Женский роман в гендерной перспективе

В статье излагаются результаты анализа становления и развития англо- и немецкоязычного женского романа – от канонического, через эмансипированный, к постфеминистскому, – в связи с широким распространением идей феминизма и опирающихся на них гендерных исследований.У статті представлено результати аналізу становлення й розвитку англо- та німецько-мовного жіночого роману – від канонічного, через емансипований до постфеміністського, – у його зв'язку з широким розповсюдженням ідей фемінізму та породженими останнім гендерними дослідженнями.The article offers the results of the author's analysis of Romance in the USA, UK and Germany, following its development from the Canon, through the Emancipated, to the present-day Post-feminist, all stages connected with and influenced by the growth of the ideas of feminism and Gender Studies

Preferences of patients and pharmacists with regard to the management of drug-drug interactions: A choice-based conjoint analysis

Background For the management of drug-drug interactions (DDI), a risk-benefit assessment should be combined with the patient's perspective. Objective To investigate patients' and pharmacists' preferences regarding DDI management Design and methods We conducted an online choice-based conjoint survey among patients and pharmacists. The choice task was about the management of a fictitious DDI: the combination of a cardiovascular drug and an antibiotic for pneumonia leading to a risk for developing muscle problems. Respondents answered twelve choice sets of two DDI-management options. The options were only described by their five characteristics (attributes) regarding risk for adverse events, benefit, and practical consequences. Each of the five attributes could have two different levels (e.g. low or high risk), which were varied over the 12 choice tasks. Data were analysed by latent class analysis in order to identify potential classes (subgroups) of respondents with similar preference patterns. Results The survey was completed by 298 patients and 178 pharmacists. The latent class model for both patients and pharmacists resulted in three classes. The first class of patients attached most importance to fewer adverse events (class probability 41%), the second class attached most importance to avoiding a medication switch (20%), and the third class attached most importance to blood sampling (39%). For pharmacists, the first class attached most importance to curing pneumonia (31%), the second class to avoiding a medication switch (31%), and the third class to avoiding blood sampling (38%). Conclusion Among patients and pharmacists diverging preferences regarding DDI management were observed. Some subgroups of respondents attached most value to risk or benefit while others attached more value to practical considerations. Awareness of existing variability in preferences among and between pharmacists and patients can contribute to shared decision making in DDI management

Preferences of Patients and Pharmacists with Regard to the Management of Drug-Drug Interactions:A Choice-Based Conjoint Analysis

INTRODUCTION: The management of drug-drug interactions (DDIs) is a complex process in which risk-benefit assessments should be combined with the patient's perspective. OBJECTIVE: The aim of this study was to determine patients' and pharmacists' preferences regarding DDI management. METHODS: We conducted a choice-based conjoint survey about a fictitious DDI concerning the combination of a cardiovascular drug and an antibiotic for pneumonia. Patients and pharmacists had to choose 12 times between two management options. The options were described by five attributes, including risk, benefit and practical consequences. Each attribute could have two different levels, which were varied over the choice tasks. Latent class analysis was used to identify potential classes of respondents with distinct patterns of similar preferences. RESULTS: In total, 298 patients and 178 pharmacists completed the questionnaire. The latent class model for both patients and pharmacists resulted in three classes. For patients, in one class the most importance was attached to avoiding switch of medication (class probability 20%), in a second class to fewer adverse events (41%), and in a third class to blood sampling (39%). For pharmacists, again one class attached the highest importance to avoiding switch of medication (31%). The other classes gave priority to curing pneumonia (31%) and avoiding blood sampling (38%). CONCLUSION: The results showed diverging preferences regarding DDI management among both patients and pharmacists. Different groups attached different value to risk and benefit versus practical considerations. Awareness of existing variability in preferences among and between pharmacists and patients is a step towards shared decision making in DDI management

Clinical Decision Support and Optional Point of Care Testing of Renal Function for Safe Use of Antibiotics in Elderly Patients : A Retrospective Study in Community Pharmacy Practice

OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a clinical decision support system (CDSS) for seven antibiotics. Alerts were generated during prescription processing in the case of previously registered renal impairment and when no information on renal function was available for patients aged 70 and over. Pharmacists could perform PoCT when renal function could not be retrieved from other health care professionals. Actions were registered in the CDSS. A retrospective descriptive analysis of alert management, performed PoCT and medication dispensing histories was performed. RESULTS: A total of 351 pharmacists registered the management of 88,391 alerts for 64,763 patients. For 68,721 alerts (77.7%), the pharmacist retrieved a renal function above the threshold for intervention. 1.7% of the alerts (n = 1532) led to a prescription modification because of renal impairment; in 3.0% of the alerts (n = 2631), the patient had renal impairment, but the pharmacist judged that no intervention was needed. Pharmacists performed 1988 PoCTs (2.2% of the alerts), which led to 15 prescription modifications (0.8% of the PoCT). CONCLUSION: Community pharmacists performed CDSS-based interventions to prevent potentially inappropriate (dosing of) antibiotics in elderly patients with renal impairment. Pharmacists were well able to retrieve information on renal function, using PoCT in a limited number of cases. The intervention rate could be greatly increased by better registration of information on renal function. Performing PoCT seems especially worthwhile in the highest age groups

Aspects influencing patients' preferences for the management of drug-drug interactions : A focus group study

OBJECTIVE: The management of drug-drug interactions (DDIs) involves a complex risk-benefit assessment, in which patients' preferences should be taken into account. The aim of this study was to examine the aspects influencing patients' preferences with regard to DDI management options. METHODS: A qualitative study consisting of five focus groups with patients chronically using cardiovascular drugs was conducted. Key questions concerned preferences regarding DDI management options for a provided fictitious DDI. Thematic analysis of the verbatim transcripts was performed. RESULTS: Despite their limited knowledge with respect to DDIs, patients easily chose a management option for the presented DDI. When additional information was provided, preferences showed to be fluid. Ten interdependent aspects influencing preferences were derived from patients' argumentations: risk perception, fear, acceptance of uncertainty, openness to change, willingness to take risk, trust in health care professional, financial & practical burdens, health condition, experience, and knowledge & assumptions. CONCLUSION: Patients' preferences regarding DDI management options were often determined by provided information. Preferences were dependent on an interplay of diverse aspects. PRACTICE IMPLICATIONS: Tailored provision of information and individualized counseling is needed for active patient involvement in DDI decision making