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Publication Date 01/07/2012         Volume. 4 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July edition of i2P – Information to Pharmacists.
This month we note that a range of clinical opportunities are beginning to open up for pharmacists and we further note that they will be introduced into a messy and congested pharmacy environment, lack of privacy and with insufficient differentiation between the clinical space and the dispensing space, all with virtually no clinical forward planning.

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Recent Comments

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News Flash

Newsflash Updates for July 2012

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P.
Access and click on the title links that are illustrated.

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Feature Contribution

A New Clinical Opportunity on the Horizon

Neil Johnston

Slowly, the opportunity for pharmacist clinical services is opening up.
Just this week the US Centre for Disease Control (CDC) announced a project to train pharmacists and retail store clinic staff at 24 rural and urban sites to deliver confidential rapid HIV testing.
CDC will use the results of the pilot effort to develop a model for implementation of HIV testing in these settings across the United States. The project is part of CDC’s efforts to support its 2006 testing recommendations, which call for all adults and adolescents to be tested for HIV at least once in their lifetime.

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The privilege of being a pharmacist

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

How often do we acknowledge the privilege of being a pharmacist; in particular the privilege of providing care to others? 
In the hubris and stress of life it is easy to become blasé about the vulnerability of those who come to us for assistance. 
Over time we can become hardened and cynical, categorising and stereotyping our patients and customers. 
We can also lose our sense of compassion and see certain customers as nuisances, problems or just a source of income or a sale.  Pharmacy is one of the caring professions and we must never lose our sense of wonder that we are allowed into the lives of our patients and to assist them in managing their health and well being.

Comments: 1

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Where have all the leaders and innovators gone?

Gerald Quigley

The Age. Friday June 15th. Melbourne. Page 2
A half-page ad espousing the virtues of Medibank Nurses 24/7

“……sometimes you have questions about your health, but you’re not sure if it’s worth a visit to your doctor…..whether it’s about your general health, symptoms, managing diagnosed conditions, discussing treatment options…..our Medibank nurses are there for you….”

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Where is the Outrage?

Peter Sayers

It never ceases to astound me the number of different levels Big Pharma operates on in the orchestration of a clinical trial.
Including the “Short Clinical Trial”, the design of which is created to have the “gold standard” endorsement except that the timeline of the trial is shortened to suit the sponsor of the drug involved.
There is a direct correlation between the length of a clinical trial and the reports of negative side-effects.
Studies cut short have been found to overestimate the study drug's effectiveness and miss dangerous side effects and complications by an average of 30 percent.
This would explain the amazing 85 percent drug study success rate in the hands of Big Pharma according to the Annals of Internal Medicine.

Comments: 5

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On the Radar Screen - Turbulence Ahead

Barry Urquhart

AN IMPORTANT TALKING POINT
 
Never let it be said... men are poor communicators.
Males do communicate and are generally efficient in getting their messages across.
Sadly, all too often the audience is themselves and the sentiment is negative.
Self-talk is calculated to represent more than 90% of the time and effort expended by males in projecting and receiving messages, thoughts and ideas. Women are more inclined to share their time and thoughts.
However, it seems males and females alike are guilty of self-admonishment. “You idiot”, “you fool” and “wrong again” are common verbal and mental reprimands.

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Reassessing leadership for today's bosses

Harvey Mackay

As we enter the long hot summer of politics and read stories daily about corporate strategies, one common theme emerges: leadership. And there is seldom agreement about what real leadership looks like or who is best to provide it.
Why?
My theory is that too often, people in leadership positions fail to realize that every decision affects real people, not just the bottom line.
Every good leader I have ever known has understood that they are leading people, not just an organization.

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The latest TGA reform - could this be the end of legitimised 'snake oil'?

