measured by kite-line tension. A kite tether line tension meter is described here, using strain gauges mounted on an aluminum ring in a Wheatstone bridge electronic circuit. It exhibits a linear response to tension 19.5 mV N−1 with good thermal stability mean drift of −0.18 N °C−1 over 5–45 °C temperature range and a rapid time response 0.2 s or better. Field comparisons of tether line tension for a Rokkaku kite with a fixed tower sonic anemometer show an approximately linear tension-wind speed relationship over the range 1–6 ms−1. © 2010 American Institute of Physics. doi:10.1063/1.3465560

The sociology of childhood as scientific communication - Observations from a social systems perspective

This article begins by identifying a close relationship between the image of children generated by several sociologists working within the new sociology of childhood perspective and the claims and ambitions of the proponents of children's autonomy rights. The image of the child as a competent, self-controlled human agent are then subjected to observation from the perspective of Niklas Luhmann's social systems theory. The new sociology of childhood's constructivist approach is compared and contrasted with Niklas Luhmann's theory of 'operational constructivism'. The article applies tenets of Luhmann's theory, to the emergence of the new childhood sociologist's image of the child as a competent, self-controlled social agent, to the epistemological status of this image and, in particular, to claims that it derives from scientific endeavour. The article proceeds to identify two theoretical developments within sociology - sociology of identity and social agency - which have brought about fundamental changes in what may be considered 'sociological' and so 'scientific' and paved the way for sociological communications about what children,really are'. In conclusion, it argues that the merging of sociology with polemics, ideology, opinion and personal beliefs and, at the level of social systems, between science and politics represents in Luhmann's terms 'dedifferentiation'- a tendency he claims may have serious adverse consequences for modern society. This warning is applied to the scientific status of sociology - its claim to be able to produce 'facts' for society, upon which social systems, such as politics and law, may rely. Like the mass media, sociology may now be capable of producing only information, and not facts, about children.

Stray light analysis of SALEX instrument

Discrepancies between recent global earth albedo anomaly data obtained from the climate models, space and ground observations call for a new and better earth reflectance measurement technique. The SALEX (Space Ashen Light Explorer) instrument is a space-based visible and IR instrument for precise estimation of the global earth albedo by measuring the ashen light reflected off the shadowy side of the Moon from the low earth orbit. The instrument consists of a conventional 2-mirror telescope, a pair of a 3-mirror visible imager and an IR bolometer. The performance of this unique multi-channel optical system is sensitive to the stray light contamination due to the complex optical train incorporating several reflecting and refracting elements, associated mounts and the payload mechanical enclosure. This could be further aggravated by the very bright and extended observation target (i.e. the Moon). In this paper, we report the details of extensive stray light analysis including ghosts and cross-talks, leading to the optimum set of stray light precautions for the highest signal-to-noise ratio attainable.

A middleware independent grid workflow builder for scientific applications

Grid workflow authoring tools are typically specific to particular workflow engines built into Grid middleware, or are application specific and are designed to interact with specific software implementations. g-Eclipse is a middleware independent Grid workbench that aims to provide a unified abstraction of the Grid and includes a Grid workflow builder to allow users to author and deploy workflows to the Grid. This paper describes the g-Eclipse Workflow Builder and its implementations for two Grid middlewares, gLite and GRIA, and a case study utilizing the Workflow Builder in a Grid user's scientific workflow deployment.

Challenges of linking scientific knowledge to river basin management policy: AquaTerra as a case study

The EU Project AquaTerra generates knowledge about the river-soil-sediment-groundwater system and delivers scientific information of value for river basin management. In this article, the use and ignorance of scientific knowledge in decision making is explored by a theoretical review. We elaborate on the 'two-communities theory', which explains the problems of the policy-science interface by relating and comparing the different cultures, contexts, and languages of researchers and policy makers. Within AquaTerra, the EUPOL subproject examines the policy-science interface with the aim of achieving a good connection between the scientific output of the project and EU policies. We have found two major barriers, namely language and resources, as well as two types of relevant relationships: those between different research communities and those between researchers and policy makers. (c) 2007 Elsevier Ltd. All rights reserved.

Hitting emissions targets with (statistical) confidence in multi-instrument Emissions Trading Schemes

A means of assessing, monitoring and controlling aggregate emissions from multi-instrument Emissions Trading Schemes is proposed. The approach allows contributions from different instruments with different forms of emissions targets to be integrated. Where Emissions Trading Schemes are helping meet specific national targets, the approach allows the entry requirements of new participants to be calculated and set at a level that will achieve these targets. The approach is multi-levelled, and may be extended downwards to support pooling of participants within instruments, or upwards to embed Emissions Trading Schemes within a wider suite of policies and measures with hard and soft targets. Aggregate emissions from each instrument are treated stochastically. Emissions from the scheme as a whole are then the joint probability distribution formed by integrating the emissions from its instruments. Because a Bayesian approach is adopted, qualitative and semi-qualitative data from expert opinion can be used where quantitative data is not currently available, or is incomplete. This approach helps government retain sufficient control over emissions trading scheme targets to allow them to meet their emissions reduction obligations, while minimising the need for retrospectively adjusting existing participants’ conditions of entry. This maintains participant confidence, while providing the necessary policy levers for good governance.

Selected topics in probiotics and prebiotics: meeting report for the 2004 international scientific association for probiotics and prebiotics

On August 2931, 2004, 84 academic and industry scientists from 16 countries gathered in Copper Mountain, Colorado USA to discuss certain issues at the forefront of the science of probiotics and prebiotics. The format for this invitation only meeting included six featured lectures: engineering human vaginal lactobacilli to express HIV inhibitory molecules (Peter Lee, Stanford University), programming the gut for health (Thaddeus Stappenbeck, Washington University School of Medicine), immune modulation by intestinal helminthes (Joel Weinstock, University of Iowa Hospitals and Clinics), hygiene as a cause of autoimmune disorders (G. A. Rook, University College London), prebiotics and bone health (Connie Weaver, Purdue University) and prebiotics and colorectal cancer risk (Ian Rowland, Northern Ireland Centre for Food and Health). In addition, all participants were included in one of eight discussion groups on the topics of engineered probiotics, host-commensal bacteria communication, 'omics' technologies, hygiene and immune regulation, biomarkers for healthy people, prebiotic and probiotic applications to companion animals, development of a probiotic dossier, and physiological relevance of prebiotic activity. Brief conclusions from these discussion groups are summarized in this paper.