Community Pharmacies and the Needs of Mobile EU Citizens - A study on Finns living in Spain

Migration within the European Union (EU) has increased since the Union was established. Community pharmacies provide open access to health care services and can be the first, most frequently used or even the only contact with a nation s health care system among mobile community residents. In some of the mass-migration areas in Southern Europe, most of the customers may represent mobile citizens of foreign background. This has not always been taken into consideration in the development of community pharmacy services. Mobile patients have been on the EU's health policy agenda, but they have seldom been mentioned in the context of community pharmacies. In most of the EU member states, governments control the specific legislation concerning community pharmacies and there is no harmonised pharmaceutical policy or consistent minimal standards for community pharmacy services in the EU. The aim of this study was to understand medication use, the role of community pharmacies and the symptom mitigation process of mobile community residents. Finns living in Spain were used as an example to examine how community pharmacies in a EU member state meet the needs of mobile community residents. The data were collected by a survey in 2002 (response rate 53%, n= 533) and by five focus group discussions in 2006 (n=30). A large number (70%) of the respondents had moved to Spain for health reasons and suffered from chronic morbidity. Community pharmacies had an important role in the healthcare of mobile community residents and the respondents were mostly satisfied with these services. However, several medication safety risks related to community pharmacy practices were identified: 1) Availability of prescription medicines without prescription (e.g., antibiotics, sleeping pills, Viagra®, asthma medications, cardiovascular medicines, psoriasis medicines and analgesics); 2) Irrational use of medicines (e.g., 41% of antibiotic users had bought their antibiotics without a prescription, and the most common reasons for antibiotic self-medication were symptomatic common colds and sore throats); 3) Language barriers between patients and pharmacy professionals; 4) Lack of medication counselling; 5) Unqualified pharmacy personnel providing pharmacotherapy. A fifth of the respondents reported experiencing problems during pharmacy visits in Spain, and the lack of a common language was the source of most of these problems. The findings of this study indicate that regulations and their enforcement can play a crucial role in actually assuring the rational and safe use of medicines. These results can be used in the development of pharmaceutical and healthcare policies in the EU. It is important to define consistent minimum standards for community pharmacy services in the EU. Then, the increasing number of mobile community residents could access safe and high quality health care services, including community pharmacy services, in every member state within the EU.

Investigating physical properties of solid dosage forms during pharmaceutical processing : Process analytical applications of vibrational spectroscopy

In order to improve and continuously develop the quality of pharmaceutical products, the process analytical technology (PAT) framework has been adopted by the US Food and Drug Administration. One of the aims of PAT is to identify critical process parameters and their effect on the quality of the final product. Real time analysis of the process data enables better control of the processes to obtain a high quality product. The main purpose of this work was to monitor crucial pharmaceutical unit operations (from blending to coating) and to examine the effect of processing on solid-state transformations and physical properties. The tools used were near-infrared (NIR) and Raman spectroscopy combined with multivariate data analysis, as well as X-ray powder diffraction (XRPD) and terahertz pulsed imaging (TPI). To detect process-induced transformations in active pharmaceutical ingredients (APIs), samples were taken after blending, granulation, extrusion, spheronisation, and drying. These samples were monitored by XRPD, Raman, and NIR spectroscopy showing hydrate formation in the case of theophylline and nitrofurantoin. For erythromycin dihydrate formation of the isomorphic dehydrate was critical. Thus, the main focus was on the drying process. NIR spectroscopy was applied in-line during a fluid-bed drying process. Multivariate data analysis (principal component analysis) enabled detection of the dehydrate formation at temperatures above 45°C. Furthermore, a small-scale rotating plate device was tested to provide an insight into film coating. The process was monitored using NIR spectroscopy. A calibration model, using partial least squares regression, was set up and applied to data obtained by in-line NIR measurements of a coating drum process. The predicted coating thickness agreed with the measured coating thickness. For investigating the quality of film coatings TPI was used to create a 3-D image of a coated tablet. With this technique it was possible to determine coating layer thickness, distribution, reproducibility, and uniformity. In addition, it was possible to localise defects of either the coating or the tablet. It can be concluded from this work that the applied techniques increased the understanding of physico-chemical properties of drugs and drug products during and after processing. They additionally provided useful information to improve and verify the quality of pharmaceutical dosage forms

Teatterinjohtamisen dramaturgiaa : Keskeiset tehtävät, arjen ongelmat ja rakenteelliset muutostarpeet

