Compressed Natural Gas (CNG) as Transportation Fuel

Packed Natural Gas (CNG) as Transportation Fuel Utilization of packed petroleum gas, or CNG, as an elective vehicle fuel is developing in essentialness with numerous city-claimed armadas changing over to the fuel. Despite the fact that not inexhaustible, CNG still holds a few focal points over other non-renewable energy sources, for example, oil. Here are five fast takeaways to assist you with understanding the utilization of CNG as a transportation fuel. The Safety of Compressed Natural Gas One of the principal examines raised concerning the utilization of CNG in vehicles is security. Perhaps this is a direct result of its covertness persona as an unscented, dismal gas, yet petroleum gas will in general strike dread into individuals over concerns of blast or related disasters. However, packed gaseous petrol has really developed in fame since it is seen, by the individuals who really know the realities, as a sheltered fuel decision. Truth be told, its not very difficult to perceive any reason why CNG is really viewed as more secure than gas. Gaseous petrol is lighter than air, so a spill wont puddle the manner in which gas will nor will it sink near the ground like propane. Rather, CNG ascends into the air and afterward disperses in the air. Moreover, CNG has a higher start temperature. At the end of the day, its harder to touch off. At last, CNG stockpiling frameworks are a lot more grounded than the run of the mill fuel tank found on a vehicle or truck. Where CNG Comes From So where does CNG originate from? The appropriate response lies far below your feet since petroleum gas is a natural compound, saved profound inside the earth. Albeit thought about an elective fuel, in contrast to a considerable lot of its partners, flammable gas is a petroleum derivative and is basically methane contained hydrogen and carbon. It is evaluated that there are sufficient reachable stores of gaseous petrol underneath the Earths surface to keep going long after stores of oil have been exhausted, however the gracefully isn't unending by any stretch. What's more, there is contention over the ecological effect of fracking, the technique used to arrive at flammable gas stores lying further under the Earths surface. Utilizing Natural Gas For Vehicles The way toward permitting gaseous petrol to be utilized by a vehicle starts with flammable gas being compacted and entering the vehicle through the petroleum gas allocator or other filling implies. From that point, it goes legitimately into high-pressure chambers found some place on the vehicle. At the point when the vehicle is quickened, CNG leaves this on-board stockpiling chamber, goes along the fuel line and afterward enter the motor compartment where it enters the controller which decreases the weight from as high as 3,600 psi down to climatic weight. A petroleum gas solenoid valve empowers flammable gas to move from the controller into the gas blender or fuel injectors. Blended in with air, gaseous petrol streams on through the carburetor or the fuel infusion framework and from that point, enters the motors ignition chambers. Packed Natural Gas Vehicles Albeit more than 25 automakers produce almost 100 models of gaseous petrol vehicles and motors for the U.S. advertise, the main CNG vehicle accessible for individual buyer use is made by Honda. CNGs showcase in the U.S. has been fundamentally for travel transports, where more than 10,000 are as of now utilized in the nation. Its evaluated that one of every five transports at present on request are CNG vehicles. In any case, numbers somewhere else around the globe are a lot of high with an expected 7.5 million flammable gas vehicles on the avenues all inclusive. That is twice what there was as of late as 2003. Its anticipated that by 2020, in excess of 65 million NGVs will be being used around the world. CNG is Cost Effective CNG is likewise financially alluring. The U.S. Division of Energy has detailed that the normal across the nation cost of a gallon of gas likeness CNG was as low as $2.04 per gallon as of late. Costs are even lower in certain territories of the nation. Nearby and state governments have detailed having their fuel charges cut down the middle by expanding the utilization of flammable gas vehicles.

Development a brain controlled prosthetic hand Research Paper

Advancement a mind controlled prosthetic hand - Research Paper Example The recorded mind signals are then used to control a physical or virtual gadget that completes an assignment as per the client's expectation. The initial step we took when structuring the prosthetic hand was to choose the best control system for finger development. The objective for our plan was to limit the quantity of actuators important to control the development of the finger and streamline the conditions expected to portray the movement of the finger. The main proposition, which was the pressure controlled model, comprised of the three joints of the finger, with a link appended to a fixed point on each connection of the finger which was run back through the finger to an actuator component at the hand or behind the wrist. For this model, each joint would have an agreeable system which constrained the resting condition of the connections to be in the bowed position. The second methodology for this structure has the grumbling instruments with the end goal that the resting state for the connections is in the fixed positions. A second plan proposition incorporated the utilization of pneumatic frameworks to drive the bowing or unyielding of the fingers. In this proposition little cylinders could be utilized to load up with either air or fluid to incite the finger. The commotion would make a similar distress for the client as non life-like prosthetics. The third proposition for the finger structure wa... In this proposition little cylinders could be utilized to load up with either air or fluid to activate the finger. The clamor would make a similar distress for the client as non life-like prosthetics. The third proposition for the finger configuration was a pulley framework to control each joint freely. Pulley's eventual set at each joint in the finger, and would be autonomously constrained by its own wire. Along these lines, when the actuator is dynamic, the fingers will twist and hold their positions. At the point when the actuator gets inert, the agreeable component would restore the fingers to their fixed positions. In the structures depicted over, a pulley at each joint in the finger would have a link folded over it only enough for it to incite the specific number of degrees of turn required at that joint. It might be conceivable to utilize flexinol instead of the engines, yet testing would should be finished to affirm that overheating doesn't happen and that temperatures of the prosthesis don't transcend the liquefying purpose of the prosthetic skin covering. One part of this structure we later fused into our last plan was the knuckle joint. This piece must be structured with the goal that it could give space to the pulley to turn just as permit the finger to pivot side to side. This piece additionally needed to take into consideration the inciting links to go through it on its way to the engines. The third, and last, way to deal with the plan of the finger utilizes a four bar system to control the development of the finger, and consistent components to move the finger back to its resting state at the straight position. In this plan, the four bar linkage is set between the two upper joints on the finger. From our primer research, we had decided the

Arthur Millar Essay Example for Free

Arthur Millar Essay In this exposition I will examine the emotional methods that Arthur Millar utilizes in his twentieth century dramatization called, A View From The Bridge. The play is set in Brooklyn during the 1940s when the Italians were moving to America to look for some kind of employment as they were poor and they expected to escape from Italy to look for some kind of employment to take care of their families in Italy. A considerable lot of these foreigners entered America Illegally. The play is about a gifted docks laborer in Brooklyn named Eddie Carbone. Eddie lives with his better half Beatrice and their niece, Catherine. Beatrices cousins named Marco and Rodolfo come to America from Italy to look for some kind of employment to take care of Marcos family in Italy, as they are extremely poor. They intend to enter illicitly. Eddie has affections for his niece Catherine that he ought not have. In the interim Catherine goes gaga for Rodolfo and Eddie loathes him since he is envious as he cherishes her and he can't stand some other man taking a gander at her and contacting her. Therefore Eddie chooses to tell the Immigration Bureau that there are unlawful settlers in his structure. In the play, Arthur Miller utilizes various emotional gadgets a significant number of which are found in the main demonstration however their importance just gets clear to the crowd in the subsequent demonstration. These sensational gadgets are: utilization of language, discourse and its sub literary implications, stage headings, characters activities, props and lighting. The primary sensational strategy I will investigate is the utilization of language in Alfieris discourse toward the beginning of the play. Mill operator has put this toward the beginning of the play to set up the crowd for what will happen later on in the play. The discourse begins to create strain in light of the fact that there are a great deal of negative and fierce words utilized. For instance, Alfieri utilizes terms, for example, Machine Gun. The impact of utilizing a term like this is to make strain for the crowd, as they presently realize that something terrible will happen later on in the play. As the play advances the crowd understand this is the main time when Alfieri utilizes negative and vicious language. So his words take on a more profound significance when the crowd understands this. I am presently going to take a gander at Eddies language in the principal demonstration. His discourse is straightforward however toward the beginning of the play his words are increasingly dynamic towards Catherine as he tells he that she is strolling wavy. Simultaneously he likewise alludes to her as a Madonna. This gives the crowd the possibility that she is unadulterated and she is a virgin and Eddie needs her to remain as she may be. Tune in, B. , shell be with a ton of handymen? What's more, mariners all over the road? This delineates Eddies affections for Catherine and it can likewise imply that he doesn't need some other men taking a gander at Catherine or wedding her. Swirls discourse changes when the cousins show up. He utilizes common laborers American informal words, for example, Yiz have a decent excursion? at the point when he asks the cousins Marco and Rodolfo about their excursion. Eddie needs to clarify that he is the man of the house and that he is in control. These articulations are possibly utilized in the primary demonstration when he is addressing Marco and Rodolfo. This assembles pressure in light of the fact that the crowd realize that Eddie is going to begin issue with Marco and Rodolfo later on.

Essay Topics For Students In USA

Essay Topics For Students In USAThere are a number of essay topics for students in universities and colleges who are studying in schools and colleges in America. These essay topics are quite different than those given in some other countries like France and India. The essay topics given to the students in USA are totally different from the topics given to students in other countries.Some of the countries give students the choice of topics for them to write on their papers. This may be like a quiz on their qualifications. The writers in USA give the students all the different topics to write on, and they might come across as quite weird. For example, in India some students are asked to write on architecture but the American students are not asked to write on architecture. The students in USA may also have to write on a variety of subjects including health and fitness and also learning.In Kerala essay topics are very interesting because they offer the students to write on their unique culture. In Kerala a student may be required to write about the history and culture of the people in the state.In the Gulf essay topics are equally interesting and more varied. The students in Gulf may be asked to write on various topics like shopping, transportation, restaurants, literature, education and sport. On the other hand students in India may have to write on the life style, national dress, art and music.In Africa essay topics are similar to the ones in Europe. However the students in Africa are given the opportunity to write on subjects related to language and culture.The main thing for the students is that they should have good English skills. These essays are going to be written at the college level and thus they need to learn proper English language skills. Essay topics given to students in the United States usually ask them to focus on their own study. The topics chosen by them are also significant.It is always important to choose the target audience for a particular essay. It is also important to know what the objective of the essay is. The student should have an idea about the topic before writing it.

