An audit of drug shortages in a community pharmacy practice

Background: There are no firm data on drug shortages in Irish community pharmacy. This prospective observational study aimed to characterise the drug shortage problem in an Irish community pharmacy.
Aims: The primary aim was to determine numbers and durations of drug shortages. Secondary aims included comparing these shortages with Irish Pharmacy Union (IPU) drug shortage lists and determining the frequency with which notifications were received prior to shortages. Further secondary aims were to examine relationships between causes of drug shortages and drug costs and between causes of drug shortages and shortage durations.
Methods: The study took place in a community pharmacy in a Limerick City suburb between October 2012 and February 2013. Data were collected daily regarding drugs that were dispensed, but unavailable to purchase. Suppliers/manufacturers provided data on the reasons for shortages.
Results: 65/1,232 dispensed drugs (5.3 %) were in short supply over the study period. Median shortage duration was 13 days (interquartile range 4–32 days) and median cost was €8.10. Numbers of unavailable drugs by month varied from 13 to 38. Monthly IPU drug shortage lists identified between six and eight of these shortages depending on the month. Two notifications were received from suppliers/manufacturers regarding shortages. Parallel exports had the highest mean costs (mean €38.05) and manufacturing problems were associated with the longest durations (mean 57.44 days).
Conclusions: This study highlights the drug shortage problem in an Irish community pharmacy. We propose that enhanced communication between all stakeholders is the most worthwhile solution. Further studies are needed.

A spectral synthesis code for rapid modelling of supernovae

We present TARDIS-an open-source code for rapid spectral modelling of supernovae (SNe). Our goal is to develop a tool that is sufficiently fast to allow exploration of the complex parameter spaces of models for SN ejecta. This can be used to analyse the growing number of highquality SN spectra being obtained by transient surveys. The code uses Monte Carlo methods to obtain a self-consistent description of the plasma state and to compute a synthetic spectrum. It has a modular design to facilitate the implementation of a range of physical approximations that can be compared to assess both accuracy and computational expediency. This will allow users to choose a level of sophistication appropriate for their application. Here, we describe the operation of the code and make comparisons with alternative radiative transfer codes of differing levels of complexity (SYN++, PYTHON and ARTIS). We then explore the consequence of adopting simple prescriptions for the calculation of atomic excitation, focusing on four species of relevance to Type Ia SN spectra-Si II, SII, MgII and Ca II. We also investigate the influence of three methods for treating line interactions on our synthetic spectra and the need for accurate radiative rate estimates in our scheme.

Type Ia supernova bolometric light curves and ejected mass estimates from the nearby supernova factory

We present a sample of normal Type Ia supernovae (SNe Ia) from the Nearby Supernova Factory data set with spectrophotometry at sufficiently late phases to estimate the ejected mass using the bolometric light curve.Wemeasure Ni masses from the peak bolometric luminosity, then compare the luminosity in the Co-decay tail to the expected rate of radioactive energy release from ejecta of a given mass. We infer the ejected mass in a Bayesian context using a semi-analytic model of the ejecta, incorporating constraints from contemporary numerical models as priors on the density structure and distribution of Ni throughout the ejecta. We find a strong correlation between ejected mass and light-curve decline rate, and consequently Ni mass, with ejected masses in our data ranging from 0.9 to 1.4 M. Most fast-declining (SALT2 x <-1) normal SNe Ia have significantly sub-Chandrasekhar ejected masses in our fiducial analysis.

