The effect of medication reconciliation in elderly patients at hospital discharge.

Objective To assess the impact of medication reconciliation interventions on medication error rates when elderly patients are discharged from hospital to community care or nursing homes.Setting Elderly patients (>65 years) living in nursing homes or in their own homes with care provided by the community nursing system. Method All medical records containing information on drug treatment were collected from hospital departments, the community care service and GPs. We then identified if there were any changes in the transfer of information i.e. if the drugs were not the same as before the transfer. Two different persons independently evaluated all information about the patients' drugs to identify medication errors for three different time periods. During all three periods structured discharge information was used. In period 2, electronic medication lists were introduced and in period 3 we introduced specific routines and support by a clinical pharmacist to ensure prescription in the specific medication dispensing system (ApoDos). Asymptotic Linear by-Linear Association Test was used to compare number of medication errors in period 1, 2 and 3 respectively. Main outcome measure Number of medication errors per patient. Results A total of 123 patients were evaluated at discharge. For the 109 patients using the ApoDos system, there were significant differences in the number of medication errors between period 1 and 3 (P = 0.048), period 2 and 3 (P = 0.037 but not between period 1 and 2 (P = 0.41). The mean numbers of errors were 1.5, 1.1 and 0.5 for period 1, 2 and 3 respectively. The 14 patients not using the ApoDos system had on average 0.4 errors per patient. Among the 58 patients with medication errors, 34 were evaluated as having low clinical risk, 22 moderate, and 2 high clinical risk. Conclusion Medication errors are still common when elderly patients are transferred from hospital to community/primary care. The main risk factor seems to be the specific medication dispensing system (ApoDos) or rather the process on how to use it. When this system was supported by clinical pharmacists, the error rate dropped to the same level as for patients without ApoDos

Apolipoprotein D synthesis progressively increases in frontal cortex during human lifespan

Apolipoprotein D (apo D) is a lipocalin present in the nervous system that may be related to processes of reinnervation, regeneration and neuronal cell protection. In the other way, apo D expression has been correlated, in some brain regions, with normal aging and neurodegenerative diseases. To elucidate the regional and cellular expression of apo D in normal human brain during aging, we performed a detailed and extensive study in samples of post-mortem human cerebral cortices. To achieve this study, slot blot techniques, for protein and mRNA, as well as immunohistochemistry and hybridohistochemistry methods were used. A positive correlation for apo D expression with aging was found; furthermore, mRNA levels, as well as the protein ones, were higher in the white than in the grey matter. Immunohistochemistry and non-isotopic HIS showed that apo D is synthesized in both neurons and glial cells. Apo D expression is notorious in oligodendrocytes but with aging the number of neurons that synthesize apo D is increased. Our results indicate that apo D could play a fundamental role in central nervous system aging and in the reduction of products derivated from lipid peroxidation. The increment in the expression of apo D with aging can be included in a global mechanism of cellular protection to prevent the deleterious effects caused by aging

Assessment of Riga city environment in the recent rural newcomers point of view

Mana pētījuma nosaukums ir „Rīgas pilsētvides vērtējums neseno laucinieku skatījumā” Mana pētījuma mērķis bija noskaidrot, kādas problēmas rodas nesenajiem lauciniekiem, pārceļoties uz dzīvi Rīgas sociālajā pilsētas vidē. Darba autore pētījumā analizēja nesenā laucinieka, kurš pilsētā dzīvo tikai no trīs līdz pieciem gadiem, Rīgas sociālās pilsētvides vērtējumu. Darba autore definēja sekojošas analīzes vienības, proti, drošība jeb cilvēku savstarpējās palīdzības sniegšana pilsētā; privātā telpa jeb nesenā laucinieka spēja norobežoties no apkārtējiem pilsētā, sociālie sakari, kā arī identitāte jeb nesenā laucinieka piederības izjūta pilsētai. Darba autore veica kvalitatīvu pētījumu, kura ietvaros tika intervēti tie nesenie laucinieki, kuri Rīgā dzīvo tikai no trīs līdz pieciem gadiem. Mana pētījuma pētnieciskais jautājums bija, kā tiek veidotas un uzturētas savstarpējās attiecības starp lauciniekiem un pilsētniekiem Rīgā? Kvalitatīvā pētījuma ietvaros tika veiktas sešas padziļinātās intervijas, lai noskaidrotu, kādi faktori nosaka neseno laucinieku pilnvērtīgu iekļaušanos Rīgas pilsētā, urbānajā kopienā, īpaši akcentējot, neseno laucinieku iekļaušanos pilsētas sociālajā vidē. Darba autore pētījumā izmantoja pilsētas ekoloģijas teorijas. Nesenā laucinieka, kurš pilsētā dzīvo tikai no trīs līdz pieciem gadiem, savstarpējās attiecības ar pilsētniekiem raksturo atsvešinātība, bezpersoniskums, virspusējība, mainība, epizodiskums, kā arī aprēķins jeb izdevīguma princips. Rīgas pilsētvide ietekmē nesenā laucinieka, kurš pilsētā dzīvo tikai no trīs līdz pieciem gadiem, mijiedarbību ar pilsētniekiem, kā arī nosaka cilvēku uzvedību pilsētā. Rezultātā nesenais laucinieks tiecas norobežoties no cieša kontakta ar cilvēkiem pilsētā. Atslēgas vārdi: Adaptācija; Kopiena; PilsētvideThe title of my study is ,,Assessment of Riga city environment in the recent rural newcomers point of view” The aim of my study was to clarify issues, which usually arise when rural newcomers move to the urban, social environment. Author of the bachelor work analyzes those rural newcomers, who have migrated to the city of Riga just three to five years ago, re-assessing social environment change of the capital. Author defines the following points of the analysis: namely, security (mutual assistance rendering practices in the city of Riga); private space (recent rural newcomer ability to shut themselves off from the surrounding social environment); the social relations as well as the identity (recent rural newcomer sense of belonging to the social and economic structure). Authorused a qualitative methodology and managed to interview those recent rural newcomers living in the capital for abovementioned period of time. The research subject of this particular study was to demonstrate, how the social relations are managed between the target research group. Within the framework of this qualitative study the author of the bachelor work managed to do six in-depth interviews in order to find out which factors determine the recent rural newcomer inclusion in the city of Riga, as well as inclusion into the urban community, with particular emphasis on the inclusion of those into the urban social environment.. Author used urban ecology theories. The mutual relations between the city dwellers and the recent rural newcomers, can be characterized as alienated, impersonalized, superficial, episodic, as well as prudent in the bad, social way. The environment of the city directly affects interaction between the newcomers, and townsmen, as well as mutual behavior of these groups, therefore. newcomers tend to shut himself off from close contact with people constantly living in the urban area. Key words: Adaptation; Community; City environment