Mental illness and stigma - Free Essay Example

Sample details Pages: 26 Words: 7679 Downloads: 2 Date added: 2017/06/26 Category Health Essay Type Essay any type Did you like this example? 1. Introduction 1.1 Mental illness and stigma Inequalities in health services delivery and utilization for people with mental illness has been widely documented.1 Subsequently this results in poorer outcomes for this population in regard to general health, such as circulatory diseases, mortality from natural causes, and access to interventions .2-4 Several issues have been identified as contributing to these disparities in health service access and delivery, including stigma.5-6Stigma associated with mental illness has been defined as negative attitudes formed on the basis of prejudice or misinformation that are triggered by markers of illness.1-5Illness markers include atypical behaviours, the types of medication prescribed and noticeable medication related adverse effects.5-7These markers allow for the continuation of stigma concerning people with mental illness, but they also allow community pharmacists to identify patients with a broad range of what are often unaddressed health related needs.1 Behavioural and mental disord ers are estimated to account for 12% of the global burden of diseases. Mental health related medications account for 10% of all medications prescribed by general medical practitioners8, therefore, it is an inescapable fact that community pharmacists must interact with patients suffering from mental health problems.9 Mental illness is relevant to practising pharmacists who can play vital roles in the treatment of patients with mental illness.10 Throughout the latter half of the previous century, the diagnosis and pharmacological treatment of mental illness improved radically.9 1990-2000 was proclaimed the à ¯Ã‚ ¿Ã‚ ½Decade of the Brain. Don’t waste time! Our writers will create an original "Mental illness and stigma" essay for you Create order to promote the study of disorders of the brain, including mental illnesses.11 Despite these advances, the stigma associated with mental illness remains a compelling negative feature in society.10 Unfortunately health care professionals, including pharmacists are not invulnerable to such harmful attitudes.9 Pharmacists attitudes toward mental illness and the mentally ill are extremely important because they can affect their professional interactions and clinical decisions.12-13 In addition, they could ultimately affect the delivery of pharmaceutical care which has been defined as the pharmacist assuming the responsibility for positive patient outcomes.14 Activities like medication counselling and monitoring of therapy have been documented to improve both satisfaction and adherence to drug therapy in patients with mental illness.15 It has been pointed out that pharmacists must become more involved in such activities for patients with mental illness.9 1.2 Optimising the use of medications for mental illness Community care offers many advantages over institutional care; however, it can place extra demands on family, friends and primary health care practitioners.16 Health professionals have identified people with mental illness as the most challenging patients to manage.8 The quality and accessibility of community care for people with mental illness needs to be improved.17 The appropriate use of medicines plays an imperative role in the effective management of mental illness, nonetheless, there is evidence that psychotropic medicines are often used inappropriately.18-19 Elderly people are especially susceptible to the effects of psychotropic medicines, and may experience adverse effects such as cardio toxicity, confusion and unwanted sedation .8 Contributing factors to the high rates of non-compliance to psychotropic medicines include, psychosocial problems, the emergence of side effects, and the delayed onset of action of anti-depressant medication.20-21 Medical co-morbidity is also co mmon, and polypharmacy increases the risk of medication misuse and drug-drug interactions.22 The World Health Organisation (WHO) has indicated that the inclusion of pharmacists as active members of the health care team can improve psychotropic medication use.23 The benefits of dynamically engaging mental health service users in their own management is supported by both clinical experience and research evidence.24 A systemic review of the role of pharmacists in mental health care, published in 2003, concluded that pharmacists can bring about improvements in the safe and effective use of psychiatric medicines.23 The wide range of pharmaceutical services provided by community pharmacists are potentially well suited to assisting patients and prescribers optimise the use of medications for mental illness.8 2. Method 2.1 Literature search strategy Pubmed (1965-March 2010), International Pharmaceutical Abstracts (1970-March 2010), Embase (1974-March 2010), Cinahl (1981-March 2010) and Psychinfo (1972-March 2010) were searched using text words and MeSH headings including: community pharmacist.s, pharmacist.s, pharmaceutical care, pharmaceutical services, mental illness, mental disorders, stigma and mental illness, mentally ill persons, depression, schizophrenia, bipolar disorder, psychotic disorders, psychotropic drugs, antidepressive agents, benzodiazepines, anxiety agents and antipsychotic agents. ~550 abstracts were read. Reference lists of retrieved articles were checked for any additional relevant published material. Exclusion criteria included articles not published in English, no service provided by pharmacists, not relevant to mental illness, and studies and surveys that were carried out to evaluate pharmacist.s services in hospital inpatient or acute care settings. The literature search identified 88 papers that repor ted or discussed community pharmacist.s involvement in the care of patients with mental illness. 2.2 Inclusion criteria and review procedure For section 3.1 of the discussion, studies and surveys conducted into the attitudes of community pharmacists toward mental illness and the impact of stigma were considered. The literature review procedure for section 3.2 of the discussion, which deals with optimising the use of medication for mental illness, differed from that of 3.1, as studies without control groups, results of postal surveys and qualitative interviews were excluded. Studies with a parallel control group that reported the provision of services by community pharmacists in community and residential aged care facilities were considered. This included trials specifically conducted for individuals with a mental illness, and studies of medication reviews and education initiatives to optimise the use of medication for mental illness. Papers that reported pharmacist.s interventions in nursing homes were included, because community pharmacists frequently provide services to nursing homes. Studies of pharmacist.s activitie s as part of multi-disciplinary teams were also included. The literature search identified 57 papers that reported or discussed community pharmacy services to optimise the use of medications for mental illness. 3. Discussion 3.1 Mental illness and stigma While the views of the public9 and of certain health care professionals25 and health care students26-28 toward mental illness have been well documented over the years, there are limited numbers of investigations accessing community pharmacists and pharmacy student.s attitudes. Crimson et al.12 examined the attitudes of 250 baccalaureate pharmacy students toward mental illness, Phokeo et al.29 studied the outlook of 283 community pharmacists toward users of psychiatric medication, Cates et al.9 detailed the attitudes of community pharmacists toward both mental illness and the provision of pharmaceutical care to patients with mental illness, and Black et al.1 studied the satisfaction that patients with mental illness have with services provided by community pharmacists. 3.1.1 Community pharmacist.s attitudes toward patients with mental illness In general, pharmacists express positive, unprejudiced attitudes toward mental illness,1, 9, 29, 30 and overall they show encouraging attitudes toward the provision of pharmaceutical care.9 Phokeo et al.29 reported that pharmacists feel uncomfortable inquiring about a patient.s use of psychiatric medication and discussing symptoms of mental illness compared to the medication and symptoms associated with cardiovascular problems. Pharmacists also monitor patients with mental disorders for compliance and adverse effects less frequently than patients with cardiovascular problems. Crimson et al.12 found an association between a personal or family history of mental illness and attitudes of pharmacists toward mental illness. Age and years in practice are also connected with attitudes toward providing pharmaceutical care to patients with mental illness. The older and more experienced pharmacists have more encouraging responses than their counterparts.9Pharmacists are of the opinion, howeve r, that patients with mental illness do not receive adequate information about their medication from their physicians. These patients may also receive less attention from pharmacists compared to medically ill patients, which raises concerns that their drug-related needs are not being met.29 3.1.2 Patient.s attitudes toward community pharmacists Consumers of mental health services generally have a positive perception of community pharmacists and their services, however, expectations are limited to standard pharmacy services, like providing patients with information about their medication and resolving prescription issues when dispensing medications.29 The majority of patients feel at ease while discussing their psychotropic medication and related illnesses with pharmacists.31 Clinically orientated services like working collaboratively with other health care providers, making dosing or treatment recommendations, monitoring response to treatment, and addressing the individuals physical and mental health needs have been found to be unavailable to patients.32 Patients with mental health problems, expectations of community pharmacists are low, and do not match the services that they can provide.33 Although stigma has been perceived to be similar with other health care professional, Black et al.1 revealed that 25% of patients wi th mental illness have experienced stigma at community pharmacies. 