scholarly journals Strategy to Improve Efficiency of Comprehensive Medication Reviews in a Community Pharmacy

2019 ◽  
Vol 35 (5) ◽  
pp. 194-202
Author(s):  
Diana Ching ◽  
Hussein El-Khatib ◽  
Anthony J. Pattin
Keyword(s):  
Community Pharmacy ◽  
Primary Objective ◽  
Support Staff ◽  
Rank Tests ◽  
Signed Rank ◽  
Before And After ◽  
New Strategy ◽  
Medication Reviews ◽  
Secondary Objective ◽  
Pharmacy Data

Background: Comprehensive medication reviews (CMRs) provide opportunities for pharmacists to perform clinical services to their patients. However, pharmacists are often not able to perform CMRs due to time constraints. Studies have shown that incorporating support staff into the CMR workflow may lead to increases in the completion of CMRs. Objective: The primary objective was to examine the change in the number of CMRs completed at the pharmacy after a new strategy was implemented to perform and prepare for CMRs. The secondary objective was to examine the changes in the revenue generated from CMRs. Methods: This study was a pre-post retrospective, observational study performed at an independent pharmacy. Data were collected and analyzed 10 months before and after implementation of a new strategy. The new strategy called for pharmacy interns to use a template for working up patients prior to CMRs. Wilcoxon signed-rank tests were run on IBM SPSS, Version 24.0, to determine the significance of the changes. Results that generated P values <.05 were considered statistically significant. Results: The total number of CMRs completed increased from 29 before the intervention to 158 after the intervention ( P = .009). The revenue generated from CMRs improved statistically ( P = .007). Conclusions: Implementing a strategic workflow that uses pharmacy interns and a patient workup template can significantly increase the number of CMRs completed in a community pharmacy. Appropriate delegation of such tasks may allow more time for pharmacists to deliver more CMRs. Additional benefits include increased compensation from delivering more CMRs.

scholarly journals Effect of voice therapy in sulcus vocalis: A single case study

2016 ◽  
Vol 63 (1) ◽  
Author(s):  
R. Rajasudhakar
Keyword(s):  
Single Case ◽  
Voice Quality ◽  
Severity Index ◽  
Primary Objective ◽  
Voice Therapy ◽  
Breath Holding ◽  
Before And After ◽  
Secondary Objective ◽  
Sulcus Vocalis ◽  
Push And Pull

Background: Sulcus vocalis is a structural deformity of the vocal ligament. It is the focal invagination of the epithelium deeply attaching to the vocal ligament. There is a dearth of literature on the outcome of voice therapy in sulcus vocalis condition.Objective: The primary objective of this study was to document voice characteristics of sulcus vocalis and the secondary objective was to establish the efficacy of voice therapy in a patient with sulcus vocalis.Method: A trial of voice therapy was given to the client who was diagnosed as having sulcus vocalis. Boon’s facilitation techniques were used in voice therapy along with other techniques such as breath holding and push and pull approach prior to surgery. Acoustic, aerodynamic, perceptual, quantitative measures of voice quality and self-rating measurements were performed before and after voice therapy.Results: Improvement was noticed in 10/10 acoustic, 4/4 aerodynamic, perceptual, dysphonia severity index and voice handicap index scores, which hinted that voice therapy can be an option critically for clients with sulcus vocalis in the initial stage.Conclusion: Voice therapy showed promising improvement in the study and it must be recommended as the initial treatment option before any surgical management.

scholarly journals Integration of rotational angiography enables better dose planning in Gamma Knife radiosurgery for brain arteriovenous malformations

2018 ◽  
Vol 129 (Suppl1) ◽  
pp. 17-25 ◽  
Author(s):  
Hirotaka Hasegawa ◽  
Shunya Hanakita ◽  
Masahiro Shin ◽  
Mariko Kawashima ◽  
Taichi Kin ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Gamma Knife ◽  
Arteriovenous Malformations ◽  
Gamma Knife Radiosurgery ◽  
Volume Ratio ◽  
Rotational Angiography ◽  
Rank Tests ◽  
Signed Rank ◽  
Dose Planning ◽  
Before And After