Loretta Marron OAM BSc

The deadline for comments on the Therapeutic Goods Administration (TGA)'s  draft document, "Evidence required to support indication for listed medicine" was 25 May 2012 with many groups, including Friends of Science in Medicine (FSM), sending submissions.  These new guidelines have come out of the 2011 "TGA reforms: a blueprint for TGA's future" which was a response to several major reviews of therapeutic goods regulation.  In Australia, alternative medicine (AltMed) is a $3 billion industry. With sponsors of complementary medicines (CMs) still not required to submit any evidence, will this new legislation give us any real consumer protection?

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The Forces Against Health in Australia

Staff Writer

Editor's Note:
The following opinion piece published originally by the Orthomolecular Medicine News Service contrasts starkly with another article appearing in this edition of i2P titled "Where is the Outrage?", which is one of the regular articles highlighting the death and destruction that typifies much of mainstream medicine's approach, utilising drugs for illness management without any thought for early prevention.
That doctors are a health hazard is supported by the evidence generated when doctors go on strike or boycott a specific hospital.
The death rate drops by up to 50%.
The medico stated objective of "first do no harm" is a joke - if it wasn't so serious.

Comments: 1

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I've Been Thinking About - What’s good for healthcare providers is good for technology providers

Mark Neuenschwander

For the past ten days I’ve been embroiled in site visits and presentations at some of Australia’s leading hospitals.
I’ve also addressed several gatherings of technology vendors.
Then yesterday afternoon I met for three hours with the Australian Commission on Safety and Quality in Health Care.
Down-under peeps are awesome.
We talked about technologies OZ has and even more about technologies they wish they had.
We have much to be grateful for “up over” here in America.In between meetings, I took in an Aussie Rules Football (footy) match—a real thriller.
I watched a few snippets of the Queen’s Jubilee on the telly this morning—a real yawner.
Monarchists are dwindling down here.
One gets the feeling Aussies just as soon watch Major League Baseball, even though it’s generally regarded as boring to them as cricket is to us.

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The value of community pharmacy cannot be measured as an Expense Item in the Federal Budget.

Neil Retallick

Editor's Note: In support of Neil Retallick's article I would advise that I was approached by a mainstream newspaper journalist to provide comment on the future of pharmacy.
I gave an upbeat and an optimistic answer to the journalist's questions even though the opening was given to provide some negative answers.
After about 10 minutes into the interview the journalist asked if it would be o.k to call back as there was a phone call needed to be made.
I am still waiting for that return phone call to complete the interview.
I am sure my answers did not support the article that was being put together, which means that another article will appear containing the "negatives" that Neil Retallick highlights.

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Massaging, Cherry-Picking, Falsifying and Polluting Clinical Evidence

Peter Sayers

An awareness is beginning to build in Australia, regarding the veracity of clinical evidence used by pharmacists, GP’s and other health clinicians, derived through the improper massaging and influence by Big Pharma companies.
Part of this massaging goes to industry concern when those same companies lavishly entertain members of the medical profession, or make direct payments to them for services rendered, or for the carriage of clinical trials that are likely to result in favour of a sponsor’s drug.
For some time i2P has been alone in Australian publishing ranks in reporting this type of behaviour.
We are now pleased to report that the National Prescribing Service has highlighted the influence of medical opinion leaders (albeit low key at this stage), in the June edition of Australian Prescriber.
We have published the NPS information below.

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9 Key Performance Indicators for Building An Effective Profit Plan (Part 2)

Chris Foster

Last month we covered the 9 specific performance indicators that you need to consider in building a profit plan for the new financial year.
This month, we'll examine how you build a profit plan, utilising those indicators.
I'll go through two simple approaches - one based on targeting a desired profit level and the second aimed at devising a profit plan based on what you might consider an achievable sales target.

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The legality of discounting

Rollo Manning

PHARMA GOSS:  The Legality of Discounting

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TAKE MEDICINES - Seriously

Rollo Manning

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Largest Health Care Fraud Settlement in U.S. History

Neil Johnston

Propaganda relies on pressure created by repeating a lie often enough until it becomes an accepted truth.
Many elements of advertising rely on this concept to drive their message through to consumers.
The success of Big Pharma in driving fraudulent messages through distorted and manipulated "evidence" has been so successful that the targeted audiences (including readers of i2P) remain complacent and dormant.
The process is often described as "dumbing down" where short targeted messages continually repeated and enhanced by audio-visual processes, eventually appear to recipients as being "normal".
What is even more appalling is that arguments for and against "evidence" are reduced to trial design arguments or "technical glitches" with no thought given to the deaths and destruction caused by these drugs.

