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ABSTRACTAim: In July 2013, the Scottish Government introduced a rotavirus vaccination programme into the childhood immunisation schedule. The aim of this research was to estimate the cost-impact of this programme.Methods: Data for rotavirus-related resource use were identified including laboratory reports, hospitalisations, attendances at accident and emergency departments (A&E), general practice consultations (GP), calls to the National Health Service telephone helpline (NHS24) and prescriptions for common rehydration treatments. We used an interrupted time series analysis approach to assess the impact on resource utilisation in all categories. Appropriate costs were added to the models and predicted pre-and post-vaccination mean annual costs were estimated. The cost of the vaccination programme was estimated using costs from the literature.Results: The vaccination programme was associated with a reduction in utilisation in all measured healthcare resource categories. These reductions were all statistically significant (at the 95% level) with p-values less than 0.001. Reductions ranged from 18% in calls to NHS24 to 73% in positive laboratory reports. The vaccination programme was associated with a reduction in annual healthcare resource costs of 38% (£595,000 per 100,000 infants < 5 years old) in our measured categories (including £495,000 from a reduction in hospital stays). The annual overall cost-impact of the rotavirus vaccination programme (the cost of delivering the programme minus the reduction in resource costs) was estimated at approximately £435,000 per 100,000 infants < 5 years old.Conclusion: The rotavirus vaccination programme was associated with a reduction in all measured categories of rotavirus-related resource use by infants < 5 years old.

Two human models were developed to quantify the stratum corneum removed by different adhesive dressings and to measure the peel force of dressing removal and relate this to stratum corneum removal. The first was an open study designed to compare the effects of applying Mepiform Safetac, Tielle and Duoderm Extra Thin to the skin of 12 normal volunteers aged 19–53 years. Treatments were applied once (one 24-hour application) or three times (three × 24-hour applications) to forearm skin which had been prestained with methylene blue. After dressing removal the dye left on the skin was sampled using the skin surface biopsy method and measured spectrophotometrically.The results show that, after one and three applications, the Mepiform Safetac sites had a higher level of dye than those on which the other dressings had been applied (p<0.05, after three applications). Based on the assumption that the more dye is left on the skin, the less damage is caused, this suggests that Mepiform Safetac is less damaging to the skin surface than the other products tested.In the second study the peel force needed to remove adhesive dressings from prestained skin was measured and related to the amount of stratum corneum removed. Mepilex Border Safetac, Duoderm Extra Thin, Allevyn Adhesive, Biatain Adhesive and Tielle Hydropolymer Dressing were compared in 20 normal volunteers aged 23–64 years. Three consecutive 24-hour applications of each product were made, with measurements of peel force at 24, 48 and 72 hours. The amount of dye remaining on the skin at 72 hours was assessed by the surface biopsy method.Statistically significant differences between products were observed in terms of both peak force and steady state force of removal. Differences in the level of damage to the superficial stratum corneum were also detected. However, low levels of peel force were not always associated with low damage and, therefore, other factors must contribute to stratum corneum removal in this model.

The nuclear magnetic resonance spectra of a series of substituted benzalmalononitriles were examined in various solvents. The chemical shifts for the olefinic protons are susceptible to large solvent effects which are interpreted as arising from association of a solvent molecule with the olefinic proton (acetone) or a site in its vicinity (benzene). With acetone this leads to a downfield shift from values observed in chloroform. In benzene solution the association produces increased shielding and is present in addition to a second solvation complex, the arrangement of which is governed by the substituent. The difference in behavior of the ethylenic proton in benzalmalononitriles from the formyl proton in benzaldehyde is ascribed to its more highly acidic nature.

The reactions of a series of phosphylating agents (RR′P(O)X) with ethanolamine have been examined, and relative yields of the products from the nucleophilic amino and hydroxyl moieties determined. In general the amount of O-phosphylation increased as R and R′ were changed from dimethylamino through alkoxy to methyl and as the leaving group (X) was changed from OP(O)RR′ to CN. The only exceptions occurred when R was dimethylamino and X was Cl. When X was F, only O-phosphylation was observed. Thus, a wide range of essentially continuously varying selectivities was found.The results are discussed in terms of the amount of charge transfer involved in the formation of the transition state which is assumed to be determined by the electrophile. When the charge transfer is small, the contributions to the activation energy of such factors as solvation and ionization potential of the nucleophile are most important, resulting in N-phosphylation. As the amount of charge transfer increases, the energy of bond formation becomes the dominant factor and O-phosphylation is preferred.

