A Call for Urgent Monitoring of Food and Water Security Based on Relevant Indicators for the Arctic

This perspective paper argues for an urgent need to monitor a set of 12 concrete, measurable indicators of food and water security in the Arctic over time. Such a quantitative indicator approach may be viewed as representing a reductionist rather than a holistic perspective, but is nevertheless necessary for actually knowing what reality aspects to monitor in order to accurately understand, quantify, and be able to project critical changes to food and water security of both indigenous and non-indigenous people in the Arctic. More relevant indicators may be developed in the future, taking us further toward reconciliation between reductionist and holistic approaches to change assessment and understanding. However, the potential of such further development to improved holistic change assessment is not an argument not to urgently start to monitor and quantify the changes in food and water security indicators that are immediately available and adequate for the Arctic context

Medication Education of Acutely Hospitalized Older Patients

OBJECTIVES: To determine the amount of time spent providing medication education to older patients, the impact of medication education on patients’ knowledge and satisfaction, and barriers to providing medication education. DESIGN: Telephone survey of patients within 48 hours of hospital discharge and direct survey of physicians and pharmacists. SETTING: Internal medicine ward in a tertiary care teaching hospital. PARTICIPANTS: Patients 65 years of age and over regularly taking at least one medication. MEASUREMENTS: Patient demographics, medication use, time spent receiving or providing medication education, and satisfaction scores. MAIN RESULTS: Forty-seven respondents with a mean age of 77.1 years reported that physicians spent a mean of 10.5 minutes (range, 0–60 minutes) and pharmacists spent a mean of 5.3 minutes (range, 0–40 minutes) providing medication education. Fifty-one percent reported receiving no education from either physician or pharmacist, and only 30% reported receiving written medication instructions. Respondents were generally quite satisfied with their education. Physicians identified one or more barriers to providing education 51% of the time and pharmacists 80%. Lack of time was the most common barrier (18%) identified by physicians, but pharmacists cited lack of notification of discharge plans (41%) and lack of time (39%) as the main barriers. Respondents made many medication errors and knew little about their medications. CONCLUSIONS: Although older hospitalized patients received little medication education or written information and made many medication errors with and without medication education, approximately one half of physicians perceived no barriers to providing education