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The profession of pharmacy is complex and diverse, encompassing a wide range of necessary practice skills. Decisions regarding which skills are essential for students are made by faculty of skills-based laboratory courses, who also determine how these skills are taught and assessed. This commentary aims to further the discussion regarding how the essential skills taught and assessed in skills laboratory curricula are identified, with the intention of preparing student pharmacists for both current and future pharmacy practice. Guidance on essential skills is provided by various organizations and documents, but ultimately each institution has the autonomy to decide what to teach. As such, this piece discusses the importance of frequent curriculum evaluation to determine how to train pharmacists of the future so they will practice at the top of their license rather than simply meet competency with historical skills.

Research through design allows creating a dialogue with the material. It uses making and reflection on action as a generator of knowledge. Our aim is to explore the opportunities and challenges of smart textiles. The Fablab is our set up, a place that allows us to combine the hacking- scientific-, and design community. It stimulates collaboration and the knowledge exchange needed for the development of smart textile systems. A collaborative prototyping workshop for medical products combined two worlds. The textile world in Saxion aims at incorporating conductive materials into textile structures and functional- / 3D printing to create systems for applications such as flexible heating systems and wearable technology. We combined this with the world of Industrial Design at TU/e, focused on the design of intelligent products, systems and services by the research through design approach. The collaboration between these different disciplines speeded up the process by reducing the resistance to the new and skipped the frustration on failure.

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Fiber-reinforced polymer (FRP) bridge decks are ideal for re-decking movable bridges. They can match the weight of existing steel grid decking to minimize bridge balance adjustment. They are bicycle- and motorcycle-friendly and quieter than steel grids. They protect the structure from precipitation and are corrosion resistant.In 2002, the Oregon Department of Transportation (ODOT) installed FRP decks on two movable bridges near Astoria. Cementitious grout pads supported the deck on the steel stringers, and the deck was secured to the stringers by welded steel studs in cementitious grout pockets. The wearing surface was to have asphalt concrete, but was changed to epoxy polymer concrete after the asphalt slid off a bascule leaf during a prolonged test lift. The grout details had failed on one of these bridges, resulting in deck replacement, and both bridges had experienced distress in the wearing surface. The attachment details and wearing surfaces used on these bridges did not accommodate the higher deflections associated with FRP decks, and were regarded as unacceptable.In 2005, the ODOT installed a FRP deck on a movable bridge in Florence. Neoprene sheets supported the deck on the steel stringers, and the deck was secured to the stringers with large structural blind fasteners installed from below. The wearing surface was urethane polymer concrete, placed by the broom and seed method. This installation showed none of the distress experienced on the two bridges at Astoria. The strong but flexible attachment details and wearing surface used on this bridge accommodate deflections well and were recommended for future installations.

Evaluations of handwritten essays or exams are often suspected of being biased, such as by mood states or individual predilections. Although most of these influences are unsystematic, at least one bias is problematic because it systematically affects evaluations of handwritten materials. Three experiments revealed that essays in legible as compared to less legible handwriting were evaluated more positively. This robust finding was related to a basic judgmental mechanism that builds on the fluency with which handwriting can be processed. The present research further revealed that this evaluative bias is not inevitable but can be controlled for. Given the importance of evaluations based on handwritten work samples for individual success throughout school, college, university, and work life, it is important for individuals to be aware of this bias.

Objective: To review the pharmacology, pharmacokinetics, clinical efficacy, and safety of denosumab, a biologic antiresorptive agent for treatment of osteoporosis and other bone-related disorders.Data Sources: Primary literature and review articles were obtained via a MEDLINE search (1966–July 2008), using the following key terms: denosumab, AMG 162, and RANKL. Additional articles were identified from the bibliographies of reviewed literature.Study Selection and Data Extraction: English-language articles identified from the data sources were reviewed. All pertinent preclinical and clinical information was included. Randomized controlled trials were evaluated to assess the efficacy of denosumab in osteoporosis, rheumatoid arthritis (RA), and breast cancer—related bone metastases.Data Synthesis: Denosumab is a humanized monoclonal antibody that neutralizes receptor activator of nuclear factor-κB-ligand, thereby decreasing osteoclast-mediated bone resorption. This agent has been compared with placebo and intravenous bisphosphonates in randomized, double-blind controlled trials. In studies involving patients with osteoporosis, RA, or breast cancer—related bone metastases, denosumab significantly improved bone mineral density and markers of bone turnover when compared with placebo. Adverse events were minimal among patients receiving denosumab, although long-term safety data are not available.Conclusions: Denosumab is a novel therapeutic agent that improved BMD and bone turnover markers in clinical studies, suggesting that it may be promising for the treatment of a variety of bone remodeling disorders.ACPE Universal Program Numbers: 407-000-09-051-H01-P (Pharmacists); 407-000-09-051-H01-T (Technicians)

