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Texto completo SciELO Espanha
Id: 184683
Autor: Ayadurai, Shamala; Sunderland, Bruce; Tee, Lisa B; Hattingh, H Laetitia.
Título: A training program incorporating a diabetes tool to facilitate delivery of quality diabetes care by community pharmacists in Malaysia and Australia
Fonte: Pharm. pract. (Granada, Internet);17(2):0-0, abr.-jun. 2019. tab.
Idioma: en.
Resumo: Objectives: To assess a clinical training program on management of Type 2 Diabetes Mellitus (T2DM) incorporating a diabetes tool, the Simpler(TM) tool. Subsequently pharmacists' experience utilising the tool to deliver structured, consistent, evidence-based T2DM care was explored. Methods: Full-time non-credentialed diabetes pharmacists providing diabetes medication management services in community settings were purposively recruited. Participants had either face-to-face or online training on diabetes management using the tool which took about two hours and 20 minutes to complete. Their diabetes management knowledge was assessed pre- and post-training using quantitative methodology. They were then required to apply the tool in daily practice for one month. Feedback on both the training sessions and tool utilisation were obtained through semi-structured interviews and analysed using a qualitative approach. Results: Twelve pharmacists participated: Six from Australia and six from Malaysia. Before attending the training session, their median test score was 6.5/27, IQR 1.4 (1st marker) and 5.3/27, IQR 2.0 (2nd marker). After training, the scores doubled to 14.3/27, IQR 4.5 (1st marker) and 11.3/27, IQR 3.1 (2nd marker), showing significant improvements (p=0.002). Interview data identified perceived effectiveness factor through use of the tool. Participants found the content relevant, structured, concise and easy to understand; enabled comprehensive medication reviews; focused on achieving glycaemic improvement; facilitated documentation processes and pharmacists' role in T2DM management; and as a specific aid for diabetes management. Barriers included lack of accessibility to patients' laboratory data in Australia. Conclusions: The targeted training improved pharmacists' knowledge on diabetes management and supported the Simpler(TM) tool use in practice as a structured and beneficial method to deliver evidence-based T2DM care

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Id: 184677
Autor: Mishriky, John; Stupans, Ieva; Chan, Vincent.
Título: An investigation of the views and practices of Australian community pharmacists on pain and fever management and clinical guidelines
Fonte: Pharm. pract. (Granada, Internet);17(2):0-0, abr.-jun. 2019. tab.
Idioma: en.
Resumo: Background: Fever and pain are common conditions in the Australian healthcare setting. Whilst clinical guidelines provide important therapeutic recommendations, evidence suggests they are not always followed. Given that community pharmacy is one of the most frequently accessed primary healthcare services, it is important to understand the views and practices of community pharmacists in pain and fever. Objectives: To investigate the views and practices of Australian community pharmacists in pain and fever management, and their views on relevant clinical guidelines. Methods: A cross-sectional study of community pharmacists in Australia was conducted using a customised, anonymous, self-administered, online questionnaire between March and May 2018. To capture a broad range of demographics, pharmacists were recruited via local industry contacts and the Pharmaceutical Society newsletter, with further recruitment through snowball sampling. The main outcomes measured were pharmacists' views, practices and treatment recommendation of choice in pain and fever management, as well as views on clinical guidelines and training. Results: A total of 113 pharmacists completed the survey. In general, paracetamol (72%) was preferred as a recommendation over ibuprofen, and was the drug of choice for most mild to moderate pain and fever scenarios. Majority of pharmacists reported good knowledge of pain and fever management, however, only approximately half reported recent pain management training. Greater than 87% of pharmacists believe that clinical guidelines are useful in fever management, and 79% of pharmacists believe that following clinical guidelines is important in pain management. Conclusions: While most pharmacists recognise the importance of guidelines and demonstrated good pain and fever management, results suggests opportunities to promote additional education, upskilling, and research in this space to further optimise pain and fever management in the community

