Overview of surface measurements and spatial characterization of submicrometer particulate matter during the DISCOVER-AQ 2013 campaign in Houston, TX

The sources of submicrometer particulate matter (PM₁) remain poorly characterized in the industrialized city of Houston, TX. A mobile sampling approach was used to characterize PM₁ composition and concentration across Houston based on high-time-resolution measurements of nonrefractory PM₁ and trace gases during the DISCOVER-AQ Texas 2013 campaign. Two pollution zones with marked differences in PM₁ levels, character, and dynamics were established based on cluster analysis of organic aerosol mass loadings sampled at 16 sites. The highest PM₁ mass concentrations (average 11.6 ± 5.7 µg/m³) were observed to the northwest of Houston (zone 1), dominated by secondary organic aerosol (SOA) mass likely driven by nighttime biogenic organonitrate formation. Zone 2, an industrial/urban area south/east of Houston, exhibited lower concentrations of PM₁ (average 4.4 ± 3.3 µg/m³), significant organic aerosol (OA) aging, and evidence of primary sulfate emissions. Diurnal patterns and backward-trajectory analyses enable the classification of airmass clusters characterized by distinct PM sources: biogenic SOA, photochemical aged SOA, and primary sulfate emissions from the Houston Ship Channel. Principal component analysis (PCA) indicates that secondary biogenic organonitrates primarily related with monoterpenes are predominant in zone 1 (accounting for 34% of the variability in the data set). The relevance of photochemical processes and industrial and traffic emission sources in zone 2 also is highlighted by PCA, which identifies three factors related with these processes/sources (~50% of the aerosol/trace gas concentration variability). PCA reveals a relatively minor contribution of isoprene to SOA formation in zone 1 and the absence of isoprene-derived aerosol in zone 2. The relevance of industrial amine emissions and the likely contribution of chloride-displaced sea salt aerosol to the observed variability in pollution levels in zone 2 also are captured by PCA.

IMPLICATIONS

This article describes an urban-scale mobile study to characterize spatial variations in submicrometer particulate matter (PM₁) in greater Houston. The data set indicates substantial spatial variations in PM₁ sources/chemistry and elucidates the importance of photochemistry and nighttime oxidant chemistry in producing secondary PM₁. These results emphasize the potential benefits of effective control strategies throughout the region, not only to reduce primary emissions of PM₁ from automobiles and industry but also to reduce the emissions of important secondary PM₁ precursors, including sulfur oxides, nitrogen oxides, ammonia, and volatile organic compounds. Such efforts also could aid in efforts to reduce mixing ratios of ozone.

Medication therapy management services in North Carolina community pharmacies: current practice patterns and projected demand

OBJECTIVE

To evaluate the types of cognitive services offered and the number of patients being served in community pharmacies, determine the number of pharmacies that plan to offer medication therapy management (MTM) services under the Medicare Part D prescription drug benefit, and assess whether current and expected practices will meet the potential needs of enrollees.

DESIGN

Cross-sectional study.

SETTING

North Carolina in January 2005.

PARTICIPANTS

1,593 community pharmacy managers.

INTERVENTIONS

Survey using a Web-based tool.

MAIN OUTCOME MEASURES

Provision of cognitive services and number of patients for whom services are provided.

RESULTS

A total of 262 (16%) pharmacy managers provided usable responses. Approximately 42% of respondents (n = 110) indicated that they provide some type of cognitive service. Comprehensive MTM services, or services consistent with the professionwide consensus definition, were provided by 31% of respondents (n = 81). Independent pharmacies were more likely to offer some type of service compared with chain pharmacies (58% versus 31%, respectively; P < .001). Pharmacy managers with a doctor of pharmacy degree were less likely than pharmacy managers with a bachelor's degree to offer services in their pharmacies (P = .02), and pharmacies with pharmacists on staff who had received certificate training were more likely to offer cognitive services (P = .03). Of all respondents, 28% (n = 73) indicated that they planned to offer MTM services under the Medicare Part D prescription drug benefit.

CONCLUSION

Comparing these results with those of a 1999 survey of North Carolina pharmacists that used some of the same items, the percentage of community pharmacies that provide cognitive services has increased in the intervening years but remains low. Among the services being offered in 2005, most were focused on patient education and training, coordinating and integrating care, and medication regimen reviews. Implementation of MTM services under the Medicare Part D prescription drug benefit should hasten the development and offering of these services in community pharmacies.

Pharmacokinetics and suggested oral dosing regimen of cisapride: a study in healthy cats

The disposition of cisapride in seven healthy cats was determined following administration of either a single oral (2 mg/kg body weight) or intravenous (i.v.) (1 mg/kg body weight) dose. Cats were studied using a random crossover design. After administration of the oral capsule, maximum plasma drug concentration (Cmax) +/- standard deviation (SD) was 73.32 +/- 16.59 ng/ml, and bioavailability +/- SD was 29.0 +/- 22.6%. Following i.v. administration, extrapolated peak cisapride concentration (C0) +/- SD was 421.30 +/- 155.37 ng/ml, and clearance +/- SD was 15 +/- 0.67 ml/kg per minute. Elimination half-life (T1/2) was similar for both routes of administration (T1/2(oral) +/- SD was 5.27 +/- 3.16 hr, T1/2(i.v.) +/- SD was 5.19 +/- 3.77 hr). Adverse effects were not observed. Based on these results, a dose of 1 mg/kg body weight per os (PO) every eight hours or 1.5 mg/kg body weight every 12 hours is expected to result in plasma drug concentrations within the therapeutic ranges established for humans.

Analysis of health education sections of health systems plans

Health Systems Agencies are required by federal guidelines to plan for and provide educational opportunities for residents of their health service areas. A study was conducted of 9 health education components of health systems plans developed by HSAs in Region III. The health education plans were analyzed and scored using the "Health Education Plan Scorecard" developed by Sullivan and adapted by the present authors. Specifically this modified scorecard consists of eight dimensions of the health education planning process: Involvement, Principles and Practice of Health Education, Defining Problems, Setting Goals and Objectives, Recommending Actions, Obtaining Resources, Planning for Implementation, and Planning for Evaluation. Ratings were generally higher on the first five dimensions of the scorecard. The last three dimensions produced lower scores. The overall average score was 41 points out of a possible 100. Thus indicating the general overall low scores received by the plans. The paper includes 18 recommendations to HSAs for improving the quality of health education plans. A key recommendation is that the Health Education Plan Scorecard should be used as a guide and check list during the plan development process.