Pharmaco-EcoMicrobiology and Its Potential Role in Medical and Environmental Sciences

Despite the call of the World Health Organization (WHO) for “Pharmacovigilance,” i.e. the monitoring, detection, assessment, and prevention of any adverse reactions, poor attention has been given to identify the long term and short term Adverse Effects (ADEs) of antimicrobial agents on the environment. It is obvious that most of the health sectors across the globe are occupied by infectious diseases (e.g. tuberculosis, HIV, and hepatitis), and to combat such threats, the pharmaceutical industries are pouring tons of drugs and reagents into a market worth billions of dollars. The discharge of these products into the ecosystem is potentially a threat to the environment and human health. In this chapter, the authors depicted a recently described terminology, “Pharmaco-EcoMicrobiology” (PEcM), that could cover these problems and their possible solutions on medical and environmental aspects. In this regard, the role of pharmacoinformatics could also be crucial, since it can provide swift information for implementation and use of information technologies for the discovery and development of drugs as well as in pharmacy education and also the detection and combat of adverse drug effects.

New Technologies in Personalized Decision Support to Enhance Patient Choice

Medical decisions are difficult when there are two or more reasonable options and each option has good and bad features that different people may value differently because of differences in health, risk factors, preferences, or values. Personalized decision support tools are being developed in many areas, but two particularly promising areas are patient decision aids and Risk Prediction Models (RPMs). These personalized decision support tools can help patients and/or providers make better decisions about preventing, managing, or treating disease, taking into consideration specific aspects of an individual patient that distinguish them from an ’average’ patient or the population at large. Decision aids tend to focus on individual differences in preferences and values, whereas RPM’s focus on individual differences in clinical, biological, and behavioral risk factors. There are tremendous opportunities with both approaches, and both have been shown to be able to improve clinical judgment and decision making. Decision support tools are needed that provide personalized service that addresses important individual differences in biology, values, and preferences, and that targets the provider-patient dyad.

Clinical Pharmacists’ Intervention Documentation in Germany with DokuPIK

The next challenge will be the creation of a tool to determine the economic effects of pharmacists’ interventions. Up to now, there is the possibility to enter direct cost savings that can be generated through the rational use of medicines. The calculation of indirect cost savings (for example reduction of the length of stay, reduction of costs arising from inappropriate dosage, adverse effects or interactions, decrease of morbidity and/or mortality) is much more difficult, and therefore has not yet been included into DokuPIK.

A Preliminary Study of the Practices and Processes of B2B E-Commerce Evaluation and Benefits Realization in Taiwanese Hospitals

Many hospitals still have not fully received the expected benefits from their investments in Business-to-Business (B2B) electronic commerce (e-commerce). Senior executives in these hospitals are often under increasing pressure to find a way to evaluate the contribution of their B2B e-commerce investments to business performance and to ensure that the expected benefits from these investments are eventually delivered. This is as true in hospitals as it is in the other industries. However, relatively little research has examined how Taiwanese hospitals evaluate their B2B e-commerce investments and to what extent their B2B e-commerce benefits are realized. Hence, the authors take a multi-case study approach to investigate the practices and processes of B2B e-commerce evaluation and benefits realization and their impact on B2B e-commerce benefits and user satisfaction in Taiwanese hospitals. Issues arising from the study include a lack of B2B benefits realization methodology or process and a lack of understanding of B2B benefits realization practices. The results also reveal that a B2B investment evaluation methodology or process was used in most hospitals interviewed. However, there appears to be a lack of proper B2B investment post-implementation review measures in most participating hospitals. Moreover, the findings also show that the level of B2B investment evaluation methodology or process adoption was directly related to the levels of organizational IT maturity and user satisfaction. Furthermore, the authors found that most Taiwanese hospitals in general had not allocated sufficient resources and funding to undertake proper evaluation of their B2B investments.