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Id: 184602
Autor: Mishriky, John; Stupans, Ieva; Chan, Vincent.
Título: Expanding the role of Australian pharmacists in community pharmacies in chronic pain management - a narrative review
Fonte: Pharm. pract. (Granada, Internet);17(1):0-0, ene.-mar. 2019.
Idioma: en.
Resumo: Chronic pain is a condition where patients continuously experience pain symptoms for at least 3 to 6 months. It is one of the leading causes of disabilities across the globe. Failure to adequately manage chronic pain often results in additional health concerns that may directly contribute to the worsening symptoms of pain. Community pharmacists are an important healthcare resource that contributes to patient care, yet their roles in chronic pain management are often not fully utilised. This review aimed to investigate and explore pharmacist-driven chronic pain educational and medication management interventions in community pharmacies on an international level, and thereby identify if there are potential benefits in modelling and incorporating these interventions in the Australian community. We found a number of studies conducted in Europe and the United States investigated the benefits of pharmacist-driven educational and medication management interventions in the context of chronic pain management. Results demonstrated that there were improvements in the pain scores, depression/anxiety scales and physical functionality in patient groups receiving the pharmacist driven-interventions, thereby highlighting the clinical benefit of these interventions in chronic pain. In conclusion, pharmacists are trustworthy and responsible advocates for medication reviews and patient education. There are currently very limited formal nationally recognised pharmacist-driven intervention programs dedicated to chronic pain management in Australian community pharmacies. International studies have shown that pharmacist-driven chronic pain interventions undertaken in community pharmacies are of benefit with regards to alleviating pain symptoms and adverse events. Furthermore, it is also clear that research around the application of pharmacist-led chronic pain interventions in Australia is lacking. Modelling interventions that have been conducted overseas may be worth exploring in Australia. The implementation of similar intervention programs for Australian pharmacists in community pharmacies may provide enhanced clinical outcomes for patients suffering from chronic pain. The recently implemented Chronic Pain MedsCheck Trial may provide some answers

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Id: 182731
Autor: Martín-Ibáñez, Luis; Pérez-Martínez, Juan; Zamora-Mínguez, David; Alcón-Rubio, Francisco; González-Alonso, Valentín; Aroca García-Rubio, Sara; Hernández-Hernández, Jesús Manuel; Díaz, Feliciano; Román-López, Pablo.
Título: Consenso Victoria I: la cadena de supervivencia táctica civil ante incidentes de múltiples víctimas intencionados / A civilian tactical survival chain for incidents involving multiple intentionalinjury victims: the Victory I Consensus Report
Fonte: Emergencias (Sant Vicenç dels Horts);31(3):195-201, jun. 2019. graf, tab.
Idioma: es.
Resumo: Son múltiples las recomendaciones internacionales que aconsejan adaptar modelos asistenciales del entorno militar a incidentes de múltiples víctimas intencionados (IMVI) ocurridos en el entorno civil, bien por el tipo de patrón lesional, bien por aspectos de seguridad y autoprotección. Debido a la experiencia en Norteamérica, donde este tipo de situaciones son más frecuentes, casi toda la bibliografía y referencias existentes no se corresponden con un modelo de sistemas de emergencias médicas como el que existe en las distintas comunidades autónomas españolas, con sus diferentes medios y procedimientos tal y como viene estipulado por sus competencias exclusivas en esta materia. No obstante, se han detectado una serie de elementos comunes que pueden servir de referencia para elaborar un plan de respuesta a los IMVI, basados en la evidencia y utilizando principios de actuación dirigidos a una acción eficaz y eficiente. Pensamos que cada actor de los eslabones de esta cadena asistencial debe tener clara su misión, su rol y su función en las diferentes zonas de la escena, y así se intentan definir en este documento de consenso, desde un primer interviniente ocasional hasta la asistencia definitiva en los centros de referencia para pacientes traumatizados

