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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.

Background and purpose Pharmacy students will interact with patients who struggle to receive the health care they need. Since attitudes can influence behavior, exposure to these struggles may positively improve patient care. This study evaluates a group of student responses to two different interventions approximately 9 months apart. The primary objectives of this study were to: (1) identify if SPENT, an online game, could alone improve students’ attitudes towards those living in poverty, (2) determine if changes imparted by SPENT were retained for nine months, and (3) identify if CAPS, a live simulation, has an additional benefit. Educational activity and setting Student participants completed both the SPENT online game and the CAPS simulation. Students were asked to complete the Undergraduate Perceptions of Poverty Tracking Survey (UPPTS) before and after each simulation Findings Ninety-nine first year and second year professional phase pharmacy students completed both interventions and all surveys. The average pre-survey and post survey “scores” for the SPENT game were 133.52 and 135.54, a statistically significant improvement (p=0.046). When comparing the SPENT post “score” and the pre-survey score of CAPS (136.45) there was no significant difference (p=0.423). The average pre-survey and post survey “scores” for CAPS were 136.45 and 139.18, a statistically significant improvement (p=0.001). An analysis of the overall change showed a statistically significant improvement of 5.6667 (p Discussion Both the online SPENT game and CAPS live simulation interventions had positive effects on the students’ empathy towards people living in poverty.

Purpose The purpose of this study was to examine the association of patient and prescription factors with statin adherence of patients enrolled a self-insured university health plan. Methods We conducted a retrospective, longitudinal analysis of pharmacy claims data from a self-insured university for those enrollees prescribed a statin during a 38-month period (2009-2012). Adherence was calculated as the portion of days covered and was defined as portion of days covered ≥80%. To be included in the study, patients had to have ≥2 statin claims and be continuously enrolled in the plan. A logistic regression model was constructed to identify longitudinal predictors of adherence. In addition, a Cox proportional hazards model was run to examine predictors of adherence during 1 year of statin therapy. Findings There were 222 patients in the study. These 222 patients generated a total of 3,349 statin claims. With a mean (SD) observation period of 970 (346.5) days, those patients taking statin medications had a mean adherence rate of 54.5%. Adherent and nonadherent patients were similar regardless of statin switching and inferred household income. However, those patients with greater adherence levels were older, more likely to be male, had previous statin exposure, paid higher mean copayments, and were more likely to use mail order as their delivery channel. In logistic regression, older age (odds ratio [OR] = 1.07, P = 0.001), male sex (OR = 1.79, P = 0.047), and the use of mail order (OR = 3.07, P = 0.002) were significantly associated with adherence. Of the original 222 patients, 200 patients completed 1 full year of therapy. In a subsequent Cox proportional hazards analysis, the retail delivery channel (hazard ratio = 1.904, P = 0.025) was associated with higher risk for nonadherence during a 1-year period. Implications Despite the benefits associated with statin medications, adherence remains a challenge for certain groups of patients, including patients who are female, younger patients, and patients who use retail pharmacies (vs mail order) when filling their prescriptions. Health care professionals and employers, especially those employers who are self-insured, would be well served in developing adherence interventions aimed at these specific populations.

©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.

To better estimate thermal maturity of Devonian shales in the northern Appalachian Basin, eleven samples of Marcellus and Huron Shale were characterized via multiple analytical techniques. Vitrinite reflectance, Rock–Eval pyrolysis, gas chromatography (GC) of whole rock extracts, and GC–mass spectrometry (GCMS) of extract saturate fractions were evaluated on three transects that lie across previously documented regional thermal maturity isolines. Results from vitrinite reflectance suggest that most samples are immature with respect to hydrocarbon generation. However, bulk geochemical data and sterane and terpane biomarker ratios from GCMS suggest that almost all samples are in the oil window. This observation is consistent with the presence of thermogenic gas in the study area and higher vitrinite reflectance values recorded from overlying Pennsylvanian coals. These results suggest that vitrinite reflectance is a poor predictor of thermal maturity in early mature areas of Devonian shale, perhaps because reported measurements often include determinations of solid bitumen reflectance. Vitrinite reflectance interpretations in areas of early mature Devonian shale should be supplanted by evaluation of thermal maturity information from biomarker ratios and bulk geochemical data.

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.