Key Issues and Challenges for Managing and Evaluating B2B E-Commerce Projects within the Australian Pharmaceutical Supply Chain

The use of Business-to-Business (B2B) e-commerce within the Australian pharmaceutical supply chain can potentially assist in setting up an infrastructure which supports complex, multiparty Internet-based trading and transactions among pharmaceutical manufacturers, wholesalers, hospitals, pharmacies, medical supply importers and exporters, and other players in the healthcare system. Effective use of B2B e-commerce can help these organizations reduce costs in supplying and distributing medicines and other medical-related products to the general public. However, despite high expectations for realizing the benefits of B2B e-commerce in the pharmaceutical supply chain, issues surrounding its evaluation and management remain poorly understood and relatively under-researched. This chapter presents case study findings on key management and evaluation issues and challenges in adopting and utilizing B2B e-commerce systems on eight pharmaceutical organizations in Australia. The key objectives of this study are: (1) to establish current practices and norms in evaluating B2B e-commerce investments and projects in the pharmaceutical industry; and (2) to identify key B2B e-commerce management issues and challenges within the Australian pharmaceutical supply chain. A key contribution of this chapter is the identification and examination of key issues and challenges faced by the pharmaceutical organizations undertaking B2B e-commerce activities within their supply chain. The findings will guide senior executives in these organizations to develop their own approaches or strategies to manage the opportunities and threats that exist in the Australian pharmaceutical supply chain.

The Humane Dimensions of Effective Communication

All communications, especially those intended to influence attitudes and behaviour, depend on the empathy, creativity, and clarity of those responsible for them. Communications of all kinds, in healthcare and other sectors, can be greatly enhanced by the appropriate use of modern media and technology, but at the heart of effective communications are humane and compassionate purposes and values, which have the welfare of the recipient clearly in focus, whatever the chosen method or medium. This chapter examines ways in which communications in healthcare have often failed to meet the highest standards in protecting the welfare and safety of patients. It proposes a number of strategies for addressing the shortcomings in areas such as information for patients and healthcare professionals, physician and pharmacist consultations, and the avoidance of medicinal and vaccination errors and crises.

The Role of Pharmacovigilance Center in Sudan in Reporting Adverse Drug Reactions

Pharmacovigilance is an active discipline, which is the study of structured mechanisms of the safety of medicines being used in clinical situations in large populations. In this chapter, the authors attempt to characterize the different types of Adverse Drug Reactions (ADRs) and related problems and mechanisms by which they cause harm to patients. They investigate the methods of detection of ADRs and various pharmacovigilance methods. The role and contributions of international organizations will be presented. The authors present the importance and need for education of healthcare professionals about pharmacovigilance and the proper reporting of ADRs for the purpose of efficient and safe use of medicines. The establishment of the Sudan pharmacovigilance center and how the system works will be discussed. Sources of data and actions taken since its inception are presented. The authors conclude by highlighting the problems and weaknesses of the system and ways to strengthen it.

The Health Care Factory

The Health Care Factory is the proposal of a highly integrated system designed with the aim of improving the overall healthcare process management and of obtaining a flexible and deeper understanding of the patient treatment mechanisms. The Health Care Factory is based on a software/hardware infrastructure designed for modeling the healthcare problem—including ubiquitous laboratory automation, miniaturized, and lab-on-a-chip devices management, local (i.e., in the hospital), and remote (telemedicine) patient health control—like an integrated large, real-time, ubiquitous, and distributed discrete plant automation problem.

In Silico Pharmaco-Gene-Informatic Identification of Insulin-Like Proteins in Plants

This chapter presents an extension of the authors’ earlier work, where they showed that nucleotide/amino acid sequences related to insulin occurred in the plant kingdom. It was believed that plants did not have, nor did they need insulin, a protein hormone considered to be restricted to the animal kingdom. In the current study, the human insulin sequence was initially obtained from UniProt/SwissProt (accession no. P01308). Plant genome sequences were obtained from NCBI PubMed (Bauhinia purpurea [Gi|229412], Vigna unguiculata [P83770], and Canavalia ensiformis [Gi|7438602]. Scores were obtained from ProtFun 2.2 [http://www.cbs.dtu.dk/services/ProtFun/]. At the next stage, functions of insulin and glucokinin (insulin like proteins in plants) were predicted by the Protein Function Prediction database (http://dragon.bio.purdue.edu/pfp/index.html), followed by functional site prediction from the ELM database (http://elm.eu.org/). ProtFun predicted the following functions: human insulin (Cell envelope), Jack bean (Energy metabolism), Bauhinia purpurea(Translation). The amino acid Glycine at 32 positions was most highly conserved. Present predictions advocate the use of these sequences (QHLCGS motif) as targets for probing the other plants with lesser homology. In summary our in silico studies have suggested that Bauhinia purpurea (Purple orchid tree-BP), Vigna unguiculata (Cow pea-CP) and Canavalia ensiformis (Jack bean-JB) have conserved the important regions of the human insulin protein.

Statistical Methods Applied in Drug Safety

This chapter introduces the commonly used statistical methods to analyze the safety issues within the DEC and explains their statistical interpretation for a better understanding of the readers.