International guidelines recommend adapting military health care protocols to emergencies involving multiple intentional-injury victims in civilian environments. Adaptations can reflect similarities in types of injuries or issues of provider safety and that arise in military and some civilian emergencies. Because more experience with such incidents has been gained in the United States, most of the literature on this topic discusses emergency medical systems that differ from the ones operating in the autonomous communities of Spain, where varying resources and procedures are mandated by local authorities charged with preparing for emergencies. However, common elements are present, offering a framework and principles to apply when drafting evidence-based plans for effective, efficient response to multiple-victim emergencies. We think that participants at each point in the chain of survival must have clear missions and understand the roles they play in the various zones that comprise the scene of an emergency. Therefore this consensus paper attempts to define the relevant principles and roles for participants at all levels, from occasional first responders up to staff at trauma referral centers
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Id: 179478
Autor: Alcaide, Fernando; Esteban, Jaime.
Título: Infecciones cutáneas y de partes blandas por micobacterias no tuberculosas / Cutaneous and soft skin infections due to non-tuberculous mycobacteria
Fonte: Enferm. infecc. microbiol. clín. (Ed. impr.);28(supl.1):46-50, ene 2010. ilus, tab.
Idioma: es.
Resumo: En los últimos años se ha observado un aumento en el número de aislamientos y variedad de especies de micobacterias no tuberculosas (MNT). Aunque la totalidad de las MNT patógenas pueden causar infecciones cutáneas y de tejidos blandos, las más frecuentes son las de crecimiento rápido (Mycobacterium fortuitum, Mycobacterium chelonae y Mycobacterium abscessus), Mycobacterium marinum y Mycobacterium ulcerans. La mayoría de las micobacteriosis cutáneas están causadas por especies de distribución mundial, como las micobacterias de crecimiento rápido, M. marinum, complejo Mycobacterium avium, Mycobacterium kansasii o Mycobacterium xenopi. Sin embargo, otras tienen una delimitación geográfica, como M. ulcerans, que produce una infección cutánea endémica, sobre todo en África central y occidental (úlcera de Buruli) y Australia (úlcera de Bairnsdale), donde es la tercera enfermedad micobacteriana más frecuente tras la tuberculosis y la lepra. Las micobacteriosis cutáneas suelen producirse por la exposición de heridas traumáticas o quirúrgicas al agua o productos contaminados con MNT, o bien por una enfermedad diseminada, mayormente, en los pacientes inmunodeprimidos. Para el diagnóstico, es necesario un elevado grado de sospecha ante lesiones cutáneas crónicas en pacientes con antecedentes de heridas cutáneas y exposición de riesgo, y con estudios microbiológicos convencionales negativos. En la mayoría de las MNT no se suele recomendar las pruebas de sensibilidad convencionales a los fármacos, salvo en ciertas especies, o en caso de fracaso terapéutico. El tratamiento se basará en la combinación de diversos antimicrobianos, teniendo en cuenta que las MNT presentan una mayor resistencia a los antituberculosos convencionales. En los casos graves y con afectación de tejidos o estructuras profundas se deberá recurrir al tratamiento quirúrgico