Hyperglycemia in hospitalized patients has been shown to increase both morbidity and mortality, regardless of the presence of preexisting diabetes. In order to achieve recommended glycemic goals, many patients require the use of intravenous insulin therapy in the critical care setting. Following the publication of a landmark trial evaluating the benefits of intensive insulin therapy in critically ill patients, a worldwide increased effort to achieve strict glycemic control has ensued. Maintaining blood glucose levels between 80 and 110 mg/dL has been shown to improve outcomes such as mortality and infectious complications in critically ill patients, while also decreasing length of hospital stay and healthcare expenditures. However, achieving strict glycemic control has proven to be a challenge for many institutions, partly due to the prevalence of hypoglycemia. As demonstrated by studies which have been terminated prematurely due to increased risk for hypoglycemic episodes, the benefits versus risks of intensive insulin therapy must be weighed carefully. Patients receiving continuous infusions of insulin require close monitoring, which may increase workload for intensive care unit staff. In an effort to balance the risks and benefits of intensive insulin therapy, many hospitals are incorporating standardized protocols and using an interdisciplinary approach toward patient care.

Simplex vulvar intraepithelial neoplasia (VIN) is an important precursor of vulvar invasive squamous cell carcinoma and characteristically occurs in postmenopausal women. In this report, the absence of high-risk human papillomavirus (HPV) combined with specific p53 and p16INK4a expression patterns points to the HPV-independent pathway as the causative agent for vulvar squamous cell carcinoma in a 28-year-old woman. Its precursor simplex VIN was initially interpreted as eczema. Although simplex VIN has a predilection for postmenopausal women, it can occur in young patients. The development of invasive vulvar squamous cell carcinoma underlines the importance of including simplex VIN in the differential diagnosis of vulvar lesions, even at a young age. Furthermore, knowledge about the HPV status in the tumor and thus the underlying causative pathway can alert the gynecologist for the presence or absence of multicentric lower genital tract disease, as this is frequent in the HPV-dependent and not in the HPV-independent pathway.

Research through design allows creating a dialogue with the material. It uses making and reflection on action as a generator of knowledge. Our aim is to explore the opportunities and challenges of smart textiles. The Fablab is our set up, a place that allows us to combine the hacking- scientific-, and design community. It stimulates collaboration and the knowledge exchange needed for the development of smart textile systems. A collaborative prototyping workshop for medical products combined two worlds. The textile world in Saxion aims at incorporating conductive materials into textile structures and functional- / 3D printing to create systems for applications such as flexible heating systems and wearable technology. We combined this with the world of Industrial Design at TU/e, focused on the design of intelligent products, systems and services by the research through design approach. The collaboration between these different disciplines speeded up the process by reducing the resistance to the new and skipped the frustration on failure.

Three magnetic fluid seals custom engineered to meet specific application objectives are discussed. These seals are: a belt edge seal, a large diameter seal and a centrifugal seal. Extensive experimental data were acquired on the first two seals to determine their performance characteristics. Some of these test results are compared with the theoretical expectations. Numerical computations are made on the centrifugal seal to Predict its sealing capabilites.

Objectives. This study was designed to assess: 1) the ability of several commercially available and laboratory-made acid etchants to penetrate occlusal fissures when used for pit and fissure sealing, and 2) the influence of adding a surfactant to the etchant on penetration of the sealer. Viscosity, surface tension and contact angle to enamel of the etchants were determined for each treatment, and these properties were related to the etchant's ability to penetrate fissures. Methods. Penetration was assessed in an acrylic fissure model having a deep-narrow fissure using a microscope and a chronometer. Penetration depth was expressed as percentage of total fissure depth and was measured in intervals up to 90 s. Commercially available etching agents with different viscosities and two solutions of phosphoric acid (37%), one with and one without a surfactant, were tested. The etch pattern obtained on the fissure wall enamel of extracted teeth with some of these products was evaluated using scanning electron microscopy. Eventually, the penetration depths of a composite sealer in fissures treated with a conventional etchant were compared to those after application of a surfactant-containing etchant on sections of extracted teeth. Results. None of the commercially available etchants studied were able to penetrate farther than 17% of the total fissure depth in the fissure model. The surfactant-containing etchant showed complete penetration within about 1 min and had a significantly lower surface tension and contact angle than the other products tested. Only the surfactant-containing etchant could produce a retentive pattern on the entire wall enamel of the fissure with the exception of locations blocked by debris and plaque. Fissures treated with this product prior to sealing showed a significantly deeper penetration of the sealer in deep-narrow fissures. Significance. Surfactant-containing etchants with a low viscosity can penetrate completely into fissures and can produce an increased retentive and wettable surface which significantly increased sealant penetration into deep fissures.

