User testing to examine patient understanding of pharmacy generated medication labels.

OBJECTIVE: To examine patients' and carers' understanding of pharmacy generated medication labels. METHODS: A user testing questionnaire was conducted individually for 80 participants at 2 hospitals through a face-to face semi-structured interview. Pharmacy generated medication labels from different locations were grouped based on components into 4 different variations. Participants were asked to read and demonstrate understanding of the dose and frequency from 1 of the 4 variations for 4 prescription medications. Twenty participants for each variation were recruited so that demographic characteristics matched between variations. RESULTS: Overall, only 45% of participants were able to correctly understand the dose and frequency presented on all the pharmacy labels presented on medications. Medication labels with standardised timing performed better than other variations with 91% of participants able to determine the correct frequency. The use of numeric figures was understood by 80-90% of participants compared to the use of capitalised text (65-70%). Pharmacy generated medication labels that proposed one step were better understood than instructions that incorporated several steps. CONCLUSION/PRACTICE IMPLICATIONS: The study supports the use of simple, clear and explicit written instructions along with the use of numeric figures in pharmacy generated medication labels to achieve higher understandability in patients.

Hydration, volume changes and nuclear magnetic resonance proton relaxation times of HeLa S-3 cells in M-phase and the subsequent cell cycle.

Most mitotic HeLa cells divided into two daughter cells with half the volume of the parent; no additional reduction in volume was detectable during late telophase or the early part of G1. Synchronous growth throughout the next generation cycle was exponential, without an additional and sudden rise in volume being detectable as cells entered M-phase. Since the wet weight/dry weight ratio and the protein per unit mass of cells remained constant throughout the cycle, measurements based on volume changes accurately reflected growth parameters and cell water content. Nuclear magnetic resonance (n.m.r.) t1 (spin-lattice) proton relaxation times for intracellular water for M-phase cells measured at both 32 MHz (25 degrees C) and 80 MHz (37 degrees C) in a Bruker spectrometer had the same values as normal interphase cells. Furthermore, cells arrested in metaphase by nitrous oxide or alkaloids gave the same t1 values. Artificial manipulation of cell hydration by adjustment of the tonicity of the external medium led to t1 values that correlated well with the level of intracellular water. On this basis, a 40% increase in hydration raised t1 values by a factor of 1.29 at 32 MHz and 1.5 at 80 MHz. This is considerably less than the increase by a factor of 1.9 in t1 time reported with the 40% rise in cell water accompanying mitosis, measured at 30 MHz and 25 degrees C under isotonic conditions by others. The protein-synthesizing ability of hydrated cells was reduced to only half the normal level after a doubling of intracellular water. The data from these several different analyses, taken together, strongly indicate that the water content of mitotic cells is very similar to that of interphase cells, and that certain features unique to the mitotic phase of the cell cycle cannot be ascribed to an elevated (free) water content.

Cigarette smoker's bronchitis: the effect of relighting.

Male volunteers for mass radiography examination aged 40 or more were questioned about their sputum production, smoking habits, and, when applicable, their method of smoking cigarettes.Of 5,438 cigarette smokers 1,051 (19%) claimed that when smoking a cigarette they usually extinguished it at some stage and later relit it to smoke again. Anyone who admitted to producing sputum from his chest on most days of the year or on most days for a minimum of three months of the year for at least the last two years was classed, in the absence of other causative disease, as a chronic bronchitic. Such chronic bronchitics totalled 1,864 (34%).The rate of chronic bronchitis among relighters (39.7%) was higher than the rate (32.9%) among the remaining cigarette smokers. The difference was of high statistical significance (P<0.001), and the same pattern was maintained when age and consumption were standardized. After allowing for a trend towards lower social class and a preference for plain as opposed to filter cigarettes the rate of chronic bronchitis among relighters was about 15% greater than that of the remaining cigarette smokers.

Chronic bronchitis: method of cigarette smoking.

Male volunteers for mass radiography examination, aged 40 or more, were questioned about their sputum production, smoking habits, and, when applicable, their method of smoking cigarettes.Of 5,438 cigarette smokers 460 (8.4%) smoked their cigarettes without removing the cigarette from the mouth between puffs ("drooping" cigarette smokers) whereas the rest smoked in the normal manner.Persons who admitted to producing sputum from their chests on most days of the year or on most days for at least three months of the year for a minimum of two years were classified as chronic bronchitics in the absence of other causative disease.The rate of chronic bronchitis among the "drooping" cigarette smokers (41.5%) was considerably greater than that among those smoking cigarettes in the normal manner (33.6%). The same pattern was maintained when age and cigarette consumption were standardized, though "drooping" cigarette smokers had a slight bias towards plain as distinct from filter cigarettes and towards a lower social class this was not sufficient to account for the excess of chronic bronchitis among those using this method of smoking.

Phlegm and filters.

Male mass radiography volunteers aged 40 or more were questioned about their sputum production and cigarette consumption in relation to type (filter or plain) smoked. Of 10,414 volunteers, 3,045 smoked filter cigarettes and 2,393 smoked plain cigarettes. The rate of persistent daily sputum of filter smokers (31.9%) was significantly lower than that of plain cigarette smokers (37.2%). A similar pattern was maintained when age and cigarette consumption were standardized. These figures are thought to understate the less injurious nature of filter cigarettes, since more than half of the filter smokers with persistent sputum developed this while previously smoking plain cigarettes.Whatever the reasons for the less injurious nature of filter cigarettes, it seems that cigarette smokers unable to stop smoking might suffer less from chronic bronchitis if they changed to filter cigarettes.

Smoking, chronic bronchitis, and lung cancer.

A follow-up was carried out on 21,579 male mass radiography volunteers aged at least 40 who had been the subject of an earlier investigation in which their smoking habits and sputum production were recorded and the prevalence of lung cancer was determined after chest x-ray examination. During the follow-up period, which was a minimum of 36 months and a maximum of 56 months, 64 new cases of lung cancer were identified by cross checking records with the registers of the regional cancer registration bureau. A significantly higher incidence of lung cancer was found in those with chronic bronchitis than in those without this disease. In the smoking categories, cigarette smokers with chronic bronchitis had a higher incidence than those without it, and this relationship was maintained irrespective of age and amount smoked. It is concluded that persons who smoke run a higher risk of chronic bronchitis than non-smokers and those who develop bronchitis run a higher risk of developing lung cancer.