OBJECTIVEIn Gamma Knife radiosurgery (GKS) for arteriovenous malformations (AVMs), CT angiography (CTA), MRI, and digital subtraction angiography (DSA) are generally used to define the nidus. Although the AVM angioarchitecture can be visualized with superior resolution using rotational angiography (RA), the efficacy of integrating RA into the GKS treatment planning process has not been elucidated.METHODSUsing data collected from 25 consecutive patients with AVMs who were treated with GKS at the authors’ institution, two neurosurgeons independently created treatment plans for each patient before and after RA integration. For all patients, MR angiography, contrasted T1 imaging, CTA, DSA, and RA were performed before treatment. The prescription isodose volume before (PIVB) and after (PIVA) RA integration was measured. For reference purposes, a reference target volume (RTV) for each nidus was determined by two other physicians independent of the planning surgeons, and the RTV covered by the PIV (RTVPIV) was established. The undertreated volume ratio (UVR), overtreated volume ratio (OVR), and Paddick’s conformal index (CI), which were calculated as RTVPIV/RTV, RTVPIV/PIV, and (RTVPIV)2/(RTV × PIV), respectively, were measured by each neurosurgeon before and after RA integration, and the surgeons’ values at each point were averaged. Wilcoxon signed-rank tests were used to compare the values obtained before and after RA integration. The percentage change from before to after RA integration was calculated for the average UVR (%ΔUVRave), OVR (%ΔOVRave), and CI (%ΔCIave) in each patient, as ([value after RA integration]/[value before RA integration] − 1) × 100. The relationships between prior histories and these percentage change values were examined using Wilcoxon signed-rank tests.RESULTSThe average values obtained by the two surgeons for the median UVR, OVR, and CI were 0.854, 0.445, and 0.367 before RA integration and 0.882, 0.478, and 0.463 after RA integration, respectively. All variables significantly improved after compared with before RA integration (UVR, p = 0.009; OVR, p < 0.001; CI, p < 0.001). Prior hemorrhage was significantly associated with larger %ΔOVRave (median 20.8% vs 7.2%; p = 0.023) and %ΔCIave (median 33.9% vs 13.8%; p = 0.014), but not %ΔUVRave (median 4.7% vs 4.0%; p = 0.449).CONCLUSIONSIntegrating RA into GKS treatment planning may permit better dose planning owing to clearer visualization of the nidus and, as such, may reduce undertreatment and waste irradiation. Further studies examining whether the observed RA-related improvement in dose planning also improves the radiosurgical outcome are needed.

scholarly journals IMPROV FOR CARE: TEACHING CAREGIVERS IMPROVISATION IMPROVES MOOD AND SENSE OF BURDEN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S852-S852
Author(s):  
Ruth Almen ◽  
Jessica Z Kirkland Caldwell
Keyword(s):  
Depressive Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Care Program ◽  
Course Completion ◽  
Rank Tests ◽  
Post Intervention ◽  
Signed Rank ◽  
Before And After ◽  
And Coping

Abstract There is a growing need for novel intervention for caregivers of family members with dementia. Improv for Care is a six-week program designed to teach improvisation (“improv”) skills to caregivers to practice flexible communication, build social support, and process the demands of caregiving through humor and play. This study aimed to examine changes in caregiver depression (Beck Depression Inventory-II), perception of burden (Zarit Burden Interview), qualitative experiences related to caregiving, and their cared-for person’s neuropsychiatric symptoms (Neuropsychiatric Inventory Questionnaire). Fifteen caregivers completed questionnaires before and after the Improv for Care program. Wilcoxon signed rank tests for related samples revealed significant declines in both caregivers’ depressive symptoms, Z = -2.64, p = .008, and sense of burden, Z = -2.16, p = .031, after completing the program. Caregivers reported that their loved ones’ neuropsychiatric symptoms increased during the course of the intervention, Z = -2.10, p = .036, though associated distress did not also increase, Z = -1.12, p = .265. Of the 15 caregivers, 12 completed follow up questionnaires three months after course completion, which showed that their post-intervention reduction in depressive symptoms remained stable, Z = -1.02, p = .306. The Improv for Care program shows promise as an intervention for caregivers to improve stress, mood, and coping skills.

