Information-gathering for self-medication via Eastern Indonesian community pharmacies: a cross-sectional study

BACKGROUND: Gathering sufficient information when handling self-medication requests in community pharmacies is an important factor in assisting patients to obtain appropriate health outcomes. Common types of information usually gathered include patient identity, signs and symptoms, action taken, medical history, and current medications being used. The aims of the study were (1) to describe the types and amount of information gathered by Eastern Indonesian community pharmacy staff when handling self-medication requests, and (2) to identify factors associated with the reported amount of information gathered. METHODS: Patient simulation and pharmacy staff interviews were used. First, patient simulation was conducted using 2 cough scenarios and 1 diarrhoea scenario. Second, a structured interview was administered to eligible pharmacy staff in the setting. The types and amount of information gathered during patient simulation encounters and reported during pharmacy staff interviews were noted. A regression analysis was performed to identify factors associated with the amount of information gathered from the interview data. RESULTS: The most frequent types of information gathered in patient simulation encounters were the nature of symptoms (88% in one of the cough scenarios) and patient identity (96% in the diarrhoea scenario). Other types of information were gathered in <40% of encounters in each scenario. From the pharmacy staff interviews, >90% of the 173 interviewees reported that they gathered information on patient identity, nature of symptoms, and associated symptoms. Information on medical history and medication used was gathered by 20% and 26% respectively of the 173 interviewees. The majority of pharmacy staff asked 0 to 2 questions in the patient simulation encounters compared to 5 questions pharmacy staff reported as their usual practice during the interviews. Being qualified as a pharmacist or a pharmacy technician was one of the factors positively associated with the reported amount of information gathered. CONCLUSION: There were deficits in the types of information gathered when pharmacy staff handling self-medication requests. Having a pharmacy educational background and additional work experience in the pharmacy was positively associated with the reported amount of information gathered. There could be other factors contributing to shortcomings in the actual practice which need to be explored

Potentiation of anti-cancer drug activity at low intratumoral pH induced by the mitochondrial inhibitor m-iodobenzylguanidine (MIBG) and its analogue benzylguanidine (BG)

Tumour-selective acidification is of potential interest for enhanced therapeutic gain of pH sensitive drugs. In this study, we investigated the feasibility of a tumour-selective reduction of the extracellular and intracellular pH and their effect on the tumour response of selected anti-cancer drugs. In an in vitro L1210 leukaemic cell model, we confirmed enhanced cytotoxicity of chlorambucil at low extracellular pH conditions. In contrast, the alkylating drugs melphalan and cisplatin, and bioreductive agents mitomycin C and its derivative EO9, required low intracellular pH conditions for enhanced activation. Furthermore, a strong and pH-independent synergism was observed between the pH-equilibrating drug nigericin and melphalan, of which the mechanism is unclear. In radiation-induced fibrosarcoma (RIF-1) tumour-bearing mice, the extracellular pH was reduced by the mitochondrial inhibitor m-iodobenzylguanidine (MIBG) or its analogue benzylguanidine (BG) plus glucose. To simultaneously reduce the intracellular pH, MIBG plus glucose were combined with the ionophore nigericin or the Na+/H+ exchanger inhibitor amiloride and the Na+-dependent HCO3−/Cl−exchanger inhibitor 4,4′-diisothiocyanostilbene-2,2′-disulphonic acid (DIDS). Biochemical studies confirmed an effective reduction of the extracellular pH to approximately 6.2, and anti-tumour responses to the interventions indicated a simultaneous reduction of the intracellular pH below 6.6 for at least 3 h. Combined reduction of extra- and intracellular tumour pH with melphalan increased the tumour regrowth time to 200% of the pretreatment volume from 5.7 ± 0.6 days for melphalan alone to 8.1 ± 0.7 days with pH manipulation (P< 0.05). Mitomycin C related tumour growth delay was enhanced by the combined interventions from 3.8 ± 0.5 to 5.2 ± 0.5 days (P< 0.05), but only in tumours of relatively large sizes. The interventions were non-toxic alone or in combination with the anti-cancer drugs and did not affect melphalan biodistribution. In conclusion, we have developed non-toxic interventions for sustained and selective reduction of extra- and intracellular tumour pH which potentiated the tumour responses to selected anti-cancer drugs. 1999 Cancer Research Campaig

Polyamide-Scorpion Cyclam Lexitropsins Selectively Bind AT-Rich DNA Independently of the Nature of the Coordinated Metal

Cyclam was attached to 1-, 2- and 3-pyrrole lexitropsins for the first time through a synthetically facile copper-catalyzed “click” reaction. The corresponding copper and zinc complexes were synthesized and characterized. The ligand and its complexes bound AT-rich DNA selectively over GC-rich DNA, and the thermodynamic profile of the binding was evaluated by isothermal titration calorimetry. The metal, encapsulated in a scorpion azamacrocyclic complex, did not affect the binding, which was dominated by the organic tail

Formación para la ciudadanía en el alumnado de secundaria en México: Diagnóstico desde un modelo democrático e intercultural

