ePrescribing: An Important Part of Medication

ePrescribing is the next service tool that will enable pharmacists and providers the ability to manage a patient’s current and historical medications. Allowing the provider to easily send an electronic prescription directly to the pharmacist will help eliminate errors in prescribing, reduce fraud and narcotic abuse, decrease the waiting time at the clinic and pharmacy, and focus on patient safety and continuity of care. Going to the doctor can sometimes be tough when your community does not have a permanent provider in the community. Time is taken to get an appointment, explain your medical history to a travelling locum, and then get a prescription. The patient then needs to go to the local or closest pharmacy and wait again for the prescription to be filled. A patient can wait for up to two hours for the whole process to be completed. There has to be a more efficient way to get the proper information, access and care the patient needs. Between 2009 and 2014, there were approximately 655 deaths reported from fentanyl overdoses in Canada.  With ePrescribing, the patient will never touch the prescription, hence minimising the risk of multiple prescriptions being filled. Instant messaging between the provider and pharmacist will save on fax and phone communication, and allow the right information to be communicated promptly to the right person. The instant communication between a provider and pharmacist can ensure that the drug being prescribed is not going to interact with other medications and ensure that the patient has not already filled the prescription. The pharmacist can also give details on the current course of medication, and inform the provider if the patient is covered by their current insurance. While a patient’s healthcare record is changing from paper to an electronic format, we need to ensure we are providing the tools necessary to help healthcare providers attain the best healthcare for patients. Hence optimal use of ePrescribing will ultimately reduce medication error rates and other safety risks

Exploring the use of ultrasound imaging by physiotherapists: An international survey

Background: National surveys in New Zealand, Australia and the United Kingdom suggest ultrasound imaging (USI) use by physiotherapists is increasing. However, concerns exist regarding clarity for scopes of practice, and availability and standardisation of training. Objectives: To investigate physiotherapists' understanding of scopes of practice for the use of USI; clarify the professional contexts, clinical uses and levels of training; and identify barriers preventing physiotherapists' USI use. Design: A cross-sectional, observational survey. Methods: An Internet-based survey, offered in 20 different languages, was used including items covering five domains: (1) demographic and professional characteristics; (2) knowledge of scope of practice; (3) USI use; (4) USI training content and duration; and (5) perceived barriers to physiotherapists' use of USI. Results: 1307 registered physiotherapists from 49 countries responded; 30% were unsure of the scope of practice for physiotherapists' USI use. 38% of participants were users of USI, reporting varied contexts and clinical uses, reflected in the broader categories of: (i) biofeedback; (ii) diagnosis; (iii) assessment; (iv) injection guidance; (v) research; (vi) and teaching. The training users received varied, with formal training more comprehensive. 62% were non-users, the most common barrier was lack of training (76%). Conclusion: These findings suggest physiotherapists' USI use is increasing in various contexts; however, there is uncertainty regarding scopes of practice. There are discrepancies in training offered, with a lack of training the most common barrier to physiotherapists' use of USI. International guidelines, including a USI training framework, are needed to support the consistent and sustainable use of USI in physiotherapy

Starting the conversation: land issues and critical conservation studies in post-colonial Africa

This thematic issue brings together the scholarly fields of critical conservation studies and African land issues, a relationship largely unexplored to date. The alienation of land for conservation purposes, introduced to Africa under colonial rule and still taking place today, has fundamental impacts on the politics of land and land use, and is contested in contemporary nation-states - including those that are attempting to implement land restitution and reform. The contributors explore these issues in a range of African contexts. Three key themes are identified: the problematic constructions of ‘community’ by outside agencies; spatial exclusion and the silencing of local voices; and the neoliberalisation of conservation spaces. In contributing to new perspectives on these themes, this thematic issue shows how discourses and practices of conservation, increasingly shaped by neoliberalism, currently impact on land ownership, access and use. It further highlights some important historical continuities. These trends can be observed in transfrontier conservation areas, on state-owned land used for conservation and ‘green’ initiatives, but also on private land where conservation is increasingly turned to commercial purposes.International Bibliography of Social Science