The frequency of isolation as well as the number of species of non-tuberculous mycobacteria (NTM) has increased in the last years. Nearly every pathogenic species of NTM may cause skin and soft tissue infections, but rapidly growing mycobacteria (Mycobacterium fortuitum, Mycobacterium chelonae and Mycobacterium abscessus), Mycobacterium marinum and Mycobacterium ulcerans are the most commonly involved. Many of these cutaneous mycobacteriosis, such as rapidly growing mycobacteria, M. marinum, Mycobacterium avium complex, Mycobacterium kansasii or Mycobacterium xenopi are world-wide distributed. In contrast, some others have a specific geographical distribution. This is the case of M. ulcerans, which causes a cutaneous diseases endemic of Central and West Africa (Buruli ulcer) and Australia (Bairnsdale ulcer), being the third mycobacterial infection after tuberculosis and leprosy. Cutaneous mycobacteriosis usually appear either after contact of traumatic or surgical wounds with water or other contaminated products, or, secondarily, as a consequence of a disseminated mycobacterial disease, especially among immunosuppressed patients. For an early diagnosis, it is necessary to maintain a high degree of suspicion in patients with chronic cutaneous diseases and a history of trauma, risk exposure and negative results of conventional microbiological studies. In general, individualized susceptibility testing is not recommended for most NTM infections, except for some species, and in case of therapeutic failure. Treatment includes a combination of different antimicrobial agents, but it must be taken into account that NTM are resistant to conventional antituberculous drugs. Severe cases or those with deep tissues involvement could also be tributary of surgical resection
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Id: 174807
Autor: Tan, Rachel; Cvetkovski, Biljana; Kritikos, Vicky; Yan, Kwok; Price, David; Smith, Peter; Bosnic-Anticevich, Sinthia.
Título: Management of allergic rhinitis in the community pharmacy: identifying the reasons behind medication self-selection
Fonte: Pharm. pract. (Granada, Internet);16(3):0-0, jul.-sept. 2018. tab, graf.
Idioma: en.
Resumo: Background: Community pharmacists have a key role to play in the management of allergic rhinitis (AR). Their role is especially important because the majority of medications used to treat AR are available for purchase over-the-counter (OTC), allowing patients to self-select their own medications and bypass the pharmacists. Patients' self-selection often results in suboptimal treatment selection, undertreated AR and poor clinical outcomes. In order for pharmacists to optimise the care for AR patients in the pharmacy, pharmacists need to be able to identify patient cohorts who self-select and are at high risk of mismanagement. Objectives: This study aimed to compare the demographics, clinical characteristics and medication selected, between pharmacy customers who choose to self-select and those who speak with a pharmacist when purchasing medication for their AR in a community pharmacy and identify factors associated with AR patients' medication(s) self-selection behaviour. Methods: A cross-sectional observational study was conducted in a convenience sample of community pharmacies from the Sydney metropolitan area. Demographics, pattern of AR symptoms, their impact on quality of life (QOL) and medication(s) selected, were collected. Logistic regressions were used to identify factors associated with participants' medication self-selection behaviour. Results: Of the 296 recruited participants, 202 were identified with AR; 67.8% were female, 54.5% were >40 years of age, 64.9% had a doctor's diagnosis of AR, and 69.3% self-selected medication(s). Participants with AR who self-select were 4 times more likely to experience moderate-severe wheeze (OR 4.047, 95% CI 1.155-14.188) and almost 0.4 times less likely to experience an impact of AR symptoms on their QOL (OR 0.369, 95% CI 0.188-0.727). Conclusions: The factors associated with AR patients' self-selecting medication(s) are the presence of wheeze and the absence of impact on their QOL due to AR symptoms. By identifying this cohort of patients, our study highlights an opportunity for pharmacists to engage these patients and encourage discussion about their AR and asthma management

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Id: 174795
Autor: Mostaghim, Mona; Snelling, Tom; Katf, Hala; Bajorek, Beata.
Título: Paediatric antimicrobial stewardship and safe prescribing: an assessment of medical staff knowledge and behaviour
Fonte: Pharm. pract. (Granada, Internet);16(2):0-0, abr.-jun. 2018. tab, graf.
Idioma: en.
Resumo: Objective: Determine baseline knowledge of antimicrobial stewardship, and safe prescribing among junior medical officers, monitor their level of participation in interactive education during protected teaching time and assess day-to-day prescribing behaviours over the subsequent 3-month period. Methods: A voluntary and anonymous survey of all non-consultant level medical officers was conducted with the use of an audience response system during mandatory face-to-face orientation sessions at a tertiary paediatric hospital. Routine prescribing audits monitored compliance with national and locally derived quality use of medicines indicators. Results: Eighty-six percent of medical officers participated by responding to at least one question (171/200). Response rate for individual questions ranged between 31% and 78%. Questions that addressed adverse drug reactions, documentation and monitoring for empiric antibiotics and the error-prone abbreviations IU and U were correctly answered by over 90% of participants. Other non-standard and error-prone abbreviations were less consistently identified. In practice, 68% of patients had complete adverse drug reaction documentation (113/166). Error-prone abbreviations were identified on 5% of audited medication orders (47/976), approximately half included a documented indication and intended dose. Conclusions: Participants demonstrated a good understanding of safe prescribing and antimicrobial stewardship. Audits of prescribing identified potential discrepancies between prescribing knowledge and behaviours