The effect of helium accretion efficiency on rates of Type Ia supernovae: Double detonations in accreting binaries

he double-detonation explosion scenario of Type Ia supernovae (SNe Ia) has gained increased support from the SN Ia community as a viable progenitor model, making it a promising candidate alongside the well-known single degenerate and double degenerate scenarios. We present delay times of double-detonation SNe, in which a sub-Chandrasekhar mass carbon–oxygen white dwarf (WD) accretes non-dynamically from a helium-rich companion. One of the main uncertainties in quantifying SN rates from double detonations is the (assumed) retention efficiency of He-rich matter. Therefore, we implement a new prescription for the treatment of accretion/accumulation of He-rich matter on WDs. In addition, we test how the results change depending on which criteria are assumed to lead to a detonation in the helium shell. In comparing the results to our standard case (Ruiter et al.), we find that regardless of the adopted He accretion prescription, the SN rates are reduced by only ∼25 per cent if low-mass He shells (≲0.05 M⊙) are sufficient to trigger the detonations. If more massive (0.1 M⊙) shells are needed, the rates decrease by 85 per cent and the delay time distribution is significantly changed in the new accretion model – only SNe with prompt (<500 Myr) delay times are produced. Since theoretical arguments favour low-mass He shells for normal double-detonation SNe, we conclude that the rates from double detonations are likely to be high, and should not critically depend on the adopted prescription for accretion of He.

The spotty donor star in the X-ray transient Cen X-4

We accurately determine the fundamental system parameters of the neutron star X-ray transient Cen X-4 solely using phase-resolved high-resolution UV-Visual Echelle Spectrograph spectroscopy. We first determine the radial-velocity curve of the secondary star and then model the shape of the phase-resolved absorption line profiles using an X-ray binary model. The model computes the exact rotationally broadened, phase-resolved spectrum and does not depend on assumptions about the rotation profile, limb-darkening coefficients and the effects of contamination from an accretion disc. We determine the secondary star-to-neutron star binary mass ratio to be 0.1755 ± 0.0025, which is an order of magnitude more accurate than previous estimates. We also constrain the inclination angle to be 32^{+8}_{-2} degrees. Combining these values with the results of the radial-velocity study gives a neutron star mass of 1.94^{+0.37}_{-0.85}M⊙ consistent with previous estimates. Finally, we perform the first Roche tomography reconstruction of the secondary star in an X-ray binary. The tomogram reveals surface inhomogeneities that are due to the presence of cool starspots. A large cool polar spot, similar to that seen in Doppler images of rapidly rotating isolated stars, is present on the Northern hemisphere of the K7 secondary star and we estimate that ~4 percent of the total surface area of the donor star is covered with spots.This evidence for starspots supports the idea that magnetic braking plays an important role in the evolution of low-mass X-ray binaries.

A window on exoplanet dynamical histories: Rossiter-McLaughlin observations of WASP-13b and WASP-32b

We present Rossiter-McLaughlin observations of WASP-13b and WASP-32b and determine the sky-projected angle between the normal of the planetary orbit and the stellar rotation axis (λ). WASP-13b and WASP-32b both have prograde orbits and are consistent with alignment with measured sky-projected angles of λ =8°^{+13}_{-12} and λ =-2°^{+17}_{-19}, respectively. Both WASP-13 and WASP-32 have Teff < 6250 K, and therefore, these systems support the general trend that aligned planetary systems are preferentially found orbiting cool host stars. A Lomb-Scargle periodogram analysis was carried out on archival SuperWASP data for both systems. A statistically significant stellar rotation period detection (above 99.9 per cent confidence) was identified for the WASP-32 system with Prot =11.6 ± 1.0 days. This rotation period is in agreement with the predicted stellar rotation period calculated from the stellar radius, R*, and vsin i if a stellar inclination of i* =90° is assumed. With the determined rotation period, the true 3D angle between the stellar rotation axis and the planetary orbit, ψ, was found to be ψ = 11° ± 14°. We conclude with a discussion on the alignment of systems around cool host stars with Teff < 6150 K by calculating the tidal dissipation time-scale. We find that systems with short tidal dissipation time-scales are preferentially aligned and systems with long tidal dissipation time-scales have a broad range of obliquities.

De bankencrisis van de jaren twintig

Lessen uit een lang vergeten crisis voor hedendaagse beleidsmakers en banken.