The preparation of some p-(ω′-dimethylaminoalkyl)- and p-(ω′-dimethylaminoalkoxy)-2-oximinoacetophenones and their methiodides is described.No general method was found for synthesis of short-chain (C0, C1, C2) p-(ω′-dimethylaminoalkyl)-2-oximinoacetophenones. The longer-chain compounds (C3, C4) were prepared by a method which would appear to be general. ω-Phenyl-1-haloalkanes undergo Friedel–Crafts acylation to yield p-(ω′-haloalkyl)-acetophenones. These were converted to the dimethylamino compounds, which, subsequently, yielded 2-oximinoacetophenones. No method of preparation of p-(2′-dimethylaminoethyl)-2-oximinoacetophenone was found.Synthesis of p-(ω′-dimethylaminoalkoxy)-2-oximinoacetophenones was accomplished using mixed α,ω-dihaloalkanes and p-hydroxyacetophenone. The p-(ω′-haloalkoxy)-acetophenones from these reactants were first converted to oximes and then to the dimethylamino compounds. Syntheses of p-(ω′-dimethylamino-ethoxy, -propoxy, -butoxy, and -pentoxy)-2-oximinoacetophenones were achieved. That of p-(dimethylaminomethoxy)-2-oximinoacetophenone was unsuccessful.

Nuclear magnetic resonance has been used to follow the decomposition of aqueous solutions of 2-methyl-Δ2-oxazoline (0.29 M) at constant pH values in the range −1 to 14. The decomposition is first order with respect to total oxazoline at any specific pH, but deviates from the simple reaction of water with the protonated species above pH 5. At neutral pH values this is shown to be partially due to a second reaction involving 2-methyl-Δ2-oxazoline and O-acetylethanolamine which yields N-2-acetoxyethyl N′-2-hydroxyethyl acetamidate. The decrease in rate constant at pH < 2 is accounted for by variation in the water concentration, which is related to the acidity function. A kinetic expression is derived for the decomposition over the whole pH range studied. The decomposition of the amidate is also discussed.

When N-(2-methylsulfonylphenyl)hydroxylamine (4) was treated with dilute sodium hydroxide solution the major product was always 2,2′-di(methylsulfonyl)azoxybenzene (5). At room temperature other significant products were 2-hydroxy-2′-methylsulfonylazoxybenzene (6a) and 2-methylsulfonylnitrobenzene (2), while 6awas also formed at reflux together with small amounts of 2-hydroxy-2′-methylsulfonylazobenzene (8), 2-methylsulfonylaniline (7), 3-methylsulfonyl-3′-nitro-4-amino-4′-hydroxybiphenyl (3), and 2. The compounds 5, 6a, and 7were also obtained when 2-methylsulfonylnitrosobenzene (9) was boiled with alkali. The decomposition of N-(4-methylsulfonylphenyl)hydroxylamine (16) in dilute alkali at room temperature gave a quantitative yield of 4,4′-di(methylsulfonyl)azoxybenzene (17) and at reflux, mixtures of 17and 4,4′-di(methylsulfonyl)azobenzene (18) were obtained. The modes of formation of the various products from the two hydroxylamines are discussed.

Objective:The study compared the level of discomfort experienced by healthy volunteers on the removal of a range of adhesive wounds.Method:This was an open, within subject comparative study of six adhesive dressings in 24 volunteers. The test site was the lower back. Allocation of test materials to the test sites was randomised. The peel force of removal was recorded after 24 hours of application using a device that removed the dressing at a constant speed and angle to the skin surface. The discomfort experienced at each removal was assessed by the subjects themselves using an electronic visual analogue scale.Results:Overall, Mepilex Border was given a significantly lower discomfort score (p≤0.01) by the subjects than the other dressings. There were no clear differences between the five other products tested. Tielle and Allevyn Adhesive had significantly higher (p≤0.05) peel force than the other products. Mepilex Border caused less discomfort on removal than Duoderm Extra Thin, Biatain and Versiva, even though the peel force was similar. Tielle and Allevyn had higher peel force, but the levels of discomfort were not significantly higher for these products.Conclusion:It may be that the level of discomfort experienced by subjects on removal of an adhesive dressing is not entirely dependent on the peel force and that other aspects of the interaction of the skin surface and adhesive play a role.Declaration of interest:This study was supported by a grant from Mölnlycke Healthcare AB, Gothenburg, Sweden.