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Id: 171852
Autor: Yiu, Angela W; Bajorek, Beata V.
Título: Health literacy and knowledge in a cohort of Australian patients taking warfarin
Fonte: Pharm. pract. (Granada, Internet);16(1):0-0, ene.-mar. 2018. tab, graf.
Idioma: en.
Resumo: Objectives: To 1) characterise older patients taking warfarin, 2) assess these patients' level of warfarin knowledge, and 3) describe their strengths and limitations in health literacy, and 4) explore relationships between participants' characteristics, warfarin knowledge and health literacy. Methods: A warfarin knowledge questionnaire and Health Literacy Questionnaire (HLQ) were administered to older patients (aged >65 years, N=34) taking warfarin in an Australian general practice setting. Results: Key gaps in participant knowledge pertained to the consequences of an international normalized ratio (INR) being below the target INR range and safety issues such as when to seek medical attention. A limitation for participants with a lower level of health literacy was the ability to appraise health information. Patients who needed assistance in completing the HLQshad significantly lower warfarin knowledge scores (p=0.03). Overseas-bornparticipants and those taking 5 or more long-term medications had lower HLQ scores for specific scales (p<0.05).Conclusion: In this study warfarin knowledge gaps and a limitation of health literacy amongst a small sample of older patients were identified. The findings suggest that education and resources may need to be tailored to the needs of older patients taking warfarin and their carers to address these knowledge gaps and limitations in health literacy. Patients who may need greater support include those that need assistance in completing the HLQ, are overseas-born, or are taking 5or morelong-term medications (AU)

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Id: 169680
Autor: Santos, A; Tavares, F.
Título: The Introduction stage of Basketball players. A view from Basketball Experts / La etapa de introducción de los jugadores de baloncesto. Consideraciones de expertos de baloncesto / A fase de introdução dos jogadores de basquete. Uma visão de especialistas em basquete
Fonte: Cuad. psicol. deporte;17(3):169-174, sept. 2017. tab.
Idioma: en.
Resumo: This study aimed to examine the introduction stage of basketball participants in countries that are ranked within the top 20 basketball countries by FIBA. Through the use of semi structured interviews, data was collected from 16 technical experts from 6 countries. We analyzed the introductory phase determining: the age at which participants start in the programs; the different avenues or forms of entry in to the sport; the objectives defined and pursued in these stages; the structure of the competitive contests and the multi-sport involvement and specialization. The data revealed an age range of 5 to 12 years for the introduction of participants to basketball. Various settings for the introduction in the sport were found to exist. USA stands out with a maximum of 7 options. Regarding the main objectives in basketball introduction, the data revealed a balance between the three learning domains, with a slight increase of the affirmative and psychomotor over the cognitive. In terms of competition there is a common standard across countries that contests during the period of introduction are focused in enjoyment and stimulation. Several strategies are used in all countries, (e.g. reducing the size of the ball, number of players, height of the basket) are used to accommodate the game to the children abilities and to the objectives of the introductory stage. In terms of multi-sport participation and the ages at which specialization in basketball should occur, opinions are favorable to a multi-sport diversification, and the average age of specialization was 15 (AU)

Este estudio tuvo como objetivo examinar la etapa de presentación de los participantes de baloncesto de los países que se clasifican dentro de los 20 países de baloncesto superior por la FIBA. Mediante el uso de entrevistas semiestructuradas, se recogieron datos de 16 expertos técnicos de 6 países. Hemos analizado la fase de introducción determinando: la edad en que los participantes comienzan en los programas; las diferentes vías o formas de entrada en el deporte; los objetivos perseguidos y definidos en estas etapas; la estructura competitiva y la participación multe-deportiva y la edad de especialización. Los datos revelaron un rango de edad de 5 a 12 años para la presentación de los participantes al baloncesto. Se comprueba la existencia de varios parámetros para la introducción en el deporte. USA se destaca con un máximo de 7 opciones. En cuanto a los principales objetivos en la introducción de baloncesto, los datos revelaron un equilibrio entre los tres dominios de aprendizaje, con un ligero aumento de la afirmativa y psicomotor sobre el desarrollo cognitivo. En cuanto a la competición, hay un estándar común en los países definiéndose el disfrute y la estimulación como los objetivos principales. Varias estrategias se utilizan en todos los países, (por ejemplo, la reducción del tamaño de la bola, número de jugadores, la altura de la canasta) se utilizan para acomodar el juego de las habilidades de los niños y para los objetivos de la etapa de introducción. En cuanto a la participación del multe-deporte y las edades en las que la especialización en el baloncesto debe ocurrir, las opiniones son favorables a una diversificación multe-deporte, y la edad media de especialización fue de 15 anos (AU)