The Vehicle, Spring 1995

Table of Contents Poetry The SwimmersJennifer Moropage 2 Everlasting ArmsSue Songerpage 2 Talking to an AddictBridgett Jensenpage 3 SecretsTiffany Abbottpage 5 CryingMatthew Berrypage 6 winter fieldsKeith Spearpage 7 untitledKemp Nishan Munizpage 7 Rainy Night in ParisDiana Matijaspage 8 nap timeKelly A. Pricepage 10 Angel of the EarthHeather Anne Winterspage 10 Color DreamsMatthew J. Nelsonpage 12 Dandelion PaintSandy Beauchamppage 13 Merry Go Round MarathonElizabeth Bromleypage 14 The ArmadilloKeith Spearpage 15 The Shoe SagaJennifer Moropage 16 Coffee Cup Confessional BoothSue Songerpage 18 What Gravity, A Rock And A Rabbit Have To Do With My Love LifeMartin Paul Brittpage 19 Good Bye, Good KnightRich Birdpage 20 Photography Railroad Station IKelly A. Pricepage 22 1000 VinesKelly A. Pricepage 23 Self PortraitKelly A. Pricepage 24 Prose Queen of Dead AirBryan Levekpage 26 Closer to the noiseMichell Heidelpage 29 Somewhere in BetweenKimberly Hunterpage 32 Miss SteakBryan Levekpage 37 Chasing the ChasteTerry Bassettpage 43 Biographies Authors, editorspage 48https://thekeep.eiu.edu/vehicle/1065/thumbnail.jp

Transferrin receptor 2 controls bone mass and pathological bone formation via BMP and Wnt signalling

Transferrin receptor 2 (Tfr2) is mainly expressed in the liver and controls iron homeostasis. Here, we identify Tfr2 as a regulator of bone homeostasis that inhibits bone formation. Mice lacking Tfr2 display increased bone mass and mineralization independent of iron homeostasis and hepatic Tfr2. Bone marrow transplantation experiments and studies of cell-specific Tfr2 knockout mice demonstrate that Tfr2 impairs BMP-p38MAPK signaling and decreases expression of the Wnt inhibitor sclerostin specifically in osteoblasts. Reactivation of MAPK or overexpression of sclerostin rescues skeletal abnormalities in Tfr2 knockout mice. We further show that the extracellular domain of Tfr2 binds BMPs and inhibits BMP-2-induced heterotopic ossification by acting as a decoy receptor. These data indicate that Tfr2 limits bone formation by modulating BMP signaling, possibly through direct interaction with BMP either as a receptor or as a co-receptor in a complex with other BMP receptors. Finally, the Tfr2 extracellular domain may be effective in the treatment of conditions associated with pathological bone formation

Validation of the ADAMO Care Watch for step counting in older adults

Background: Accurate measurement devices are required to objectively quantify physical activity. Wearable activity monitors, such as pedometers, may serve as affordable and feasible instruments for measuring physical activity levels in older adults during their normal activities of daily living. Currently few available accelerometer-based steps counting devices have been shown to be accurate at slow walking speeds, therefore there is still lacking appropriate devices tailored for slow speed ambulation, typical of older adults. This study aimed to assess the validity of step counting using the pedometer function of the ADAMO Care Watch, containing an embedded algorithm for measuring physical activity in older adults. Methods: Twenty older adults aged ≥ 65 years (mean ± SD, 75±7 years; range, 68–91) and 20 young adults (25±5 years, range 20–40), wore a care watch on each wrist and performed a number of randomly ordered tasks: walking at slow, normal and fast self-paced speeds; a Timed Up and Go test (TUG); a step test and ascending/descending stairs. The criterion measure was the actual number of steps observed, counted with a manual tally counter. Absolute percentage error scores, Intraclass Correlation Coefficients (ICC), and Bland–Altman plots were used to assess validity. Results: ADAMO Care Watch demonstrated high validity during slow and normal speeds (range 0.5–1.5 m/s) showing an absolute error from 1.3% to 1.9% in the older adult group and from 0.7% to 2.7% in the young adult group. The percentage error for the 30-metre walking tasks increased with faster pace in both young adult (17%) and older adult groups (6%). In the TUG test, there was less error in the steps recorded for older adults (1.3% to 2.2%) than the young adults (6.6% to 7.2%). For the total sample, the ICCs for the ADAMO Care Watch for the 30-metre walking tasks at each speed and for the TUG test were ranged between 0.931 to 0.985. Conclusion: These findings provide evidence that the ADAMO Care Watch demonstrated highly accurate measurements of the steps count in all activities, particularly walking at normal and slow speeds. Therefore, these data support the inclusion of the ADAMO Care Watch in clinical applications for measuring the number of steps taken by older adults at normal, slow walking speeds

CANDELS Visual Classifications: Scheme, Data Release, and First Results

We have undertaken an ambitious program to visually classify all galaxies in the five CANDELS fields down to H \u3c 24.5 involving the dedicated efforts of over 65 individual classifiers. Once completed, we expect to have detailed morphological classifications for over 50,000 galaxies spanning 0 \u3c z \u3c 4 over all the fields, with classifications from 3 to 5 independent classifiers for each galaxy. Here, we present our detailed visual classification scheme, which was designed to cover a wide range of CANDELS science goals. This scheme includes the basic Hubble sequence types, but also includes a detailed look at mergers and interactions, the clumpiness of galaxies, k-corrections, and a variety of other structural properties. In this paper, we focus on the first field to be completed—GOODS-S, which has been classified at various depths. The wide area coverage spanning the full field (wide+deep+ERS) includes 7634 galaxies that have been classified by at least three different people. In the deep area of the field, 2534 galaxies have been classified by at least five different people at three different depths. With this paper, we release to the public all of the visual classifications in GOODS-S along with the Perl/Tk GUI that we developed to classify galaxies. We present our initial results here, including an analysis of our internal consistency and comparisons among multiple classifiers as well as a comparison to the Sérsic index. We find that the level of agreement among classifiers is quite good (\u3e70% across the full magnitude range) and depends on both the galaxy magnitude and the galaxy type, with disks showing the highest level of agreement (\u3e50%) and irregulars the lowest (k-corrections between the V-band and H-band observations and find that a small fraction (84 galaxies in total) are classified as being very different between these two bands. These galaxies typically have very clumpy and extended morphology or are very faint in the V-band

Early and extended erythropoietin monotherapy after hypoxic ischaemic encephalopathy:a multicentre double-blind pilot randomised controlled trial

Objective: To examine the feasibility of early and extended erythropoietin monotherapy after hypoxic ischaemic encephalopathy (HIE). Design: Double-blind pilot randomised controlled trial.Setting: Eight neonatal units in South Asia. Patients: Neonates (≥36 weeks) with moderate or severe HIE admitted between 31 December 2022 and 3 May 2023. Interventions: Erythropoietin (500 U/kg daily) or to the placebo (sham injections using a screen) within 6 hours of birth and continued for 9 days. MRI at 2 weeks of age. Main outcomes and measures: Feasibility of randomisation, drug administration and assessment of brain injury using MRI. Results: Of the 154 neonates screened, 56 were eligible; 6 declined consent and 50 were recruited; 43 (86%) were inborn. Mean (SD) age at first dose was 4.4 (1.2) hours in erythropoietin and 4.1 (1.0) hours in placebo. Overall mortality at hospital discharge occurred in 5 (19%) vs 11 (46%) (p=0.06), and 3 (13%) vs 9 (40.9%) (p=0.04) among those with moderate encephalopathy in the erythropoietin and placebo groups. Moderate or severe injury to basal ganglia, white matter and cortex occurred in 5 (25%) vs 5 (38.5%); 14 (70%) vs 11 (85%); and 6 (30%) vs 2 (15.4%) in the erythropoietin and placebo group, respectively. Sinus venous thrombosis was seen in two (10%) neonates in the erythropoietin group and none in the control group. Conclusions: Brain injury and mortality after moderate or severe HIE are high in South Asia. Evaluation of erythropoietin monotherapy using MRI to examine treatment effects is feasible in these settings. Trial registration number: NCT05395195