Thermal maturation patterns of Pennsylvanian strata in the Appalachian basin were determined by compiling and contouring published and unpublished vitrinite reflectance (VR) measurements. VR isograd values range from 0.6% in eastern Ohio and eastern Kentucky (western side of the East Kentucky coal field) to greater than 5.5% in eastern Pennsylvania (Southern Anthracite field, Schuylkill County), corresponding to ASTM coal rank classes of high volatile C bituminous to meta-anthracite. VR isograds show that thermal maturity of Pennsylvanian coals generally increases from west to east across the basin. The isograds patterns, which are indicative of maximum temperatures during burial, can be explained by variations in paleodepth of burial, paleogeothermal gradient, or a combination of both. However, there are at least four areas of unusually high-rank coal in the Appalachian basin that depart from the regional trends and are difficult to explain by depth of burial alone: 1) a west-northwestward salient centered in southwestern Pennsylvania; 2) an elliptically-shaped, northeast-trending area centered in southern West Virginia and western Virginia; 3) the eastern part of Black Warrior coal field, Alabama; and 4) the Pennsylvania Anthracite region, in eastern Pennsylvania. High-rank excursions in southwest Pennsylvania, the Black Warrior coal field, and the Pennsylvania Anthracite region are interpreted here to represent areas of higher paleo-heat flow related to syntectonic movement of hot fluids towards the foreland, associated with Alleghanian deformation. In addition to higher heat flow from fluids, the Pennsylvania Anthracite region also experienced greater depth of burial. The high-rank excursion in southwest Virginia was probably primarily controlled by overburden thickness, but may also have been influenced by higher geothermal gradients.

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.

A 2013 study among 169 Indiana men aged 18-45 who have sex with men assessed the acceptability of and preferences for pharmacy-based and over-the-counter (OTC) HIV testing. Rural men in general and men who did not know their HIV status were more likely to purchase an OTC HIV test. Men who did not know their HIV status also preferred an OTC HIV test to pharmacy-based testing. Pharmacies should enhance information around the sale of OTC HIV tests, particularly in rural areas. Information should include test results, opportunities for consultation, and linkage to care.

Ants are abundant, diverse, and ecologically dominant in tropical forests. Subterranean ants in particular are thought to have a significant environmental impact, although difficulties associated with collecting ants underground and examining their ecology and behavior have limited research. In this paper, we present the results of a study of subterranean ant diversity in Amazonian Ecuador that employs a novel probe to facilitate the discovery of species inhabiting the soil horizon. Forty-seven species of ants in 19 genera, including new and apparently rare species, were collected in probes. Approximately 19% of the species collected at different depths in the soil were unique to probe samples. Analysis of similarity (ANOSIM) results showed that the species composition of ants collected with the probe was significantly different from samples collected using other techniques. Additionally, ANOSIM computations indicated the species assemblage of ants collected 12.5 cm below the surface was significantly different from those found at 25, 37.5, and 50 cm. Ant diversity and species accumulation rates decreased with increasing depth. There were no species unique to the lowest depths, suggesting that subterranean ants may not be distributed deep in the soil in Amazonia due to the high water table. The technique we describe could be used to gain new insights into the distribution and biology of subterranean ant species and other members of the species-rich soil invertebrate macrofauna.

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.

Low-permeability sandstones of the Lower Silurian regional oil and gas accumulation cover about 45,000 mi2 (117,000 km2) of the Appalachian basin and may contain as much as 30 tcf of recoverable gas resources. Major reservoirs consist of the "Clinton" sandstone and Medina Group sandstones. The stratigraphically equivalent Tuscarora Sandstone increases the area of the Lower Silurian regional accumulation (LSRA) by another 30,000 mi2 (78,000 km2). Approximately 8.7 tcf of gas and 400 million bbl of oil have been produced from the Clinton/Medina reservoirs since 1880.The eastern predominantly gas-bearing part of the LSRA is a basin-center gas accumulation, whereas the western part is a conventional oil and gas accumulation with hybrid features of a basin-center accumulation. The basin-center accumulations have pervasive gas saturation, water near irreducible saturation, and generally low fluid pressures. In contrast, the hybrid-conventional accumulations have less-pervasive oil and gas saturation, higher mobile-water saturation, and both normal and abnormally low fluid pressures.High mobile-water saturation in the hybrid-conventional reservoirs form the updip trap for the basin-center gas creating a broad transition zone, tens of miles wide, that has characteristics of both end-member accumulation types. Although the Tuscarora Sandstone part of the basin-center gas accumulation is pervasively saturated with gas, most of its constituent sandstone beds have low porosity and permeability. Commercial gas fields in the Tuscarora Sandstone are trapped in naturally fractured, faulted anticlines.The origin of the LSRA includes (1) generation of oil and gas from Ordovician black shales, (2) vertical migration through an overlying 1000-ft (305-m)-thick Ordovician shale; (3) abnormally high fluid pressure created by oil-to-gas transformation; (4) updip displacement of mobile pore water by overpressured gas; (5) entrapment of pervasive gas in the basin center; (6) postorogenic uplift and erosion, causing gas leakage and a marked reduction in fluid pressure.Most future natural-gas production in the Clinton/Medina sandstones is anticipated to come from the basin-center accumulation. The Tuscarora Sandstone has additional gas resources but typically low reservoir porosity and permeability, and the likelihood of low-energy (in British thermal units) gas reduce the incentive to explore for it.