scholarly journals Clinical and Organizational Impacts of Medical Ordering Settings on Patient Pathway and Community Pharmacy Dispensing Process: The Prospective ORDHOSPIVILLE Study

Pharmacy ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 2
Author(s):  
Justine Clarenne ◽  
Julien Gravoulet ◽  
Virginie Chopard ◽  
Julia Rouge ◽  
Amélie Lestrille ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Community Pharmacists ◽  
Patient Discharge ◽  
Primary Objective ◽  
Process Time ◽  
Drug Related Problems ◽  
Patient Pathway ◽  
Primary Care Settings ◽  
Secondary Objective ◽  
A Prospective Study

During the dispensing process of medical orders (MOs), community pharmacists (CPs) can manage drug-related problems (DRPs) by performing pharmacist interventions (PIs). There is little evidence that the PI rate is higher with MOs from hospitals (MOHs) than ambulatory (MOAs) settings, and their impact on the patient and community pharmacy is unknown. The primary objective of this study was to compare the MOH and MOA PI rates. The secondary objective was to describe PIs and their clinical and organizational impacts on patient and community pharmacy workflow. A total of 120 CPs participated in a prospective study. Each CP included 10 MOH and 10 MOA between January and June 2020. DRP and PI description and clinical and organizational impacts between MOH and MOA were assessed and compared. We analyzed 2325 MOs. PIs were significantly more frequent in MOH than in MOA (9.7% versus 4.7%; p < 0.001). The most reported PI was the difficulty of contacting hospital prescribers (n = 45; 52.2%). MOHs were associated with a longer dispensing process time and a greater impact on patient pathway and community pharmacy workflow than MOAs. Lack of communication between hospital and primary care settings partly explains the results. Implementation of clinical pharmacy activities at patient discharge could alleviate these impacts.

scholarly journals Whitening Efficacy of 3% Carbamide Peroxide Gel Activated by Lactoperoxidase

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Mehdi Khemiss ◽  
Ines Kallel ◽  
Hela Zouaghi ◽  
Mohamed Ben Khelifa ◽  
Sana Bagga
Keyword(s):  
Clinical Study ◽  
Carbamide Peroxide ◽  
Rank Tests ◽  
Tooth Color ◽  
Color Changes ◽  
Signed Rank ◽  
Before And After ◽  
Mandibular Incisors

Objective. The aim of this clinical study was to evaluate the effectiveness of a whitening toothpaste containing 3% carbamide peroxide and lactoperoxidase. Materials and methods. Participants were instructed to brush their teeth using an enzymatic-activated dentifrice following a particular procedure for three weeks. Color was recorded before and after treatment using a VITA Easyshade spectrophotometer. Differences in L ∗ (tooth color lightness), a ∗ (displacement along the red-green axis), and b ∗ (displacement along the yellow-blue axis) were measured before and after treatment using the paired t and the Wilcoxon signed-rank tests. Color changes (ΔE) were calculated using the obtained measurements. Results. Thirty-four volunteers were included. ΔE was 4.03. For the set of 348 teeth, a greater tendency towards green (lower a ∗ ) and blue (lower b ∗ ) was observed ( p  < 0.05). There were no significant differences in lightness after treatment. Mandibular central incisors showed a greater tendency towards green (lower a ∗ ) and blue (lower b ∗ ). Bleaching effectiveness was observed in both the upper and lower central incisors and in the lateral mandibular incisors. Conclusion. Based on these results, it may be concluded that brushing with an enzymatic-activated dentifrice is effective for whitening teeth.

