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The performance ofBombus terrestrismicro-colonies fed five diets differing in pollen species composition and level of nine essential amino acids (EAA; leucine, lysine, valine, arginine, isoleucine, phenylalanine, threonine, histidine, methionine) was assessed for 37 days by recording total biomass gain, nest building initiation, brood production (eggs, small and large larvae, pupae, drones), nectar, and pollen collection. Stronger colony performance was linked to higher amino acid levels but no consistent differences in biomass gain were recorded between mono- and poly-species diets. Poorest performance occurred in micro-colonies offered pure oilseed rape (OSR) pollen which contained the lowest EAA levels. Reduced micro-colony development (delayed nest initiation and lower brood production) was related to OSR proportion in the diet and lower EAA levels. Results are discussed in relation to selection of plant species in the design of habitats to promote bee populations.

The impact on pollination of supplementing wild pollinators with commercially reared Osmia bicornis in commercial orchards growing the self-fertile sweet cherry variety “Stella” was investigated in...

The performance of Bombus terrestris micro-colonies fed five diets differing in pollen species composition and level of nine essential amino acids (EAA; leucine, lysine, valine, arginine, isoleucine, phenylalanine, threonine, histidine, methionine) was assessed for 37 days by recording total biomass gain, nest building initiation, brood production (eggs, small and large larvae, pupae, drones), nectar, and pollen collection. Stronger colony performance was linked to higher amino acid levels but no consistent differences in biomass gain were recorded between mono- and poly-species diets. Poorest performance occurred in micro-colonies offered pure oilseed rape (OSR) pollen which contained the lowest EAA levels. Reduced micro-colony development (delayed nest initiation and lower brood production) was related to OSR proportion in the diet and lower EAA levels. Results are discussed in relation to selection of plant species in the design of habitats to promote bee populations.

To identify factors associated with pharmacist dispensing practice and comfort counseling patients about pre-exposure prophylaxis for HIV prevention (PrEP). Cross-sectional 2016 census of Indiana managing pharmacists measured PrEP awareness, comfort dispensing and counseling patients. Modified Poisson models with robust error variance estimated relative risks and confidence intervals. 15.8% of 284 pharmacists had dispensed PrEP and 11.6% had consulted about it. Dispensing and comfort counseling were associated with confidence in knowledge about PrEP medication adherence and adverse effects of PrEP medication; awareness about PrEP before the survey, number of full time pharmacists in their pharmacy, and increases in new HIV cases from 2015 to 2016 in communities served. Comfort counseling about PrEP was associated with the belief that pharmacists can be an important resource for HIV and HCV treatment.

Background While naloxone, the overdose reversal medication, has been available for decades, factors associated with its availability through pharmacies remain unclear. Studies suggest that policy and pharmacist beliefs may impact availability. Indiana passed a standing order law for naloxone in 2015 to increase access to naloxone. Objective To identify factors associated with community pharmacy naloxone stocking and dispensing following the enactment of a statewide naloxone standing order. Methods A 2016 cross-sectional census of Indiana community pharmacists was conducted following a naloxone standing order. Community, pharmacy, and pharmacist characteristics, and pharmacist attitudes about naloxone dispensing, access, and perceptions of the standing order were measured. Modified Poisson and binary logistic regression models attempted to predict naloxone stocking and dispensing, respectively. Results Over half (58.1%) of pharmacies stocked naloxone, yet 23.6% of pharmacists dispensed it. Most (72.5%) pharmacists believed the standing order would increase naloxone stocking, and 66.5% believed it would increase dispensing. Chain pharmacies were 3.2 times as likely to stock naloxone. Naloxone stocking was 1.6 times as likely in pharmacies with more than one full-time pharmacist. Pharmacies where pharmacists received naloxone continuing education in the past two years were 1.3 times as likely to stock naloxone. The attempted dispensing model yielded no improvement over the constant-only model. Conclusions Pharmacies with larger capacity took advantage of the naloxone standing order. Predictors of pharmacist naloxone dispensing should continue to be explored to maximize naloxone access.

