Axillary and rectal thermometry in the newborn: do they agree?

BACKGROUND: Accurate measurement of body temperature is critical for the assessment of a newborn’s general well-being. In nursery settings, the gold standard rectal thermometry has been replaced by the axillary method. However, evidence pertaining to the agreement between axillary and rectal thermometry in the newborn is controversial. In this cross-sectional study, the agreement between axillary and rectal temperature in newborns, as well as the effects of neonatal, maternal and environmental factors on this agreement were investigated. METHODS: The mean difference between axillary and rectal temperatures was compared in stable term and preterm newborns using paired t-test for the means of differences, Pearson correlation coefficient (r), and the Bland-Altman plot. Stepwise multivariate regression assessed predictors of this difference in the overall group and by gestational age categories. RESULTS: The study included 118 newborns with gestational ages ranging from 29 to 41 weeks, median birth weight of 2980 grams (IQR: 2321.3-3363.8). Axillary and rectal temperatures correlated significantly (r = 0.5, p = 0.000) and had similar overall means but differed in 34–36 weeks gestation newborns (p = 0.01). Correlation between both methods increased with advancing gestational age being highest in term newborns (r = 0.6, p = 0.000). Bland-Altman plots revealed good agreement in gestational ages above 29 weeks. The difference between measurements increased with Cesarean delivery (ß = 0.2; 95% CI: 0.02, 0.38), but decreased with advancing chronological age (ß = -0.01; 95% CI: -0.02,-0.01), and with gestational age (ß = -0.05; 95% CI: -0.08,-0.01). CONCLUSION: In clinically stable term and preterm infants, axillary thermometry is as reliable as rectal measurement. Predictors of agreement between the two methods include gestational age, chronological age and mode of delivery. Further studies are needed to confirm this agreement in sick newborns and in extremely premature infants

Specialized competency framework for pharmacists in managerial positions in sales and marketing (SCF-PMSM): development, validation, and correlates

Abstract Background Pharmacists in sales and marketing roles need specific skills for managerial positions, and a framework for evaluating and developing these competencies is necessary. Currently, no such framework is known to exist. Objective This study aimed to develop and validate a specialized competency framework for pharmacists in sales and marketing managerial positions and assess correlates related to the competency domains. Methods This web-based study carried out between March and October 2022 enrolled a convenient sample of 60 pharmacists with managerial positions in sales and marketing, contacted by phone, working in the field of sales and marketing from the five governorates of Lebanon (Beirut, Beqaa, Mount Lebanon, South, and North). Results The framework demonstrated good construct and structural validity in all domains except for emergency preparedness, which had a low correlation with other domains. Competencies were well correlated with respective domains, and behaviors had excellent loadings on corresponding competencies. As for the correlates of the competency domains, males were more confident than females (p < .05), and participants with more experience (or heavier workload) reported higher competency levels (p < .05), particularly for upper management skills, communication skills, and professional practice. Further, education level was not significantly correlated with declared competency, with experience being the most cited source of competence (68.25%), followed by postgraduate degrees (42.48%) and continuing education sessions (33.93%), while undergraduate education was the least reported (29.5%). Conclusion This study could develop and validate the Specialized Competency Framework for Pharmacists in Managerial Positions in Sales and Marketing (SCF-PMSM) among a sample of Lebanese pharmacists. This framework demonstrated good reliability, content, construct, and structural validity in all the domains, with the competencies being well correlated with their respective domains and behaviors having excellent loadings on related competencies, except for emergency preparedness and response. It also revealed a mismatch between what is taught at undergraduate and postgraduate levels and the needs in practice

Moderating effect of work fatigue on the association between resilience and posttraumatic stress symptoms: a cross-sectional multi-country study among pharmacists during the COVID-19 pandemic

Abstract Introduction In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists’ resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic. Methods A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS. Results A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = − 0.33; p < .001 and Beta = − 0.21; p = .001), mental (Beta = − 0.29; p < .001 and Beta = − 0.18; p = .006) and emotional (Beta = − 0.31; p < .001 and Beta = − 0.17; p = .008) work fatigue, higher resilience was significantly related to lower PTSS levels. However, for pharmacists with high levels of physical/mental/emotional work fatigue, the association between resilience and PTSS became non-significant. Conclusion This study highlights the complex relationship between work-related fatigue, resilience, and PTSS in pharmacists. It emphasizes the need to address work-related fatigue for pharmacists’ psychological well-being during crises, offering insights for tailored support and interventions