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Biomedical subjects

R A Hutchinson

Publications and source records attributed to R A Hutchinson.

At least 19 recordsLinked to original sources
PubMed2004

Experimental hut comparisons of nets treated with carbamate or pyrethroid insecticides, washed or unwashed, against pyrethroid-resistant mosquitoes.

The efficacy against mosquitoes (Diptera: Culicidae) of a bednet treated with carbamate insecticide [carbosulfan capsule suspension (CS) 200 mg/m(2)] was compared with four types of pyrethroid-treated nets in veranda-trap huts at Yaokoffikro near Bouaké, Côte d'Ivoire, where the malaria vector Anopheles gambiae Giles carries the kdr gene (conferring pyrethroid resistance) at high frequency and Culex quinquefasciatus Say is also pyrethroid resistant. Pyrethroids compared were lambdacyhalothrin CS 18 mg/m(2), alphacypermethrin water dispersible granules (WG) 20 mg/m(2), deltamethrin 50 mg/m(2) (Permanet) and permethrin emulsifiable concentrate (EC) 500 mg/m(2). Insecticidal power and personal protection from mosquito bites were assessed before and after the nets were used for 8 months and hand washed five times in cold soapy water. Before washing, all treatments except permethrin significantly reduced blood-feeding and all had significant insecticidal activity against An. gambiae. The carbosulfan net gave significantly higher killing of An. gambiae than all pyrethroid treatments except the Permanet. Against Culex spp., carbosulfan was more insecticidal and gave a significantly better protective effect than any of the pyrethroid treatments. After washing, treated nets retained various degrees of efficacy against both mosquito genera - but least for the carbosulfan net. Washed nets with three types of pyrethroid treatment (alphacypermethrin, lambdacyhalothrin, permethrin) gave significantly higher mortality rates of Culex than in huts with the same pyrethroid-treated nets before washing. After five washes, the Permanet, which is sold as a long-lasting insecticidal product, performed no better than the other nets in our experimental conditions.

Animals↗
PubMed2003

A comparison of Lucitraps and sticky targets for sampling the blowfly Lucilia sericata.

The Lucitrap (Miazma Pty Ltd, Queensland, Australia) combined with a synthetic odour bait, Lucilure (Miazma Pty Ltd, Queensland, Australia), is a commercially available trap for sampling and control of Lucilia cuprina (Wiedemann) in Australia. It was tested in Hungary against Lucilia sericata (Meigen) (Diptera: Calliphoridae), a cause of sheep strike throughout temperate Europe. The standard Lucitrap was tested against black or yellow sticky target traps. Both trap types were baited with either Lucilure or liver and 10% w/v sodium sulphide solution. With Lucilure as bait, L. sericata were caught on sticky traps but not in Lucitraps. With liver and sodium sulphide as bait, sticky traps caught 500-1500 times more L. sericata than Lucitraps. An adhesive sheet fitted to the top of a Lucitrap captured 30-300 times more L. sericata then were captured inside an unaltered Lucitrap. Direct observation of metallic green calliphorids (92.1% L. sericata) alighting on Lucitraps indicated that most flies stayed for a short while (modal class 2-4 s) and only a few stayed longer, to an observed maximum of 28 s. Flies explored a mean of 1.5 entry holes (range 0-7) during a visit but only 6% entered the trap. Size of L. sericata was not a physical barrier to Lucitrap entry, because many larger species were captured. However, L. sericata captured inside Lucitraps were significantly smaller than those captured on sticky traps, demonstrating that size was of behavioural importance. The data demonstrate that the Lucitrap is not effective as a trap for L. sericata in Hungary, due mainly to a failure of flies to enter the trap in large numbers. In Australia and South Africa, L. sericata is commonly caught in Lucitraps baited with Lucilure, although L. cuprina is more numerous. Our study highlights the potential for diversity of fly behaviour between different geographical populations of the same species. Such diversity can have a significant effect on the functioning of systems for fly sampling and control, when these systems depend for their success on certain behavioural responses of the target species.

Animals↗
PubMed2000

Equivalent inbreeding depression under laboratory and field conditions in a tree-hole-breeding mosquito.

Understanding the consequences of inbreeding has important implications for a wide variety of topics in population biology. However, most studies quantifying the effects of inbreeding are performed under artificial farm, greenhouse, laboratory or zoo conditions. Although several authors have argued that the deleterious effects of inbreeding (inbreeding depression) are likely to be more severe under natural field conditions than in artificial experimental environments, these arguments are usually speculative or based on indirect comparisons. We quantified the effects of inbreeding on fitness traits in a tree-hole-breeding mosquito Aedes geniculatus) under near-optimal laboratory conditions and in three natural tree holes. Our index of fitness (Ro) was lower in the field than in the laboratory and declined due to inbreeding in both However, environments, we found no significant interactions between inbreeding depression and environmental conditions. In both the field and laboratory a 10% increase in the inbreeding coefflicient (F) led to a 12-15) decline in fitness (Ro) These results suggest that inbreeding depression will not necessarily be more extreme under natural field conditions than in the laboratory.

Aedes↗
PubMed2000

An association perspective: responding to the American Dental Association's future of dentistry project.