Comments: 3

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Why we can't live forever: understanding the mechanisms of ageing

Staff Writer

Professor Christopher Thomas is a physician and a scientist. His work links the complex disciplines of biochemistry and biology to the real needs of real people.His research laboratory is situated at the JDRF/ Danielle Alberti Memorial Centre for the study of Diabetes Complications at the Baker IDI Heart and Diabetes Institute in Melbourne. 
His work is focused on reducing the burden of diabetes and kidney disease in Australia. The Juvenile Diabetes Research Foundation, Diabetes Australia, the Australian NHMRC, Kidney Health Australia and the National Heart Foundation also support his work.

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Farcical Fraud in Medicine

Neil Johnston

Medicines Australia (MA), the organisation representing drug manufacturers in Australia, has been struggling to produce an acceptable code of conduct on behalf of its members, that demonstrates integrity and transparency.
At issue is the range of payments made to doctors for services provided and the reluctance of Medicines Australia to name the doctors involved, the amounts paid to each individual doctor and what was the service actually performed.
Drug companies have agreed to disclose the total amount they pay to doctors to attend seminars or serve on advisory boards, but say any move to name individual doctors receiving the payments could be years away.

Comments: 1

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Get Disruptive…not Disrupted

Neil Johnston

Pharmacies are not the only forms of business with declining margins and feeling commercial pressures.
Nearly 75% of all Australian businesses are likewise feeling the pinch and are starting to believe they are entering into a freefall.
Ernst & Young recently conducted a global survey soliciting opinions from 285 senior executives and have formed the opinion that a “brand new order” of business has commenced.
“The brand new order is an environment of continuous, accelerating change and spiralling complexity.
It is transforming and disrupting the business landscape for consumer products and services companies and presenting them with huge opportunities and risks.”

Comments: 1

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The Digital Cure of the Future: Wearable Sensors

Staff Writer

Healthcare costs have risen to unsustainable levels and delivering care will require innovative and more cost effective methods in the future. 
Advancements in digital and mobile technologies, combined with a more information savvy consumer, are helping usher in new approaches to the healthcare continuum.
Wearable sensors, combined with mobile technology, are one of these novel approaches that allow monitoring and interpreting the physiology of the user in a transformative way.

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'Manual Muscle Testing' - it's just tosh trickery

Loretta Marron OAM BSc

A good friend was impressed at the way his strength improved after a chiropractor used 'manual muscle testing' (MMT) on him. Another two, one with Parkinson’s and the other with rheumatoid arthritis, purchased Power Balance bracelets for increased strength and to improve balance. Yet another was amazed how her Kinesiologist diagnosed her nutritional deficiencies with a similar test. They would not believe that this was just 'smoke and mirrors' and tosh trickery. So what is MMT, what claims are being made, and are they true?

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Have we bottomed out yet?

Gerald Quigley

Where will this stupidity end?
Free, prescription only drugs!!
Doctors are happy,
Consumers are happy.
Our professional bodies shake their heads.
Not our problem the leaders say.
Well, I disagree….it is their problem, and perhaps, they are our problem!

Comments: 3

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Managing Expectations

Barry Urquhart

Every prospective and existing customer and client arrives at the premises, on the telephone or on-line with expectations.
These can be and are influenced, or indeed often determined in part or in whole, by past experiences, word-of-mouth references, advertising, website designs, literature, premises presentations, image, reputations and the attitudes of staff members.
Achieving and sustaining satisfaction are functions of the consistency and continuity of the service provided.
This can involve numerous people, departments and sections which contribute to the experiences encountered and, hopefully, enjoyed by the customers and clients.

