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Search Results: 1 - 10 of 140575 matches for " Geoffrey K. Spurling "
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Do advertisements for antihypertensive drugs in Australia promote quality prescribing? A cross-sectional study
Brett D Montgomery, Peter R Mansfield, Geoffrey K Spurling, Alison M Ward
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-167
Abstract: We performed a cross-sectional study of 113 advertisements for antihypertensive drugs from 4 general practice-oriented Australian medical publications in 2004. Advertisements were evaluated using a quality checklist based on a review of hypertension management guidelines. Main outcome measures included: frequency with which antihypertensive classes were advertised, promotion of thiazide class drugs as first line agents, use of statistical claims in advertisements, mention of harms and prices in the advertisements, promotion of assessment and treatment of cardiovascular risk, promotion of lifestyle modification, and targeting of particular patient subgroups.Thiazides were the most frequently advertised drug class (48.7% of advertisements), but were largely promoted in combination preparations. The only thiazide advertised as a single agent was the most expensive, indapamide. No advertisement specifically promoted any thiazide as a better first-line drug. Statistics in the advertisements tended to be expressed in relative rather than absolute terms. Drug costs were often reported, but without cost comparisons between drugs. Adverse effects were usually reported but largely confined to the advertisements' small print. Other than mentioning drug interactions with alcohol and salt, no advertisements promoted lifestyle modification. Few advertisements (2.7%) promoted the assessment of cardiovascular risk.Print advertisements for antihypertensive medications in Australia provide some, but not all, of the key messages required for guideline-concordant care. These results have implications for the regulation of drug advertising and the continuing education of doctors.Hypertension is a major risk factor for cardiovascular disease [1] and the most common single problem managed in Australian general practice. [2] For more than a decade expensive new antihypertensive drugs have been prescribed more frequently than the older and more cost effective thiazide diuretics. [3-6] Newer
Information from Pharmaceutical Companies and the Quality, Quantity, and Cost of Physicians' Prescribing: A Systematic Review
Geoffrey K. Spurling ,Peter R. Mansfield,Brett D. Montgomery,Joel Lexchin,Jenny Doust,Noordin Othman,Agnes I. Vitry
PLOS Medicine , 2010, DOI: 10.1371/journal.pmed.1000352
Abstract: Background Pharmaceutical companies spent $57.5 billion on pharmaceutical promotion in the United States in 2004. The industry claims that promotion provides scientific and educational information to physicians. While some evidence indicates that promotion may adversely influence prescribing, physicians hold a wide range of views about pharmaceutical promotion. The objective of this review is to examine the relationship between exposure to information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing. Methods and Findings We searched for studies of physicians with prescribing rights who were exposed to information from pharmaceutical companies (promotional or otherwise). Exposures included pharmaceutical sales representative visits, journal advertisements, attendance at pharmaceutical sponsored meetings, mailed information, prescribing software, and participation in sponsored clinical trials. The outcomes measured were quality, quantity, and cost of physicians' prescribing. We searched Medline (1966 to February 2008), International Pharmaceutical Abstracts (1970 to February 2008), Embase (1997 to February 2008), Current Contents (2001 to 2008), and Central (The Cochrane Library Issue 3, 2007) using the search terms developed with an expert librarian. Additionally, we reviewed reference lists and contacted experts and pharmaceutical companies for information. Randomized and observational studies evaluating information from pharmaceutical companies and measures of physicians' prescribing were independently appraised for methodological quality by two authors. Studies were excluded where insufficient study information precluded appraisal. The full text of 255 articles was retrieved from electronic databases (7,185 studies) and other sources (138 studies). Articles were then excluded because they did not fulfil inclusion criteria (179) or quality appraisal criteria (18), leaving 58 included studies with 87 distinct analyses. Data were extracted independently by two authors and a narrative synthesis performed following the MOOSE guidelines. Of the set of studies examining prescribing quality outcomes, five found associations between exposure to pharmaceutical company information and lower quality prescribing, four did not detect an association, and one found associations with lower and higher quality prescribing. 38 included studies found associations between exposure and higher frequency of prescribing and 13 did not detect an association. Five included studies found evidence for association with higher costs, four
Hearing-impairment among workers in a surface gold mining company in Ghana
Geoffrey K Amedofu
African Journal of Health Sciences , 2002,
Abstract: A study to determine the impact of hazardous noise on workers was conducted in a surface gold mining company in Ghana. The procedure adopted included noise survey, case history, otoscopy and conventional pure-tone audiometry. Five main areas were surveyed for hazardous noise namely, Pit, Processing, Ana Laboratory, Bore-hole and Mess area. The results showed that all the above areas except the Mess area produced noise levels above 85 dBA. Again, a total of 252 workers were seen at the company, and out of this number 59(23%) had the classical noise induced hearing loss (NIHL) at 4KHz. In addition, NIHL increased as a function of age and duration of exposure. It is also noted that out of 81 workers with a pre-employment history of noise exposure, 41(51%) had NIHL. NIHL also varied with regard to job location. 14(6%) of the workers had hearing loss greater than 25 dB at the speech frequencies. Thus, factors not under the control of the company may affect the hearing of an employee. [Afr. J. Health Sci. 2002; 9:91-97 ]
The Australian draft National Palliative Care Strategy: Is primary palliative care at crossroads?
Geoffrey K Mitchell
Australasian Medical Journal , 2010,
Abstract: The Australian draft National Palliative Care Strategy foreshadows an approach aimed at strengthening specialist palliative care services, and developing people with special interest in palliative care. It pays less attention to building up the skills of the health workforce with a general interest in palliative care. Yet this is where most of the palliative work is done. Has general practice deserved this sidelining? Or is the draft strategy mistakenly reducing its focus on primary palliative care?
A Book Review of Tourism, Poverty and Development by Andrew Holden  [PDF]
Geoffrey K. Riungu
Open Access Library Journal (OALib Journal) , 2015, DOI: 10.4236/oalib.1101446
Abstract:

Andrew Holden’s book titled “Tourism, Poverty and Development [1] gives a solid introduction of how a pro poor tourism agenda can be used to alleviate poverty and propel development in Least Developing Countries (LDCs). The book uses case studies to paint a picture of the prevailing conditions in LDCs and how some countries are trying to use tourism as a stepping stone towards freeing themselves from economic and social bondage. The book also brings into question the motivation behind Bretton wood institutions and their halfhearted attempts to alleviate poverty in developing economies. Some of the drawbacks in this book include the lack of a holistic view of the African continent that primarily has a majority of LDCs especially with the lack of attention to North African countries and the status of poverty there.

Simulations and scaling of horizontal convection
Mehmet ILIcak,Geoffrey K. Vallis
Tellus A , 2012, DOI: 10.3402/tellusa.v64i0.18377
Abstract: In this paper we describe the results of various numerical simulations of sideways or horizontal convection. Specifically, a two-dimensional Boussinesq fluid is both heated and cooled from its upper surface, but the walls and the bottom of the tank are insulating and have no flux of heat through them. We perform experiments with a range of Rayleigh numbers up to 1011, obtained by systematically reducing the diffusivity. We also explore the effects of a nonlinear equation of state and of a mechanical force imposed on the top surface at a fixed Rayleigh number. We find that, when there is no mechanical forcing, both the energy dissipation and the strength of the circulation itself monotonically fall with decreasing diffusivity. At Rayleigh numbers greater than 1010 the flow is unsteady; however, the eddying flow is still much weaker than the steady flow at smaller Rayleigh numbers. At high Rayleigh numbers, the stratification and the mean circulation are increasingly confined to a thin layer at the upper surface, with the layer thickness decreasing according to Ra 1/5. There is no evidence that the flow ever enters a regime that is independent of Rayleigh number. Using a nonlinear equation of state makes little difference to the flow phenomenology at a moderate Rayleigh number. The addition of an imposed stress at the upper surface makes a significant difference in the flow. A strong, energy-dissipating circulation can be maintained even at Ra = 109, and the stratification extends more deeply into the fluid than in the unstressed case. Overall, our results are consistent with the notion that in the absence of mechanical forcing a fluid that is heated and cooled from above cannot maintain a deep stratification or a strong sustained flow at high Rayleigh numbers, even if the interior flow is unsteady.
Best practice workplace HIV/AIDS programmes in South Africa: A review of case studies and lessons learned
Geoffrey K.G. Setswe
African Journal of Primary Health Care & Family Medicine , 2009, DOI: 10.4102/phcfm.v1i1.30
Abstract: Background: A group of experts attending a tripartite interregional meeting on best practices in HIV/AIDS workplace policies and programmes organised by the International Labour Organisation (ILO) in Geneva, Switzerland, identified 34 best practice workplace HIV programmes from across the world. Method: The ten criteria that were used for reviewing best practice workplace HIV/AIDS programmes in South Africa include acceptability, accessibility, ethical soundness, perceived impact, relevance, appropriateness, innovativeness, efficiency, sustainability and replicability. Results: More than one-third (35.3%) of the 34 best practice workplace interventions identified were found in businesses and industries in South Africa. This constitutes a significant and encouraging effort to deal with HIV/AIDS in the workplace. Approximately 16.7% of the best practice workplace HIV/AIDS interventions focused on policy and legal frameworks, 50% of these interventions focused on prevention, 16.7% provided links beyond the workplace and a further 16.7% were interventions that focused on knowledge and evidence. A third (33.3%) of practices were found in the mining industry, 16.7% in the motor industry, 16.7% from workers’ unions, and the rest (33.3%) were found in a sugar company, an electricity supply company, a pharmaceutical company and the ministry of Public Service and Administration. Conclusion: It is encouraging that over one-third of all best practice workplace HIV interventions identified by the ILO experts were found in South Africa. The majority of these policies and programmes were focused on HIV prevention. How to cite this article: Setswe G. Best practice workplace HIV/AIDS programmes in South Africa: A review of case studies and lessons learned. Afr J Prm Health Care Fam Med. 2009;1(1), Art. #30, 6 pages. DOI: 10.4102/phcfm.v1i1.30
Current Treatment for Venom-Induced Consumption Coagulopathy Resulting from Snakebite
Kalana Maduwage,Geoffrey K. Isbister
PLOS Neglected Tropical Diseases , 2014, DOI: 10.1371/journal.pntd.0003220
Abstract: Venomous snakebite is considered the single most important cause of human injury from venomous animals worldwide. Coagulopathy is one of the commonest important systemic clinical syndromes and can be complicated by serious and life-threatening haemorrhage. Venom-induced consumption coagulopathy (VICC) is the commonest coagulopathy resulting from snakebite and occurs in envenoming by Viperid snakes, certain elapids, including Australian elapids, and a few Colubrid (rear fang) snakes. Procoagulant toxins activate the clotting pathway, causing a broad range of factor deficiencies depending on the particular procoagulant toxin in the snake venom. Diagnosis and monitoring of coagulopathy is problematic, particularly in resource-poor countries where further research is required to develop more reliable, cheap clotting tests. MEDLINE and EMBASE up to September 2013 were searched to identify clinical studies of snake envenoming with VICC. The UniPort database was searched for coagulant snake toxins. Despite preclinical studies demonstrating antivenom binding toxins (efficacy), there was less evidence to support clinical effectiveness of antivenom for VICC. There were no placebo-controlled trials of antivenom for VICC. There were 25 randomised comparative trials of antivenom for VICC, which compared two different antivenoms (ten studies), three different antivenoms (four), two or three different doses or repeat doses of antivenom (five), heparin treatment and antivenom (five), and intravenous immunoglobulin treatment and antivenom (one). There were 13 studies that compared two groups in which there was no randomisation, including studies with historical controls. There have been numerous observational studies of antivenom in VICC but with no comparison group. Most of the controlled trials were small, did not use the same method for assessing coagulopathy, varied the dose of antivenom, and did not provide complete details of the study design (primary outcomes, randomisation, and allocation concealment). Non-randomised trials including comparison groups without antivenom showed that antivenom was effective for some snakes (e.g., Echis), but not others (e.g., Australasian elapids). Antivenom is the major treatment for VICC, but there is currently little high-quality evidence to support effectiveness. Antivenom is not risk free, and adverse reactions can be quite common and potentially severe. Studies of heparin did not demonstrate it improved outcomes in VICC. Fresh frozen plasma appeared to speed the recovery of coagulopathy and should be considered in bleeding
Interferometry Analysis of Cellophane Birefringence  [PDF]
Dickson M. Kinyua, Geoffrey K. Rurimo, Patrick M. Karimi, Stephen N. Maina, Calvin F. Ominde
Optics and Photonics Journal (OPJ) , 2013, DOI: 10.4236/opj.2013.36052
Abstract:

This paper reports on a simple approach of determining the ability of a transparent material, such as cellophane to rotate the direction of polarization of a light beam. In order to determine the birefringence of such a material, a Mach-Zehnder interferometer is used to generate interference patterns when the cellophane sheet is mounted on one arm such as to intercept a portion of the laser beam. The recorded interferograms show a phase shift which is calculated to be 0.98π radians. By rotating the cellophane sheet on the object beam, the fringe separation is measured for different angles and the values used to calculate the ordinary and extraordinary refractive indices as 1.4721 ± 0.0002 and 1.4680 ± 0.0002 respectively at 632.8 nm wavelength. A surface error of approximately λ/16 (peak to valley) is measured from the recorded interferograms. Because of its sufficient birefringence and small thickness of 24 μm, cellophane can be used to fabricate special polarization pupil masks by cutting and aligning different cellophane structures appropriately.

Development and Application of a Validated HPLC Method for the Determination of Clindamycin Palmitate Hydrochloride in Marketed Drug Products: An Optimization of the Current USP Methodology for Assay  [PDF]
Geoffrey K. Wu, Abhay Gupta, Mansoor A. Khan, Patrick J. Faustino
Journal of Analytical Sciences, Methods and Instrumentation (JASMI) , 2013, DOI: 10.4236/jasmi.2013.34026
Abstract:

A simple efficient isocratic reversed-phase HPLC method was developed and validated for the determination of clindamycin palmitate hydrochloride (CPH) and its commercially available oral solution products. Separation was achieved on a Phenomenex Zorbax (Luna) cyano column (150 × 4.6 mm, 5 μm) with a Phenomenex cyano guard cartridge (4 × 3.0 mm) on Agilent 1050 series HPLC system. CPH and its resolution standard lincomycin were eluted isocratically at a flow rate of 1 mL/min with a simplified mobile phase (potassium phosphate buffer (5 mM, pH 3.0)—acetonitrile—tetrahydrofuran (20:75:5, v/v/v)) and detected at 210 nm. The column was maintained at 25?C. The method was validated according to USP category I requirements. Robustness and forced degradation studies were also conducted. CPH marketed drug products were obtained from a drug distributor and assayed for potency using the validated method. Validation acceptance criteria were met in all cases. The analytical range for CPH was 15 - 500 μg/mL and the linearity was r2 > 0.999 over three days. The method was determined to be specific and robust. Both accuracy (92.0% - 103.8%) and precision (0.67% - 1.52%) were established across the analytical range for low, intermediate and high QC concentrations. Method applicability was demonstrated by analyzing two marketed products of CPH, in which results showed potency >98%. The method was determined to be an enhancement over the current USP methodology for assay as a result of increased efficiency, reduced organic solvents and the elimination of matrix modifiers. This method was successfully applied for the quality assessment of: 1) currently marketed drug products and 2) will in future assess the product quality of novel dosage forms of CPH for pediatric use.

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