Background Pharmacies have much to contribute to the health of people who inject drugs (PWID) and to community efforts in HIV and hepatitis C (HCV) prevention through syringe access. However, little is known about what predicts pharmacy syringe sales without a prescription. Objective To identify factors predicting pharmacy syringes sales to PWID. Methods A hybrid staggered online survey of 298 Indiana community pharmacists occurred from July-September 2016 measuring pharmacy policy, practice, and pharmacist perceptions about syringe sales to PWID. Separate bivariate logistical regressions were followed by multivariable logistic regression to predict pharmacy syringe sales and pharmacist comfort dispensing syringes to PWID. Results Half (50.5%) of Indiana pharmacies sold syringes without a prescription to PWID. Pharmacy syringe sales was strongly associated with pharmacist supportive beliefs about syringe access by PWID and their comfort level selling syringes to PWID. Notably, pharmacies located in communities with high rates of opioid overdose mortality were 56% less likely to sell syringes without a prescription than those in communities with lower rates. Pharmacist comfort dispensing syringes was associated with being male, working at a pharmacy that sold syringes to PWID and one that stocked naloxone, having been asked about syringe access by medical providers, and agreement that PWID should be able to buy syringes without a prescription. Conclusions As communities with high rates of opioid overdose mortality were less likely to have pharmacies that dispensed syringes to PWID, a concerted effort with these communities and their pharmacies should be made to understand opportunities to increase syringe access. Future studies should explore nuances between theoretical support for syringe access by PWID without a prescription and actual dispensing behaviors. Addressing potential policy conflicts and offering continuing education on non-prescription syringe distribution for pharmacists may improve comfort distributing syringes to PWID, and therefore increase pharmacy syringe sales.

©2013 Association of Schools of Public Health The evolution of pharmacy practice in the last 15 years has created expanded public health access. Community pharmacies now provide a range of public health services with promising improvements in health access and outcomes. The observed practice changes call our attention to systemic issues that remain in need of collective attention. As we strengthen our intersectoral public health system, we must focus on the pharmacy-public health partnership and establish collaborative policy and research agendas to guide this system change for maximum public health impact. Our collective effort to assure the health of communities depends upon our seeing opportunities across systems and sectors, and upon our success in shifting the policy environment to allow health system flexibility.

Pharmacist attitudes about the over-the-counter (OTC) sale of HIV rapid tests in pharmacies were explored through interviews conducted among 17 licensed community pharmacists in a Midwestern, moderate HIV incidence state between May and September 2012. Participants recognized that OTC rapid HIV tests would increase the number of people aware of their HIV status. Concerns included linkage to care and results consultation for those who test HIV-positive. Point of sale was identified as an opportunity for consultation about the test and to establish a relationship for future discussion about results and linkage to care. Pharmacists could provide initial test consultation or information, and consultation about the test results in order to provide post diagnosis support and facilitate linkage to care.

Objective. To determine baseline attitudes of pharmacy, physician assistant studies, and communication science and disorders students toward people in poverty and to examine the effectiveness of using the online poverty simulation game SPENT to affect these attitudes. Methods. Students completed pre/postassessments using the validated Undergraduate Perceptions of Poverty Tracking Survey (UPPTS). Students played the online, open access, SPENT game alone and/or in pairs in a 50-minute class. Results. Significant improvements in scale scores were seen in students after playing SPENT. Quartile results by prescore indicated that students with the lowest attitudes towards patients in poverty improved the most. Results suggested that most students found the experience worthwhile for themselves and/or for their classmates. Conclusions. The results of this study suggest SPENT may improve perspectives of undergraduate pharmacy and other health professions students.

In spite of the ecological dominance of Neotropical ants and termites, little is understood about how their interactions influence their species richness and distribution. We surveyed ground-dwelling termite and ant species in a primary rainforest in Ecuador and analyzed ecological correlates of diversity. Termite richness was positively correlated with ant richness and abundance of twig-nesting ants. We found no evidence of competition for twigs between termites and ants. No ecological factors were correlated with termite diversity although elevation and twig and log abundance influenced ant diversity. When ant richness was compared to the richness of termites employing different predator defenses, a positive correlation was found with soldierless termites, but not genera employing chemical or mechanical defense. Our results suggest that multiple ecological factors influence ant and termite diversity, and that ant predation on termites may have a greater effect than competition between ant and termites for nest sites and food sources.

