• A longitudinal study of United Kingdom pharmacists' misdemeanours--trials, tribulations and trends.

      Tullett, Julie; Rutter, Paul M.; Brown, David (Springer Verlag, 2003)
      BACKGROUND: Standards of UK pharmacy practice are maintained by the Royal Pharmaceutical Society of Great Britain, which has the power to take a range of sanctions, including removal of the right to practice, against those found guilty of malpractice. This function is currently under review. OBJECTIVE: To conduct a longitudinal study in order to define trends and identify areas where remedial or preventative support could be focused. METHOD: Case analysis of reports of individuals' misdemeanours published in the British Pharmaceutical Journal over a 12-year period (September 1988-October 2000). Professional and personal misdemeanours were considered. MAIN OUTCOME MEASURE: Nature of misdemeanour, conviction or disciplinary proceedings against individual, practising pharmacists in the study period. Reasons offered for committing the misdemeanour and penalties applied. RESULTS: 344 cases, involving a wide range of personal (162) and professional (590) misdemeanours were found. On an annual basis, the maximum incidence of pharmacists found guilty of any misdemeanour was extremely low (< 0.1 of 1% on the pharmaceutical register). The most common professional misdemeanour was failure to keep adequate written records. The most common personal misdemeanour was fraud. The most common reason cited for committing any misdemeanour was financial gain. Numbers in individual offence categories were persistent but low and there were few obvious trends with time. The odds of involvement ratio for male versus female pharmacists was 7.36 (CI: 5.23-10.35) and for ethnic minority versus Caucasian pharmacists was 3.8 (CI: 3.06-4.72). The most stringent penalties (either imprisonment or removal of the right to practice and frequently both) were applied to cases involving personal use or trafficking of drugs subject to abuse. CONCLUSIONS: The current self-regulation of pharmacy practice in the UK involves a wide range of misdemeanours of varying severity; but the incidence of reports of pharmacists found guilty of malpractice was extremely low. The nature of misdemeanours appeared to change little over the period of the study; this study therefore indicates the spectrum of misdemeanours likely to be encountered by a regulating board in the immediate to medium-term future. If regulatory changes such as competence-based practice rights are introduced, the spectrum may change.
    • Does physical fitness affect injury occurrence and time loss due to injury in elite vocational ballet students?

      Twitchett, Emily; Brodrick, Anna; Nevill, Alan M.; Koutedakis, Yiannis; Angioi, Manuela; Wyon, Matthew A. (J Michael Ryan Publishing, 2010)
      Most ballet dancers will suffer at least one injury a year. There are numerous causes of injury in dance, and while many investigators have documented risk factors such as anatomical characteristics, past medical history, menstrual history, dance experience, length of dance training, fatigue, and stress, risk factors related to body characteristics and nutrient intake, levels of conditioning, or physical fitness parameters have only recently received the same amount of attention. The aim of the present study was, therefore, to investigate correlations between ballet injury and body fat percentage, active and passive flexibility, lower limb power, upper body and core endurance, and aerobic capacity. Low levels of aerobic fitness were significantly associated with many of the injuries sustained over a 15-week period (r=.590, p=0.034), and body fat percentage was significantly associated with the length of time a dancer was forced to modify activity due to injury (r=-.614, p=0.026). This information may be of benefit to dancers, teachers, physical therapists and physicians in dance schools and companies when formulating strategies to prevent injury.
    • Does physical fitness affect injury occurrence and time loss due to injury in elite vocational ballet students?

      Twitchett, Emily; Brodrick, Anna; Nevill, Alan M.; Koutedakis, Yiannis; Angioi, Manuela; Wyon, Matthew A. (J. Michael Ryan, 2010)
      Most ballet dancers will suffer at least one injury a year. There are numerous causes of injury in dance, and while many investigators have documented risk factors such as anatomical characteristics, past medical history, menstrual history, dance experience, length of dance training, fatigue, and stress, risk factors related to body characteristics and nutrient intake, levels of conditioning, or physical fitness parameters have only recently received the same amount of attention. The aim of the present study was, therefore, to investigate correlations between ballet injury and body fat percentage, active and passive flexibility, lower limb power, upper body and core endurance, and aerobic capacity. Low levels of aerobic fitness were significantly associated with many of the injuries sustained over a 15-week period (r=.590, p=0.034), and body fat percentage was significantly associated with the length of time a dancer was forced to modify activity due to injury (r=-.614, p=0.026). This information may be of benefit to dancers, teachers, physical therapists and physicians in dance schools and companies when formulating strategies to prevent injury.
    • Hormonal factors in the development of differences in strength between boys and girls during adolescence: a longitudinal study.