DRAMATURGY OF THEATRE MANAGEMENT Essential tasks, everyday problems and the need for structural changes Theatre justifies its existence only through high quality performances. Maintaining the artistic level and organizing performances are the primary tasks of a manager, even though in everyday life this often seems to be overshadowed by all the other tasks of a manager s work. How does a theatre manager design strategies and make everyday decisions if aims are to have artistically meaningful performances, financial success and a socially healthy ensemble, when not only artistic work or leadership of an organization are to be taken into consideration, but also a manpower-based art institution with long traditions? What does theatre management consist of and what kind of dramaturgical movement happens in it? Based on interviews carried out in five different city theatres in Finland in the years 2004-2008, incident stories were written within a continuous comparison theory frame. Social constructionism within a dramaturgic framework enabled versatile dialog on a manager s work and problem areas. The result is an interpretative study, where instead of common regularities, many details are collected that can be taken into consideration when similar situations occur. Based on the interviews and historical data, four factors that influence a manager s work were chosen: ownership, media, work community and programme. Within theatre management, the central problems were 1) the inconsistent use of theatre resources and problems in corporate governance caused by the administrative models; 2) the theatre s image, based on the image of its manager, as presented by the media and its influence on the wellbeing of the staff; 3) unsolved problems between the staff left behind by the previous managers and problems related to casting; 4) knowledge of the audience. These points influence how the manager plans the artistic programme and divides the resources. The theatre manager s job description has remained quite the same since the early days of Kaarlo Bergbom. In the future, special attention should be placed on why managers face fairly similar problems decade after decade. Reducing these problems partly depends on whether structural improvements are made to a theatre s close network of owners, financers and labour unions. During this study clear evidence was seen that structural changes are necessary in the production of performances and in the creation of a more versatile programme. In this process, different kinds of co-operation, experiments, development projects, continuing education and international relations have special importance, especially if the aim is to make it possible for all citizens of Finland to enjoy a vibrant and revitalized theatre.

Variation in liveweight gain of feedlot steers in southern Queensland

The rise in demand by domestic and export markets for a high quality uniform beef carcase has led to more steers being finished in feedlots. However, the profitability of feedlotting is small and economic survival hinges on efficiency (Ryan 1990). Lack of published data prevents conclusions being drawn about the level of efficiency of Australian feedlotting operations but the few studies reported show considerable variation in liveweight performance and carcase characteristics such as fat depth and marbling (Baud et al.) 21st Biennial Conference. 8-12 July, University of Queensland, Brisbane.

Aseptic Packaging of Tropical Fruit Purees

The object of this investigation was to develop high quality aseptically packaged mango and passionfruit puree products. Kensington mango puree (acidified to ph 3.5) and deseeded passionfruit pulp (ph 3.0) were sterilised in a scraped-surface heat exchanger, cooled to 20°C in a tubular heat-exchanger, aseptically packaged in sterile laminate bags. Six sterilising time/temperature combinations were compared - 85°C/15 secs, 85°C/60 secs, 90° C/15 secs, 90°/60 secs, 95°C/15 secs, 95°C/60 secs. Products were assessed immediately after processing, and after eight months ambient storage, for microbial, physical, chemical, and sensory quality. All treatments were microbiologically sound and showed no enzyme activity. Sensory quality was very acceptable, and there was no evidence of heat damage. Quality (especially colour and flavour) decreased during storage in all heat treatments.

The freezing of mango slices (Mangifera indica var. Kensington)

'Kensington' mango slices were frozen with sucrose syrup, with dry sucrose and without sugar addition, using blast freezing at -30°C, and still air freezing at -18°C. According to taste panel assessment, slices frozen in syrup were best. A syrup strength of 200 g/L was sufficient to produce a high quality product. the blast-frozen slices had a higher texture score than the still air-frozen slices.

Storage of Macadamia Nut-In-Shell

The effect of moisture content and storage temperature on the high quality storage life on macadamia nut-in-shell (NIS), and the subsequent influence of NIS storage on the shelf-life of roasted kernel, is being investigated. Macadamia integrifolia 'Keauhou" (HAES 246) NIS is being stored at 5°, 25°C and 40°C with a moisture content of 15.0, 12.5, 10.0, 7.5 and 3.5% for a maximum of 12 months. Preliminary results showed that unacceptable levels of visual mould developed on NIS with 15.0 and 12.5% moisture at 25°C following relatively short periods of storage. Discolouration and the production of an off-flavour in the raw kernel resulted after 1 month's storage of NIS with a moisture content of 10.0% at 40°C. Roasting times were reduced with increased storage duration of NIS with a moisture content of 15.0, 12.5 and 10.0% at 25°C, 15.0 and 12.5% at 5°C and 3.5% at 40°C. The percentage of roasted kernel rejects increased with increased storage duration of NIS with a moisture content of 15.0 and 12.5% at 25°C.

