Managing chemotherapy-related toxicities in the community setting: A survey of pharmacists in Ontario

2020 ◽  
Vol 26 (8) ◽  
pp. 1903-1911
Author(s):  
Kathy Vu ◽  
Aliya Pardhan ◽  
Nita Lakhani ◽  
Stephanie Metcalfe ◽  
Mindaugas Mozuraitis ◽  
...  
Keyword(s):  
Anticancer Drugs ◽  
Management Practices ◽  
Community Setting ◽  
Community Pharmacists ◽  
Specialized Knowledge ◽  
Oncology Education ◽  
Study Support ◽  
Almost All ◽  
To Receive ◽  
Question Survey

Background Toxicity management is a challenge with cancer treatment, including oral anticancer drugs. A review of claims data showed that a majority of publically funded oral anticancer drugs were filled in the community where pharmacists may not necessarily possess the specialized knowledge, skills, and experience required to provide effective patient care. A survey of community pharmacists in Ontario was conducted to identify the behaviours and preferences of community pharmacists specific to the management of treatment-related toxicities in order to standardize cancer care in this area. Methods An electronic questionnaire was distributed to approximately 5000 community pharmacists. The 21-question survey gathered information on the demographic profile of the pharmacists, basic geographic and socioeconomic variables associated with their practice setting, current toxicity management practices, education and training needs, and preferences for communicating with other providers. Results Of 349 pharmacists, almost all (94.9%) were interested in managing chemotherapy-related toxicities as part of their work, but the majority (77.1%) did not feel that their current level of pharmacy training has provided them with an oncology education sufficient for the demands of their practice. Approximately 52% of respondents indicated that they have reached out to the health care provider at a cancer centre, and of those, 72.7% reported that their questions were resolved within 48 h. More than half of all survey respondents (53.9%) indicated that they would prefer to receive a response within 12 h from cancer centres. Conclusions The results of this study support the need to provide community pharmacists with oncology-specific training and timely correspondences from providers at prescribing institutions in order to manage toxicities.

COUNSELLING ACTIVITIES OF DRUG USE IN 58 COMMUNITY PHARMACIES AT HUE CITY

2017 ◽  
pp. 75-80
Author(s):  
Quoc Duong Doan ◽  
Thi Ha Vo
Keyword(s):  
Blood Pressure ◽  
Drug Use ◽  
Community Pharmacy ◽  
Key Words ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Cough Headache ◽  
Rational Drug ◽  
Question Survey

Background: Community pharmacists play an important role in counseling of rational drug use for population. The study aimed to characterize counselling activities of drug use and demand of counselling tools at some community pharmacies at Hue City. Materials and method: A 17-question survey were asked to fill pharmacy staffs of a convenient sample of 100 community pharmacies at Hue City from 2/2017 to 7/2017. Results: There were 58 pharmacies (58.0%) answered this survey. Cough, headache, fever, high blood pressure and diabetes were the most popular symptoms/diseases presented in pharmacies. Patients often need counselling about dose (82.8%) and when to take medicine (79.3%). The main bariers for counselling were a lack of time (53.4%), and of skills/medthods for counseling (31.7%). About 96.6% pharmacies demanded counselling tools and favorite formats were book (32.9%) or pocket handbook (29.3%). Conclusion: Most pharmacies demanded counselling tools. Other studies should be conducted to develop supporting tools for counseling and to assess the quality of counseling in pharmacies. Key words: community pharmacy, counseling of drug use, pharmacist, Hue

Using Gleams to Evaluate the Agricultural Waste Application Rule-Based Decision Support (AWARDS) Computer Program

1993 ◽  
Vol 28 (3-5) ◽  
pp. 625-634 ◽  
Author(s):  
D. A. Ford ◽  
A. P. Kruzic ◽  
R. L. Doneker
Keyword(s):  
Surface Water ◽  
Ground Water ◽  
Management Practices ◽  
Agricultural Waste ◽  
Rule Base ◽  
Rule Based ◽  
Pollutant Loading ◽  
Physical Features ◽  
To Receive ◽  
Complex Computer

AWARDS is a rule-based program that uses artificial intelligence techniques. It predicts the potential for fields receiving agricultural waste applications to degrade water quality. Input data required by AWARDS include the physical features, management practices, and crop nutrient needs for all fields scheduled to receive these nutrients. Based on a series of rules AWARDS analyzes the data and categorizes each field as acceptable or unacceptable for agricultural waste applications. The acceptable fields are then ranked according to their potential for pollutant loading. To evaluate the validity of the AWARDS field ranking system, it was compared to pollutant loading output from GLEAMS, a complex computer model. GLEAMS simulated the characteristics of each field ranked by AWARDS. Comparison of the AWARDS field ranking to the GLEAMS pollutant loading was favorable where ground water and both surface and ground water were to be protected and less favorable where surface water was to be protected. The rule base in AWARDS may need to be refined to provide more reasonable results where surface water is the resource of concern.