Efficacy of Ḥammām-i-yābis (dry bath) in metabolic syndrome: a single arm, open-labelled clinical trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mohammad Zaki Ahmad ◽  
Abdul Nasir Ansari ◽  
Mohd Nayab
Keyword(s):  
Metabolic Syndrome ◽  
Clinical Trial ◽  
Primary Objective ◽  
Repeated Measure ◽  
Serum Triglycerides ◽  
Before And After ◽  
Safety Parameters ◽  
Secondary Objective

Abstract Objectives This study intended to evaluate the efficacy of Ḥammām-i-yabis (dry bath) in metabolic syndrome as primary objective and perceived improvement and changes in quality of life as secondary objective. Methods The study was designed as single arm, open-labelled, pre and post without control clinical trial comprising 30 diagnosed cases of metabolic syndrome belonging to 20–50 years of age of either sex. The enrolled patients were exposed to the dry heat of Ḥammām-i-yābis for 15 min at a temperature of 60 degree centigrade on every third day for a duration of 30 days (A total of 10 sittings). Objective parameters comprising systolic &diastolic blood pressure and waist circumference were assessed on every follow up, while other objective parameters (FBS, HDL and Serum Triglycerides) were assessed before and after the study. Results Significant statistical difference was observed in objective parameters. Two tailed paired Student’s t-test, (for pre and post) and Repeated Measure ANOVA (for 0, 15th and 30th day) were used to find the significance of mean change in study parameters. No significant adverse change appeared in safety parameters. Conclusions Ḥammām-i-yābis was found effective, safer, more feasible and less expensive regimenal modality for the patients of Metabolic Syndrome.

The Student Room Survey: Changes in the Post Graduate Study for Cardiothoracic Surgery

2020 ◽  
Vol 23 (2) ◽  
pp. 71-74
Author(s):  
Md Faizus Sazzad ◽  
Mohammed Moniruzzaman ◽  
Dewan Iftakher Raza Choudhury ◽  
Arif Ahmed Mohiuddin ◽  
Raafi Rahman ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Retrospective Analysis ◽  
Primary Objective ◽  
Graduate Study ◽  
Postgraduate Students ◽  
Depth Interview ◽  
Secondary Objective ◽  
Cardio Vascular ◽  
The University ◽  
Day By Day

Background: The number of postgraduate students in Cardiac surgical discipline is increasing day by day with incremental proportion are measurably suffering from the unnecessary lingering of the present course curriculum. The primary objective of this study was to find out the last 5 years’ of results of Masters in Surgery course under the University of Dhaka from a student room survey. A secondary objective was to find out positive changes that could show us the way of a step toward up-gradation. Methods: It is a retrospective analysis of all examination results of Cardio-vascular & Thoracic Surgery published since January 2008 to January 2013 from the University of Dhaka with in depth interview of 11 participants. Results: 85.24% students failed to pass part-I of Masters in Surgery for Cardio-vascular & Thoracic Surgery course while, 82.18% in part-II and 71.28% failed to pass the final part. Average 2.51 attempts needed to complete each part of the designed course resulted into lingering of course duration for 42.18 months/student. In the thoracic surgery discipline the number of students alarmingly reduced up to 0% in the recent academic sessions. Conclusions: Masters in Surgery is resulting in unnecessary prolongation of the course. We should step forward to meet the next generation challenge. Journal of Surgical Sciences (2019) Vol. 23(2): 71-74

Epidemiology of pheochromocytoma and paraganglioma: population-based cohort study

2021 ◽  
Vol 184 (1) ◽  
pp. 19-28
Author(s):  
Alexander A Leung ◽  
Janice L Pasieka ◽  
Martin D Hyrcza ◽  
Danièle Pacaud ◽  
Yuan Dong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Administrative Data ◽  
Laboratory Data ◽  
Population Based ◽  
Incidence Rates ◽  
Primary Objective ◽  
Administrative Databases ◽  
Secondary Objective ◽  
True Frequency ◽  
Clinical Records