Strategic Analysis: A key factor in developing horticultural supply chains in transitional Asian economies

Globalisation is set to have a major impact on world horticultural production and distribution of fruit and vegetables throughout the world. In contrast to developing countries such as China, production and consumption of fresh fruit and vegetables in most developed countries is relatively static. For developed countries, we are starting to see consolidation in the number of farms producing fruit and vegetables with falling or static prices and real farm incomes. Global supply chains are now dominated by a few large multi-national retailers supplied by preferred trans-national distribution companies. The major competitive advantages that are emerging are consistency of supply of high quality product over an extended season and the control of genetic resources and their marketing. To capture these new competitive advantages, new strategic analyses and planning processes must be implemented. In the past, strategic analyses and planning has been undertaken on an ad hoc basis without accurate global intelligence. In the future, working ‘on the supply chain’ will become equally, if not more important, than working ‘in the supply chain’. A revised approach to strategic planning, which encompasses and adjusts for the changes caused by globalisation, is urgently needed. A new 6-step strategic analyses process is described.

A near Optimal Cane Rail Scheduler under Limited and Unlimited Capacity Constraints

Australia is the world’s third largest exporter of raw sugar after Brazil and Thailand, with around $2.0 billion in export earnings. Transport systems play a vital role in the raw sugar production process by transporting the sugarcane crop between farms and mills. In 2013, 87 per cent of sugarcane was transported to mills by cane railway. The total cost of sugarcane transport operations is very high. Over 35% of the total cost of sugarcane production in Australia is incurred in cane transport. A cane railway network mainly involves single track sections and multiple track sections used as passing loops or sidings. The cane railway system performs two main tasks: delivering empty bins from the mill to the sidings for filling by harvesters; and collecting the full bins of cane from the sidings and transporting them to the mill. A typical locomotive run involves an empty train (locomotive and empty bins) departing from the mill, traversing some track sections and delivering bins at specified sidings. The locomotive then, returns to the mill, traversing the same track sections in reverse order, collecting full bins along the way. In practice, a single track section can be occupied by only one train at a time, while more than one train can use a passing loop (parallel sections) at a time. The sugarcane transport system is a complex system that includes a large number of variables and elements. These elements work together to achieve the main system objectives of satisfying both mill and harvester requirements and improving the efficiency of the system in terms of low overall costs. These costs include delay, congestion, operating and maintenance costs. An effective cane rail scheduler will assist the traffic officers at the mill to keep a continuous supply of empty bins to harvesters and full bins to the mill with a minimum cost. This paper addresses the cane rail scheduling problem under rail siding capacity constraints where limited and unlimited siding capacities were investigated with different numbers of trains and different train speeds. The total operating time as a function of the number of trains, train shifts and a limited number of cane bins have been calculated for the different siding capacity constraints. A mathematical programming approach has been used to develop a new scheduler for the cane rail transport system under limited and unlimited constraints. The new scheduler aims to reduce the total costs associated with the cane rail transport system that are a function of the number of bins and total operating costs. The proposed metaheuristic techniques have been used to find near optimal solutions of the cane rail scheduling problem and provide different possible solutions to avoid being stuck in local optima. A numerical investigation and sensitivity analysis study is presented to demonstrate that high quality solutions for large scale cane rail scheduling problems are obtainable in a reasonable time. Keywords: Cane railway, mathematical programming, capacity, metaheuristics

Introduction

Australian perspectives and practices within early childhood education and care are underpinned by understandings of children, how they learn, their emotional and physical needs and their connectedness to family and their communities. There is strong international research evidence supporting the value of providing high quality and accessible early childhood education and care, and this evidence base continues to grow. Drawing on international and Australian research, this book provides an introduction to this complex and multifaceted field.

Guest Editorial: Emerging Scholars' Section

This issue of the QUT Law Review features an Emerging Scholars’ section containing contributions from early career researchers and doctoral students. This section was conceived by the previous General Editor of the journal, Prof Dan Hunter, as a forum to showcase high-quality legal scholarship from emerging scholars. We are grateful to Prof Hunter for his work on this initiative.

DArT markers: Diversity analyses and mapping in Sorghum bicolor

The sequential nature of gel-based marker systems entails low throughput and high costs per assay. Commonly used marker systems such as SSR and SNP are also dependent on sequence information. These limitations result in high cost per data point and significantly limit the capacity of breeding programs to obtain sufficient return on investment to justify the routine use of marker-assisted breeding for many traits and particularly quantitative traits. Diversity Arrays Technology (DArT™) is a cost effective hybridisation-based marker technology that offers a high multiplexing level while being independent of sequence information. This technology offers sorghum breeding programs an alternative approach to whole-genome profiling. We report on the development, application, mapping and utility of DArT™ markers for sorghum germplasm. Results: A genotyping array was developed representing approximately 12,000 genomic clones using PstI+BanII complexity with a subset of clones obtained through the suppression subtractive hybridisation (SSH) method. The genotyping array was used to analyse a diverse set of sorghum genotypes and screening a Recombinant Inbred Lines (RIL) mapping population. Over 500 markers detected variation among 90 accessions used in a diversity analysis. Cluster analysis discriminated well between all 90 genotypes. To confirm that the sorghum DArT markers behave in a Mendelian manner, we constructed a genetic linkage map for a cross between R931945-2-2 and IS 8525 integrating DArT and other marker types. In total, 596 markers could be placed on the integrated linkage map, which spanned 1431.6 cM. The genetic linkage map had an average marker density of 1/2.39 cM, with an average DArT marker density of 1/3.9 cM. Conclusion: We have successfully developed DArT markers for Sorghum bicolor and have demonstrated that DArT provides high quality markers that can be used for diversity analyses and to construct medium-density genetic linkage maps. The high number of DArT markers generated in a single assay not only provides a precise estimate of genetic relationships among genotypes, but also their even distribution over the genome offers real advantages for a range of molecular breeding and genomics applications.