Background/Aims: Bio-artificial liver support systems for treatment of hepatic failure require maintained expression of hepatocyte function in vitro. We studied cultures of human hepatocyte cell-lines proliferating within alginate beads, investigating the hypothesis that 3-dimensional cohesive colonies of hepatocyte cell-lines would achieve polarity and cell-to-cell contact resulting in upregulation of function.Methods: HepG2 and HHY41 human cell lines in alginate beads were cultured for >20 days.Results: Proliferation was maintained for 20 days. Production of albumin, prothrombin, fibrinogen, alpha-1-acid glycoprotein and alpha-l-antitrypsin was maintained throughout, maximal at days 8-10, when upregulation was 300-1100% compared with monolayer cultures at similar cell number per unit volume. Detoxificatory functions: ethoxyresorufin deethylase activity, androstenedione metabolism, and urea synthesis from arginine was also increased severalfold. Function returned to pre-freezing levels within 18 h of thawing after cryopreservation of cells in alginate, Electron microscopy revealed spherical colonies of cells of cuboidal shape, with cell-to-cell contact via desmosomes and junctional complexes, abundant microvilli, and cytoplasmic appearances suggesting transcriptionally active hepatocytes.Conclusion: Hepatocyte cell-lines, proliferating in alginate express a range of liver-specific functions at levels approaching those found in vivo, relevant to their use in liver support systems.(C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.

Objective To assess the feasibility, readiness, and acceptability of offering rapid human immunodeficiency virus (HIV) testing in community pharmacies. Design Qualitative study. Setting Community pharmacies in Indiana from May to September 2012. Participants 17 licensed community pharmacists. Intervention Semistructured interviews among a convenience sample of community pharmacists. Main outcome measures Community pharmacists' self-reported attitudes toward rapid HIV testing in community pharmacies, perceptions of peer acceptability, and opinions about readiness for implementation of the practice in community pharmacies. Results Participants accepted the idea of pharmacy-based HIV testing, describing it as accessible, convenient, and nonstigmatizing. Acceptability was closely linked to positive patient relationships and pharmacist comfort with consultation. Identified challenges to pharmacy-based HIV testing included staffing issues, uneasiness with delivering positive test results, lack of information needed to link patients to care, insufficient consulting space, and need for additional training. Participants indicated that peer beliefs about the acceptability of pharmacist-based HIV testing would vary but that more recently trained pharmacists likely would be more accepting of the practice. Conclusion Most participants felt that offering HIV testing was a reasonable addition to the evolving role of the community pharmacist, pending resolution of personal and institutional barriers.

Atomic force microscopy enables the simultaneous acquisition of high-resolution topographical and biophysical data allowing integrated analysis of cell surfaces during development and pathogenesis, and, critically, can link molecular and biophysical events. Here we used atomic force microscopy to analyse endometrial epithelial cells and neuronally differentiated P19 cells. Optimized reproducible sample preparation techniques enabled micro- and nanoscale multi-parameter analysis. Comparative analysis using atomic force microscopy and scanning electron microscopy demonstrated the utility of atomic force microscopy for examining tissue morphology, and its ability to generate data allowing differentiation of cells from different origins to be monitored. At low resolution atomic force microscopy produced topographic data complementary to scanning electron microscopy images, whilst at high resolution atomic force microscopy captured novel cell surface structural detail for both epithelial and neuronal cell types. Analysis of surface roughness provided biophysical data which enabled qualitative and quantitative differences between samples to be measured. This study provides an important optimization of sample preparation enabling more generalized atomic force microscopy utilization for cellular analysis required for advanced cell surface morphological studies.