3.1.3 Substance misuse The prevalence of coexisting substance misuse and mental illness (dual diagnosis) has increased over the past decade, and the indications are that it will continue to do so.15 A patient with both a mental illness and a substance misuse problem can face prejudice and stigma from health care professionals, who might question the capacity of dually diagnosed individuals to respond to care.34 A Canadian survey into the attitudes of community pharmacist.s toward mental illness showed that only 55% of respondents agreed that substance misuse is a mental health problem. This finding reflects the perception that addiction represents poor self control or is a self inflicted problem.29 Over recent years, the capacity to intervene pharmacologically in substance misuse has increased greatly, pharmacotherapy is now available for opiate, alcohol and nicotine misuse.19 Some psychiatric patients with comorbid substance abuse achieve stabilisation rapidly, furthermore, severe mental illness does no t necessarily predict worse outcomes.35 Socio-economic and emotional aspects are the main challenges to recovery, and case management in the context of integrated community and residential services has been shown to increase medication compliance over time.36 The contribution that community pharmacists have in the management of substance abuse has been well documented.37 Most general psychiatrists are only in the position to give patients 5-10 minutes of brief advise or intervention regarding a substance misuse problem,38 whereas community pharmacist.s are easily accessible to the public and are in a central position to provide specific advice about substance misuse.37 Community pharmacists currently provide dispensing services to drug addicts,38 and they are also the first point of contact for people misusing substances who are not in touch with the substance misuse services.39 3.1.4 Overcoming the barriers created by stigma Studies have indicated that patients prefer to go to the same pharmacy for their medication and other pharmacy needs and a significant number of patients favour to interact with the same pharmacist, which suggests that the relationship they have with their pharmacist plays an imperative role in their health and well being.1 A lack of privacy from failure to use an available private counselling room in the pharmacy contributes to patients feelings of discomfort regarding talking about their medication and their illness.31 Pharmacists are trained to educate and support patients regarding psychotropic medications, including how a drug works, monitoring for treatment response and adverse effects, and guiding patients through the process of stopping treatment, however, there are inconsistencies in the provision of these services.29 The potential for discrimination and stigma in community pharmacies has been well documented and initiatives to improve exposure of pharmacists to persons wi th mental illnesses in practice and in training has been suggested.23, 29 Pharmacists experience an increased level of discomfort in this therapeutic area as they receive inadequate undergraduate training in mental health.9 Adequate training in mental health is needed to improve the professional interactions of community pharmacists toward users of psychiatric medication.1 3.2 Optimising the use of medications for mental illness Community pharmacists are one of the primary health care providers in the community and have the opportunity to influence patient.s perception of their mental illness. Patients are far less likely to adhere to medications for mental health problems outside the hospital setting. Community pharmacists can significantly contribute to optimising medication use in mental illness through counselling, 40-42 patient education and treatment monitoring, 43-36 medication review services, 30, 47-49 pharmacotherapy meetings with general medical practitioners, 50-54 delivering services to community mental health centres and outpatient clinics,55-57 improving the transfer of information between health care settings,58-60 and being active members of community mental health teams.61-63 3.2.1 Counselling services In the Netherlands, three studies were carried out to highlight the impact of community pharmacist.s medication counselling sessions for people commencing non-tricyclic antidepressant therapy.40, 42 Intervention patients participated in three consecutive counselling sessions which lasted between 10 and 20 minutes each. They also received a take-home video that reiterated the importance of adherence. Throughout the counselling session, pharmacists informed patients about the appropriate use of their medications, which included, providing information about the benefits of taking the medication, informing patients about potential side effects, informing patients about the onset of action for antidepressant medication and explaining the crucial importance of taking their medication on a daily basis. Medication compliance was measured using an electronic pill container that recorded the time and frequency that the cover was opened.41 At the three month follow up the intervention patient s had significantly more positive attitudes compared to the controls.40 At six months greater medication compliance was observed with the intervention patients that remained in the study25 55, also apparent improvements in symptoms were noted.41 Research on adherence shows that the patient.s knowledge and beliefs about the benefits of adhering to their medication regime plays a critical role in compliance.64 Non-adherence is not an irrational act but rather a product of poor communication.65 Patient compliance to health care recommendations is more likely when communication is optimal.66 The results of these studies indicated improvements in depressive symptoms,41 more positive attitudes,40 and better compliance to their medication.42 A limitation of this method was that the same pharmacist provided counselling services to both the intervention and the control group. As the intervention studied was multifactorial, it is inconclusive whether the three face-to-face counselling sess ions or the take home video were primarily responsible for changes in drug attitude, adherence and the symptom scores.40-42 3.2.2 Patient education and treatment monitoring Four studies have reported results from pharmacist conducted patient education and treatment monitoring services for people prescribed antidepressant medications in the United States.43-46 These services involved the pharmacist taking a medication history, providing information about the prescribed antidepressant medications, and conducting telephone and face-to-face follow-ups. In two of the investigations, one of which was controled43 and the other randomised controlled, 62 medication adherence was calculated by reviewing prescription dispensing data, and reported using an intention-to-treat analysis. Both studies also demonstrated that involvement of the pharmacist was associated with a decrease in the number of visits to other primary health care providers; however, statistical significance was only achieved in one of the studies. Improved adherence to antidepressant medication was reported in both studies, 43-44 although patient satisfaction was only evident in one.44 The othe r two studies were randomised controlled.45-46 One of the studies was conducted using a self administered health survey,45 while in the other study antidepressant adherence was measured by asking patients how many times a day they took their medication in the past month. The results obtained from these investigations45-46 showed that patients who were taking their medication at the six month follow-up exhibited better antidepressant compliance and improved symptoms. However, antidepressant adherence and depression symptoms scores were similar for both the intervention and control group.46 Given the high rates of antidepressant discontinuation during the first three months of treatment, pharmacists have a potentially crucial role in providing medicines information and conducting treatment monitoring for those patients at high risk of non-compliance. Studies need to be conducted to compare outcomes of pharmacist.s treatment monitoring of people commencing antidepressant medication and other health professionals monitoring.8 An investigation into the impact of nurses treatment monitoring, also demonstrated improved medication adherence.67 3.2.3 Medication management reviews Pharmacist conducted medication management reviews are crucial in identifying potential medication related problems among people taking medications for mental illness.8 Medication review services provided by pharmacists comprise of comprehensive medication history taking, patient home interviews, medication regimen reviews, and patient education.68 A randomised controlled study of pharmacist conducted domiciliary medication reviews was carried out in the United States. The patients involved in the study were individuals living independently in the community that were identified to be at high risk of medication misadventure. The results showed a significant decline in the in the overall numbers and monthly costs of medication, however, there was no major difference in cognitive or affective functioning between the intervention and control group. The majority of patients were unwilling to follow the pharmacist.s recommendations to discontinue benzodiazepines and narcotic analgesics.4 7 The great potential of pharmacist conducted medication reviews for people with mental illness may not be limited to optimising the use of mental health medication.8 Physical health care for people with mental illness is generally less than adequate. This is caused by the tendency among health professionals to focus solely on the management of the mental illness among people with both mental and physical illnesses. Pharmacist conducted medication reviews may be a comprehensive strategy to improve medication use for both mental and physical illness.68 3.2.4 Medication management reviews in nursing homes Older people who are cared for in nursing homes are arguably the most vulnerable patient group, and the useful contribution that pharmacists can make to the care of these patients has been documented.30 Older people are particularly sensitive to the effects of medication,69 regular use of psychotropic medication is associated with an increased risk of recurrent falls,70 and also long term usage is linked with tardive dyskinesia.71 Psychotropic medication use may also be connected with an increased rate of cognitive decline in dementia.72 The beneficial effects of psychotropic medication must be balanced against extrapyramidal and other side effects.73 In 1995 it was reported that psychotropic drug use in Australian nursing homes was 59%, although this figure has fallen in recent years.74 In Ireland, 19% of older people in nursing homes were reported to be taking phenothiazines,75 however, this figure is lower now following a tightening of the licensing indications of thiordazine . In the England, a study showed that 30% of residents in nursing homes were taking antipsychotics.76 Two studies have looked at the appropriateness of psychotropic medication prescribing in the United Kingdom. In Scotland antipsychotic medication use in nursing homes is 24%, it was found that 88% of these prescriptions were inappropriate if the United States criteria for use were applied. In England, 54% of prescriptions were found to be inappropriate according to the United States criteria.77 A study conducted in Denmark suggested that behavioural problems were a determinant for the use of antipsychotics and benzodiazepines, irrespective of the psychiatric diagnosis of the resident.78 A randomised controlled study of pharmacist-led multidisciplinary initiative to optimise prescribing in 15 Swedish nursing homes was carried out. The study involved pharmacists participating in multidisciplinary team meetings with nurses and physicians at regular intervals within a 12 month period . A significant decline in the use of antipsychotics, benzodiazepines and antidepressants by 19%, 37% and 59%, respectively was observed in the intervention facilities.79 A follow-up investigation of the same intervention and control facilities three years later indicated that the intervention facilities maintained a significantly higher quality of drug use, with far fewer residents being prescribed more than three drugs that could lead to confusion, not-recommended hypnotics and combinations of interacting drugs.48 An additional randomised controlled study showed that pharmacist.s medication reviews in residential care facilities demonstrated significant reductions in the number and cost of medications prescribed. 