Primary Uterine Cancer in Maryland: Impact of Distance on Access to Surgical Care at High-Volume Hospitals

2013 ◽  
Vol 23 (7) ◽  
pp. 1244-1251 ◽  
Author(s):  
Camille C. Gunderson ◽  
Ana I. Tergas ◽  
Aimee C. Fleury ◽  
Teresa P. Diaz-Montes ◽  
Robert L. Giuntoli
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Uterine Cancer ◽  
Multivariable Analysis ◽  
Community Setting ◽  
Surgical Care ◽  
High Volume ◽  
High Volume Hospital ◽  
To Receive ◽  
Zip Code

ObjectiveTo evaluate the influence of distance on access to high-volume surgical treatment for patients with uterine cancer in Maryland.MethodsThe Maryland Health Services Cost Review Commission database was retrospectively searched to identify primary uterine cancer surgical cases from 1994 to 2010. Race, type of insurance, year of surgery, community setting, and both surgeon and hospital volume were collected. Geographical coordinates of hospital and patient’s zip code were used to calculate primary independent outcomes of distance traveled and distance from nearest high-volume hospital (HVH). Logistic regression was used to calculate odds ratios and confidence intervals.ResultsFrom 1994 to 2010, 8529 women underwent primary surgical management of uterine cancer in Maryland. Multivariable analysis demonstrated white race, rural residence, surgery by a high-volume surgeon and surgery from 2003 to 2010 to be associated with both travel 50 miles or more to the treating hospital and residence 50 miles or more from the nearest HVH (allP< 0.05). Patients who travel 50 miles or more to the treating hospital are more likely to have surgery at a HVH (odds ratio, 6.03; 95% confidence interval, 4.67–7.79) In contrast, patients, who reside ≥50 miles from a HVH, are less likely to have their surgery at an HVH. (odds ratio, 0.37; 95% confidence interval, 0.32–0.42).ConclusionIn Maryland, 50 miles or more from residence to the nearest HVH is a barrier to high-volume care. However, patients who travel 50 miles or more seem to do so to receive care by a high-volume surgeon at an HVH. In Maryland, Nonwhites are more likely to live closer to an HVH and more likely to use these services.

scholarly journals Securing the wireless emergency alerts system

2021 ◽  
Vol 64 (10) ◽  
pp. 85-93
Author(s):  
Jihoon Lee ◽  
Gyuhong Lee ◽  
Jinsung Lee ◽  
Youngbin Im ◽  
Max Hollingsworth ◽  
...  
Keyword(s):  
Open Source ◽  
Open Source Software ◽  
Software Defined Radio ◽  
Severe Weather ◽  
Base Stations ◽  
The Public ◽  
Software Libraries ◽  
Amber Alerts ◽  
Almost All ◽  
To Receive

Modern cell phones are required to receive and display alerts via the Wireless Emergency Alert (WEA) program, under the mandate of the Warning, Alert, and Response Act of 2006. These alerts include AMBER alerts, severe weather alerts, and (unblockable) Presidential Alerts, intended to inform the public of imminent threats. Recently, a test Presidential Alert was sent to all capable phones in the U.S., prompting concerns about how the underlying WEA protocol could be misused or attacked. In this paper, we investigate the details of this system and develop and demonstrate the first practical spoofing attack on Presidential Alerts, using commercially available hardware and modified open source software. Our attack can be performed using a commercially available software-defined radio, and our modifications to the open source software libraries. We find that with only four malicious portable base stations of a single Watt of transmit power each, almost all of a 50,000-seat stadium can be attacked with a 90% success rate. The real impact of such an attack would, of course, depend on the density of cellphones in range; fake alerts in crowded cities or stadiums could potentially result in cascades of panic. Fixing this problem will require a large collaborative effort between carriers, government stakeholders, and cellphone manufacturers. To seed this effort, we also propose three mitigation solutions to address this threat.

scholarly journals E-Governance in India to Combat COVID-19

2021 ◽  
Vol 8 (12) ◽  
pp. 1-5
Author(s):  
Dr. Mangesh M. Ghonge ◽  
Mr. Deepak Pathratkar
Keyword(s):  
Private Sector ◽  
Mutual Contact ◽  
Work From Home ◽  
The World ◽  
Current Scenario ◽  
The Government ◽  
Almost All ◽  
To Receive

Viral pandemics are a serious threat. COVID-19 is not the first, and it won't be the last. As the whole world is going through the black phase of COVID-19 virus, the scientists are trying to invent a fighting vaccine against the same. Each and every sector in every part of the world is infected by the outburst of the fatal virus. Right from business and trade to sports and entertainment, every aspect of life is suffering a lot. To combat the outbreak of the pandemic, most of the countries have used partial to complete lockdown as the only weapon to stop the spread of the virus. In the current scenario, almost all the private sector companies as well as the government offices have suggested all the employees to work from home to stop the community spread of the disease that may occur if people come in mutual contact. While we think of governing authorities around the world, each and every government provides some e-facilities to their citizens to some what extent. Generally E-Governance can be stated as the facility to receive each and everything electronically i.e. you don’t need to go to outside home to receive any document or order. In this paper, we briefly described the different aspects of e-governance.

