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Christian Kunow, Bernhard Langer Department of Health, Nursing, Management, University of Applied Sciences Neubrandenburg, Neubrandenburg, GermanyCorrespondence: Bernhard LangerDepartment of Health, Nursing, Management, University of Applied Sciences Neubrandenburg, Brodaer Straße 2, Neubrandenburg, 17033, GermanyTel +49 395 5693-3107Fax +49 395 5693-73107Email langer@hs-nb.deBackground: In Germany, over-the-counter (OTC) medicines for self-medication may only be dispensed by community pharmacies (CPs). From the customer’s point of view, “adequate” counseling includes not only the recommendation of medicines that meet guidelines, but ao the dispensing of low-priced medicines. This is all the more important in Germany against the background of free pricing and a lack of obligation to display prices. The aim was to analyze the dispensing and possible price variability of OTC medicines for headache.Methods: The cross-sectional design of the study based on the simulated patient methodology (SPM) included all 42 CPs of the German big city Potsdam and used eight trained simulated patients (SPs). Between October and December 2020, four different SPs visited each CP four times with two almost identical scenarios with the demand for a medicine for headache.Results: All 168 planned visits were successfully completed and ibuprofen (60.1%) was dispensed most frequently. Across all dispensed medicines, prices varied from € 0.93 to € 9.97 (∆ 972%; median € 3.46 [interquartile range (IQR) € 2.25]). For repeated dispensing of the same CPs, the price variability was a maximum of € 8.77. In addition, packs with ≤ 10 tablets were dispensed in 47.6%, with 11 to 20 tablets in 50.6%, and with > 20 tablets in 1.8% of visits.Conclusion: Increasing price transparency and strengthening price competition could make it easier for customers to access OTC medicines according to their personal needs.Keywords: pricing, dispensing, OTC medicines, headache, community pharmacies, simulated patient

A variety of electron emission processes have been studied in detail for both atomic and molecular systems, using a highly efficient experimental system comprising two time-of-flight (TOF) rotatable electron energy analyzers and a 3rd generation synchrotron light source. Two examples are used here to illustrate the obtained results. Firstly, electron emissions in the the HCL molecule have been mapped over a 14 eV wide photon energy range over the Cl 2p ionization threshold. Particular attention is paid to the dissociative core-excited states, for which the Auger electron emission shows photon energy dependent features. Also, the evolution of resonant Auger to the normal Auger decay distorted by post-collision interaction has been observed and the resonating behavior of the valence photoelectron lines studied. Secondly, an atomic system, neon, in which exciation of doubly excited states and their subsequent decay to various accessible ionic states has been studied. Since these processes only occurs via inter-electron correlations, the many body dynamics of an atom can be probed, revealing relativistic effects, suprising in such a light atom. Angular distribution of the decay of the resoances to the parity unfavored continuum exhibits significant deviation fro the LS coupling predictions.

We report on photoelectron spectra of SiO2 nanoparticles (d = 157 ± 6 nm) above the Si 2p threshold in the photon energy range 118–248 eV with electron kinetic energy 10–140 eV and analyze the photoelectron yield as a function of photon energy. Comparison of the experimental results with Monte–Carlo simulations on electron transport allows us to quantify the inelastic mean-free path and mean escape depth of photoelectrons in the nanoparticle samples. The influence of the nanoparticle geometry and electron elastic scattering on photoelectron yields is highlighted. The results show that the previously proposed direct proportionality of the photoelectron signal to the inelastic mean-free path or the mean escape depth does not hold for photoelectron kinetic energies below 30 eV due to the strong influence of electron elastic scattering. The present results deviate for photoelectron kinetic energies below 30 eV from the previously proposed direct proportionality of the photoelectron signal to the inelastic mean-free path or the mean escape depth, which is the result of a strong influence of electron elastic scattering. The presented inelastic mean-free paths and mean escape depths appear to be useful for the quantitative interpretation of photoemission experiments on nanoparticles and for modeling of the experimental results. [ABSTRACT FROM AUTHOR]

Background: In Germany over-the-counter medications (OTC) – which since 2004 are no longer subject to binding prices – can only be purchased in pharmacies. Pharmacy owners and their staff therefore have a special responsibility when dispensing, advising on and setting the prices of medications. Objective: The aim of this study was to assess medication dispensing, additional therapeutic recommendations and pricing practices for acute diarrhoea in adults and to evaluate the role of the patient’s approach (symptom-based versus medication-based request) in determining the outcome of these aspects. Methods: A cross-sectional study was conducted from 1 May to 31 July 2017 in all 21 community pharmacies in a medium-sized German city. Symptom-based and medication-based scenarios related to self-medication of acute diarrhoea were developed and used by five simulated patients (SPs) in all of the pharmacies (a total of 84 visits). Differentiating between the different test scenarios in terms of the commercial and active ingredient names and also the prices of the medications dispensed, the SPs recorded on collection forms whether the scenario involved generic products or original preparations as well as whether recommendations were made during the test purchases regarding an additional intake of fluids. Results: In each of the 84 test purchases one preparation was dispensed. However, a preparation for oral rehydration was not sold in a single test purchase. On the other hand, in 74/84 (88%) of test purchases, medications with the active ingredient loperamide were dispensed. In only 35/84 (42%) of test purchases, the patient was also recommended to ensure an ‘adequate intake of fluids’ in addition to being dispensed a medication. In symptom-based scenarios significantly more expensive medications were dispensed compared to the medication-based scenarios (Wilcoxon signed rank test: z = -4.784, p < 0.001, r = 0.738). Also within the different scenarios there were enormous price differences identified – for example, in the medication-based scenarios, even for comparable loperamide generics the cheapest preparation cost EUR 1.99 and the most expensive preparation cost EUR 4.53. Conclusions: Oral rehydration was not dispensed and only occasionally was an adequate intake of fluids recommended. There were also enormous price differences both between and within the scenarios investigated.