10.2% fewer residents were administered psychoactive medications and 21.3% fewer hypnotic medications. The impact of medication reviews on mortality was also measured and a noteworthy reduction was observed.49 One study indicated that one hour per week of a pharmacist.s t ime can make a significant contribution to patient care in nursing homes. It was found that this input was well received by nursing staff and prescribers and that general medical practitioners accepted the pharmacist.s advice in 78% of cases.30 Physician.s recognition was 91% in south Manchester, where 55% of interventions resulted in treatment modifications. Community pharmacist.s in Northamptonshire analysed prescriptions of nursing home residents and provided prescribing advice to general medical practitioners. The advice was accepted in 73% of cases and it was estimated that pharmacist involvement could give a 14% reduction in the cost of prescribing.69 A randomised controlled trial in 14 nursing homes in England showed that a brief medication review reduced the quantity of medication overall with no detriment to the mental and physical functioning of the patients.58 A reduction in the use of primary and secondary care resources by pharmacist medication review services has also been shown.80 The recommendations provided by pharmacists included stopping and starting medicines, generic substitution, switching to another medicine, dose modification, changes in administration frequency, formulation change and requests for laboratory tests or nurse monitoring.30 Almost 50% of the recommendations were to stop medication and 66% of these were due to the fact that there was no indication for the drug prescribed. This suggested that medication regimes were not reviewed. Conversely, initiation of a new drug made up 8% of recommendations, which implied that indications were present but not always treated76. Pharmacists have an important part to play in multi-disciplinary health teams and they must be integrated into any proposed models of care. Nursing home residents are a vulnerable group of patients who deserve the same high-quality clinical care as people of any age living at home.30 3.2.4 Pharmacotherapy interventions to optimise prescribing Pharmacist.s educational visits to general medical practitioners have been shown to modify prescribing behaviour.54 Four studies have evaluated the impact of pharmacists educational visits to general medical practitioners to optimise the prescribing of benzodiazepines and other psychotropic medications prescribed for mental illness,50-53 two of which showed positive results.52-53 A cluster randomised controlled study carried out in the United States found that pharmacists educational visits to general medical practitioners were associated with a significant decline in the prescribing of potentially inappropriate psychotropic medications in intervention facilities.53 An Australian study of educational visits to general medical practitioners, conducted by three physicians and one pharmacist resulted in a noteworthy decline in the prescribing of benzodiazepines.52 In the Netherlands, groups of local pharmacists and general medical practitioners conduct inter-professional meetings t o optimise prescribing. These pharmacotherapy meetings are undertaken as part of routine clinical practice. A cluster randomised study of pharmacotherapy meetings to discuss prescribing of antidepressant medications resulted in a 40% reduction in the prescribing of highly anticholinergic antidepressants, compared to a control group of practitioners that did not partake in these meetings39. The possible awareness of prescribing related issues generated by asking general medical practitioners to conduct a self-audit of their prescribing caused this overall reduction.52-53 Additionally, pharmacist.s initiatives to improve prescribing are most effective when both pharmacists and general medical practitioners have an opportunity to build rapport.39 3.2.5 Community mental health centres and outpatients clinics Two studies were carried out to investigate the effect of pharmacist delivered services to community mental health centres and outpatient.s clinics.56-57 In a controlled trial, pharmacists managed patient cases in a community mental health centre in the United States. Significantly better personal adjustment scores were observed from patients receiving case management from a pharmacist in comparison to those receiving it from a nurse, social worker or psychologist.56The patients also rated themselves as healthier and were considerably less likely to seek help from other health care providers. The medication service provided allowed the pharmacist to adjust medication doses and dose timing, and prescribe or discontinue medications under supervision. The cost effectiveness of incorporating a pharmacist as part of the health care team was also measured. It was estimated that a 60% cost reduction can be achieved when medication monitoring is conducted by a pharmacists instead of a clin ic psychiatrist. The pharmacist also performed more medication monitoring of patients per month than the clinic psychiatrist and had more contact with each individual patient .56 In Malaysia, a study of patients discharged from hospital after admission for relapse of schizophrenia, who were identified as having poor medication adherence were allocated to receive pharmacist medication counselling or standard care.57 The importance of compliance to medication was also reinforced by the patient.s psychiatrists at follow up visits. At the 12 month follow-up, patients receiving counselling from a pharmacist and who were exposed to daily or twice daily medication treatments, had significantly fewer relapses that required hospitalisation than patients receiving standard care.57 3.2.6 Integrated mental health services The needs of people with recurrent, severe mental illness fluctuate over time and services must be coordinated, and be able to anticipate, prevent and respond to crisis. Integrated mental health services across primary and specialist services should promote early interaction and allow the provision of continuous care to meet patients needs.58 Prescribed medication is an important component in the successful management of mental illness. Accurate information should be transferred seamlessly between primary and secondary sectors to ensure the optimum care of these patients.59 The simple delivery of information to community pharmacists regarding drugs prescribed at discharge enables comparison with general medical practitioners prescriptions and any discrepancies can be followed up and resolved.82 Discrepancies that may occur can be described as any changes observed between supplies of prescribed drugs, including a wide spectrum of observed events.83 These can range from simple cha nges between supplies of prescribed drugs to more complex errors that might result in adverse reactions.60 This information transfer enables a cost-effective reduction in all unintentional discrepancies, including those judged to have significant adverse effects on patient care.58 An investigation that evaluated the impact of providing mental health patients with a pharmacist generated medication care plan at the time of discharge found that patients with care plans were less likely to be readmitted to hospital than those without. Information contained in the care plan included lists of discharge medications, a summary of the patient education that was provided, and the potential adverse effects that need to be assessed. Community pharmacists who received copies of the care plan were also more likely to identify medication related problems for the discharged mental health patients than those pharmacists who were not provided with copies of the care plan, however, the results from th is study are not significantly significant.57Other methods of transferring information such as electronic transfer have the potential to be of value in this patient population.84 People with mental illness have complex needs which are not recognised by organised boundaries.58When discussing discharge and after-care in the community, medication management must be prioritised.85Mentally ill patients are vulnerable and medication is a vital part of their well being. It is therefore essential that an accurate transfer of information between care settings minimises the potentially harmful discrepancies that can occur. Community pharmacist.s interaction in this area could prevent such incidents.58 3.2.7 Community mental health teams Most people with bipolar mood disorders and psychotic illnesses in the United Kingdom and Australia are managed by interdisciplinary community mental health teams (CMHTs).86 The potential benefits of greater involvement by pharmacists in CMHTs have been documented and debated for over 30 years.87-90 The majority of clinical team meetings conducted by CMHTs do not involve a pharmacist. A review of CMHTs in New South Wales found that just 1 in 5 had a designated pharmacist.91 Pharmaceutical care programs provided by pharmacists working as members of CMHTs can fulfil an important public need.32 Psychotropic medications are frequently used for unapproved indications,92-94 outside recommended dosages,95-96 and are prescribed concurrently.97-99 Adverse drug reactions to psychiatric medications include extrapyramidal side effects, weight gain, sedation, orthostatic hypotension and antcholinergic effects.32 Patients taking psychotropic medications may have higher rates of mortality, hospit alisation, and experience more adverse drug reactions.100-101 Routine monitoring for potential metabolic and cardiovascular complications of antipsychotic treatment is suboptimal.102-103 In addition, patients with mental illnesses have reported their dissatisfaction with the quantity and quality of drug information provided by their health professionals.104 Potential roles for community pharmacist.s in CMHTs in the United Kingdom have been investigated, with 7 possible pharmaceutical care roles being identified, they included, patient facilitating, instalment dispensing, domiciliary visiting, provision of medication education and advice, adherence monitoring, medication reviews, and inter-professional liaison.61 A survey of pharmacist.s interventions at 12 mental health trusts in the United Kingdom reported the detection of 579 cases of less than ideal prescribing of which 60% were clinical in nature.105 Between 35% and 81% of pharmacists recommendations for patients of CMHTs hav e been judged clinically significant by expert panels.62-63 Pharmacists participation in CMHTs could be facilitated by the formation of collaborative working relationships with community pharmacists working in the same locality as CMHTs. An Australian study into the impact of community pharmacists being active members of CMHTs was carried out, in one case the study pharmacist was also the local community pharmacist, this was perceived as a factor that contributed to the success of the collaboration. New models of pharmaceutical care proposed from focus groups comprising of psychiatrists, indicated the new level of awareness and recognition of the potential of community pharmacy services. Most of the studies conducted in this area raised the important issue of whether pharmacists should be considered as essential and legitimate members of interdisciplinary CMHTs.32 4. Conclusion Herein, I have discussed the contribution that community pharmacist.s can make to the care of patients with mental illness. The provision of community pharmacist.s services are limited by a lack of