      Round, J. M.; Jones, David A.; Honour, J. W.; Nevill, Alan M. (Taylor & Francis for the Society for the Study of Human Biology, 1999)
      The development of elbow flexor (biceps) and knee extensor (quadriceps) strength has been followed in a mixed longitudinal study of 50 boys and 50 girls from the age of 8 to 17 years. Sex differences in strength emerged at the time of peak height velocity and were especially marked for the biceps. Data for individual children were aligned to the time of peak height velocity and associations between strength, height, weight and circulating testosterone were investigated using multi-level modelling. The results show that, for girls, quadriceps strength is proportional to height and weight while for boys there is an additional factor which can be fully attributed to increasing levels of testosterone. Testosterone is important in explaining differences in biceps strength between the sexes but an additional factor is also required. It is suggested that, in addition to a direct effect on muscle, testosterone could have a second indirect action on biceps strength by promoting growth in length of the humerus as part of the general development of the male upper limb girdle.
    • Impacts of undetected and inadequately treated hypertension on incident stroke in China

      Han, Thang S.; Wang, Harry H.X.; Wei, Li; Pan, Yuesong; Ma, Ying; Wang, Yu; Wang, Jiaji; Hu, Zhi; Sharma, Pankaj; Chen, Ruoling; et al. (BMJ, 2017-10-08)
      © Article author(s) 2017. Objectives China carries the greatest burden of stroke given its largest volume of people with hypertension. This study assessed the impacts of suboptimal controls of hypertension on incident stroke and projected the number of patients with stroke saved after the control of blood pressure improved in population. Setting Anhui, China. Participants We examined data from the Anhui cohort of 2001-2011, consisting of 3336 participants aged ≥60 years who were randomly recruited from the urban and rural Anhui. 2852 participants (89.2%) had hypertensive status measured and no stroke at baseline, and were followed up until 2011 in three surveys using a standard method of interview. Results At baseline, 1646 participants (57.7%) were identified to have hypertension, among whom 912 (55.4%) were previously undetected, 115 (7.0%) detected but not treated, 452 (27.5%) treated but not controlled and only 127 (7.7%) controlled. During the 10-year follow-up, 211 incident stroke cases (12.8/1000 person-years) occurred. Compared with normotensive individuals at baseline, multivariate adjusted HR for having stroke increased in those with undetected hypertension by 1.63 (95%CI 1.15 to 2.32), untreated by 2.21 (1.26-3.85) and uncontrolled hypertension by 3.34 (2.28-4.88), but did not differ from those with controlled hypertension (1.34; 0.60-2.99). Based on a two-fold increase in the detection and management of current levels of hypertension and algorithms on the current situation in China, approximately 250 000 incident stroke cases could be prevented annually. Conclusions In China, hypertension is frequently undetected or inadequately treated. With appropriate management of hypertension, a substantial number of people could be saved form stroke.
    • Role of sexual behavior in the acquisition of asymptomatic Epstein-Barr virus infection: a longitudinal study.

      Woodman, Ciaran; Collins, Stuart; Vavrusova, Nicol; Rao, Ankit; Middeldorp, Jaap; Kolar, Zdenek; Kumari, Angela; Nelson, Paul N.; Young, Lawrence S.; Murray, Paul G. (Lippincott Williams & Wilkins, 2005)
      BACKGROUND: The natural history of Epstein-Barr virus (EBV) infection is poorly defined. We report the prevalence and subsequent incidence of EBV infection in a cohort of sexually active young women and explore the social and sexual determinants of incident infections. METHODS: The study population was drawn from a cohort of young women, who were recruited for a longitudinal study of risk factors for early cervical neoplasia. A case-control analysis, nested within the cohort of 45 women for whom the first EBV sample tested was EBV-negative and who had further follow-up, was undertaken. EBV serostatus was determined in serum with a synthetic peptide-based enzyme-linked immunosorbent assay; EBV DNA was measured in cervical smears with the use of quantitative polymerase chain reaction. RESULTS: Of 1023 women 15-19 years of age included in this analysis, 978 (95.6%) tested positive for antibodies to EBV in their first serum sample. Of 45 women who tested negative, 22 subsequently acquired an asymptomatic EBV infection; the median time to seroconversion was 25 months (range, 1-60 months), and the median age at seroconversion was 18 years (range, 16-21 years). The risk of seroconversion increased with increasing number of sexual partners [compared with 1 partner, odds ratio (OR) was 1.28 for 2 partners and 2.23 for 3 or more; chiTREND 5.02; df 1; P < 0.05] and was greatest when a new sexual partner had been acquired in the 2 years before seroconversion (OR 4.78; chi 4.62; df 1; P < 0.05). EBV DNA was detected in 9 of 14 women who seroconverted and who also provided cervical samples. CONCLUSIONS: In susceptible young women, the acquisition of EBV infection is associated with their sexual behavior.