Objective Despite the significant morbidity and mortality associated with pheochromocytoma and paraganglioma, little is known about their epidemiology. The primary objective was to determine the incidence of pheochromocytoma and paraganglioma in an ethnically diverse population. A secondary objective was to develop and validate algorithms for case detection using laboratory and administrative data. Design Population-based cohort study in Alberta, Canada from 2012 to 2019. Methods Patients with pheochromocytoma or paraganglioma were identified using linked administrative databases and clinical records. Annual incidence rates per 100 000 people were calculated and stratified according to age and sex. Algorithms to identify pheochromocytoma and paraganglioma, based on laboratory and administrative data, were evaluated. Results A total of 239 patients with pheochromocytoma or paraganglioma (collectively with 251 tumors) were identified from a population of 5 196 368 people over a period of 7 years. The overall incidence of pheochromocytoma or paraganglioma was 0.66 cases per 100 000 people per year. The frequency of pheochromocytoma and paraganglioma increased with age and was highest in individuals aged 60–79 years (8.85 and 14.68 cases per 100 000 people per year for males and females, respectively). An algorithm based on laboratory data (metanephrine >two-fold or normetanephrine >three-fold higher than the upper limit of normal) closely approximated the true frequency of pheochromocytoma and paraganglioma with an estimated incidence of 0.54 cases per 100 000 people per year. Conslusion The incidence of pheochromocytoma and paraganglioma in an unselected population of western Canada was unexpectedly higher than rates reported from other areas of the world.

Incidência da utilização de protetores bucais em diversos esportes de contato

2020 ◽  
Vol 12 (45) ◽  
pp. 118-122
Author(s):  
Victor Paes Dias Gonçalves ◽  
Hugo Leonardo Matias Nahmias ◽  
Marcus Menezes Alves Azevedo
Keyword(s):  
Martial Arts ◽  
Rio De Janeiro ◽  
Dental Trauma ◽  
Primary Objective ◽  
Type Ii ◽  
Contact Sports ◽  
The Face ◽  
Secondary Objective ◽  
The City

Among contact sports, the practice of martial arts offers a greater risk of causing dental trauma and fractures as contact with the face is more frequent. The primary objective of the research is to evaluate the incidence of mouthguard use, and the secondary objective is to verify which type has a greater predominance and the difficulties in its use correlating to the type of mouthguard used. A documentary study was carried out with 273 athletes of different contact sports, among them: MMA, Boxing, Muay Thai, Jiu-Jitsu, and Taekwondo of the city of Campos dos Goytacazes, Rio de Janeiro, Brazil. It was concluded that the most commonly used mouthguard is PB Boils and Bites - Type II and its level of approval is poor, interfering with the athletes’ performance, mainly in relation to the breathing factor.

The Degree of Subjective Complaints of Students Practice in Mechanical Technology Laboratories

2018 ◽  
Vol 4 (1) ◽  
pp. 22
Author(s):  
I Ketut Widana
Keyword(s):  
Engineering Students ◽  
Standing Position ◽  
Statistical Test ◽  
Rank Test ◽  
Cross Sectional ◽  
Signed Rank ◽  
Before And After ◽  
Signed Rank Test ◽  
The Difference ◽  
Paired T Test

The working practice of the engineering students is part of the learning process that is irreducible and indispensable. The composition of  lecturing between theoretical and practical one is 40% to 60%. With this condition, the students spend more time at the laboratory. Generally, the students perform in the laboratory work by standing position. The design of research is observational cross-sectional. The method applied is observation, interview and measuring. The subjects of research are practicing students amounting to 21 students. Referring to the analysis of statistical test or Wilcoxon signed ranks test, the difference of effect of work position is significant, namely p < 0.05 towards musculoskeletal disorders (MSDs) before and after working. The quantity of the average complaint after working is score 44.62 ± 9.47. The result of Wilcoxon signed rank test shows that there is significant different effects of standing work position, namely p < 0.05 towards fatigue generally before and after working. The degree of the working pulse is on the average of 110.78  ± 17.80 bpm (beats per minutes) which can be categorized into the medium workload. Using paired t-test, the result is p < 0.05.

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