specific training to counsel this patient population, and pharmacist.s attitudes toward people with mental illness. Community pharmacist.s need to examine an address factors that can predispose, enable, and reinforce activities and behaviours associated with stigma toward people with mental illnesses in their practice setting. I believe that the wide range of pharmaceutical services provided by community pharmacist.s are potentially well suited to assisting patients and prescribers optimise the use of medications for mental illness. The review of the international literature highlights that medication counselling and treatment monitoring conducted by community pharmacist.s can improve medication adherence. Community pharmacist.s performed medication reviews and resulting recommendations to optimise medication regimens may reduce the numbers of potentially inappropriate medications for mental illness prescribed to elderly people. This review of the available published evidence supports the continued expansion of pharmaceutical service delivery to people with mental illness. I am of the opinion that, community pharmacist.s services are seriously under utilised in the mental health sector of the health system. Community pharmacists should be considered as essential and legitimate members of multi-disciplinary health and social services teams, and they must be integrated into any proposed model of care. References 1. Black, E.; Murphy, A. L.; Gardner, D. M. à ¯Ã‚ ¿Ã‚ ½Community pharmacist.s services for people with mental illnesses: preferences, satisfaction, and stigmaà ¯Ã‚ ¿Ã‚ ½. Psychiatric Services 60, (2009): 1123-1127 2. Kisley, S.; Smith, M.; Lawrence, D. à ¯Ã‚ ¿Ã‚ ½Inequitable access for mentally ill patients to some necessary proceduresà ¯Ã‚ ¿Ã‚ ½. Canadian Medical Association Journal 176, (2007): 779-784 3. Hiroech, U.; Kapur, N.; Webb, R. à ¯Ã‚ ¿Ã‚ ½Deaths from natural causes in people with mental illness: a cohort studyà ¯Ã‚ ¿Ã‚ ½. Journal of Psychosomatic Research 64, (2008): 275-283 4. Kisley, S.; Smith, M.; Lawrence, D. à ¯Ã‚ ¿Ã‚ ½Mortality in individuals who have had psychiatric treatment: population based study in Nova Scotiaà ¯Ã‚ ¿Ã‚ ½. British Journal of Psychiatry 187, (2005): 552-558 5. Schulze, B. à ¯Ã‚ ¿Ã‚ ½Stigma and mental health professionals: a review of the evidence on an intricate relationshipà ¯Ã‚ ¿Ã‚ ½. Internationa l Review of Psychiatry 19, (2007): 137-155 6. Stuber, J.; Meyer, I.; Link, B. à ¯Ã‚ ¿Ã‚ ½Sigma, prejudice, discrimination and healthà ¯Ã‚ ¿Ã‚ ½. Social Science and Medicine 67, (2008): 351-357 7. Schulze, B.; Augermeyer, M. C. à ¯Ã‚ ¿Ã‚ ½Subjective experiences of stigma: a focus group study of schizophrenic patients, their relatives and mental health professionalsà ¯Ã‚ ¿Ã‚ ½. Social Science and Medicine 56, (2003): 299-312 8. Bell, S.; McLachlan, A. J.; Aslani, P.; Whitehead, P.; Chen, T. F. à ¯Ã‚ ¿Ã‚ ½Community pharmacy services to optimise the use o medications for mental illness: a systemic reviewà ¯Ã‚ ¿Ã‚ ½. Australia and New Zealand Health Policy 70, (2005): 77-88 9. Cates, M. E.; Burton, A. R.; Woolley, T. W. à ¯Ã‚ ¿Ã‚ ½Attitudes of pharmacists toward mental illness and providing pharmaceutical care to the mentally illà ¯Ã‚ ¿Ã‚ ½. The Annals of Pharmacotherapy 39, (2005): 1450-1455 10. Hitchens, K. à ¯Ã‚ ¿Ã‚ ½The pharmacist.s role i n mental healthà ¯Ã‚ ¿Ã‚ ½. Drug Topics 14, (1997): 28-37 11. Byrne, P. à ¯Ã‚ ¿Ã‚ ½Stigma of mental health and ways of diminishing ità ¯Ã‚ ¿Ã‚ ½. Advanced Psychiatric Treatment 6, (2000): 65-72 12. Crimson, M. L.: Jermain, D. M.; Torian, S. J. à ¯Ã‚ ¿Ã‚ ½Attitudes of pharmacy students toward mental illnessà ¯Ã‚ ¿Ã‚ ½. American Journal of Hospital Pharmacy 47, (1990): 1368-1373 13. Crimson, M. L.: Jermain, D. M. à ¯Ã‚ ¿Ã‚ ½Students attitudes toward the mentally ill before and after clinical rotationsà ¯Ã‚ ¿Ã‚ ½. American Journal of Pharmacy Education 55, (1999): 45-48 14. Wells, B. G. à ¯Ã‚ ¿Ã‚ ½Under recognised and under treatment of depression: what is the pharmacist.s culpability?à ¯Ã‚ ¿Ã‚ ½ Pharmacotherapy 19, (1999): 1237-1239 15. Bultman, D. C.; Svarstad, B. L. à ¯Ã‚ ¿Ã‚ ½Effects of pharmacist monitoring on patient satisfaction with antidepressant medication therapyà ¯Ã‚ ¿Ã‚ ½. Journal of the American Pharmaceutical Association 42, (2 002): 36-43 16. Meadows, G. N. à ¯Ã‚ ¿Ã‚ ½Overcoming barriers to reintegration of patients with schizophrenia: developing a best-practice model for discharge from specialist careà ¯Ã‚ ¿Ã‚ ½. Medical Journal of Australia 178 (2003): 53-56 17. Chang, E.; Daly, J.; Bell, P.; Brown, T.; Allan, J.; Hancock, K. à ¯Ã‚ ¿Ã‚ ½A continuing educational initiative to develop nurse.s mental health knowledge and skills in rural and remote areasà ¯Ã‚ ¿Ã‚ ½. Nursing Education Today 22, (2002): 542-551 18. à ¯Ã‚ ¿Ã‚ ½Improving access and use of psychotropic medicinesà ¯Ã‚ ¿Ã‚ ½. Geneva, World Health Organisation (2004) 19. Mort, J. R.; Aparasu, R. R. à ¯Ã‚ ¿Ã‚ ½Prescribing of psychotropic.s in the elderly: Why is it so often inappropriate?à ¯Ã‚ ¿Ã‚ ½ CNS Drugs 16, (2002): 99-109 20. Lambert, M.; Conus, P.; Elde, P.; Mass, R.; Karrow, A.; Moritz, S.; Golks, D.; Naber, D. à ¯Ã‚ ¿Ã‚ ½Impact of present and past antipsychotic side effects on attitude toward typ ical antipsychotic treatment and adherenceà ¯Ã‚ ¿Ã‚ ½. European Psychiatry 19, (2004): 415-422 21. Rettenbacher, M. A.; Holder, A.; Eder, U.; Hummer, M.; Kemmier, G.; Weiss, E. M.; Fleischhacker, W. W. à ¯Ã‚ ¿Ã‚ ½Compliance in schizophrenia: psychopathology, side-effects, and patients attitudes toward the illness and medicationà ¯Ã‚ ¿Ã‚ ½. Journal of Clinical Psychiatry 65, (2004): 1211-1218 22. Lambert, T. J. R.; Velakoulis, D.; Pantelis, C. à ¯Ã‚ ¿Ã‚ ½Medical comorbidity in schizophreniaà ¯Ã‚ ¿Ã‚ ½. Medical Journal of Australia 178, (2003): 67-70 23. Finley, P. R.; Crimson, M. L.; Rush, A. J. à ¯Ã‚ ¿Ã‚ ½Evaluating the impact of pharmacists in mental health: a systemic reviewà ¯Ã‚ ¿Ã‚ ½. Pharmacotherapy 23, (2003): 1634-1644 24. Blenkiron, P.; Hong Mo, K.; Cuzen, J.; Hamill, A. C. à ¯Ã‚ ¿Ã‚ ½Involving service users in their mental health care: the CUES projectà ¯Ã‚ ¿Ã‚ ½. Psychiatric Bulletin 27, (2003): 334-338 25. Cohen, J.; Struening, E. L. à ¯Ã‚ ¿Ã‚ ½Opinions about mental illness in the personnel of two large mental hospitalsà ¯Ã‚ ¿Ã‚ ½. Journal of Abnormal Social Psychology 64, (1962): 349-360 26. Roskin, G.; Carsen, M. L.; Rabiner, C. J.; Lenon, P. A. à ¯Ã‚ ¿Ã‚ ½Attitudes toward patientsà ¯Ã‚ ¿Ã‚ ½. Journal of Psychiatric Education 10, (1986): 40-49 27. Bairan, A.; Farnsworth, B. à ¯Ã‚ ¿Ã‚ ½Attitudes toward mental illness: does a psychiatric nursing course make a difference?à ¯Ã‚ ¿Ã‚ ½ Archives of Psychiatric Nursing 3, (1989): 351- 357 28. Drolen, C. S. à ¯Ã‚ ¿Ã‚ ½The effect of educational setting on student opinions of mental illnessà ¯Ã‚ ¿Ã‚ ½. Community Mental Health 29, (1993): 223-234 29. Phokeo, V.; Sproule, B.; Raman-Wilms, L. à ¯Ã‚ ¿Ã‚ ½Community pharmacist.s attitudes toward and professional interaction with users of psychiatric medicationà ¯Ã‚ ¿Ã‚ ½. Psychiatric Services 55, (2004): 1434-1436 30. Furniss, L. à ¯Ã‚ ¿Ã‚ ½Use of medicines in nursing homes for older peopleà ¯Ã‚ ¿Ã‚ ½. Advances in Psychiatric Treatment 8, (2002): 198-204 31. Bell, J. S.; Aaltonen, S. E.; Bronstein, E. à ¯Ã‚ ¿Ã‚ ½Attitudes of pharmacy students toward people with mental disorders, a six country studyà ¯Ã‚ ¿Ã‚ ½. Pharmacy World and Science 30, (2008): 595-599 32. Bell, J. S.; Rosen, A.; Aslani, P. à ¯Ã‚ ¿Ã‚ ½Developing the roles of pharmacists as members of community mental health teams: perspectives of pharmacists and mental health professionalà ¯Ã‚ ¿Ã‚ ½. Research in Social and Administrative Pharmacy 3, (2007): 392-409 33. Bell, J. S.; Whitehead, P.; Aslami P. à ¯Ã‚ ¿Ã‚ ½Drug related problems in the community setting: pharmacist.s findings and recommendations for people with mental illnessesà ¯Ã‚ ¿Ã‚ ½. Clinical Drug Investigation 26, (2006): 415-425 34. Crawford, V.; Clancy, C.; Crome, I. B. à ¯Ã‚ ¿Ã‚ ½Co-existing problems of mental health and substance misuse (dual diagnosis): a literature reviewà ¯Ã‚ ¿Ã‚ ½. Drugs: Education, Prevention and Policy 10, (2003): 1-74 35. Hunt, G. E.; Bergin, J.; Bashir, M. à ¯Ã‚ ¿Ã‚ ½Medication compliance and comorbid substance abuse in schizophrenia: impact on community survival 4 years after a relapseà ¯Ã‚ ¿Ã‚ ½. Schizophrenia Research 54, 253-264 36. Tyrer, P.; Weaver, T. à ¯Ã‚ ¿Ã‚ ½Desperately seeking solutions: the search for appropriate treatment for comorbid substance misuse and psychosis (editorial)à ¯Ã‚ ¿Ã‚ ½. Psychiatric Bulletin 28, (2004): 1-2 37. Gath, A. à ¯Ã‚ ¿Ã‚ ½The pharmacist.s contribution to the management of substance misuseà ¯Ã‚ ¿Ã‚ ½. Psychiatric Bulletin 15, (1991): 314-315 38. Howarth, W. H. à ¯Ã‚ ¿Ã‚ ½The pharmacist.s role in misuse of medicinesà ¯Ã‚ ¿Ã‚ ½. Pharmaceutical Journal 237, (1986): 76-77 39. Cherry, P.; Tredree, R.; Streeter, H.; Brain, K. à ¯Ã‚ ¿Ã‚ ½The development of an addiction treatment serviceà ¯Ã‚ ¿Ã‚ ½. Pharmaceutical Journal 236, (1986): 329-331 40. Brook, O.; van Hout, H. P. J.; Nieuwenhuysea, H.; Heerdink, E. à ¯Ã‚ ¿Ã‚ ½Impact of coaching by community pharmacists on drug attitude of depressive primary care patients and accessibility to patients; a randomised controlled studyà ¯Ã‚ ¿Ã‚ ½. European Neuropsychopharmacology 13, (2003): 1-9 41. Brook, O. H.; van Hout, H. P. J.; Nieuwenhuysea, H.; De Haan, M. à ¯Ã‚ ¿Ã‚ ½Effects of coaching by community pharmacists on psychological symptoms of antidepressant users; a randomised controlled studyà ¯Ã‚ ¿Ã‚ ½. European Neuropsychopharmacology 13, (2003): 347-354 42. Brook, O. H.; van Hout, H. P. J.; Stalman, W.; Nieuwenhuysea, H.; Bakker, B.; Heerdink, E.; De Haan, M. à ¯Ã‚ ¿Ã‚ ½A pharmacy based coaching programto improve adherence to antidepressant treatment among primary care patientsà ¯Ã‚ ¿Ã‚ ½. Psychiatric Services 56, (2005): 487-489 43. Finley, P. R.; Rens, H. R.; Pont, J. T.; Gess, S. L.; Louie, C.; Bull, S. A.; Bero, L. A. à ¯Ã‚ ¿Ã‚ ½Impact of collaborative pharmacy practice model on the treatment of depression in primary careà ¯Ã‚ ¿Ã‚ ½. American Journal of Health-System Pharmacy 59, (2002): 1518-1526 44. Finley, P. R.; Rens, H. R.; Pont, J. T.; Gess, S. L.; Louie, C.; Bull, S. A.; Lee, J. Y.; Bero, L. A. à ¯Ã‚ ¿Ã‚ ½Impact of collaborative care model on depression in a primary care setting: a randomised controlled trialà ¯Ã‚ ¿Ã‚ ½. Pharmacotherapy 23, (2003): 1175-1185 45. Adler, D. A.; Bungay, K. M.; Wilson, I. B.; Pei, Y.; Supran, S.; Peckham, E.; Cynn, D. J.; Rogers, W. H. à ¯Ã‚ ¿Ã‚ ½The impact of a pharmacists intervention on 6-month outcomes in depressed primary care patientsà ¯Ã‚ ¿Ã‚ ½. General Hospital Psychiatry 26, (2004): 199-209 46. Capoccia, K. L.; Boudreau, D. M.; Blough, D. K.; Ellsworth, A. J.; Clark, D. R.; Stevens, N. G.; Katon, W. J.; Sullivan, S. D. à ¯Ã‚ ¿Ã‚ ½Randomised trial of pharmacist interventions to improve depression care and outcomes in primary careà ¯  ¿Ã‚ ½. American Journal of Health-System Pharmacy 61, (2004): 364-372 47. Williams, M. E.; Puliam, C. C.; Hunter, R.; Johnson, T. M.; Owens, J. E.; Kincaid, J.; Porter, C.; Koch, G. à ¯Ã‚ ¿Ã‚ ½The short-term effect of interdisciplinary medication review on function and cost in ambulatory elderly peopleà ¯Ã‚ ¿Ã‚ ½. Journal of American Geriatrics Society 52, (2004): 93-98 48. Coleman, E. A.; Grothaus, L. C.; Sandhu, N.; Wagner, E. H. à ¯Ã‚ ¿Ã‚ ½Chronic care clinics: a randomised controlled trial of a new model of primary care for frail older adultsà ¯Ã‚ ¿Ã‚ ½. Journal of American Geriatrics Society 47, (1999): 775-783 49. Roberts, M. S.; Stokes, J. A.; King, M. A.; Lynne, T. A.; Purdie, D. M.; Glaziou, P. P.; Wilson, D. A. J.; McCarthy, S. T.; Brooks, G. E.; de