In-vitro evaluation of the quality of Paracetamol and Co-trimoxazole tablets used in Malawi based on pharmacopoeial standards

Objectives This study was an in-vitro evaluation of different brands of paracetamol and cotrimoxazole tablets, used or found in Malawi, based on Pharmacopoeia standards, in order to ascertain the existence and extent of substandard medicines in Malawi and to give an overview of their distribution in the public and private sectors. Methodology A cross-sectional analytical study was conducted using 11 samples each of paracetamol and cotrimoxazole tablets. Stratified random sampling was used to collect samples. Samples were analyzed using HPLC and Spectrophometric methods as outlined in the BP-2007 and USP-32 at the National Drug Quality Control Laboratory (NDQCL)-Lilongwe (under Pharmacy Medicines and Poisons Board-PMPB) and Orient Pharma Co. Ltd of Taiwan. The results were analyzed using Epi Info. Results and discussion Fifty percent of samples (n=22) were not registered in the country by the PMPB as required by the PMP Act with the majority of those coming from public health facilities. All paracetamol and cotrimoxazole samples complied with identification tests using spectrophotometric and HPLC method. Overall, 27.3% of samples failed to meet the BP-2007 standards for Active Ingredient content, while 22.7% of the samples failed the Friability test. The results from Malawi are similar in magnitude to those within surrounding countries in Africa. Conclusion This pilot study provides objective evidence to show that substandard and unregistered paracetamol and cotrimoxazole are present and being used in Malawi, and thus posing a considerable hazard to public health in Malawi. PMPB, together with the Ministry of Health, must continue to develop a quality assurance system to ensure that medicines are randomly and routinely checked.

School engagement and burnout in a sample of brazilian students

Objective: Some studies have suggested that school engagement can be an ally in the prevention of psychosocial and occupational risks, to which students are exposed daily. The aim of this study is to estimate the impact of emotional, behavioral, and cognitive engagement on burnout syndrome among pharmacy undergraduate students. Methods: A total of 363 students enrolled in the pharmacy undergraduate program in the College of Pharmaceutical Sciences at Sao Paulo State University’s Araraquara Campus (UNESP) participated, 78.0% of whom were female. Mean age was 20.3 (SD = 2.7) years. The Maslach Burnout Inventory for students (MBI-SS) and the University Students School Engagement Inventory (USEI) were used. Confirmatory factor analysis was performed to assess the psychometric properties of the instruments. The data were included in a structural equation model in which burnout was considered the central construct. The impact of school engagement on burnout was based on the statistical significance of causal paths (β) evaluated by z tests (α = 5%). Results: The psychometric properties of the MBI-SS and USEI were adequate and the structural model also presented an adequate fit. Behavioral engagement (β = −0.56) and the emotional engagement (β = −0.71) explained 81.0% of burnout variability in the sample. Cognitive engagement was not found to contribute significantly. This data provides evidence of the impact of school engagement on burnout that can be used by educators and policymakers in charge of educational process. Conclusion: School engagement presented inverse and significant influence on burnout syndrome among pharmacy students.

Pharmacists’ knowledge and perception of topical antibacterial drug dispensing in community pharmacy setting in Kedah, Malaysia

Purpose: To assess Pharmacists’ Perceptions and Experiences of Topical Antibacterial Drug Dispensing in Community Pharmacy Setting in Kedah State, Malaysia in order to minimize drug resistance issues. Methods: A cross-sectional study involving a pre-validated questionnaire was conducted in community pharmacies within Kedah State, Malaysia. Descriptive statistics and Spearman’s correlation coefficient were used for data analysis. The collected were analysed using statistical package for social sciences (SPSS) version 18.0. Results: The result shows that, 53.4 % of CPs in Kedah State perceived that topical antibacterial is not necessary for every topical bacterial infection. Fusidic acid was the most frequently dispensed topical antibacterial drug while superficial wound was reported to be the most frequently encountered topical bacterial infection. CPs (12.60 %) encountered antibacterial resistance cases but none reported them. The drug that had resistance issue was neomycin. Conclusion: CPs in Kedah State, Malaysia generally have the right perceptions on the dispensing of topical antibacterial drugs. However, their knowledge on the rational use of topical antibacterial drugs and vigilance on antibacterial resistance issue need improvement.

A retrospective study examining the nature, contributory factors and predictors of dispensing errors in community pharmacy

Introduction: Since 2005, the workload of community pharmacists in England has increased with a concomitant increase in stress and work pressure. However, it is unclear how these factors are impacting on the ability of community pharmacists to ensure accuracy during the dispensing process. This research seeks to extend our understanding of the nature, outcome, and predictors of dispensing errors. Methodology: A retrospective analysis of a purposive sample of incident report forms (IRFs) from the database of a pharmacist indemnity insurance provider was conducted. Data collected included; type of error, degree of harm caused, pharmacy and pharmacist demographics, and possible contributory factors. Results: In total, 339 files from UK community pharmacies were retrieved from the database. The files dated from June 2006 to November 2011. Incorrect item (45.1%, n = 153/339) followed by incorrect strength (24.5%, n = 83/339) were the most common forms of error. Almost half (41.6%, n = 147/339) of the patients suffered some form of harm ranging from minor harm (26.7%, n = 87/339) to death (0.3%, n = 1/339). Insufficient staff (51.6%, n = 175/339), similar packaging (40.7%, n = 138/339) and the pharmacy being busier than normal (39.5%, n = 134/339) were identified as key contributory factors. Cross-tabular analysis against the final accuracy check variable revealed significant association between the pharmacy location (P < 0.024), dispensary layout (P < 0.025), insufficient staff (P < 0.019), and busier than normal (P < 0.005) variables. Conclusion: The results provide an overview of some of the individual, organisational and technical factors at play at the time of a dispensing error and highlight the need to examine further the relationships between these factors and dispensing error occurrence.