Guest Editorial: Emerging Scholars' Section

This issue of the QUT Law Review also features an Emerging Scholars’ section containing contributions from early career researchers and doctoral students. This section was conceived by the previous General Editor of the journal, Prof Dan Hunter, as a forum to showcase high-quality legal scholarship from emerging scholars. We are grateful to Prof Hunter for his work on this initiative.

Systematic analysis of changes in cannabis use among participants in control conditions of randomised controlled trials

Introduction Cannabis remains the most used illegal substance across the globe, and negative outcomes and disorders are common. A spotlight therefore falls on reductions in cannabis use in people with cannabis use disorder. Current estimates of unassisted cessation or reduction in cannabis use rely on community surveys, and few studies focus on individuals with disorder. A key interest of services and researchers is to estimate effect size of reductions in consumption among treatment seekers who do not obtain treatment. Effects within waiting list or information-only control conditions of randomised controlled trials offer an opportunity to study this question. Method This paper examines the extent of reductions in days of cannabis use in the control groups of randomised controlled trials on treatment of cannabis use disorders. A systematic literature search was performed to identify trials that reported days of cannabis use in the previous 30 (or equivalent). Results Since all but one of the eight identified studies had delayed treatment controls, results could only be summarised across 2–4 months. Average weighted days of use in the previous 30 days fell from 24.5 to 19.9, and a meta-analysis using a random effects model showed an average reduction of 0.442 SD. However, every study had at least one significant methodological issue. Conclusions While further high-quality data is needed to confirm the observed effects, these results provide a baseline from which researchers and practitioners can estimate the extent of change required to detect effects of cannabis treatments in services or treatment trials.

Laadukasta yliopisto-opetusta kehittämässä : Laadukkaan yliopisto-opetuksen kehittäminen ja yliopistopedagogisen koulutuksen yhteys opetuksen kehittämiseen Helsingin yliopiston opettajilla

Objectives. The purpose of this study was to examine the development of high-quality university teaching among the teachers of the University of Helsinki. Furthermore, the relation of university pedagogical training to development of teaching was analyzed. This study introduces a new perspective to the research of quality of university teaching by considering quality from the teaching development perspective. The individual level examination was done from teacher's perspective. The development of high-quality university teaching was approached through three factors of teaching development defined by Biggs (2003). These factors are 1) the level of thinking about teaching on which the teaching development is based on (can also be called the quality model), 2) the methods for and 3) the impediments to teaching development. The research of Trigwell and Prosser (1996), Lindblom-Ylänne, Nevgi and Postareff (2004) and Postareff, Lindblom-Ylänne and Nevgi (2007) and the ideas of Ramsden (1992) have been central sources to this study. Methods. This study was a survey study. The data was collected with an electronic questionnaire in the spring of 2007. The sample consisted of 655 person of which some had and some had not university pedagogical training. Total of 251 answered the study. The data was mainly analyzed with SPSS statistical programme. Item analysis, principal component analysis, nonparametric Kruskal-Wallis and Mann-Whitney tests, correlation and crosstabulation were the methods used to analyze the data. Results and conclusions. According to the results it seems that the teachers of the University of Helsinki have good basis for developing high-quality university teaching. The 3rd level of thinking about teaching, which emphasizes student-centred features, could be identified on majority of the teachers. The use of teaching development methods was comprehensive. Most frequently used methods were related to the enhancement of content knowledge. In general the impediments to teaching development were not considered to be very significant. The most significant impediments were the factors related to lack of appreciation of teaching and factors related to lack of time meant for the planning and developing of teaching. Differences were found according to sex, teaching experience, degree, position and faculty. This study also showed that university pedagogical training seems to have a positive relation to the development of high-quality university teaching among the teachers of University of Helsinki. According to the results when the amount of teachers university pedagogical training increased, the 3rd level of thinking about teaching could be identified more often. Teachers also used more often teaching development methods related to cooperation and active participation and enhancement of pedagogical skills. Furthermore, they considered the factors related to lack of pedagogical skills and motivation to be lesser impediments to teaching development.