Looze, F. J.; Del Mar, C. B. à ¯Ã‚ ¿Ã‚ ½Outcomes of a randomised controlled trial of a clinical pharmacy intervention in 52 nursing homesà ¯Ã‚ ¿Ã‚ ½. British Journal of Pharmacology 51, (2001): 257-265 50. Hartlubb, P. P.; Barret, P. H.; Marine, W. M.; Murphy, J. R. à ¯Ã‚ ¿Ã‚ ½Evaluation of an intervention to change benzodiazepine-prescribing behaviour in a prepaid group practice settingà ¯Ã‚ ¿Ã‚ ½ American Journal of Preventative Medicine 9, (2003): 346-352 51. Crotty, M.; Whitehead, C.; Rowett, C.; Halbert, J.; Weller, W.; Finucane, P.; Esterman, A. à ¯Ã‚ ¿Ã‚ ½An outreach intervention to implement evidence best practice in residential care: a randomised controlled trialà ¯Ã‚ ¿Ã‚ ½. BMC Health Services Research 4, (2004): 6 52. de Burgh, S.; Mant, A.; Mattick, R. P.; Donnely, N.; Hall, W.; Bridges-Webb, C. à ¯Ã‚ ¿Ã‚ ½A controlled trial of educational visits to improve benzodiazepine prescribing in general practiceà ¯Ã‚ ¿Ã‚ ½. Australian Journal of Public Health 19, (1995): 142-148 53. Avorn, J.; Soumeral, S. B.; Everitt, D. E.; Ross-Degnan, D.; Beers, M. H.; Sherman, D.; Salem-Schatz, S. R.; Fields, D. à ¯Ã‚ ¿Ã‚ ½A ra ndomised controlled trial of a program to reduce the use of psychoactive drugs in nursing homesà ¯Ã‚ ¿Ã‚ ½. New England Journal of Medicine 327, (1992): 168-173 54. Thomson O.Brien, M. A.; Oxman, A. D.; Davis, D. A.; Haynes, R. B.; Freemantle, N.; Harvey, E. L. à ¯Ã‚ ¿Ã‚ ½Educational outreach visits: effects of professional practice and health outcomesà ¯Ã‚ ¿Ã‚ ½. Cochrane Database of Systemic Reviews (2005) 55. Rosen, C. E.; Holmes, S. à ¯Ã‚ ¿Ã‚ ½Pharmacist.s impact in chronic psychiatric outpatients in community mental healthà ¯Ã‚ ¿Ã‚ ½. American Journal of Hospital Pharmacy 35, (1978): 704- 708 56. Razali, M. S.; Yahya, H. à ¯Ã‚ ¿Ã‚ ½Compliance with treatment in schizophrenia: a drug intervention program in a developing countryà ¯Ã‚ ¿Ã‚ ½. Acta Psychiarica Scandinavia 91, (1995): 331-335 57. Shaw, H.; Mackie, C. A.; Sharkie, I. à ¯Ã‚ ¿Ã‚ ½Evaluation of effect of pharmacy discharge planning on medication problems experienced discharge d acute admission mental health patientsà ¯Ã‚ ¿Ã‚ ½. International Journal of Pharmacy Practice 8, (2000): 144-153 58. Morcos, S.; Francis, S, A.; Duggan, C. à ¯Ã‚ ¿Ã‚ ½Where are the weakest links? A descriptive study of discrepancies in prescribing between primary and secondary sectors of mental health provisionà ¯Ã‚ ¿Ã‚ ½. Psychiatric Bulletin 26, (2002): 371-374 59. Cochrane, R. A.; Mandel, A. R.; Ledger-Scott, M. à ¯Ã‚ ¿Ã‚ ½Changes in drug treatment after discharge from hospital in geriatric patientsà ¯Ã‚ ¿Ã‚ ½. British Medical Journal 305, (1992): 694-696 60. Lesar, T.; Briceland, L.; Stein, D. S. à ¯Ã‚ ¿Ã‚ ½Factors relating to errors in medication prescribingà ¯Ã‚ ¿Ã‚ ½. Journal of the American Medical Association 277, (1997): 312-317 61. Ewan, M.; Greene, R.; Anderson, C. à ¯Ã‚ ¿Ã‚ ½A qualitative investigation of the potential role of the community pharmacist in the care of the long term mentally illà ¯Ã‚ ¿Ã‚ ½. The Pharmaceutical Journal 261, (1998): 61-66 62. Harris, D.; Anderson, C. à ¯Ã‚ ¿Ã‚ ½Interventions of community pharmacists for older people with mental health problems: are they appropriate?à ¯Ã‚ ¿Ã‚ ½ International Journal of Pharmacy practice 11, (2003): 56-61 63. Ewan, M. A.; Greene, R. J. à ¯Ã‚ ¿Ã‚ ½Evaluation of mental health care interventions made by three community pharmacists à ¯Ã‚ ¿Ã‚ ½ a pilot studyà ¯Ã‚ ¿Ã‚ ½. International Journal of Pharmacy practice 9, (2001): 225-243 64. DiMatteo, M. R.; Reiter, R. C.; Gambone, C. à ¯Ã‚ ¿Ã‚ ½Enhancing medication adherence through communication and informed collaborative choiceà ¯Ã‚ ¿Ã‚ ½. Health Communication 6, (1994): 253-265 65. Donavan, J. L.; Blake, D. R. à ¯Ã‚ ¿Ã‚ ½Patient non-compliance: Deviance or reasoned decisioning?à ¯Ã‚ ¿Ã‚ ½ Social Science and Medicine 34, (1992): 507-513 66. Maguire, T. à ¯Ã‚ ¿Ã‚ ½Good communication à ¯Ã‚ ¿Ã‚ ½ How to get it rightà ¯Ã‚ ¿Ã‚ ½. The Pharmaceutical Journal 268, (2002): 214-216 67. Aubert, R. E.; Fulop, G.; Xia, F.; Thiel, M.; Maldonato, D.; Woo, C. à ¯Ã‚ ¿Ã‚ ½Evaluation of a depression health management program to improve outcomes in first or recurrent episode depressionà ¯Ã‚ ¿Ã‚ ½. American Journal of Managed Care 9, (2003): 374-380 68. Hocking, B. à ¯Ã‚ ¿Ã‚ ½Reducing a mental illness stigma and discrimination à ¯Ã‚ ¿Ã‚ ½ everybody.s businessà ¯Ã‚ ¿Ã‚ ½. Medical Journal of Australia 178, (2003): 47-48 69. Lindley, J.; McNair, P.; Lund, B. à ¯Ã‚ ¿Ã‚ ½Inappropriate medication is a major cause of adverse drug reactions in elderly patientsà ¯Ã‚ ¿Ã‚ ½. Age and Ageing 21, (1992): 294-300 70. Thapa, P. B.; Meador, K. G.; Gideon, P. à ¯Ã‚ ¿Ã‚ ½Effects of antipsychotic withdrawal in elderly nursing home residentsà ¯Ã‚ ¿Ã‚ ½. Journal of American Geriatric Society 42, (1994): 280-286 71. Nygaard, H. A.; Bakke, K. J.; Breivik, K. à ¯Ã‚ ¿Ã‚ ½Mental and physical capacity and consumption of neuroleptic drugs in residents of nursing homesà ¯Ã‚ ¿Ã‚ ½. International Journal of Geriatric Psychiatry 5, (1990): 303-308 72. McShane, R.; Keane, J.; Gedling, K. à ¯Ã‚ ¿Ã‚ ½Do neuroleptic drugs hasten cognitive decline in dementia? Prospective study with necropsy follow-upà ¯Ã‚ ¿Ã‚ ½. British Medical Journal 314, (1997): 266-270 73. Granek, E.; Baker, S. P.; Abbey, H. à ¯Ã‚ ¿Ã‚ ½Medications and diagnoses in relation to falls in a long-term care facilityà ¯Ã‚ ¿Ã‚ ½. Journal of the American Geriatric Society 35, (1987): 503- 511 74. Snowdon, J. à ¯Ã‚ ¿Ã‚ ½A follow-up survey of psychotropic drug use in Sydney nursing homesà ¯Ã‚ ¿Ã‚ ½. Medical journal of Australia 170, (1999): 299-301 75. Panmore, A. P.; Crawford, V. L. S.; Beringer, T. R. O. à ¯Ã‚ ¿Ã‚ ½Determinants of drug utilisation in an elderly population in north and west Belfastà ¯Ã‚ ¿Ã‚ ½. Pharmacoepidemiology and Drug Safety 4, (1995): 147-160 76. Furniss, L.; Burns, A.; Craig, S. K. L. à ƒ ¯Ã‚ ¿Ã‚ ½Effects of a pharmacist.s medication review in nursing homes. Randomised controlled trialà ¯Ã‚ ¿Ã‚ ½. British Journal of Psychiatry 176, (2000): 563-567 77. McGrath, A. M.; Jackson, G. A. à ¯Ã‚ ¿Ã‚ ½Survey of neuroleptic prescribing in residents of nursing homes in Glasgowà ¯Ã‚ ¿Ã‚ ½. British Medical Journal 312, (1996): 611-612 78. Sorensen, L.; Foldspang, A.; Gulmann, N. C. à ¯Ã‚ ¿Ã‚ ½Determinants for the use of psychotropics among nursing home residentsà ¯Ã‚ ¿Ã‚ ½. International journal of Geriatric Psychiatry 16, (2001): 147-154 79. Schmidt, I. K.; Fastborn, J. à ¯Ã‚ ¿Ã‚ ½Quality of drug use in Swedish nursing homes à ¯Ã‚ ¿Ã‚ ½ A follow-up studyà ¯Ã‚ ¿Ã‚ ½. Clinical Drug Investigation 20, (2000): 433-446 80. Hughes, C. M.; Lapane, K. L.; Mor, V. à ¯Ã‚ ¿Ã‚ ½Impact of the legislation on nursing home care in the United States: lessons for the United Kingdomà ¯Ã‚ ¿Ã‚ ½. British Medical Journal 319 (1999): 1060-1063 81. Esse x, B.; Doig, R.; Renshaw, J. à ¯Ã‚ ¿Ã‚ ½Pilot study of records of shared care for people with mental illnessesà ¯Ã‚ ¿Ã‚ ½. British Medical Journal 300, (1990): 1442-1446 82. Duggan, C.; Bates, I.; Hough, J. à ¯Ã‚ ¿Ã‚ ½Discrepancies in prescribing à ¯Ã‚ ¿Ã‚ ½ where do they occur?à ¯Ã‚ ¿Ã‚ ½ Pharmaceutical Journal 256, (1999): 65-67 83. Bates, D. W.; Cullen, D. J.; Laird, N.; à ¯Ã‚ ¿Ã‚ ½Incidence of adverse drug events and potential adverse drug events: implications for preventionà ¯Ã‚ ¿Ã‚ ½. Journal of the American Medical Association 274, (1995): 29-34 84. Young, A. à ¯Ã‚ ¿Ã‚ ½Improving information transfer from hospital to primary careà ¯Ã‚ ¿Ã‚ ½. Hospital Pharmacist 13, (2006): 312-314 85. Warner, J. P.; King, M.; Blizard, R. à ¯Ã‚ ¿Ã‚ ½Patient-held shared care records for individuals with mental illness: randomised controlled evaluationà ¯Ã‚ ¿Ã‚ ½. British Journal of Psychiatry 177, (2000): 319-324 86. Harvey, C. A.; Fielding, J. M. à ¯Ã‚ ¿Ã‚ ½The configuration of mental health services to facilitate care for people with schizophreniaà ¯Ã‚ ¿Ã‚ ½. Medical Journal of Australia 178, (2003): 49-52 87. Stimmel, G. L. à ¯Ã‚ ¿Ã‚ ½Clinical pharmacy practice in a community mental health centreà ¯Ã‚ ¿Ã‚ ½. Journal of the American Pharmaceutical Association 15, (1975): 400-401 88. Branford, D. à ¯Ã‚ ¿Ã‚ ½Is there a role for community pharmacists in community psychiatry?à ¯Ã‚ ¿Ã‚ ½ Pharmaceutical Journal 279, (2002): 842 89. Gray D. R.; Namikas, E. A.; Sax, M. J. à ¯Ã‚ ¿Ã‚ ½Clinical pharmacists as allied health care providers to psychiatric patientsà ¯Ã‚ ¿Ã‚ ½. Contemporary Pharmacy Practice 2, (1972): 108- 116 90. Watson, P. J. à ¯Ã‚ ¿Ã‚ ½Community pharmacists and mental health: an evaluation of two pharmaceutical care programmesà ¯Ã‚ ¿Ã‚ ½. Pharmaceutical Journal 258, (1997): 419-122 91. Buhrich, N.; Butchart, A.; Johnston, S. Lauchlaan, R. à ¯Ã‚ ¿Ã‚ ½Delivery of medication to psychiatric patients in community health services in New South Walesà ¯Ã‚ ¿Ã‚ ½. Australian and New Zealand Journal of Psychiatry 30, (1996): 523-530 92. Keks, N. A.; Alston, K.; Hope, J. à ¯Ã‚ ¿Ã‚ ½Use of antipsychotics and adjunctive medication by an inner urban community psychiatric serviceà ¯Ã‚ ¿Ã‚ ½. Australian and New Zealand Journal of Psychiatry 33, (1999): 896-901 93. Snowdon, J.; Days, S.; Baker, W. à ¯Ã‚ ¿Ã‚ ½Why and how antipsychotic drugs are used in 40 Sydney nursing homesà ¯Ã‚ ¿Ã‚ ½. International Journal of Geriatric Psychiatry 20, (2005): 1146-1152 94. Obourne, C. A.; Hooper, R.; Chi Li, K.; Swift, C. G.; Jackson, S. H. D. à ¯Ã‚ ¿Ã‚ ½An indicator of appropriate neuroleptic prescribing in nursing homesà ¯Ã‚ ¿Ã‚ ½. Age and Ageing 31, (2002): 435-439 95. Owen, P. R.; Thrush, C. R.; Kirchner, J. E.; Fischer, E. P.; Booth, B. M. à ¯Ã‚ ¿Ã‚ ½Performance measurement for schizophrenia: adherence to guidelines for antipsychoti c doseà ¯Ã‚ ¿Ã‚ ½. International journal of quality health care 12, (2000): 475-482 96. Meagher, D.; Moran, M. à ¯Ã‚ ¿Ã‚ ½Sub-optimal prescribing in an adult community mental health service: prevalence and determinantsà ¯Ã‚ ¿Ã‚ ½. Psychiatric Bulletin 27, (2003): 266- 270 97. Harrington, M.; Lelliott, P.; Patton, C.; Okocha, R.; Duffet, R.; Sensky, T. à ¯Ã‚ ¿Ã‚ ½The results of a multi-centre audit of prescribing of antipsychotic drugs for inpatients in the UKà ¯Ã‚ ¿Ã‚ ½. Psychiatric Bulletin 26, (2002): 414-418 98. Paton, C.; Lelliott, P. à ¯Ã‚ ¿Ã‚ ½The use of prescribing indicators to measure the quality of care in psychiatric inpatientsà ¯Ã‚ ¿Ã‚ ½. International journal of quality health care 13, (2004): 40- 45 99. Callaly, T.; Trauer, T. à ¯Ã‚ ¿Ã‚ ½Patterns of use of antipsychotic medication in a regional community mental health serviceà ¯Ã‚ ¿Ã‚ ½. Australia and New Zealandà ¯Ã‚ ¿Ã‚ ½s Journal of Psychiatry 8, (2000): 220-224 10 0. Centorrino, F.; Goren, J. L.; Hennen, J. Salvatore, P.; Kelleher, J. P.; Baldessarini, R. J. à ¯Ã‚ ¿Ã‚ ½Multiple versus single antipsychotic agents for hospitalized psychiatric patients: case-control study of risks versus benefitsà ¯Ã‚ ¿Ã‚ ½. American Journal of Psychiatry 161, (2004): 700-706 101. Centorrino, F.; Fogarty, K. V.; Sani, G. à ¯Ã‚ ¿Ã‚ ½Use of combinations of antipsychotics: McLean hospital inpatientsà ¯Ã‚ ¿Ã‚ ½. Human Psychopharmacology 20, (2005): 485-492 102. Taylor, D.; Young, C.; Esop, R.; Paton, C.; Walwyn, R. à ¯Ã‚ ¿Ã‚ ½Testing for diabetes in hospitalised patients prescribed antipsychotic drugsà ¯Ã‚ ¿Ã‚ ½. British Journal of Psychiatry 185, (2004): 152-156 103. Merrill, D. B.; Dec, G. W.; Goff, D. C. à ¯Ã‚ ¿Ã‚ ½Adverse cardiac effects associated with clozapineà ¯Ã‚ ¿Ã‚ ½. Journal of Clinical Psychopharmacology 25, (2005): 32-41 104. Happel, B.; Manias, E.; Rooper, C. à ¯Ã‚ ¿Ã‚ ½Wanting to be heard: mental health consumer.s experiences of information about medicationà ¯Ã‚ ¿Ã‚ ½. International Journal of Mental Health Nursing 13, (2004): 242-248 105. Paton, C.; Gill-Banham, S. à ¯Ã‚ ¿Ã‚ ½Prescribing errors in psychiatryà ¯Ã‚ ¿Ã‚ ½. Psychiatric Bulletin 27, (2003): 208-210