WORK DESIGN: WORK FEATURES OF CIVIL SERVANTS OF THE SUPERIOR COURT OF JUSTICE

2021 ◽  
Vol 22 (3) ◽  
Author(s):  
PABLO F. P. FREITAS ◽  
CATARINA C. ODELIUS
Keyword(s):  
Management Practices ◽  
Civil Servants ◽  
Work Design ◽  
Specialized Knowledge ◽  
Design Work ◽  
Organizational Policies ◽  
Court Of Justice ◽  
Public Body ◽  
Special Knowledge ◽  
The Subject

ABSTRACT Purpose: To identify and analyze differences in the tasks, knowledge, and social features of the work of civil servants of the Superior Court of Justice, and, secondarily, to verify the factorial, convergent, predictive, and discriminative validity of the Work Design Questionnaire (WDQ) in the Brazilian Judiciary context. Originality/value: With the WDQ’s development, the work design became the subject of further studies all around the world. Also, in Brazil, since its translation and adaptation, this variable has caused great repercussions in people management, becoming the first study within the scope of the Brazilian Judiciary. Design/methodology/approach: Through a survey sent to 2,898 civil servants, 895 responses were obtained and subjected to descriptive statistical analysis, confirmatory factorial analysis, reliability analysis, Kendall’s tau correlation analysis, and the Kruskal-Wallis test. Findings: The most indicated work feature was social support, and the least indicated was interaction outside the organization. Special knowledge was most required from professionals with higher education. For the men, there were more problem solving, specialized knowledge, and decision-making autonomy in their work. Civil servants who work in judicial activities claimed to have more meaningful tasks. Managers claimed to have less autonomy in planning their tasks, as all other civil servants stated that their work has a more definite beginning, middle, and end. In a public body of great size and complexity, work features are differentiated by their sociodemographic and functional variables, requiring customization in the management practices of people and organizational policies.

Irrigation Management and Water Pricing in Turkey

2012 ◽  
pp. 73-86
Author(s):  
Erol H. Cakmak
Keyword(s):  
Irrigation Water ◽  
Management Practices ◽  
Global Climate ◽  
Irrigation Management ◽  
Water Pricing ◽  
Irrigated Agriculture ◽  
Water Users ◽  
Total Water Consumption ◽  
Water Charges ◽  
Almost All

Irrigated agriculture in Turkey currently consumes 75 percent of the total water consumption, which corresponds to about 30 percent of the renewable water supply. Unfavorable future global climate and economic conditions will increase the stress in the water sector. The operation and maintenance (O&M) of almost all large surface irrigation schemes developed by the state has been transferred to irrigation associations governed by the farmers. The purpose of this paper is to provide an overview of irrigation management practices and an evaluation of irrigation water pricing after the transfer using price data at the association level since 1999. Results indicate that both irrigation water charges and collection rates increased following the transfer. However, the recuperation of investment costs for irrigation development from the users has remained minimal. The price of the irrigation water continued to be on per hectare basis, and farmers using pumping water face 2.5 times higher water charge per hectare then the gravity water users. The uptake of more efficient water application technology accompanied by pricing mechanisms reflecting scarcity value of water will certainly ease the adjustment burden of the irrigation sector in the future.

Irrigation Management and Water Pricing in Turkey

2010 ◽  
Vol 1 (2) ◽  
pp. 13-26
Author(s):  
Erol H. Cakmak
Keyword(s):  
Irrigation Water ◽  
Management Practices ◽  
Global Climate ◽  
Irrigation Management ◽  
Water Pricing ◽  
Irrigated Agriculture ◽  
Water Users ◽  
Total Water Consumption ◽  
Water Charges ◽  
Almost All

Irrigated agriculture in Turkey currently consumes 75 percent of the total water consumption, which corresponds to about 30 percent of the renewable water supply. Unfavorable future global climate and economic conditions will increase the stress in the water sector. The operation and maintenance (O&M) of almost all large surface irrigation schemes developed by the state has been transferred to irrigation associations governed by the farmers. The purpose of this paper is to provide an overview of irrigation management practices and an evaluation of irrigation water pricing after the transfer using price data at the association level since 1999. Results indicate that both irrigation water charges and collection rates increased following the transfer. However, the recuperation of investment costs for irrigation development from the users has remained minimal. The price of the irrigation water continued to be on per hectare basis, and farmers using pumping water face 2.5 times higher water charge per hectare then the gravity water users. The uptake of more efficient water application technology accompanied by pricing mechanisms reflecting scarcity value of water will certainly ease the adjustment burden of the irrigation sector in the future.

