High-Pressure Stopped-Flow Study of Inclusion Reactions with α-Cyclodextrin: Dynamic Aspects in Host-Guest Interactions

The full volume and entropy profiles of the inclusion reaction between α-cyclodextrin and the guest molecules, ethylorange (1) and mordant yellow 7 (2), have been constructed from variable-pressure and -temperature stopped-flow kinetic experiments

Formation et recherche en pharmacie hospitalière et communautaire – état des lieux et perspectives en Suisse romande

Résumé Objectif : En Suisse, l’entrée en vigueur, en 1994, d’une nouvelle loi sur l’assurance maladie et la signature, en 1999, de la Déclaration de Bologne visant à promouvoir un espace européen de l’enseignement supérieur, ont conduit à une mutation profonde des concepts de la formation de base et post-diplôme en pharmacie. Cet article décrit la structure de la formation de base, présente différentes filières de formation post-diplôme et illustre les principaux axes de recherche en pharmacie hospitalière et communautaire en Suisse romande. Mise en contexte : La formation universitaire de base est constituée de deux blocs : l’un, d’une durée de trois ans, débouchant sur le Baccalauréat en sciences pharmaceutiques et l’autre, qui lui fait suite, d’une durée de deux ans, conduisant à la Maîtrise en pharmacie. Pour la formation post-diplôme et continue, plusieurs filières sont proposées dont l’une, le Master of advanced studies en pharmacie hospitalière, possède un ancrage universitaire alors que les autres sont sous la responsabilité des associations professionnelles. La recherche constitue la clef de voûte de l’amélioration de la qualité des prestations pharmaceutiques et d’enseignement. Quatre axes de recherche sont privilégiés en milieu hospitalier et trois en pharmacie communautaire. Conclusion : Sous l’effet des pressions économiques et légales et grâce à l’impulsion conjointe des universités et des associations professionnelles, la Suisse a connu en quelques années des mutations profondes dans le domaine pharmaceutique. Le pharmacien dispose aujourd’hui d’une vaste palette de programmes de formation structurés, qui lui permettront d’assurer des prestations de qualité adaptées à l’évolution rapide des besoins du système de santé.

Improving Primary Care Medication Processes by Using Shared Electronic Medication Plans in Switzerland: Lessons Learned From a Participatory Action Research Study

Background: Several countries have launched health information technology (HIT) systems for shared electronic medication plans. These systems enable patients and health care professionals to use and manage a common list of current medications across sectors and settings. Shared electronic medication plans have great potential to improve medication management and patient safety, but their integration into complex medication-related processes has proven difficult, and there is little scientific evidence to guide their implementation. Objective: The objective of this paper is to summarize lessons learned from primary care professionals involved in a pioneering pilot project in Switzerland for the systemwide implementation of shared electronic medication plans. We collected experiences, assessed the influences of the local context, and analyzed underlying mechanisms influencing the implementation. Methods: In this formative action research study, we followed 5 clusters of health care professionals during 6 months. The clusters represented rural and urban primary care settings. A total of 18 health care professionals (primary care physicians, pharmacists, and nurses) used the pilot version of a shared electronic medication plan on a secure web platform, the precursor of Switzerland's electronic patient record infrastructure. We undertook 3 group interviews with each of the 5 clusters, analyzed the content longitudinally and across clusters, and summarized it into lessons learned. Results: Participants considered medication plan management, digitalized or not, a core element of good clinical practice. Requirements for the successful implementation of a shared electronic medication plan were the integration into and simplification of clinical routines. Participants underlined the importance of an enabling setting with designated reference professionals and regular high-quality interactions with patients. Such a setting should foster trusting relationships and nurture a culture of safety and data privacy. For participants, the HIT was a necessary but insufficient building block toward better interprofessional communication, especially in transitions. Despite oral and written information, the availability of shared electronic medication plans did not generate spontaneous demand from patients or foster more engagement in their medication management. The variable settings illustrated the diversity of medication management and the need for local adaptations. Conclusions: The results of our study present a unique and comprehensive description of the sociotechnical challenges of implementing shared electronic medication plans in primary care. The shared ownership among multiple stakeholders is a core challenge for implementers. No single stakeholder can build and maintain a safe, usable HIT system with up-to-date medication information. Buy-in from all involved health care professionals is necessary for consistent medication reconciliation along the entire care pathway. Implementers must balance the need to change clinical processes to achieve improvements with the need to integrate the shared electronic medication plan into existing routines to facilitate adoption. The lack of patient involvement warrants further study.</p

The first volume profile for a host-guest interaction: a variable pressure kinetic study of an inclusion reaction with α-cyclodextrin

The full volume and entropy profiles of the inclusion reaction between α-cyclodextrin and the guest molecule, mordant yellow 7, are constructed from variable pressure and temperature kinetic experiments, showing a two-step mechanism where both steps involve contracted transition states