Down But Not Out: Vasectomy Is Faring Poorly Almost Everywhere-We Can Do Better To Make It A True Method Option.

INTRODUCTION: Demand for vasectomy-1 of 2 contraceptive methods for men-has been low, with deep-seated myths, misconceptions, and provider bias against it widespread. Programmatic attention and donor funding have been limited and sporadic. METHODS: We analyzed vasectomy use in 84 low- and middle-income countries (LMICs) plus the 11 high-income countries with vasectomy prevalence above 1%. These 95 countries comprise 90% of the world's population. Data come from United Nations survey compilations, population estimates, and gender inequality rankings. We also reviewed recent articles on vasectomy and analyses of chronic challenges to vasectomy service provision. RESULTS: Vasectomy use is 61% lower now than 2 decades ago. Of 922 million women using contraception worldwide, 17 million rely on vasectomy-27 million fewer than in 2001. In contrast, 219 million women use tubectomy-8 million more than in 2001. Of 84 LMICs, 7 report vasectomy prevalence above 2%. In 56 LMICs, no more than 1 in 1,000 women relies on vasectomy. Female-to-male disparities in permanent method use widened globally, from 5:1 to 13:1, and are much higher in some regions and countries (e.g., 76:1 in India). Countries with the highest vasectomy prevalence are among those with the highest gender equality and vice versa. CONCLUSION: Vasectomy use is surprisingly low globally and declining. Use remains negligible in almost all LMICs, reflecting low demand and program priority. For vasectomy to become an accessible, rights-based option, program efforts need to be holistic, ensuring an enabling environment while coordinating demand- and service-focused efforts. Vasectomy champions at all levels should be supported on a sustained basis. On the demand side, harnessing mass and social media to increase accurate knowledge and normalize vasectomy as a method and service will be particularly valuable. Evidence from Bolivia suggests relatively few trained providers and procedures could result in a country's attaining 1% vasectomy prevalence.

Credentialing of pharmacy technicians in the USA.

OBJECTIVE: This review will compare the USA and UK regarding pharmacy technicians' roles, it will summarize the current roles and responsibilities of pharmacy technicians in the USA, public perception of pharmacy technicians, pharmacy organizations' perspectives on pharmacy technician credentialing, academic programmes for pharmacy technicians, accreditation of pharmacy technician programmes, pharmacy technician certification exams and differing perspectives on the push for standardized technician training. It will conclude with observations regarding the importance of standardized pharmacy technician training. METHODS: Articles were identified via searches of PubMed and IPA from inception to November 2010 related to credentialing of pharmacy technicians. Search terms included pharmacy technician, pharmacy technician certification, pharmacy registration, technician education and technician requirements. Articles describing the roles and responsibilities of a technician, public perception of technicians, demographics, certification processes and the future of technician roles were included. An Internet search was also performed to identify articles in the lay press related to this topic. KEY FINDINGS: Providing a pharmacy technician with proper training and education is necessary for operating a successful pharmacy. In the USA, mandating a national standardized training programme is the source of the debate. Current rules and regulations regarding the training and education needed for a pharmacy technician vary from state to state in the USA. Attitudes of technicians towards standardized training may be difficult to change. CONCLUSION: This paper provides a review of pharmacy technicians' roles and responsibilities across different pharmacy settings. Although the literature provides some insight, more studies are needed to assess the value and impact of the knowledge and skills possessed by certified pharmacy technicians with standardized training compared with technicians with site-specific or limited training.

Changing incidence of methicillin-resistant staphylococcus aureus skin abscesses in a pediatric emergency department.

OBJECTIVES: The primary objective of this study was to determine the etiology of skin abscesses in a pediatric emergency department (ED) during a 4-year period and to determine whether the incidence of methicillin-resistant Staphylococcus aureus (MRSA) skin abscesses has increased. The secondary objective was to characterize MRSA infections by antibiotic susceptibility during the same period. METHODS: A retrospective chart review examining all cases of skin abscess requiring an incision and drainage seen in a free-standing children's hospital ED from January 1, 2003, to December 30, 2006, was performed. Demographic and clinical data were abstracted from the medical records. Culture results, including sensitivities to antibiotics, were obtained to identify how many of these patients had MRSA. RESULTS: The charts of 442 children were analyzed, and 274 (62%) had MRSA isolated during the entire study period. In 2003, 36.2% of all drained abscesses were caused by MRSA, and by 2006, this increased to 66.5% (P < 0.001). Methicillin-resistant S. aureus isolates were sensitive to trimethoprim-sulfamethoxazole in 99% of the cases, but the sensitivity of MRSA to clindamycin decreased from 96% in 2003 to 87% by 2006. All isolates remain sensitive to rifampin, vancomycin, and gentamicin. CONCLUSIONS: The incidence of MRSA skin abscesses has increased in the pediatric ED population and now accounts for greater than 50% of all abscesses. If antimicrobial therapy is indicated for the treatment of these abscesses, cultures should be obtained, and antibiotics should be chosen to provide MRSA coverage.

A high-throughput Arabidopsis reverse genetics system.

A collection of Arabidopsis lines with T-DNA insertions in known sites was generated to increase the efficiency of functional genomics. A high-throughput modified thermal asymmetric interlaced (TAIL)-PCR protocol was developed and used to amplify DNA fragments flanking the T-DNA left borders from approximately 100000 transformed lines. A total of 85108 TAIL-PCR products from 52964 T-DNA lines were sequenced and compared with the Arabidopsis genome to determine the positions of T-DNAs in each line. Predicted T-DNA insertion sites, when mapped, showed a bias against predicted coding sequences. Predicted insertion mutations in genes of interest can be identified using Arabidopsis Gene Index name searches or by BLAST (Basic Local Alignment Search Tool) search. Insertions can be confirmed by simple PCR assays on individual lines. Predicted insertions were confirmed in 257 of 340 lines tested (76%). This resource has been named SAIL (Syngenta Arabidopsis Insertion Library) and is available to the scientific community at www.tmri.org.