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I’ve been thinking about : Shopper and patient migration patterns during my lifetime.

Mark Neuenschwander

For most of my years, the point of sale has been fixed at the front of the store. We shoppers have been gathering our goods and taking them to cashiers who manually key prices into registers and collect our cash (or Visa Cards, which were introduced the year I graduated from high school with the class of ‘66). IBM studies during the early ‘70s revealed that 23 percent of items were entered over or under their actual prices.

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Infection spread: will breathing kill you?

Staff Researcher

Travelling in a car with a person infected with the flu can mean your chance of getting sick is up to 99.9 per cent, a study from Queensland University of Technology (QUT) shows.
Professor Lidia Morawska
, director of QUT's International Laboratory for Air Quality and Health, said the risk of transmitting influenza over a 90-minute car trip with someone ill could be higher than travelling on a Boeing 747 for 17 hours with an infected person.

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SHPA Announces Immunology Symposium

Staff Writer

SHPA NSW Immunology Symposium, Saturday 18th August 2012

 The NSW Branch of the Society of Hospital Pharmacists of Australia is pleased to announce that registrations are open for their 2012 Immunology Symposium. 
The one-day event will be held at The University of Sydney on the 18th August and is designed to give pharmacists and interns a therapeutic update in the area of immunology focusing on the use of biological agents.

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Bilirubin protects against heart disease

Staff Researcher

There's new hope for the fight against cancer and cardiovascular disease, following breakthrough research identifying a pigment in our bile.
A fluid produced by the liver and stored in the gallbladder, bile's function was simply thought to aid in the digestion process.
Original Griffith University media release by Louise Durack, is found here

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Epilepsy drugs increase risk of fractures and falls

Staff Researcher

New research has shed light on the high risk of fractures, falls, and osteoporosis among epilepsy patients using antiepileptic drugs with most patients unaware of the risks associated with taking the drugs.
The study led by the University of Melbourne and published in the prestigious Neurology journal, found that people taking antiepileptic drugs are up to four times more likely to suffer spine, collarbone and ankle fractures and are more likely to have been diagnosed with osteoporosis.

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Making biologically active yet stable antibodies

Staff Researcher

Australian scientists have overcome one of the most pressing problems facing the pharmaceutical industry – how to create antibodies that are stable enough to meet stringent requirements necessary for production in large quantities, injection into patients and long-term storage. 
Members of the Antibody Engineering Laboratory at Sydney’s Garvan Institute of Medical Research – Dr Daniel Christ* and PhD students Kip Dudgeon and Romain Rouet – have developed specific mutations that universally increase the stability of antibody molecules.
The breakthrough finding is published today in the early online edition of the Proceedings of the Academy of Science (PNAS), the journal of the United States National Academy of Sciences.

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Iodine deficiency still a problem

Staff Researcher

Iodine deficiency is still a problem in Australia today and about 30% of the world’s population remains at risk of the preventable condition that can cause everything from mild learning difficulties to sever retardation, cretinism and stillbirth.
That is the message from Australian scientific statesman Dr Basil Hetzel more than 40 years after his seminal studies illuminated iodine’s essential role in brain development.

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Plants may be key to diabetes treatment

Staff Researcher

With the growing worldwide incidence of diabetes, a new study reveals that traditional Aboriginal and Indian plant extracts show potential for managing the disease.
Researchers from Swinburne University of Technology have investigated 12 medicinal plant extracts to determine their potential to slow down two key enzymes in carbohydrate metabolism which affect blood sugar and diabetes.

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Advice for winter cold and flu blues

Staff Writer

As many of us sniffle and cough our way through another winter, University of Sydney Professor Robert Booy, from the National Centre for Immunisation Research and Surveillance at Sydney Medical School has some advice about colds and flu.
It is not just people's perceptions that this year has been particularly bad for colds and flu.
It has been the busiest year for hospital admissions, including to intensive care, for complications from flu infections for the last three years.