In response to the American Dental Association's (ADA) Future of Dentistry Project, the American Dental Education Association (ADEA) provided its perspective on the most critical issues facing the dental profession. ADEA responded in six areas, each corresponding to the areas of focus in the ADA project. The comments in this Association Report reflect those provided to the six panels conducting the project.

American Dental Association↗
PubMed2000

Report of the ADEA president's task force on the Surgeon General's report on oral health. American Dental Education Association.

In response to the first-ever Surgeon General's report on oral health, released on May 25, 2000, ADEA President Rowland A. Hutchinson, D.D.S., M.S., appointed a task force to study the report from the perspective of dental education. The task force was charged with making recommendations to the ADEA Board of Directors as to the Association's message to members and the general public, the Association's role in addressing oral health disparities, the legislative and policy implications of the report, and areas of collaboration between ADEA and others in the dental and health professions. The task force reviewed the report and made five recommendations, including increasing public awareness of the report's messages, promoting collaborative activities with a goal of improving America's oral health, and providing leadership in the drive to promote the incorporation of new science in dental education. The task force also identified numerous ADEA initiatives that address issues related to the Surgeon General's report.

Community-Institutional Relations↗
PubMed1996

A comparative profile of clinical pharmacy activities for pharmacotherapists and residents in a university hospital.

Due to increasing financial pressure on maintaining and improving pharmacy services, there is a need for productivity data and time distribution among different activities for pharmacy practice residents and their faculty preceptors (pharmacotherapists). This study measured the clinical productivity of 13 residents and 25 pharmacotherapists for a 14-day period. The study identified the average time (minutes) and frequency spent each day on categories of activities, which included direct patient care, chart use, rounds, professional encounter, teaching, research, and administration. Results showed that the productivity profiles for residents and pharmacotherapists were comparable. Findings were utilized to defend the educational programs for the department and as a baseline for periodic monitoring of the productivity of these programs.

Chicago↗
PubMed1995

Comprehensive services in an ambulatory care pharmacy.

The development of a comprehensive model of pharmacy practice in an ambulatory care setting is described. From 1991 to 1994, the department of ambulatory care pharmacy services at The University of Illinois at Chicago Medical Center converted its main outpatient pharmacy into a Pharmaceutical Care Center to serve as a model for community and hospital-based ambulatory care pharmacy services. The Pharmaceutical Care Center includes a waiting area, five private patient-assessment rooms, an examination room, a place for reviewing patient profiles and reference materials, space for storage and automation, an i.v. admixture area, a conference room, and office space. It serves 120-150 patients per day (10% just discharged from the hospital, 90% seen in the clinic system). Pharmacy clerkship students and residents, under the oversight of faculty, conduct patient assessments, educate patients and family, monitor outcomes, and intervene when drug-related problems are detected. Patient assessments and therapeutic interventions are documented in the patient's medical record. Computers, automated medication filling, and technical support are used to enable pharmacists to concentrate on patient care. A model ambulatory care pharmacy provides both drug distribution and direct patient care services.

Academic Medical Centers↗
PubMed1992

Patient care contributions of clinical pharmacists in four ambulatory care clinics.

This study investigates both cost-avoidance and improvement in the quality of care and patient outcome attributed to pharmacist intervention in four ambulatory care clinics. Four clinical pharmacists reported 199 interventions made in the pharmacotherapeutic management of 87 ambulatory clinic patients in 1 month. The majority of interventions were based on acceptable professional practices as ranked by peer reviewers. Positive impact of the interventions on patient outcome based on objective and subjective data was documented in 49% of the interventions. Forty-two percent of the interventions improved the process of care with no measurable impact on patient outcome. Cost avoidance was calculated according to interventions made at different steps of the drug use process. Net cost avoidance figures projected to 1 year amounted to $221,056.

Chicago↗
PubMed1992

Pharmacy agenda for change: the time is now.

In the midst of society's debate and focus on patient care and outcome, healthcare providers must articulate their strategic positioning to be part of the collective societal drive. Pharmacy as an integral component of healthcare provided, must also take the opportunity to create its own agenda for change. This agenda revolves around pharmacists agreeing on aspects of pharmaceutical care for which they are legally and ethically responsible. Pharmacists must also strive to gain social and cultural authority for those aspects for which the profession has accepted responsibility. Pharmacist action is needed to ensure appropriate drug therapy to the public.

Drug Utilization↗
PubMed1992

Pharmaceutical services in rural hospitals in Illinois--1991.