According to the National Cancer Institute (NCI) triple...

According to the National Cancer Institute (NCI) triple negative breast cancer is subtype of breast cancer that lack estrogen receptors, progesterone receptors or large amounts of HER2/neu proteins. It’s commonly known as ER-negative, PR-negative and HER2/neu-negative breast cancer (1). Due to the aforementioned characteristic of triple negative breast cancer it is insensitive to most of the effective therapies available for breast cancer treatment including HER2-directed therapy such as trastuzumab (2). Chemotherapy is the only systemic treatment for Triple Negative Breast Cancer. Even though standard chemotherapy regimens can be effective for patients in the early stages of triple negative breast cancer, but patients with†¦show more content†¦Second generation Antibody-drug conjugate consider as a new approach for treatments of TNBC. The main idea is to use an antibody and cytotoxic agents together to produce a synergistic effect and to ensure delivery of the cytoto xic agent to the target cell (6) Our main goal in this research is to develop a novel antibody based therapy against LRP8. We hypothesis that an anti-LRP8 antibody conjugated to cytotoxic drug will lead toward effective therapy for TNBC. We will perform experiments using flow cytometry and confocal microscopy to prove that LRP8 is suitable ADC target. Two main factors will contribute to whether it is suitable target: i. 100,000 LPR8 receptors should be expressed on the surface of 18-20 cells line. Our hypothesis is that will be more than 100,000 LPR8 receptors on the surface of breast cancer cell line. ii. Internalization of antibody bound to LRP8 We hypothesis that the antibody bind to the LRP8 have the ability to internalize and eventually causes cell death or apoptosis. Background and Preliminary Results: In February 2013, an anti-HER2 antibody trastuzumab was approved by the FDA following the positive outcome of the Phase III EMILIA trial. In this trial, Patients with HER2 (also known as ERBB2)-positive metastatic breast cancer had an improved median overall survival benefit compared to the combination of lapatinib and capecitabine (6). This drug represents anShow MoreRelatedPersonalized Medicine in the Treatment of Cancer Essay2322 Words   |  10 Pagespersonalized medicine (Theodorescu, 24). Today one of the principal areas for the application of personalized medicine is oncology; cancer cases have provided an excellent channel to investigate the abilities of personalized medicine techniques (Gilbert, 18). Conventional cancer management included â€Å"treating according to the organ or tissue in which the cancer originates† (Van’t Veer, 564). Personalized medicine involves the use of biomarkers to classify patients, and unlike conventional treatments

Financial Reporting Of Australia And UK †MyAssignmenthelp.com

accounting Question: Discuss about the Financial Reporting Of Australia And UK. Answer: Introduction This report takes an honest attempt towards the analysis of the regulatory framework for financial reporting of two countries. It can be seen that most of the developed countries all over the world have their own regulatory framework for financial reporting. For this report, the regulatory framework for financial reporting of Australia and United Kingdom is taken into consideration. There are two major parts of this report. The aim of the first part is to analyse and evaluate the necessary factors related to the financial reporting of the selected countries. The aim of the second part of this report is to make analysis of the selected financial reporting environment of the selected countries by relating Regulatory Capture Theory. Lastly, the conclusion will be developed with the help of a critical analysis on these selected financial regulatory environments for getting the idea of the extent of capture. Analysis of the Regulatory Framework for Financial Reporting Framework of Australia and United Kingdom Australia Australian Accounting Standard Board (AASB) is an Australian government agency responsible for the development of the necessary standards and principles for financial reporting (aasb.gov.au, 2018). Problems: Specific issue can be seen in the standard setting process of AASB. The example of a specific issue in Australian financial reporting system is the concern related with relevance and reliability of financial information in the financial statements of the companies. In addition, another perceived problems is related with the reduction of cost of the process of financial reporting. It needs to be mentioned that AASB is currently working on specific projects to address these problems (aasb.gov.au, 2018). How it works: As per the earlier discussion, AASB is the major decision maker in the financial reporting framework of Australia. The main responsibility of AASB is to develop issue and maintain financial reporting standards. It needs to be mentioned that AASB operates under Australian Securities and Investments Commission Act 2001 (rba.gov.au, 2018). The Australian Securities and Investments Commission, commonly known as ASIC, is another major part of the financial reporting regularity environment of Australia. The major responsibility of ASIC is to maintain the market integrity and to protect the customers from various frauds in the financial system. Another major part is the Australian Prudential Regulation Authority (APRA) and it is responsible for the deposit taking institutes. In this context, the name of the Reserve Bank of Australia needs to be mentioned as it is responsible for the development of monetary policy and to bring stability in the Australian financial system (rba.g ov.au, 2018). Progress Towards adoption IFRS: In the year 2005, 1 January, Australia adopted the standards of International Financial Reporting Standard (IFRS). Over the years, major progress in the adoption of IFRS by Australia can be observed. Smoothness can be seen in the transition process of IFRS by Australia. Major success can be seen in the application of IFRS standards for the financial reporting of not-for-profit Australian companies (iasplus.com, 2018). However, there is a need for further modification in the areas of quality and cost efficiency of financial reporting. Most importantly, with the adoption of IFRS across all the sectors, the users and developers have become able to move between sectors and countries with enough skills and knowledge (iasplus.com, 2018). In the recent years, one major project of AASB related to IFRS is to review the adoption of IFRS reporting standards by Australia. The main aim of this review program is the strategy of AASB to modify the standards of IFRS f or the financial reporting of not-for-profit business entities. Moreover, another aim is to bring simplification and clarification in the process of financial reporting (iasplus.com, 2018). United Kingdom (UK) Problems: The presence of some specific problems can in the financial reporting regulatory environment of UK. The financial reporting standard of UK has witnessed major problems on how to respond to the major development of IFRS (icaew.com, 2018). It needs to be mentioned that the companies of UK have to incur high cost along with major complexities in the adoption of the standards and principles of IFRS. This is the greatest problem faced by UK financial reporting regulatory environment. Apart from this, the UK financial reporting standard has been facing major issues related with the specific reporting needs for the charities (icaew.com, 2018). These are the major problems. How It Works: In the financial reporting regulatory environment of UK, the presence of two financial reporting frameworks can be seen. They are IFRS; and UK and Ireland GAAP (Generally AcceptedAccounting Principles). It is required for the public listed companies of UK to adopt the standards and principles of IFRS in order to prepare the financial reports of their group (frc.org.uk, 2018). However, the companies also have the option to select between IFRS and UK and Ireland GAAP in order to prepare the financial reports of their individual parent companies. In this context, FRS 100 Application of Financial Reporting Requirements provides the whole framework of financial reporting. The major legislative requirements of UK financial reporting are FRS 102 (frc.org.uk, 2018). The Financial Reporting Standard applicable in the UK and Republic of Ireland, FRS 101 Reduced Disclosure Framework and FRS 105 the Financial Reporting Standard applicable to the Micro-entities Regime (frc.org.uk, 2 018). Progress towards Adopting IFRS: It can be observed that IFRS has been the part of the financial reporting regulatory environment of UK since 2005 as per the EC regulation. Over these years, major progress can be observed in the adopting of IFRS by UK (aasb.gov.au, 2018). As per IFRS standards, it is required for all the domestic companies of UK trading their securities in the regulated market are required to use IFRS standards for financial reporting as per EU. It implies that these companies are required to comply with the standards of IFRS for the preparation of their financial statements. However, exception can be seen in case of foreign companies. In case of SMEs, they have the option to use the standards of IFRS with some further modifications (aasb.gov.au, 2018). Based on the above discussion, it can be observed that both Australia and UK uses different standards for the purpose of their financial reporting as Australia follow AASB and UK follows UK and Ireland GAAP (frc.org.uk, 2018). However, it can be observed that both the countries have done major progress towards adopting the standards and principles of IFRA. In the presence of IFRS standards and principles, it has become possible for establishing accurate process of financial reporting for the companies. Analysis of the Selected Environments in Relation to Regulatory Capture Theory Regulatory Capture Theory: In the year 1971, George Strigler introduced this Regulatory Capture Theory (Carpenter Moss, 2013). This particular theory states that a firm or an industry can become beneficial from different relevant legislations if they capture the related regulatory body. According to this theory, manipulations are done in the regulations for fulfilling the requirements of the parties having interest in them. Apart from this, this theory also states that after a specific period of time, the regulations serve the interest of their concerned industries (Carpenter Moss, 2013). Usefulness: The main advantage of this theory is that it helps in providing the explanation of the main intentions of the regulations. The development of these regulations involves the individuals and companies affected by them Young, 2012). For this reason, this particular theory helps in the adequate representation of policies and interest groups for the betterment of the companies and the industries. With the help of this theory, the companies and the industries become able to capture the negative intentions of the regulators for the betterment of their own interests (Young, 2012). Characteristics: In the Regulatory Capture Theory, George Strigler has mentioned about three major characteristics or three major assumptions that indicate that a particular regulatory environment is captured. According to the first characteristic, a regulatory environment will be considered as