The roles of community pharmacists and other pharmacy staff:public perceptions

Introduction: The focus of the community pharmacist’s (CP’s) activities continues to move away from traditional dispensing activities towards the provision of health services. Current functions of CPs cover a combination of roles including prescription matters, counselling and service provision. These expanding roles, along with raised prescription volume, have increased CP workload. Therefore, it has become commonplace to delegate certain activities to other pharmacy staff (PS). This research aimed to examine public perceptions of CPs and other PS functions. Methodology: A self-completion postal questionnaire was sent to a random sample of 9769 members of the general public in England. Participants were asked to indicate which functions they believed CPs and other PS perform. Data were imported into SPSS 22 for analysis. Results: A response rate of 15.7% (n = 1537) was achieved. The roles most commonly attributed to CPs were monitoring prescription appropriateness (90.4%, n = 1390) and counselling patients on prescribed medicines (90.4%, n = 1389). The role most commonly attributed to other PS was sales transactions (92.4%, n = 1420). Similar numbers of responders agreed that the delivery of health services was the role of both CPs and other PS (58.9%, n = 906; 57.0%, n = 876). Conclusion: Despite a move towards more service based practice, the public still primarily associate the CP’s role with activities centred on dispensing. The provision of health services was seen to be equally carried out by CPs and other PS. As the CP’s service-based activities continue to develop, promotional activities may be required to ensure developments in CP functions are recognised by the public

Reducing the global burden of depression : population level analysis of intervention cost-effectiveness in 14 world regions

International evidence on the cost and effects of interventions for reducing the global burden of depression remain scarce. Aims: To estimate the population-level cost-effectiveness of evidence-based depression interventions and their contribution towards reducing current burden. Method: Primary-care-based depression interventions were modelled at the level of whole populations in 14 epidemiological subregions of the world. Total population-level costs (in international dollars or I$) and effectiveness (disability adjusted life years (DALYs) averted) were combined to form average and incremental cost-effectiveness ratios. Results: Evaluated interventions have the potential to reduce the current burden of depression by 10–30%. Pharmacotherapy with older antidepressant drugs, with or without proactive collaborative care, are currently more cost-effective strategies than those using newer antidepressants, particularly in lower-income subregions. Conclusions: Even in resource-poor regions, each DALYaverted by efficient depression treatments in primary care costs less than 1 year of average per capita income, making such interventions a cost-effective use of health resources. However, current levels of burden can only be reduced significantlyif there is a substantialincrease substantial increase intreatment coverage.

Radiobiological model comparison of 3D conformal radiotherapy and IMRT plans for the treatment of prostate cancer

The main aim of radiotherapy is to deliver a dose of radiation that is high enough to destroy the tumour cells while at the same time minimising the damage to normal healthy tissues. Clinically, this has been achieved by assigning a prescription dose to the tumour volume and a set of dose constraints on critical structures. Once an optimal treatment plan has been achieved the dosimetry is assessed using the physical parameters of dose and volume. There has been an interest in using radiobiological parameters to evaluate and predict the outcome of a treatment plan in terms of both a tumour control probability (TCP) and a normal tissue complication probability (NTCP). In this study, simple radiobiological models that are available in a commercial treatment planning system were used to compare three dimensional conformal radiotherapy treatments (3D-CRT) and intensity modulated radiotherapy (IMRT) treatments of the prostate. Initially both 3D-CRT and IMRT were planned for 2 Gy/fraction to a total dose of 60 Gy to the prostate. The sensitivity of the TCP and the NTCP to both conventional dose escalation and hypo-fractionation was investigated. The biological responses were calculated using the Källman S-model. The complication free tumour control probability (P+) is generated from the combined NTCP and TCP response values. It has been suggested that the alpha/beta ratio for prostate carcinoma cells may be lower than for most other tumour cell types. The effect of this on the modelled biological response for the different fractionation schedules was also investigated.

Privacy invasive geo-mashups : privacy 2.0 and the limits of first generation information privacy laws

Online technological advances are pioneering the wider distribution of geospatial information for general mapping purposes. The use of popular web-based applications, such as Google Maps, is ensuring that mapping based applications are becoming commonplace amongst Internet users which has facilitated the rapid growth of geo-mashups. These user generated creations enable Internet users to aggregate and publish information over specific geographical points. This article identifies privacy invasive geo-mashups that involve the unauthorized use of personal information, the inadvertent disclosure of personal information and invasion of privacy issues. Building on Zittrain’s Privacy 2.0, the author contends that first generation information privacy laws, founded on the notions of fair information practices or information privacy principles, may have a limited impact regarding the resolution of privacy problems arising from privacy invasive geo-mashups. Principally because geo-mashups have different patterns of personal information provision, collection, storage and use that reflect fundamental changes in the Web 2.0 environment. The author concludes by recommending embedded technical and social solutions to minimize the risks arising from privacy invasive geo-mashups that could lead to the establishment of guidelines for the general protection of privacy in geo-mashups.