Objective Assisted living (AL) residents are vulnerable to adverse events as a result of using numerous medications and frequently need assistance in administering medications. Very little is known, however, about the ways in which medications are managed within this level of care. Design AL administrators from the metropolitan Baltimore, Maryland area were invited to participate in focus groups to explore issues involved in medication management. Setting and participants Four administrators from smaller (15 beds or fewer) and six larger (more than 15 beds) certified AL facilities serving primarily older residents participated. Administrators must have served in their position at least six months. Results Administrators described interactions with residents, physicians, and pharmacists as well as the issues of state regulations and their enforcement. We uncovered themes concerning the challenges faced in negotiating competing needs of residents, providers, and regulatory bodies. Conclusions Administrators often feel torn between competing requirements of their position, and they experience some degree of conflict in allowing residents to retain autonomy in the face of demands of family, providers, and regulators. Small-facility administrators especially report being in a position to allow them to monitor residents' medication reactions and needs. Large-facility administrators sometimes find their actions hampered by decisions made at higher (ownership) levels. Administrators want AL facilities to remain at an intermediate level of care, with less stringent regulations than for those for nursing facilities, but would also like more consistency in enforcement of regulations. Qualitative assessment of medication-related issues in AL can help to guide policy in this area.

The glenoid labrum is a significant passive stabilizer of the shoulder joint. However, its microstructural form remains largely unappreciated, particularly in the context of its variety of functions. The focus of labral microscopy has often been histology and, as such, there is very little appreciation of collagen composition and arrangement of the labrum, and hence the micromechanics of the structure. On transmission electron microscopy, significant differences in diameter, area and perimeter were noted in the two gross histological groups of collagen fibril visualized; this suggests a heterogeneous collagenous composition with potentially distinct mechanical function. Scanning electron microscopy demonstrated three distinct zones of interest: a superficial mesh, a dense circumferential braided core potentially able to accommodate hoop stresses, and a loosely packed peri-core zone. Confocal microscopy revealed an articular surface fine fibrillar mesh potentially able to reduce surface friction, bundles of circumferential encapsulated fibres in the bulk of the tissue, and bone anchoring fibres at the osseous interface. Varying microstructure throughout the depth of the labrum suggests a role in accommodating different types of loading. An understanding of the labral microstructure can lead to development of hypotheses based upon an appreciation of this component of material property. This may aid an educated approach to surgical timing and repair.

Brain stem death may be a difficult concept for relatives to understand. Our ITU practice follows published recommendations that the use of explanatory leaflets showing CT scans and observing brain stem death testing in some cases may help relatives to understand that death has occurred. Using this strategy, we interviewed 27 relatives 12 months after bereavement following certification by brain stem testing, investigating their understanding of brain stem death, subsequent attitudes to organ donation, grief reactions and attitudes of those who had observed the tests. Most relatives understood that the brain stem death tests indicated that survival was not possible, although three relatives had not fully understood this and valued the opportunity to discuss it again. Only five relatives observed the tests, all were pleased that they had done so as this had confirmed their understanding that death had occurred; however, these relatives had more evidence of psychological distress. No relatives who agreed to organ donation regretted this but three who did not allow donation subsequently expressed regret. Several relatives thought that observing the tests would have helped them to understand that death had occurred, making easier the decision to allow organ donation.

