The Potential Success of the F.D.A.’S New Paradigm Based on Community Pharmacists’ Opinons

For the past 40 years the F. D. A. (Food and Drug Administration) has considered creating a third class of drugs in the United States of America that would be a pharmacist-only class which could only be sold with the approval of a pharmacist. Several things have inhibited its creation, the main one being the Durham-Humphrey Amendment which states that there are only two classes of drugs: prescription and over-the-counter. This has culminated into the development of the F.D.A.’s new paradigm, which is an expansion of the over-the-counter class of drugs to create and O.T.C.+ category. Community Pharmacists were interviewed in order to learn more about their knowledge and opinions of the new paradigm in order to measure the potential success of an O.T.C.+ class of drugs. Though many barriers were seen facing the implementation of the new paradigm, the majority of those interviewed believed it would be beneficial

Probiotics for preventing acute otitis media in children

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: to assess the effects of probiotics to prevent the occurrence and reduce the severity of acute otitis media in children.</p

Is the infant car seat challenge useful?:A pilot study in a simulated moving vehicle

Background and Objective: The American Academy of Pediatrics recommends preterm infants complete a pre-discharge “car seat challenge” observation for cardiorespiratory compromise whilst in a car seat. This static challenge does not consider the more upright position in a car or the vibration of the seat when the car is moving. This pilot study was designed to assess the cardiorespiratory effects of vibration, mimicking the effect of being in a moving car, on preterm and term infants.Methods: A simulator was designed to reproduce vertical vibration similar to that in a rear facing car seat at 30mph. 19 healthy newborn term and 21 preterm infants, ready for hospital discharge, underwent cardiorespiratory measurements whilst lying flat in a cot (baseline), static in the seat (30°), simulator (40°) and during motion (vibration 40°). Results: Median test age was 13 days (range 1- 65 days), and median weight was 2.5Kg [iqr: 2.1-3.1Kg]. Compared to baseline observations, only the total number of desaturations was significantly increased when infants were placed at 30° (p=0.03). At 40°, or with vibration, respiratory and heart rates increased and oxygen saturation decreased significantly. Profound desaturations &lt;85% significantly increased during motion, regardless of gestational age.Conclusions: This is the first study to assess the effect of motion on infants seated in a car safety seat. Term and preterm infants showed significant signs of potentially adverse cardiorespiratory effects in the upright position at 40° particularly with simulated motion; not identified in the standard challenge. A larger study is required to investigate the significance of these results

PORTRAIT OF A DARK HORSE: A PHOTOMETRIC AND SPECTROSCOPIC STUDY OF THE ULTRA-FAINT MILKY WAY SATELLITE PEGASUS III

National Science Foundation (U.S.) (AST-1255160

Understanding Chemolithotrophic Reduction Mechanisms from the Dark Marine Biosphere

As greenhouse gas emissions contribute to global warming and an increase in CO2 concentration in the earth’s atmosphere, the scientific community is under pressure not just to examine new technologies to reduce emissions, but also to consider the effect that increased CO2 concentration has on our terrestrial and marine ecosystems. In marine ecosystems, atmospheric CO2 dissolves and reacts with water to form carbonic acid. This diprotic acid then dissociates, contributing to a lowered pH of ocean water and affecting all levels of marine life. Fortunately, nature already has carbonate reduction mechanisms in place that can reduce the harmful effects of ocean acidification. Being able to identify individual bacteria in biological carbonate-fixing consortia can lead to adaptive systems engineered around biofilms. In this study, environmental samples taken from defined sites the dark marine biosphere (ocean depth of 2100-2300 meters) in the Gulf of Mexico will be grown in a number of selective medias with defined carbonate contents. Bacterial samples will then be analyzed using ion chromatography to measure carbonate consumption as a function of time. The data collected thus far suggests that by selectively pressuring environmental consortia from the dark marine biosphere toward the purpose of fixing carbon, mechanisms and pathways can be generated to control the level of CO2 in the marine environment

Feasibility cluster randomised controlled trial of a within-consultation intervention to reduce antibiotic prescribing for children presenting to primary care with acute respiratory tract infection and cough

Objective To investigate recruitment and retention, data collection methods and the acceptability of a ‘within-consultation’ complex intervention designed to reduce antibiotic prescribing. Design Primary care feasibility cluster randomised controlled trial. Setting 32 general practices in South West England recruiting children from October 2014 to April 2015. Participants Children (aged 3 months to <12 years) with acute cough and respiratory tract infection (RTI). Intervention A web-based clinician-focussed clinical rule to predict risk of future hospitalisation and a printed leaflet with individualised child health information for carers, safety-netting advice and a treatment decision record. Controls Usual practice, with clinicians recording data on symptoms, signs and treatment decisions. Results Of 542 children invited, 501 (92.4%) consented to participate, a month ahead of schedule. Antibiotic prescribing data were collected for all children, follow-up data for 495 (98.8%) and the National Health Service resource use data for 494 (98.6%). The overall antibiotic prescribing rates for children’s RTIs were 25% and 15.8% (p=0.018) in intervention and control groups, respectively. We found evidence of postrandomisation differential recruitment: the number of children recruited to the intervention arm was higher (292 vs 209); over half were recruited by prescribing nurses compared with less than a third in the control arm; children in the intervention arm were younger (median age 2 vs 3 years controls, p=0.03) and appeared to be more unwell than those in the control arm with higher respiratory rates (p<0.0001), wheeze prevalence (p=0.007) and global illness severity scores assessed by carers (p=0.045) and clinicians (p=0.01). Interviews with clinicians confirmed preferential recruitment of less unwell children to the trial, more so in the control arm. Conclusion Differential recruitment may explain the paradoxical antibiotic prescribing rates. Future cluster level studies should consider designs which remove the need for individual consent postrandomisation and embed the intervention within electronic primary care records

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy