Career outlook and satisfaction in the presence of workload intensification-a survey of early career pharmacists

BACKGROUND

The demographics of the pharmacy workforce is changing with an increased proportion of pharmacists less than 30 years old (early career pharmacists-ECPs). In parallel, the profession has experienced workload intensification and workforce attrition. It is important to understand ECPs career satisfaction to retain this section of the pharmacy profession.

OBJECTIVES

This study aimed to collect data on the current career satisfaction of ECPs, and identify workplace factors that were most important to this group. Further, to use these findings to inform sector recommendations.

METHODS

A steering group of ECPs in Aotearoa New Zealand developed a survey based on one used previously. An invitation email was sent to all pharmacists who had been registered for less than 10 years and were members of the Pharmaceutical Society of New Zealand.

RESULTS

A total of 1418 ECPs were identified and invited to participate, and responses were received by 416 of these. While 90% believe that they are making a useful contribution to the health of their patients, over half are unhappy and discontented, with over a third dissatisfied with their careers. A large proportion (44%) were considering leaving the profession in the next 5 years. The top three factors for career satisfaction were ability to progress and learn new skills, the people they work with, and the remuneration.

CONCLUSIONS

This study provides a starting point for understanding the current environment and level of dissatisfaction of young pharmacists. There are several areas of concern that need to be addressed if a strong vibrant viable pharmacy profession is to be achieved.

Stress, burnout, and the need for support: a survey of early career pharmacists

BACKGROUND

Burnout of health professionals is of concern internationally and the pharmacy profession is no exception. The period of transition from University to autonomous practitioner is recognized to be challenging and these Early Career Pharmacists (ECPs), may be at increased risk of stress and burnout.

OBJECTIVES

This study aimed to collect data on the current extent of self-identified stress and burnout, of ECPs, and to (i) identify contributing factors and (ii) identify strategies used to manage this stress.

METHODS

This study was conducted in Aotearoa New Zealand and was based on a survey used previously in Australia. A national database was used to identify all pharmacists who had been registered for <10 years. The survey was emailed to each pharmacist, and was further advertised through social media platforms.

RESULTS

A total of 1418 ECPs were identified and invited to participate, and responses were received by 416 of these. The majority of respondents were female (73%) and community pharmacy based (79%). A vast majority (89%) indicated that a normal working day was at least moderately stressful with 79% indicating a level of burnout. These reflect a combination of "external" stressors, i.e. negative patient interactions, staff shortages, and "internal" stressors, i.e. fear of making a mistake, adjustment from University to working life.

CONCLUSIONS

Stress and burnout appear to be widespread in the ECPs, this study highlights areas of concern and potential support where efforts can be focussed to create a more sustainable working environment.

Building capacity through the IFLA Building Strong Library Associations programme

An introduction to the Building Strong Library Associations programme of the International Federation of Library Associations and Institutions. The programme is rolled out through country projects which include workshops, specialist mentoring, online blended activities and specially developed cross-programme activities. Three country projects per year will be implemented from 2010 until 2012, one each in Africa, Asia and Oceania, and Latin America and the Caribbean. The programme will be evaluated on three levels with a view towards ensuring sustainability of the programme and each country project.

Our Space: professional development for new graduates and professionals in Australia

This paper explores the changing work environment in libraries and information management and the impact on new professionals and new graduates. New graduates need to have their own support networks and targeted professional development to successfully navigate job and sector changes and to gain transferable skills. The development and structure of a targeted professional development event, the New Librarians’ Symposium, is discussed. This successful event, held in Australia biennially, could be considered a model of targeted professional development for other professional associations and groups.

Influence of prescription charges on repeat prescribing in primary care

BACKGROUND

Repeat dispensing by community pharmacists has now been rolled out nationally within England in order to improve patient convenience and reduce doctors' workload. Little is known about how the charge status of the patient may impact on the uptake and prescribing practices of this service.

OBJECTIVE

To examine whether the charge status of the patient influences the length of the repeat prescribing cycle.

METHOD

Thirty-six community pharmacies collected data on repeatable prescriptions dispensed over a 4-month period. A purposive sample of 13 general practices actively involved as pathfinder sites were selected for interview, to explore views on repeat prescriptions and influence of prescription charges.

RESULTS

Completed audit forms were collected on 4029 repeatable prescriptions. Differences in the length of the prescribing interval between charge payers and exempt patients were found to be statistically significant (Mann-Whitney U-test, P < 0.001), indicating that prescribers were issuing prescriptions for longer interval periods for charge payers. Thirteen general practitioners (GPs) and three practice managers were interviewed across 13 practices. Some GPs varied their prescribing to minimize the cost to patients. Others were motivated to reduce waste and promoted 28-day prescribing for all patients.

CONCLUSION

The study has shown that charge paying patients are more likely to have longer prescribing intervals and that cost to the patient is a consideration for GPs when making these decisions. Future work should explore the influence of other factors such as age, socio-economic status and patient morbidity on prescribing in primary care.

Reported frequency of domestic violence: cross sectional survey of women attending general practice

OBJECTIVES

To determine exposure to violence by a partner or spouse among women attending general practice and its association with respondents' demographic and personal characteristics; frequency of inquiry about violence by general practitioners; and women's views on routine questioning about domestic violence by general practitioners.

DESIGN

Cross sectional, self administered, anonymous survey.

SETTING

22 volunteer Irish general practices.

PARTICIPANTS

1871 women attending general practice.

MAIN OUTCOME MEASURES

Proportion who had experienced domestic violence, severity of such violence, and context in which violence occurred.

RESULTS

Of the 1692 women who had ever had a sexual relationship, 651 (39%, 95% confidence interval 36% to 41%) had experienced violent behaviour by a partner. 78/651 (12%) women reported that their doctor had asked about domestic violence. 298/651 (46%, 42% to 50%) women had been injured, 60 (20%) of whom reported that their doctor had asked about domestic violence. 1304/1692 (77%, 77% to 80%) were in favour of routine inquiry about domestic violence by their usual general practitioner. 1170 women (69%) reported controlling behaviour by their partner and 475 (28%) reported feeling afraid of their previous or current partner. Women who reported domestic violence were 32 times more likely to be afraid of their partner than women who did not report such violence.

CONCLUSIONS

Almost two fifths of women had experienced domestic violence but few recalled being asked about it. Most women favoured routine questioning by their practitioner about such violence. Asking women about fear of their partner and controlling behaviour may be a useful way of identifying those who have experienced domestic violence.

Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in entrants to Irish prisons: a national cross sectional survey

OBJECTIVES

To determine the prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in entrants to Irish prisons and to examine risk factors for infection.

DESIGN

Cross sectional, anonymous survey, with self completed risk factor questionnaire and oral fluid specimen for antibody testing.

SETTING

Five of seven committal prisons in the Republic of Ireland.

PARTICIPANTS

607 of the 718 consecutive prison entrants from 6 April to 1 May 1999.

MAIN OUTCOME MEASURES

Prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in prison entrants, and self reported risk factor status.

RESULTS

Prevalence of antibodies to hepatitis B core antigen was 37/596 (6%; 95% confidence interval 4% to 9%), to hepatitis C virus was 130/596 (22%; 19% to 25%), and to HIV was 12/596 (2%; 1% to 4%). A third of the respondents had never previously been in prison; these had the lowest prevalence of antibodies to hepatitis B core antigen (4/197, 2%), to hepatitis C (6/197, 3%), and to HIV (0/197). In total 29% of respondents (173/593) reported ever injecting drugs, but only 7% (14/197) of those entering prison for the first time reported doing so compared with 40% (157/394) of those previously in prison. Use of injected drugs was the most important predictor of antibodies to hepatitis B core antigen and hepatitis C virus.

CONCLUSIONS

Use of injected drugs and infection with hepatitis C virus are endemic in Irish prisons. A third of prison entrants were committed to prison for the first time. Only a small number of first time entrants were infected with one or more of the viruses. These findings confirm the need for increased infection control and harm reduction measures in Irish prisons.

Comparison between self-reported hepatitis B, hepatitis C, and HIV antibody status and oral fluid assay results in Irish prisoners

Self-reported hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infection status was compared with the results of oral fluid assays of antibodies to these viruses in prisoners from nine of the 15 prisons in the Republic of Ireland. A total of 1205 out of 1366 prisoners completed a confidential questionnaire and 1193 provided analysable oral fluid specimens for testing for antibodies to HBV core antigen (anti-HBc), HCV (anti-HCV), and HIV (anti-HIV). The self-reported prevalence of hepatitis infection (hepatitis B: 5%; hepatitis C: 19%) was lower than that derived from oral fluid assays (anti-HBc: 9%; anti-HCV: 37%). The self-reported prevalence of HIV infection was similar to that found by oral fluid assay (2%). Many discrepancies were found between self-reported results and the results of oral fluid assays. Of those who reported being positive for HBV, HCV, or HIV, 48%, 5%, and 58%, respectively, tested negative on the oral fluid assay. Of those who reported a previous negative test result for HBV, HCV, or HIV, 10%, 37%, and 2%, respectively, had positive oral fluid assays. Self-reports of hepatitis and HIV infection status are unreliable and should not be used as a basis for planning preventive and treatment services for prisoners. All prisoners should have the opportunity to be tested for HBV, HCV, and HIV infection.

Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in Irish prisoners: results of a national cross sectional survey

OBJECTIVES

To determine the prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in the prison population of the Republic of Ireland and to examine risk factors for infection.

DESIGN

Cross sectional, anonymous, unlinked survey, with self completed risk factor questionnaire and provision of oral fluid specimen for antibody testing.

SETTING

Nine of the 15 prisons in the Republic of Ireland.

PARTICIPANTS

1366 prisoners, of whom 1205 (57 women) participated. In the smaller prisons all prisoners were surveyed, while in the three largest prisons one half of the population was randomly sampled. Three small prisons believed not to have a problem with injecting drug use were excluded.

MAIN OUTCOME MEASURES

Prevalence of antibodies to hepatitis B core antigen, antibodies to hepatitis C virus, and antibodies to HIV. Self reported risk factor status.

RESULTS

Prevalence of antibodies to hepatitis B core antigen was 104/1193 (8.7%; 95% confidence interval 7.2% to 10.5%), to hepatitis C virus, 442/1193 (37%; 34.3% to 39.9%), and to HIV, 24/1193 (2%; 1.3% to 3%). The most important predictor of being positive for hepatitis B and hepatitis C was a history of injecting drug use. Thirty four women (60%) and 474 men (42%) reported ever injecting drugs. A fifth (104) of 501 injecting drug users reported first injecting in prison, and 347 (71%) users reported sharing needles in prison.

CONCLUSIONS

Infection with hepatitis C secondary to use of injected drugs is endemic in Irish prisons. Better access to harm reduction strategies is needed in this environment.

Randomised controlled trial of follow up care in general practice of patients with myocardial infarction and angina: final results of the Southampton heart integrated care project (SHIP). The SHIP Collaborative Group

OBJECTIVE

To assess the effectiveness of a programme to coordinate and support follow up care in general practice after a hospital diagnosis of myocardial infarction or angina.

DESIGN

Randomised controlled trial; stratified random allocation of practices to intervention and control groups.

SETTING

All 67 practices in Southampton and south west Hampshire, England.

SUBJECTS

597 adult patients (422 with myocardial infarction and 175 with a new diagnosis of angina) who were recruited during hospital admission or attendance at a chest pain clinic between April 1995 and September 1996.

INTERVENTION

Programme to coordinate preventive care led by specialist liaison nurses which sought to improve communication between hospital and general practice and to encourage general practice nurses to provide structured follow up.

MAIN OUTCOME MEASURES

Serum total cholesterol concentration, blood pressure, distance walked in 6 minutes, confirmed smoking cessation, and body mass index measured at 1 year follow up.

RESULTS

Of 559 surviving patients at 1 year, 502 (90%) were followed up. There was no significant difference between the intervention and control groups in smoking (cotinine validated quit rate 19% v 20%), lipid concentrations (serum total cholesterol 5.80 v 5.93 mmol/l), blood pressure (diastolic pressure 84 v 85 mm Hg), or fitness (distance walked in 6 minutes 443 v 433 m). Body mass index was slightly lower in the intervention group (27.4 v 28.2; P=0.08).

CONCLUSIONS

Although the programme was effective in promoting follow up in general practice, it did not improve health outcome. Simply coordinating and supporting existing NHS care is insufficient. Ischaemic heart disease is a chronic condition which requires the same systematic approach to secondary prevention applied in other chronic conditions such as diabetes mellitus.

Follow-up care in general practice of patients with myocardial infarction or angina pectoris: initial results of the SHIP trial. Southampton Heart Integrated Care Project

OBJECTIVE

We aimed to assess the effectiveness of a nurse-led programme to ensure that follow-up care is provided in general practice after hospital diagnosis of myocardial infarction (MI) or angina pectoris.

METHODS

We conducted a randomized controlled trial with stratified random allocation of practices to intervention and control groups within all 67 practices in Southampton and South-West Hampshire, England. The subjects were 422 adult patients with a MI and 175 patients with a new diagnosis of angina recruited during hospital admission or chest pain clinic attendance between April 1995 and September 1996. Intervention involved a programme of secondary preventive care led by specialist liaison nurses in which we sought to improve communication between hospital and general practice and to encourage general practice nurses to provide structured follow-up. The main outcome measures were: extent of general practice follow-up; attendance for cardiac rehabilitation; medication prescribed at hospital discharge; self-reported smoking, diet and exercise; and symptoms of chest pain and shortness of breath. Follow-ups of 90.1 % of subjects at 1 month and 80.6% at 4 months were carried out.

RESULTS

Median attendance for nurse follow-up in the 4 months following diagnosis was 3 (IQR 2-5) in intervention practices and 0 (IQR 0-1) in control practices; the median number of visits to a doctor was the same in both groups. At hospital discharge, levels of prescribing of preventive medication were low in both intervention and control groups: aspirin 77 versus 74% (P = 0.32), cholesterol lowering agents 9 versus 10% (P = 0.8). Conversely, 1 month after diagnosis, the vast majority of patients in both groups reported healthy lifestyles: 90 versus 84% reported eating healthy food (P = 0.53); 73 versus 67% taking regular exercise (P = 0.13); 89 versus 92% not smoking (P = 0.77). Take up of cardiac rehabilitation was 37% in the intervention group and 22% in the control group (P = 0.001); the median number of sessions attended was also higher (5 versus 3 out of 6).

CONCLUSIONS

The intervention of a liaison nurse is effective in ensuring that general practice nurses follow-up patients after hospital discharge. It does not alter the number of follow-up visits made by the patient to the doctor. Levels of prescribing and reported changes in behaviour at hospital discharge indicate that the main tasks facing practice nurses during follow-up are to help patients to sustain changes in behaviour, to encourage doctors to prescribe appropriate medication and to encourage patients to adhere to medication while returning to an active life. These are very different tasks to those traditionally undertaken by practice nurses in relation to primary prevention, where the emphasis has been on identifying risk and motivating change. Assessment of the effectiveness of practice nurses in undertaking these new tasks requires a longer follow-up.

Factors affecting practice nurse involvement in follow-up care of patients following myocardial infarction

BACKGROUND

Preventive care can reduce the morbidity and mortality of patients following myocardial infarction. Recent evidence has shown that such care is not being provided effectively. The involvement of practice nurses has been proposed as a means of improving the completeness of follow-up and the quality of preventive care.

OBJECTIVES

We aimed to determine the extent to which follow-up care for people discharged from hospital after a myocardial infarction is currently being undertaken by practice nurses and to assess the factors influencing the provision of such care and the nurses' attitudes towards this extended role.

METHOD

Postal questionnaires were sent to 183 practice nurses working in general practices in the Southampton and South-West Hampshire Health District; 121 nurses responded (66%), representing 58 out of 64 practices surveyed (91%).

RESULTS

The majority of responding practice nurses (55%, 95% CI 47-64%) had hospital experience of caring for patients with ischaemic heart disease, and most (83%, 95% CI 76-89%) believed that they played a key role in follow-up care of patients following myocardial infarction. In the absence of external support from a cardiac liaison nurse, few nurses (26%, 95% CI 16-41%) provide such care at present and only 21% work in practices with a register of myocardial infarction patients. Factors predicting the provision of follow-up care are having adequate time (odds ratio 4.59, 95% CI 1.66-12.7), the support of a cardiac liaison nurse (odds ratio 3.07, 95% CI 1.28-7.34) and GP colleagues (odds ratio 3.38, 95% CI 1.38-8.23), training in consultation skills (odds ratio 7.25, 95% CI 2.08-25.3), fundholding (odds ratio 3.11, 95% CI 1.26-7.69) and the confidence and knowledge of the practice nurse (odds ratios and 95% CIs respectively: 2.84, 1.18-6.83 and 2.80, 1.13-6.89).

CONCLUSION

Most practice nurses are enthusiastic and have some of the necessary experience to provide follow-up care for patients who have experienced a myocardial infarction. Yet few currently provide it. The most important organizational incentives for providing such care are further training and the support of GPs and the cardiac liaison nurse.

Preventive care for patients following myocardial infarction. The Wessex Research Network (WReN)

OBJECTIVE

We aimed to assess general practice care for patients following a myocardial infarction (MI).

METHOD

A structured review was carried out of general practice records of patients identified from hospital administration data. A total of 266 survivors following MI were identified from the discharge data of 13 hospitals in Southern England and registered with 71 GPs belonging to the Wessex Research Network. Median time since hospital discharge was 2.1 years. The main outcome measures were the provision of appropriate preventive care, including cardiac rehabilitation, drug therapy, and lifestyle advice for modifiable risk factors.

RESULTS

Basic care was provided to nearly all patients; 253 (95.1%, 95% Cl 91.8-97.4) had blood pressure documented after their MI, 216 of 234 patients eligible for aspirin (92.3%; 88.1-95.4) had been recommended treatment, and the provision of advice on smoking cessation was documented for 27 of 33 continuing smokers (81.8%; 64.5-93.0). However, only 73 of 236 patients eligible to attend a structured rehabilitation programme (30.9%; 25.0-36.8) were documented as having received rehabilitation. Of 89 patients with heart failure following MI, 33 (37.1%; 27.1-48.0) had no record of having been offered treatment with an ACE inhibitor. Total cholesterol measurement was documented for only 144 patients (54.1%; 48.1-60.1). We estimate that there is still the potential to prevent between 4 and 9 deaths in this group of 266 surviving patients in the next 2 years by further improving the quality of follow-up care.

CONCLUSIONS

Preventive care in patients with proven ischaemic heart disease in general practice remains haphazard, even among doctors enthusiastic to participate in research and to audit their quality of care. As general practitioners we should ensure that we are providing high quality preventive care to patients with clinical disease before we focus on the even more demanding task of primary prevention.

A new short form individual quality of life measure (SEIQoL-DW): application in a cohort of individuals with HIV/AIDS

Quality of life is an increasingly important outcome measure in medicine and health care. Many measures of quality of life present patients with predetermined lists of questions that may or may not be relevant to the individual patient. This paper describes a brief measure, the SEIQoL-DW, which is derived from the schedule for evaluation of individual quality of life (SEIQoL). The measure allows respondents to nominate the areas of life which are most important, rate their level of functioning or satisfaction with each, and indicate the relative importance of each to their overall quality of life. Given its practicality and brevity, the measure should prove particularly useful in clinical situations where patient generated data on quality of life is important. This article describes the first clinical application of the measure, assessing the quality of life of a cohort of patients with HIV/AIDS managed in general practice.

Analysis of care of HIV positive patients: hospital and general practice components

Fifty-seven HIV positive adults (mostly injecting drug users) attending two inner city Dublin general practices were followed for one year to identify the general practice and hospital components of their care. Many patients had advanced disease; during the year 10/57 (17.5%) died. The group made a median of seven visits to general practice (range 0-35) and two visits to hospital HIV clinics (range 0-21). A quarter of the group (14/57) was seen only in general practice and did not attend hospital; only two patients did not attend either the HIV Clinic or the GP during the year. Hospital admission was needed for 15/57 (26.3%) patients on a total of 31 occasions with an average length of stay of 10 days per admission; 80% of these admissions were generated by 10 patients with AIDS. The indication for almost all admissions was serious physical illness or diagnostic or therapeutic procedure. Patients with symptomatic or advanced HIV disease required a higher level of care than those with asymptomatic disease. It is essential that the agencies involved in meeting this level of demand be adequately resourced and that they liaise closely.

Attitudes towards and experience of general practice among HIV-positive patients in the Republic of Ireland

In order to study their attitudes to and experience of general practitioner care, 150 attenders at the only HIV specialist clinic in the Republic of Ireland were asked to complete an anonymous, self administered questionnaire. (81%) of respondents reported having a regular GP and 94% of those indicated that the GP was aware of their HIV diagnosis. The majority (64%) of patients with a regular GP reported seeing their doctor on more than 5 occasions during the previous year. Most patients were satisfied with the support which they received from their GPs. Even so, the majority of patients (72%) would go directly to the hospital clinic for any problem which they perceive to be HIV related.

Irish general practice and the human immunodeficiency virus

Over a quarter (499) of general practitioners in the Republic of Ireland were sent a questionnaire on the human immunodeficiency virus (HIV) infection. Two hundred and fifty eight (51.7%) general practitioners returned completed questionnaires. Ninety six respondents (37.2%) had seen at least one HIV positive patient in their practice. In Dublin two thirds (67%) of respondents had seen HIV positive patients. A large majority (77.6%) of HIV positive people identified by the survey were attending general practitioners in the Eastern Health Board area. Most (61.2%) respondents favour the involvement of general practitioners in the future care of patients with HIV.

Translocation of cytoplasmic estrogen receptors to the nucleus: immunohistochemical demonstration utilizing rabbit antibodies to estrogen receptors of mammary carcinomas

Rabbit antibodies to cytoplasmic estrogen receptors (ER) of human breast carcinoma were utilized for investigating steroid-triggered in-vitro translocation of cytoplasmic ER to the nuclear compartment of the estrogen target cells. The immunofluorescent method (IF) previously described (S Raam et al., Eur J Cancer Clin Oncol 18: 1-12, 1982) was employed for immunohistochemical localization of ER. Four cases of normal endometrium, two cancers of the endometrium, and MCF-7 human breast cancer cells were maintained in a steroid free medium and exposed at 37 degrees C for two hours to growth medium alone (control) or to 2.5, 25 or 250 nanomoles of estradiol (E2), diethylstilbestrol (DES), or monohydroxytamoxifen (OH-TX). At the end of the incubation period the cells were processed for intracellular localization of ER. Complete traslocation of IF from the cytoplasm to the nuclear compartment was evident in all normal endometrial cells exposed to E2, DES or OH-TX for two hours. While cells from the endometrial cancer 'S', like the normal cells, translocated IF to the nucleus, cells of another cancer ('KLE') failed to translocate when exposed to E2 or OH-TX. Partial translocation was evident in 'KLE' cells exposed to DES. In MCF-7 cells grown in the absence of E2, IF was exclusively cytoplasmic. When these cells were exposed to the hormones, 50% showed a complete transfer of IF to the nucleus; in 40% a delayed response was evident; 10% failed to translocate. The results revealed the suitability of anti-ER antibodies for investigating the intracellular dynamics of ER in target cells responding to estrogens or antiestrogens.

Weathering Characteristics of Petroleum Hydrocarbons Deposited in Fine Clay Marine Sediments, Searsport, Maine

Further examination of the 1971 spill site in Long Cove, Searsport, Maine, has been carried out during 1976, and has led to the following observations: 1. Petroleum residues isolated from this spill give the appearance of weathering particularly slowly in the cold anoxic sediments of Long Cove. 2. Leaching from contaminated terrestial sediments onto portions of the intertidal zone on the west shore of the Cove while continuing in trace concentrations does not appear to be making a major contribution to the maintenance of a nearly steady state pollution problem found in several areas of the Cove. 3. On the average, the spill area currently appears to contain roughly 20% less material than in 1971. At a number of sites, however, there appears to have been either little or no decline in gross hydrocarbon concentrations, and essentially no weathering of the aliphatic portions of the petroleum residues. 4. One of the principal factors to influence the character of petroleum residues isolated 5 yr postspill appears to have been the weathering of the hydrocarbons during transport to the site of sediment penetration from upland locations. Thus, the current compound distribution was determined early in the spill period. 5. Repopulation of the Cove by M. arenaria, which is proceeding very slowly, correlates directly with the gross concentration variations of petroleum hydrocarbons. Key words: petroleum, gas chromatography, weathering, clay sediments, Maine

A survey of the haematological, nutritional and biochemical state of the rural elderly with particular reference to vitamin C

A survey of the rural elderly has been carried out to determine basic haematological and biochemical data, and to establish a pattern of living for this 'well' population. The blood parameters related to diet, such as haemoglobin, folate, cholesterol, vitamin C etc., show considerable changes with increasing age in the male but little significant change in the female. The vitamin C status for both sexes compares favourably with that reported by other workers studying the urban elderly. The biochemical and haematological data derived provide a normal range with which the 'sick' elderly can be compared. The subjects were generally active and independent in spite of (or because of) a somewhat Spartan existence.

Vitamin C and post-suxamethonium pains

A double-blind trial of the effects of vitamin C on the frequency, severity and duration of post-suxamethonium pains was performed. Fifty-three patients undergone bronchoscopy received either a placebo or 10 g of vitamin C. No beneficial effect was demonstrated. In 18 patients no relationship was found between pre-anaesthetic buffy layer vitamin C levels and the subsequent pains. Measurement of buffy layer and plasma vitamin C levels before and after anaesthesia did not suggest that vitamin C deficiency occurs during or immediately after administration of suxamethonium. It is concluded that the administration of vitamin C cannot be recommended as a means for prevention of suxamethonium pains.