The results of a 1991 survey of pharmaceutical services in rural hospitals in Illinois are reported and compared with the results of previously published national and regional surveys. A questionnaire was developed and mailed to the director of pharmacy at each hospital in the study population (n = 95 rural hospitals in Illinois) to obtain information about inpatient drug distribution services, ambulatory-care services, clinical services, and human resources. The response rate was 81% (77 usable responses). Respondents reported a mean hospital size of 115.5 licensed beds. The mean average daily census was 51.2. Drug distribution systems appear similar to those reported in the 1990 ASHP survey, with complete unit dose drug distribution systems existing in 90.1% of respondent rural Illinois hospitals and complete and comprehensive i.v. admixture services in 71.2%. The percentage of pharmacy departments that are decentralized is lower among rural Illinois hospitals than among previous survey populations. Respondents indicated that they provided the following clinical pharmacy services: drug therapy monitoring (73%), patient rounds (12.2%), nutritional support (37.8%), pharmacokinetic consultations (32.4%), and patient education and counseling (24.3%). These results are comparable to those reported in previous surveys. Respondents reported an average of 5.9 full-time equivalents per hospital pharmacy department. The pharmacist vacancy rate and the total vacancy rate per department were reported as 10% and 5.3%, respectively, with vacant positions taking an average of 15 months to fill. The pharmacist vacancy rate is markedly higher than that reported in the 1990 ASHP survey. Rural Illinois hospitals are comparable to other U.S. hospitals in the provision of most pharmaceutical services.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care↗
PubMed1992

Comparison of two systems for documenting pharmacist interventions in patient care.

Manual and computerized systems for documenting interventions by pharmacists at a large university teaching hospital are compared. The manual system allows patient data and pharmacist interventions to be quickly documented on written profiles. Completed forms are entered into a personal computer for analysis. The computerized system is a direct-entry version of the manual intervention log. Five screens allow pharmacists to enter information into a mainframe computer from any terminal. Data can be downloaded from the mainframe into a personal computer. During the first part of the study, nine pharmacists used the manual system for seven days. After a two-week pause, the same pharmacists used the computerized system for seven days. The systems were evaluated by using time-and-motion analysis and a questionnaire. Also, the number of interventions documented and the characteristics of each were compared. The mean +/- S.D. time required to document an intervention was significantly less with the computerized system (81.8 +/- 24.9 seconds) than with the manual system (100.7 +/- 37.3 seconds). Administrative time for analysis and report generation was also less with the computerized system. The pharmacists rated the computerized system more highly in terms of ease of use, accessibility, time efficiency, and acceptability. The number of interventions documented did not differ between the systems. A computerized system for documenting pharmacist interventions compared favorably with a manual system.

Chicago↗
PubMed1990

Inconsistencies in the drug use process.

Rational drug therapy has historically been viewed as the right drug, in the right dose, at the right time, for the right patient. Today, the emphasis on cost containment has added an extra dimension: cost-effective therapeutic regimens. Most stages of the DUP have not been extensively studied. Evidence presented to date reflects duplication of efforts and suboptimal decisions, with little concerted effort to identify means for improvements that may have a favorable impact on cost and patient outcome. The increasing use of drugs as the primary mode to treat diseases, the reduction in the number of hospital employees at a time increased severity of patient illness, the nursing shortage, and the increasing cost and complexity of drugs, along with the inconsistencies that exist in drug use, demonstrate a need for a complete review of the DUP. The DUP, as it currently operates, is not conducive to the provision of a systematic approach to therapy. The stages in this process are often independent of each other and poorly performed by a variety of health professionals. The subsequent development of strategies for improving the chance for optimal drug therapy through the use of pharmacists as drug therapy experts is needed. The pharmacy profession is in a prime position where expanded patient care services and supervision of the entire DUP may actually decrease the total cost of health care. This expansion represents the key to increasing acceptance of pharmacists' clinical role and for ensuring long-term survival of the profession.

Cost-Benefit Analysis↗
PubMed1989

The use of pharmacy personnel to positively impact hospital finances.

Cutting the pharmacy budget is a tool widely used by hospital administrators as an effective way to contain their institutional costs. The authors of this article utilized data published by the Lilly Hospital Pharmacy Surveys to support their contention that drug costs, more than personnel costs, are responsible for the increased expenditures attributed to this department. The application of pharmacists' knowledge to improve the rational use of drugs is advocated for better overall cost-containment and better patient care.

Budgets↗
PubMed1989

Development and implementation of a strategic-planning process at a university hospital.

The development and implementation of a long-range strategic plan for the pharmacy department at a university hospital is described. Because of rapidly occurring changes in health-care delivery, financing, and education, the pharmacy department at the University of Illinois Hospitals decided to create a strategic plan that would stimulate growth, be responsive to a changing health-care environment, and emphasize the department's philosophy of striving for professional leadership in education, research, and innovation. Actual strategy development was done during a three-day administrative retreat, which was conducted according to a structured agenda that facilitated extensive brainstorming and discussion. As a result, the department developed eight major strategies that have been directing its growth and development over the last four years. Each strategy had an implementation plan that included substrategies with statements of specific results that were expected, an action plan (a list of specific tasks to be accomplished), and a general statement summarizing the benefits of each substrategy. Annual meetings were held to review the continued appropriateness of these strategies. Implementation of the strategic plan has resulted in major improvements in drug cost containment, improved ambulatory-care pharmaceutical services, a results-oriented performance-appraisal system, more support for clinical education programs, and a substantial increase in support for research. The strategic plan has allowed the department to constructively participate in two downsizing events within the hospital without major adverse effects on its own services and programs. Use of the strategic-planning process should be considered by other hospital pharmacy departments as a means of responding to the external and internal forces of change that currently affect most hospitals.

Chicago↗