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Why we can't live forever: understanding the mechanisms of ageing

Staff Writer

Professor Christopher Thomas is a physician and a scientist. His work links the complex disciplines of biochemistry and biology to the real needs of real people.His research laboratory is situated at the JDRF/ Danielle Alberti Memorial Centre for the study of Diabetes Complications at the Baker IDI Heart and Diabetes Institute in Melbourne. 
His work is focused on reducing the burden of diabetes and kidney disease in Australia. The Juvenile Diabetes Research Foundation, Diabetes Australia, the Australian NHMRC, Kidney Health Australia and the National Heart Foundation also support his work.

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New research discovers link between high blood pressure and menopausal hormone therapy

Staff Writer

A new medical study by the University of Western Sydney has found that hormone therapy used by women to combat the effects of menopause is associated with increased chances of developing high blood pressure, particularly among younger postmenopausal women.
It also found that the longer a woman uses menopausal hormone therapy, the higher her odds of having high blood pressure.

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Breakthrough treatment reduces post-surgical scarring for glaucoma patients

Staff Researcher

Scientists at the Singapore Eye Research Institute (SERI) and Nanyang Technological University (NTU) have developed an innovative way to combat post-surgical scarring for glaucoma patients.
A clinical trial has shown that the use of a new drug delivery method has resulted in 40 per cent fewer injections needed by glaucoma patients to prevent scarring after surgery.
This also means fewer hospital visits for these patients in future.

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Brain discovery sheds light on link between vision and emotion

Staff Researcher

Neuroscientists have discovered a new area of the brain that is uniquely specialised for peripheral vision and could be targeted in future treatments for panic disorders and Alzheimer’s disease.
Published today in high impact journal Current Biology, researchers led by Dr Hsin-Hao Yu and Professor Marcello Rosa from Monash University’s Department of Physiology found that a brain area, known as prostriata, was specialised in detecting fast-moving objects in peripheral vision.

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Chronic pain distorts sufferers’ sense of space and time

Staff Researcher

Einstein’s famous theory of relativity proposed that matter can distort space and time. Now a new study recently published in the journal Neurology suggests that chronic pain can have the same effect.
Neuroscientists from the University of South Australia, Neuroscience Research Australia and the University of Milano Bicocca in Italy, studied people with chronic back pain, the most common painful condition which costs western countries billions of dollars in lost productivity every year.

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Diabetes risk for elderly couch potatoes in Australia

Staff Researcher

Australians aged 60 and over spend more time watching TV than other adults and are at greater risk of developing type 2 diabetes, a new study from The University of Queensland has found.
The study of almost 2,000 elderly Australians found that over 60s watch TV for an average of nearly four hours a day, about an hour longer than younger adults.

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Kids who play interactive video games have better motor skills

Staff Researcher

Deakin University health researchers have found pre-schoolers who play interactive video games, such as Wii, have better motor skills.
The researchers, in collaboration with a colleague from the University of Wollongong, conducted a pilot study of 53 pre-schoolers to see if there was an association between playing electronic games and the children’s fundamental movement skills.
The results showed that object control motor skills, such as kicking, catching, throwing a ball, were better in the children who played interactive games.

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Patient Aggression Linked to Increase in Dispensing Errors

Neil Johnston

Editor’s Note: We noticed the news item below published in Pharmacy News as a rewrite from the International Journal of Pharmacy Practice.
It highlights the fact that dispensing pharmacists are coming under progressive and increasing pressure to do “more with less”, a strategy that government bureaucracy has been inflicting on pharmacy for some years.
The “dead hand” of government always plays out so that whatever program they are involved with never has sufficient funds to make it work properly.
What is inflicted upon pharmacy owners is passed along the food chain so that a systemic “pressure cooker” evolves and pharmacists, and their assistants, begin to buckle under the strain.
It is significant that the only comment posted for this article was from Kay Dunkley of the Pharmacist Support Service who is also a writer for i2P.
As usual, we asked Mark Coleman to comment and expand on the wider aspects of this increasing problem.
His views appear below the media item:

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