[spa] El título de la tesis refleja el propósito de este estudio: Diagnosticar la situación de la Formación para la Ciudadanía de secundaria en México, desde un modelo de Ciudadanía Democrático e Intercultural. El actual contexto sociopolítico de México, evidencia una ciudadanía que trabaja fuertemente por consolidar su democracia. Sin embargo, la desigualdad social, la poca participación y una falta de reconocimiento a la diversidad cultural y lingüística, que aún persiste en la sociedad mexicana socava sus propios principios democráticos. Bajo este marco, la pregunta que surgió se focalizó en comprender qué está haciendo el Sistema Educativo Mexicano, a través de sus políticas y del curriculum escolar para luchar contra esta situación, y qué es lo que está logrando en su alumnado de secundaria. La elección de este nivel, respondió al hecho de contar con alumnado en una etapa fundamental en la formación de la identidad, elemento fundamental en la Formación para la Ciudadanía, y por ser el colectivo más numeroso del Sistema por estar a punto de comenzar a ejercer sus derechos ciudadanos. Para realizar el diagnóstico se creó un modelo teórico de Formación para la Ciudadanía Democrática e Intercultural, el cual respondía a las necesidades del contexto mexicano. Este modelo se construyó a partir de la revisión de varios modelos de Educación para la Ciudadanía, entre ellos el Modelo de Educación para la Ciudadanía Activa, Responsable, Crítica e Intercultural del GREDI (Grup de Recerca en Educació Intercultural) de la Universidad de Barcelona, del cual se tomaron varios elementos vertebrales. Las principales dimensiones del modelo construido -Concepción de Ciudadanía, Interculturalidad, Sentimiento de Pertenencia, Competencias Ciudadanas y Participación Ciudadana- fueron los parámetros utilizados para analizar el curriculum de Formación para la Ciudadanía en México. Asimismo, dichas dimensiones se operativizaron en un cuestionario para el alumnado de la muestra. El estudio diagnosticó que el curriculum escolar de Formación para la Ciudadanía en México tiene presentes todas las dimensiones del modelo teórico construido. Además, el estudio empírico validó la relación entre todas las dimensiones del modelo teórico. Se identificó también que la presencia del modelo de Formación para la Ciudadanía Democrática e Intercultural podría articular los elementos necesarios para una sólida Formación para la Ciudadanía y por lo tanto se podría aspirar más consistentemente a una convivencia más democrática en México. La investigación cuenta con tres capítulos teóricos. El primero de ellos presenta la Concepción de Ciudadanía por la que apuesta México, el segundo establece los elementos clave que deben estar presentes en la Formación para la Ciudadanía y el tercero desarrolla el modelo de Formación para la Ciudadanía Democrática e Intercultural. Posteriormente, se dedica un capítulo al análisis del curriculum de la Formación para la Ciudadanía en México. El capítulo quinto refleja la metodología empleada y el sexto presenta los resultados obtenidos empíricamente a la luz del análisis curricular. Finalmente se presentan las conclusiones, propuestas de mejora, y los limitantes y prospectiva de la investigación.[eng] The title of the thesis reflects the purpose of this study: Diagnose the situation of the Training for Citizenship in secondary school students in Mexico, from a Democratic and Intercultural Citizenship Model. The current socio-political context of Mexico shows a citizenship that works hard to consolidate its democracy. However social inequality, poor participation and a lack of recognition of cultural and linguistic diversity that still exists in Mexican society undermines its own democratic principles. Under this framework, the research focused on understanding what the Mexican Educational System is doing through its policies and through the school curriculum, to eliminate the situations that hinder , the democratic development of the Mexican republic, and the achievements of its secondary students. The choice of this level was to do with the fact of having students at a critical stage of their identity building process, key element in the Citizenship Education, and also for being the largest collective of the System about to begin to exercise their civil Rights. For doing the diagnose, we established a Democratic and Intercultural Citizenship theoretical Model which respond to the profile and requirements of the Mexican context. This Model was constructed based on the review of several models of Citizenship Education, including the GREDI´s (Intercultural Education Research Group) Active, Responsible, Critic and Intercultural Education Citizenship Model, from the University of Barcelona, which give us many important elements. The main dimensions of the model we built – Citizenship conception, Interculturality, Sense of ownership, Citizenship Competencies and Citizenship participation- were the parameters used to analyze the curriculum of Citizen Education in Mexico. Likewise, these dimensions were used in a questionnaire that we applied to the secondary education students. The diagnosis found that the Mexican Citizenship Education curriculum has all the aspects of our model and the empiric study holds the relations between all these. The research has three theoretical chapters. The first one it is about the Mexican Citizenship conception, the second one established the key elements that must be present in the Citizenship Education and the third one, develops the Democratic and Intercultural Citizenship Education Model. Subsequently, a chapter is devoted to the analysis of curriculum for Citizenship Education in Mexico. The fifth chapter reflects the methodology used and the sixth explain the empirically results. Finally, we present the conclusions, suggestions for improvement, and the constraints and prospects of research