captured when there will be greed among the regulatory agency, regulatory party and customers; and their intention will be to maximize their own interest. Thus, in the presence of the intention of the maximization of own interest, the regulatory environment will be considered as captured (Chalmers, Godfrey Lynch, 2012). According to the second characteristic, the regulatory environment will be considered as captured when all the interested parties in the regulatory environment have rational expectation for the other parties (Boyer Ponce, 2012). According to the third characteristic, a regulatory environment will be considered as captured when the industries or the companies take huge time and effort for capturing the regulator (Portman, 2014). It is the responsibility of the regulators to set regulations in such a manner that the industries or the companies do not take much time to understand them. It can be seen that there are many instances where the financial regulators failed to implement correct financial regulations for the companies and the industries (Livermore Revesz, 2012). Analysis: From the above discussion, it can be seen that there are three major assumptions in the regulatory capture theory. In case of the financial reporting regulatory environment of both Australia and UK, there is a need to analyse the above-discussed characteristic of regulatory capture theory in respect of these environments. In this context, it needs to be mentioned that both the Australia and UK have some major history related with the development of accounting policies and standards (Agrell Gautier, 2012). Apart from this, there are some major cases where the regulatory environment was captured. In this context, the example of ASRB can be provided here. At the time of the discussion of the establishment of ASRB, the professional accountant members did lobby by ensuring the fact that the board would not have any independent capability; there would not be any independent chairperson and there would only be administrative officer in place of research director. Apart from this, the members of ASRB stated that the industries are required to set priorities after the discussions with the board. From this, It can be seen that ASRB considered the fulfilment of their interest above all. Most importantly, it can be observed that the members of ASRB were only professional that shows the lack of independence of the board (Chalmers, Godfrey Lynch, 2012). However, at present, the situation is very different in case of the financial reporting regulatory environment of Australia and UK. The motive behind the development of the board of both AASB and UK FRC is to provide independence to these bodies so that they can be beneficial. The 11 board members of AASB have come from different background like accounting, audit, public sector, finance and others. The same aspect can be seen in case of FRC. This aspect provides independence to these regulatory bodies (Baldwin, Cave Lodge, 2012). Apart from this, there is not any presence of lobbying in the development of the objectives of these accounting standards. It needs to be mentioned that the main aim of the financial regulatory boards of Australia is to provide the users with required financial information of the companies by establishing correct financial reporting standards (ifrs.org, 2018). Thus, it can be observed that the main priority of these boards is the development of single accounting standard for all the companies. Most importantly, the adoption of IFRS by Australia and UK has brought transparency, accountability and efficiency in the financial markets all over the world (ifrs.org, 2018). In this context, it needs to be mentioned that all of these financial regulators have established standards and principles that are easy for the companies and industries to capture. It can be noticed that there is not any rational expectations among the parties. It needs to be mentioned that there is another major aim of the development of FRC. With the implementation of FRC, it has become possible for the stakeholders of the companies to have a say in the accounting standard-setting process. More importantly, in the board of AASB, FRC and IFRS, people from different fields like private companies, regulators, directors and shareholders can be seen as the acting members (ifrs.org, 2018). There have been many debates related with the adoption of IFRS by Australia and UK. Many people have argued that regulatory environments of Australia and UK can be captured due to the adoption of the policies of IFRS as the standards setters are lobbying to fulfil their own interest in the presence of a single accounting standard. However, it needs to be mentioned that there is not any strong point in this argument, as there has not been anything bad happened in the presence of IFRS (ifrs.org, 2018). Thus, based on the above discussion, it can be said that there is less possibilities for these standards to be captured in the presence of all these aspects. Conclusion From the whole discussion, it can be observed that this report has aimed to discuss various aspects of framework for financial reporting of Australia and UK. At the same time, the report has also attempted to evaluate the framework for financial reporting of these two countries with the help of the various components of regulatory capture theory. It needs to be mentioned that the report has analyzed and evaluate all the necessary aspects of the framework for financial reporting of these selected countries with the regulatory capture theory. The following discussion shows the critical analysis of the framework for financial reporting of Australia and UK in relation to regulatory capture theory. In case of the framework for financial reporting of Australia, it can be seen that relevance and reliability are the major issues in the financial reporting of Australia. The above discussion also states that AASB is majorly responsible for the development of financial standards and policies for financial reporting. Some of the other major bodies are APRA, ASIC and others. It can also be observed that Australia has adopted all the standards and principles of IFRS in order to bring accuracy in the financial reporting process. After applying the assumptions of regulatory capture theory, it can be observed that there is not any area in the framework for financial reporting in Australia that can be captured. The above discussion shows that there is enough independence in the body of AASB and IFRS as members from different area can be seen. After that, from the major activities of AASB, it is clear that there is not any lobbying in this body to fulfill the self-needs of the body members a s the main aim of AASB is provide the users with necessary financial information by improving the quality of financial reporting. Thus, based on the above discussion, it can be conclude that all these aspects diminish the possibility of regulatory capture for the framework for financial reporting in Australia. Almost same concept can be seen in case of the framework for financial reporting in UK. The above discussion states that framework for financial reporting of UK faces major problem in the adoption of various principles and standards of IFRS. It can be observed that there are two major frameworks for financial reporting available in UK; they are IFRS and UK and Ireland GAAP. At the same time, FRC also has to play an important part in financial reporting. It can also be observed that UK has adopted all the standards and principles of IFRS. In case of the application of regulatory capture theory, it can be observed that there is not any significant factor contributed towards the capturing of framework for financial reporting. Same as Australia, the board of FRC consists of members from different area. Apart from this, it can also be seen there is not any place for lobbying in the board members. Thus, based on the above discussion, it can be conclude that all these aspects diminish the p ossibility of regulatory capture for the framework for financial reporting in UK. References AASB Board. (2018).Aasb.gov.au. Retrieved 31 March 2018, from https://www.aasb.gov.au/AASB-Board.aspx AASB RESEARCH REPORT NO 4: REVIEW OF ADOPTION OF INTERNATIONAL FINANCIAL REPORTING STANDARDS IN AUSTRALIA. (2018).Aasb.gov.au. Retrieved 31 March 2018, from https://www.aasb.gov.au/admin/file/content102/c3/AASB_Review_of_IFRS_research_report_03-17.pdf About the AASB. (2018).Aasb.gov.au. Retrieved 31 March 2018, from https://www.aasb.gov.au/About-the-AASB.aspx Agrell, P. J., Gautier, A. (2012). 14. Rethinking regulatory capture.Recent advances in the analysis of competition policy and regulation, 286. Australia's Financial Regulatory Framework | Council of Financial Regulators Annual Report 2002 | RBA. (2018).Reserve Bank of Australia. Retrieved 31 March 2018, from https://www.rba.gov.au/publications/annual-reports/cfr/2002/aus-fin-reg-frmwk.html Baldwin, R., Cave, M., Lodge, M. (2012).Understanding regulation: theory, strategy, and practice. Oxford University Press on Demand Boyer, P. C., Ponce, J. (2012). Regulatory capture and banking supervision reform.Journal of Financial Stability,8(3), 206-217. Carpenter, D., Moss, D. A. (Eds.). (2013).Preventing regulatory capture: Special interest influence and how to limit it. Cambridge University Press. Chalmers, K., Godfrey, J. M., Lynch, B. (2012). Regulatory theory insights into the past, present and future of general purpose water accounting standard setting.Accounting, Auditing Accountability Journal,25(6), 1001-1024. Chalmers, K., Godfrey, J. M., Lynch, B. (2012). Regulatory theory insights into the past, present and future of general purpose water accounting standard setting.Accounting, Auditing Accountability Journal,25(6), 1001-1024. Financial Reporting Council. (2018).Frc.org.uk. Retrieved 31 March 2018, from https://www.frc.org.uk/frc-for-you/frc-mission Financial Reporting Council. (2018).Frc.org.uk. Retrieved 31 March 2018, from https://www.frc.org.uk/accountants/accounting-and-reporting-policy/uk-accounting-standards/standards-in-issue IFRS adoption in Australia was relatively smooth. (2018).Iasplus.com. Retrieved 31 March 2018, from https://www.iasplus.com/en/news/2017/03/australia IFRS in the UK. (2018).Iasplus.com. Retrieved 31 March 2018, from https://www.iasplus.com/en-gb/standards/ifrs-in-the-uk-1 IFRS. (2018).Ifrs.org. Retrieved 31 March 2018, from https://www.ifrs.org/use-around-the-world/use-of-ifrs-standards-by-jurisdiction/united-kingdom/ IFRS. (2018).Ifrs.org. Retrieved 31 March 2018, from https://www.ifrs.org/about-us/ Knowledge guide to UK accounting standards. (2018).Icaew.com. Retrieved 31 March 2018, from https://www.icaew.com/library/subject-gateways/accounting-standards/knowledge-guide-to-uk-accounting-standards Livermore, M. A., Revesz, R. L. (2012). Regulatory review, capture, and agency inaction.Geo. LJ,101, 1337. Overview of the financial reporting framework. (2018).Frc.org.uk. Retrieved 31 March 2018, from https://www.frc.org.uk/getattachment/baa79d97-8bf1-49e3-af14-f0dfd7f1fdfc/Overview-WEB-READY.pdf Portman, M. E. (2014). Regulatory capture by default: Offshore exploratory drilling for oil and gas.Energy Policy,65, 37-47. The standard-setting process. (2018).Aasb.gov.au. Retrieved 31 March 2018, from https://www.aasb.gov.au/About-the-AASB/The-standard-setting-process.aspx Young, K. L. (2012). Transnational regulatory capture? An empirical examination of the transnational lobbying of the Basel Committee on Banking Supervision.Review of International Political Economy,19(4), 663-688.