ABSTRACTThe impact of cereal rye (Secale cerealeL.) mulch or a mixture of rye mulch and red clover (Trifolium pratenseL.) on weeds, insect pests and diseases of cabbage (Brassica oleraceavar. capitataL. cv. ‘Market Prize’) was investigated. Autumn-planted rye was killed the following spring either with glyphosate and then mowed and left as a plant residue, or by mowing the rye and then seeding red clover into the rye residue. Initial suppression of most weed species by rye or rye/clover mulch was similar to that resulting from conventional tillage where trifluralin was used. Supplemental weed control was necessary in the rye plots later in the season. Early dandelion (Taraxacum officinaleWeber) infestation from windblown seeds was a problem in rye mulch in 1995. Redroot pigweed (Amaranthus retroflexusL.) and velvetleaf (Abutilon theophrastiMedicus) were significantly reduced by the rye mulch. Cabbage grown in rye mulch had lower insect pest populations than cabbage under conventional tillage. The lower populations of diamondback moth (Plutella xylostella(L.)), imported cabbage worm (Pieris rapae(L.)), cabbage looper (Trichoplusia ni(Hübner)) and aphids (primarily Myzus persicae(Sulzer) and Lipaphis erysimi(Kaltenbach)) in rye mulch may have been related to the smaller size and lower head weights of the plants. Applications of a microbial insecticide derived from Bacillus thuringiensis(Bt) controlled diamondback moth populations adequately but not cabbage loopers in 1995. Cabbage planted in rye mulch and treated with Bt-insecticide had the lowest insect damage ratings of any treatment but yields were still lower than those obtained in conventional tillage. Improvements in insect and weed control occurred at the expense of severe yield losses due to difficulties in cover crop management: poor kill of rye, soil compaction during mowing, and competition by red clover.

Rosette is the most destructive virus disease of groundnut in sub-Saharan Africa. It is caused by a complex of three agents, namely groundnut rosette assistor virus, groundnut rosette virus and its satellite RNA. The disease appears to be indigenous to Africa as it has not been recorded elsewhere. Thus rosette represents a new-encounter situation as the disease is thought to have spread to the introduced groundnut from indigenous host plants. Rosette has been known since 1907 and much information has been obtained on the main features of the disease, viz.its biology, transmission, viral aetiology and diagnosis, and the impact of chemical control of the aphid vector, cultural practices and virus-resistant varieties on disease management. However, there are still many gaps in the available knowledge, especially the reasons for the large and unpredictable fluctuations in the incidence and severity of rosette disease throughout sub-Saharan Africa. Three unresolved issues of particular importance concern the nature of the primary source(s) of inoculum, the means of survival of virus and vector during unfavourable periods, and the distances over which the aphid vector can disperse and disseminate virus. Now that the aetiology of the disease is understood and diagnostic tools have been developed, the time is opportune for new initiatives in understanding the ecology and epidemiology of rosette. Substantial progress can be made by developing a co-ordinated multi-disciplinary research programme and making full use of the latest techniques, approaches and experience gained elsewhere with other insect-borne viruses. This information would help to explain the sporadic disease epidemics that cause serious crop losses and sometimes total crop failure, and would also facilitate the development of disease forecasting methods and sustainable integrated disease management strategies.

Dysfunctional communication, behaviorproblems, and the lack of meaningful exchanges make it difficult for the nursing assistant (NA) to establish a relationship with the nursing home resident who has Alzheimer's disease (AD). As a result, the NA may avoid communication. Long term care is inevitable for many persons with AD. Therefore, it is important to understand the impact of verbal and nonverbal communication on the caregiving relationship between the formal caregiver in the nursing home and the person with AD.The purpose of the study was to describe communication barriers and successes identified by NAs. NAs did not understand resident behaviors such as fearfulness, agitation and wandering. They were also frustrated with the demands of family members. Results indicated that NAs did not have the necessary education orsupportto communicate effectively with the individual with AD and the family, and that training NAs to work more effectively should be a priority for nursing homes.

By means of a 12-minute field test, the effect of cigarette smoking on endurance performance was measured in 419 airmen before and after six weeks of basic training. In 47 airmen, cardiopulmonary indexes also were obtained during maximal treadmill performance. Field testing showed that endurance performance was inversely related to the number of cigarettes smoked daily and the duration of smoking. The training response also was impaired significantly in the smokers. During treadmill studies, smokers had a decrease in respiratory minute volume and a lower oxygen consumption at equivalent heart rates than nonsmokers. Further statistical studies demonstrated not only the independent effect of smoking, but also the effect of prior athletic history and physical characteristics on endurance performance. The latter effects become less significant as physical training progressed.