American College of Clinical Pharmacy White Paper: Cultural Competency in Health Care and Its Implications for Pharmacy Part 3A: Emphasis on Pharmacy Education, Curriculums, and Future Directions

Culture influences patients\u27 beliefs and behaviors toward health and illness. As the U.S. population becomes more diverse, a critical need exists for pharmacy education to incorporate patient-centered culturally sensitive health care knowledge and skills into the curriculum. Nursing was the first profession to incorporate this type of learning and training into its curriculums, followed by medicine. Pharmacy has also made great progress to revise curriculums, but inconsistency exists in depth, breadth, and methods across pharmacy colleges. This article addresses important aspects of pharmacy education such as curriculum development, incorporation of educational innovations and techniques into the teaching of patient-centered culturally sensitive health care across the curriculum from didactic to experiential learning, assessment tools, and global education. A preliminary model curriculum with objectives and examples of teaching methods is proposed. Future directions in pharmacy education, teaching and learning scholarship, postgraduate education, licensure, and continuing education are also presented

Molecular characterization, toxin detection and resistance testing of human clinical Clostridium difficile isolates from Lebanon

Clostridium (Clostridioides) difficile is the main cause for nosocomial diarrhoea in industrialised nations. Epidemiologic data on the pathogen’s occurrence in other world regions are still scarce. In this context we characterized with phenotypic and molecular genetic methods C. difficile isolates stemming from hospitalised patients with diarrhoea in Lebanon. From 129 stool samples of symptomatic patients at a tertiary care University hospital in Lebanon, a total of 107 C. difficile strains were cultivated and underwent ribotyping, toxin gene detection and antibiotic resistance testing. Ribotype 014 (RT014, 16.8%) predominated, followed by RT002 (9.3%), RT106 (8.4%) and RT070 (6.5%). Binary toxin gene-positive isolates (RT023, RT078 and RT126) were rarely detected and RT027 was absent. Interestingly, within one isolate only the toxin A gene (tcdA) was detected. Multiple-locus variable-number tandem repeat analysis (MLVA) revealed strong strain diversity in most RTs. The isolates were sensitive to metronidazole and vancomycin, and only a small proportion of strains displayed resistance against moxifloxacin, rifampicin, and clarithromycin (5.6%, 1.9%, and 2.8%), respectively. The data indicate that the genetic strain composition of Lebanese strains differs markedly from the situation seen in Europe and North America. Especially the epidemic RTs seen in the latter regions were almost absent in Lebanon. Interestingly, most strains showed almost no resistance to commonly used antibiotics that are suspected to play a major role in the development of C. difficile infection, despite frequent use of these antibiotics in Lebanon. Thus, the role of antimicrobial resistance as a major driving force for infection development remains uncertain in this area

PRN OPINION PAPER: Application of precision medicine across pharmacy specialty areas

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149551/1/jac51107_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149551/2/jac51107.pd

Knowledge and practice of patients with diabetes mellitus in Lebanon: a cross-sectional study

Abstract Background The objective of this study was to assess the knowledge and practice of Lebanese patients living with diabetes mellitus in regards to their diabetes self- management. Methods A cross-sectional study, conducted between January and June 2015, enrolled 207 urban adult patients with diabetes mellitus from community pharmacies while purchasing their diabetes medications. Their knowledge and self-management practices were assessed using a structured anonymous interview survey questionnaire. Results The mean age of the participants was 60.2 ± 15.5 years, and the Male/Female ratio was 1.38. The mean knowledge score was 2.34 ± 0.88 points (out of 6). Very few participants (17.4%) knew their current medication side effects. The mean practice score was 5.86 ± 1.77 points (out of 8). Only 15.9% of patients reported current physical activity. A multiple linear analysis showed that those with a university degree had a significantly higher knowledge (Beta = 0.448, p = 0.001) and practice score (Beta = 0.523 p = 0.047) than those with intermediate or primary schooling. Those who reported following a special diabetes diet had a higher knowledge score (Beta = 0.482, p < 0.001) than those who did not. Knowledge score and practice score were highly correlated (Beta = 0.844, p < 0.001). There was no significant differential by gender and age for knowledge and practice scores. Conclusions The knowledge and practice scores of patients with diabetes mellitus were not satisfactory. Well-targeted interventions are needed, such as improving the communication between the pharmacist and people living with diabetes. The observed low adherence to physical exercise among patients with diabetes should also be addressed

Evidences of Bayesian Machines Robustness Against SEUs and SETs

International audienceThis work revisits the stochastic computation paradigm as a way to implement architectures dedicated to Bayesian computation. Fault injection experiments assess the intrinsic robustness of a Bayesian Machine with respect to Soft Errors

Evidences of Stochastic Bayesian Machines Robustness Against SEUs and SETs

International audienceThis work revisits the stochastic computationparadigm as a way to implement architectures dedicated toBayesian computation. It is assumed that Stochastic BayesianMachines (SMBs) are intrinsically tolerant to the effects ofradiation. However, practical assessment is mandatory beforeconsidering SBMs in hazardous environments. Results of faultinjectioncampaigns performed at the RTL level provide the firstevidences of SBMs robustness with respect to SEUs and SETs

Assessing Continuing Education Practices and Preferences amongst Lebanese Hospital Pharmacists

Background: Continuing education (CE) is an international tool that requires lifelong active participation in learning activities allowing the pharmacist to stay a major player among others. In 2014 the CE program was introduced to the pharmacists licensed in Lebanon as a mandatory requirement for re-licensure. In the absence of guidelines regarding the quality and quantity of CE programs, behavioral resistance to precipitate in the CE programs might be encountered among the pharmacists. Objective: The objective of this study is to assess the perceptions of pharmacists working in Lebanese hospitals on the continuing education preferences. The advantage of this program is to collect information that would help the Order of Pharmacy in Lebanon to upgrade the CE program in a way that is more acceptable and convenient for the pharmacists. Methods: A cross-sectional study was carried out in 2016, using a proportionate random sample of Lebanese hospital pharmacies from all governorates in Lebanon. A structured questionnaire was distributed to all hospital pharmacies in Lebanon. Descriptive statistics were calculated for all study variables. This includes the mean and standard deviation for continuous measures, counts and percentages for categorical variables Results: A total of 107 (53.5%) participants completed the questionnaires. The majority of participants were from Beirut and Mount Lebanon. The percentage of participants working at private hospitals was (68.2%).The majority of participants who completed the questionnaire (86.2%) agreed that continuing education programs affects their way of practice and increases their knowledge. Their preferred CE types to be used in the future were the computer based ones (60.6%), interactive workshops (45.5%) and printed materials (44.9%). Their considerations for selecting the CE type is based on their interest in the topic (80.6%), the ease of access to print or online material (77.2%), or the convenience of being offered during an event (67.1%). Participants noted that barriers to attend live CEs were mainly work responsibilities (76%), travel distance (65.6%), family commitments (48.4%) and scheduling (40.6%). Conclusions: Lebanese hospital pharmacists are highly committed to CE. They consider it a practical tool for career development and advancement