scholarly journals STARZ-DRP AS A TRIAGING TOOL FOR COMMUNITY PHARMACISTS: PERSPECTIVES AND EXPECTATIONS OF STAKEHOLDERS

2017 ◽  
Vol 9 (10) ◽  
pp. 81 ◽  
Author(s):  
Nazri Nordin ◽  
Mohamed Azmi Ahmad Hassali ◽  
Azmi Sarriff
Keyword(s):  
Community Pharmacy ◽  
Systematic Approach ◽  
Community Pharmacists ◽  
Medical Practitioner ◽  
Face To Face ◽  
Triage Decision ◽  
The Face ◽  
Almost All ◽  
Ideal Framework ◽  
Systematic Framework

Objective:  To investigate perspectives and expectations of stakeholders of community pharmacists’ (CPs) roles and the use of STARZ-DRP as a structured and systematic framework to help CPs to extend their role to make an accurate triage decision in community pharmacy settings.Methods: Individuals who were in high positions in the Ministry of Health (MOH), pharmacy, medical and consumer associations and individuals who were a private medical practitioner and retail pharmacist were invited via mail to participate in the face to face interview. The interviews were audio-taped and transcribed verbatim to identify themes as many as possible.Results: Eight stakeholders had responded to the invitation. Mean (± standard deviation) age (years) of stakeholders was 56.50 ± 11.82. Five themes were noted which were: (i) CPs are focusing more on business-oriented, (ii) CPs should perform patient-oriented services, (iii) responsibilities to triage customers, (iv) a systematic approach for triaging activities, (v) STARZ-DRP as a systematic approach to making triage decision.Conclusion: CPs are paying particular attention on business-oriented than patient-oriented services. All stakeholders point out that CPs should intensify their current practice and all of them have the same opinion that CPs should take the responsibilities to make an accurate triage decision for self-care customers. Almost all stakeholders agree that STARZ-DRP is an ideal framework to help CPs to make an accurate triage decision in community pharmacy settings. 

P792 Breastfeeding in our patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
M Charro Calvillo ◽  
M Charro-Calvillo ◽  
E Peña-Gonzalez ◽  
Y Ber-Nieto ◽  
M T Botella Esteban ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Disease Outbreaks ◽  
World Health Organisation ◽  
Public Hospitals ◽  
World Health ◽  
Great Opportunity ◽  
Inflammatory Bowel ◽  
Almost All ◽  
To Receive

Abstract Background Breastfeeding is one of the most important environmental factors in early childhood for later development of an Inflammatory Bowel Disease. The duration of lactation is essential for it to have a protective effect. In addition to IBD patients, breastfeeding can have a beneficial effect for preventing disease relapse. For these reasons, we plan to know how lactation develops in our group of patients with Inflammatory Bowel Disease (IBD). Methods A retrospective analysis of patients followed by gastroenterology consultations, with established diagnosis of IBD and with at least one gestation, in a period from January 2011 to January 2016. The data were collected a posteriori through two simple questionnaires, one completed by the patient, collecting the type of childbirth and breastfeeding she experienced and factors that influenced it. Another form is filled out by the gastroenterologist recording the characteristics of his inflammatory bowel disease. The data is collected in a structured database in Microsoft Excel and analysed with the SPSS statistic package for Windows. Results Data from 78 patients diagnosed with IBD are analysed from eight public hospitals in our autonomous community. 61.1% of patients have ulcerative colitis and 38.9% Crohn’s disease. The deliveries were mainly vaginal (82%), compared with 18% of caesarean-sections, four of them directly motivated by digestive disease. More than half of patients (57.7%) started breastfeeding after childbirth, 10.25% breastfeeding and 32.05% mixed breastfeeding But only 34.6% reach six months of breastfeeding, reaching 39.7% if we include mixed breastfeeding. In 17 patients (21.8%) their base-based inflammatory bowel disease directly influenced the development of lactation. Pharmacological treatment is the main cause for breastfeeding, followed by disease outbreaks, hospitalisations and surgery. Only 47.4% of the patients stated that in the IBD consultation they were given some information about breastfeeding, although almost all replied that they would have liked to receive it. Conclusion The majority of patients with inflammatory bowel disease in our consultations, do not reach six months of breastfeeding currently recommended by the World Health Organisation, so we have a great opportunity for improvement in this field and as gastroenterologists, we can contribute by providing more information to our patients about breastfeeding and its relationship with IBD.

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