Este estudo teve como objetivo analisar a fase de introdução de participantes de basquete de países que são classificados dentro dos primeiros 20 países de basquete pela FIBA. Através do uso de entrevistas semiestruturados, os dados foram recolhidos a partir de 16 especialistas técnicos de 6 países. Analisou-se a fase introdutória determinando: a idade em que os participantes começam nos programas; os diferentes caminhos ou formas de entrada para a modalidade; os objetivos definidos e perseguidos nessa fase; a estrutura competitiva, o envolvimento multidesportivo e a especialização. Os dados revelaram uma faixa etária de 5 a 12 anos para a introdução de participantes para o basquete. Foram reveladas várias formas de introdução na modalidade. Os EUA destaca-se com um máximo de 7 opções. Em relação aos principais objetivos, os dados revelaram um equilíbrio entre os três domínios de aprendizagem, com um ligeiro aumento da afirmativa e psicomotor sobre o cognitivo. Em termos de competição há um padrão comum entre os países centrando-se os objetivos competitivos na diversão e estimulação. Várias estratégias são utilizadas em todos os países, (por exemplo, reduzindo o tamanho da bola, o número de jogadores, altura do cesto) para acomodar o jogo às capacidades crianças e aos objetivos da fase introdutória. As opiniões dos especialistas são favoráveis à participação multidesportiva e a idade em que a especialização deve ocorrer em basquetebol, foi em média de 15 anos (AU)
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  10 / 35 IBECS  
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Id: 156627
Autor: Chan, Vincent; Tran, Hung.
Título: Purchasing Over-the-counter medicines from Australian pharmacy: what do the pharmacy customers value and expect?
Fonte: Pharm. pract. (Granada, Internet);14(3):0-0, jul.-sept. 2016. tab.
Idioma: en.
Resumo: Background: Over-the-counter medicines (OTC) are widely available and can be purchased without a prescription. Their availability means that a customer may choose to purchase them without the involvement of a pharmacy/pharmacist. It is important to understand customer OTC purchasing perceptions and behaviour from a pharmacy to better understand the needs and opportunities in this space. Objective: This study aimed to examine customers' key expectations and what they value when purchasing OTC and how the effect of health status/stress and perceived risks/benefits of purchasing OTCs from a pharmacy may influence their OTC shopping behaviour. Methods: Customers from two metropolitan pharmacies across two different suburbs in Brisbane, Queensland, Australia completed a self-administered questionnaire. Data collection was conducted over a six-week period. The questionnaire examined demographics, current level of health and stress, as well as a range of questions (seven-point Likert-scale) examining perceived benefits and risks, what they value, trust and expect when purchasing OTC. Results: A total of 86 customers from a broad range of demographics were captured in this study. When asked about their current health state, 41% and 23% respectively indicated that they were stressed and tense when they arrived at the pharmacy but many were feeling well (38%). Most customers strongly agreed/agreed that trust in the advice from a pharmacy (96%), trust in the products (73%), and the altruistic approach of a pharmacy (95%) were critical to them. Further, 82% and 78% respectively disagreed that time pressures or costs were concerns, despite many feeling tense and stressed when they came in. When asked where they intend to buy their future OTC, 89% indicated pharmacy instead of a supermarket. Conclusions: High levels of trust, confidence and sense of altruism and care were key factors for customers buying OTC from a pharmacy, regardless of time pressures, costs or existing levels of stress and health (AU)

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