Derivation of scientific software from mathematical specifications

Often the modification and enhancement of large scientific software systems are severely hampered because many components of the system are written in an implementation dependent fashion, they are inadequately documented, and their functionalities are not precisely known. In this paper we consider how mathematics may be employed to alleviate some of these problems. In particular, we illustrate how the formal specification notation VDM-SL is being used to specify precisely abstract data types for use in the development of scientific software.

Direct Detection of YORP Spin-up on Asteroid (25143) Itokawa and Implications for its Internal Structure

Near-Earth asteroid (25143) Itokawa was visited by the Hayabusa spacecraft in 2005, resulting in a highly detailed surface shape and topography model. This model has led to several predictions for the expected radiative torques on this asteroid, suggesting that its spin rate should be decelerating. Through an observational survey spanning 2001 to 2013 we have successfully measured an acceleration in its spin rate of dω/dt = 3.54 (± 0.38) × 10^(-8) rad day^(-2), equivalent to a decrease of its rotation period of ~ 45 ms year^(-1). Using the shape model determined from the Hayabusa spacecraft, we applied a detailed thermophysical analysis, to reconcile the predicted YORP strength with that observed. We find that the center-of-mass for Itokawa must be shifted by ~20 m along the long-axis of the asteroid to reconcile observations with theory. This can be explained if Itokawa is composed of two separate bodies with very different bulk densities of 1740 ± 110 kg m^(-3) and 2730 ± 440 kg m^(-3), and was formed from the merger of two separate bodies, consistent with the collapse of a binary system or the re-accumulation of material from a catastrophic collisional disruption. We demonstrate that an observational measurement of radiative torques, when combined with a detailed shape model, can provide insight into the interior structure of an asteroid.

Power, Pedagogy and Participation: ethics and pragmatics in research with young people

This article addresses issues of methodology and ethical reflexivity when attempting to investigate the opinions of young people. Drawing specifically on three studies of young people's understandings of citizenship and their views on topical issues, two from England and one from Lebanon, the authors present ways in which the ethical and practical challenges of such research can be met. While acknowledging the power relationship between researchers and informants, they suggest that what they call ‘pedagogical research approaches’ built on a participative methodology can open up a space where both parties benefit. They argue that, when working in schools, teacher educators can take advantage of this status to present themselves simultaneously as insiders and outsiders. The authors have devised what are intended to be non-exploitative research instruments that permit the gathering of useful qualitative data during a short encounter. They illustrate their approach with examples of classroom activities they have developed to provide simultaneously a valid learning experience and usable data.

Non-domination, non-alienation and social equality: towards a republican understanding of equality

The republican idea of non-domination stresses the importance of certain social relationships for a person’s freedom, showing that freedom is a social-relational state. While the idea of freedom as non-domination receives a lot of attention in the literature, republican theorists say surprisingly little about equality. Therefore, the aim of this paper is to carve out the contours of a republican conception of equality.. In so doing, I will argue that republican accounts of equality share a significant normative overlap with the idea of social equality. However, closer analysis of Philip Pettit’s account of ‘expressive egalitarianism’ (which Pettit sees as inherently connected to non-domination) and recent theories of social equality shows that republican non-domination – in contrast to what Pettit seems to claim – is not sufficient for securing (republican) social equality. In order to secure social equality for all, republicans would have to go beyond non-domination.

Nifedipine-induced gingival hyperplasia

This case study reports on the management of a woman suffering from thrombocytopenic purpura who was referred to the periodontal clinic with gingival swelling and bleeding. This condition was related to nifedipine therapy for hypertension.

Promoting self-regulated learning in technology enhanced learning environments : keeping a digital track of the learning process

Tese de doutoramento (co-tutela), Psicologia (Psicologia da Educação), Faculdade de Psicologia da Universidade de Lisboa, Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Technial University of Darmstadt, 2014