The third author should be listed under "Conceived and designed the experiments." The correct contribution should read: "Conceived and designed the experiments: KTRW ALM JFAT"

We have developed an individualized melanoma vaccine based on transfection of autologous dendritic cells (DCs) with autologous tumor-mRNA. Dendritic cells loaded with complete tumor-mRNA may generate an immune response against a broad repertoire of antigens, including unique patient-specific antigens. The purpose of the present phase I/II trial was to evaluate the feasibility and safety of the vaccine, and the ability of the DCs to elicit T-cell responses in melanoma patients. Further, we compared intradermal (i.d.) and intranodal (i.n.) vaccine administration. Twenty-two patients with advanced malignant melanoma were included, each receiving four weekly vaccines. Monocyte-derived DCs were transfected with tumor-mRNA by electroporation, matured and cryopreserved. We obtained successful vaccine production for all patients elected. No serious adverse effects were observed. A vaccine-specific immune response was demonstrated in 9/19 patients evaluable by T-cell assays (T-cell proliferation/interferon-gamma ELISPOT) and in 8/18 patients evaluable by delayed-type hypersensitivity (DTH) reaction. The response was demonstrated in 7/10 patients vaccinated intradermally and in 3/12 patients vaccinated intranodally. We conclude that immuno-gene-therapy with the described DC-vaccine is feasible and safe, and that the vaccine can elicit in vivo T-cell responses against antigens encoded by the transfected tumor-mRNA. The response rates do not suggest an advantage in applying i.n. vaccination.

62 No. 1 McAllister 34–019–20553 57 No. 1–341165 Peoples Community 34–019–21513 55 No. 1–341532 Eick 34–019–21744 53 No. 1 Nofsinger 34–019–20234 51 No. 2 Wheeler-Evans 34–151–22383 50 No. 2 Hackett 34–151–22292 48 No. 3 Natale 34–151–23844 45 No. 3 Ohio Power-Stark County Comm. 34–151–24649 44 No. 1 Provost 34–151–24040 41 No. 13 State of Ohio 34–151–24725 39 No. 1–342919 Kreider 34–151–24429 37 No. 1 Buchman 34–151–24041 34 No. 2 Barkman 34–169–23181 32 No. 1 Gerber 34–169–22110 30 No. 1 Sevenson 34–169–24905 28 No. 1 Yost-Miller 34–169–24204 26 No. 1 Yoder 34–169–21671 25 No. 2 Marthey 34–169–21630 22 No. 1 Weekley 34–169–21869 19 No. 1–84 Long 34–169–23742 16 No. 2 Infield 34–169–23912 12 No. 1–D—W–29 Redick 34–169–23619 10 No. 1 Berger 34–169–24173 8 No. 1 Krommes 34–169–24754 6 No. 4 Cehrs 34–005–22387 1 No. 1–A Swinehart 34–005–22925 5 No. 1 Emmons 34–005–23166

Most studies to date on sound levels in entertainment establishments have concentrated on exposure levels for the attending public, rather than employees who may be at greater risk of hearing loss. Of particular concern are young employees. The aim of this pilot study was to (i) estimate typical sound levels in different areas where amplified music was played, (ii) measure temporary threshold shift (TTS) and (iii) estimate the dependence of hearing threshold shifts on measured noise levels.This study focused on students working part-time (up to 16 h/week) in music bars and discotheques in a university entertainment venue. All 28 staff were invited to participate in the study. Pre- and post-exposure audiometry was used to determine hearing threshold at both high and low frequencies. Personal dosemeters and static measurements were made to assess noise levels and frequency characteristics. A questionnaire was used to determine patterns of noise exposure and attitudes to noise levels and hearing loss.Of the 28 student employees working in the three areas, 14 (50%) agreed to take part in the study, giving 21 pre- and post-shift audiograms. The mean personal exposure levels for security staff were higher than those of bar staff, with both groups exceeding 90 dB(A). The maximum peak pressure reading for security staff was 124 dB. Although TTS values were moderate, they were found to be highly significant at both low and high frequencies and for both ears. Twenty-nine per cent of subjects showed permanent hearing loss of more than 30 dB at either low or high frequencies. The correlation between TTS and personal exposure was higher at 4 kHz than the low and high frequencies.Contemporary music may be an important yet little considered contributor to total personal noise exposure, especially amongst young employees. Employees need to be better informed of risks of hearing loss and the need to report changes in hearing acuity. Suggestions are made on strategies for improving the assessment of noise exposure in entertainment venues.