Séance d’apprentissage interprofessionnel animée par un pharmacien pour les résidents en médecine familiale spécialisés dans les soins liés au VIH

Implication Statement We developed a pharmacist-led one-month teaching rotation for medical residents to learn HIV pharmacotherapy.  This interprofessional education (IPE) was deemed extremely valuable by postgraduate-year-3 residents who intended to have a future practice in HIV care.  The overarching concept of this rotation was for the medical trainee to “become-the-pharmacist”, learning to recognize, prevent, and manage drug-related issues in HIV patients.  Pharmacist-led IPE should be considered to support medical training in other highly specialized pharmacotherapeutic areas.Énoncé des implications de la recherche Nous avons mis au point une formation sur la pharmacothérapie du VIH, présentée par un pharmacien, pour les résidents en médecine de troisième année. Ces derniers ont trouvé cette expérience d’apprentissage interprofessionnel extrêmement précieuse pour leurs interventions futures dans le traitement du VIH. Le concept au cœur de cette rotation d’une durée d’un mois était de mettre les stagiaires en médecine dans la peau du pharmacien pour leur apprendre à reconnaître, à prévenir et à gérer les problèmes liés à la prise de médicaments chez les patients séropositifs. Nous recommandons la formule d’apprentissage interprofessionnel mené par un pharmacien pour appuyer la formation médicale dans les domaines hautement spécialisés de la pharmacothérapie

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Computerising the accounting function : a small and medium enterprise perspective.

The approach in this project IS geared towards explaining the interrelationship between Information Technology (IT), Small and Medium Enterprise (SME) and the Accounting Function.BUSINES

A pharmacist-led interprofessional education program for family practice medical residents specializing in HIV care

Implication Statement We developed a pharmacist-led one-month teaching rotation for medical residents to learn HIV pharmacotherapy.  This interprofessional education (IPE) was deemed extremely valuable by postgraduate-year-3 residents who intended to have a future practice in HIV care.  The overarching concept of this rotation was for the medical trainee to “become-the-pharmacist”, learning to recognize, prevent, and manage drug-related issues in HIV patients.  Pharmacist-led IPE should be considered to support medical training in other highly specialized pharmacotherapeutic areas

Correlations between precursor molecular weight and dynamic mechanical properties of polyborosiloxane (PBS)

It is possible to tailor the dynamic response of polyborosiloxanes (PBS) based on picking the right molecular weight of a precursor. The molecular weight of hydroxy-terminated polydimethylsiloxane (PDMS) defines the shear-stiffening performance of PBS due to straightforward condensation reaction between hydroxy end groups of PDMS and boric acid. Introduced borono groups behave as stickers, hence, are prone to supramolecular interactions. New correlations are discovered for five PBS synthesized from hydroxy-terminated PDMS with different molecular weights. Si─O─B infrared band intensities for all PBS follow the same trend with molecular weight as the number of PDMS hydroxy groups which confirms the full completion of the reaction. After synthesis, the molecular weight of PBSs remained almost the same, which indicates the absence of significant chain scissoring, polymerization, or crosslinking. During the rheological analysis, it is found that crossover point modulus follows the same trend as the number of PDMS hydroxy groups and Si─O─B band intensities. PBS demonstrates a linear increase in peak forces with molecular weight during the drop weight impact test. The low molecular weight of a precursor, hence, a high number of stickers is a primary requirement for effective protection against low-velocity impact

High prevalence of syndemic health problems in patients seeking post-exposure prophylaxis for sexual exposures to HIV.

INTRODUCTION: The standard clinical approach to non-occupational HIV post-exposure prophylaxis (nPEP) focuses on biomedical aspects of the intervention, but may overlook co-occurring or 'syndemic' psychosocial problems that reinforce future vulnerability to HIV. We therefore sought to determine the prevalence of syndemic health problems in a cohort of Ontario nPEP patients, and explored the relationship between syndemic burden and HIV risk. METHODS: Between 07/2013-08/2016, we distributed a self-administered questionnaire to patients presenting to three clinics in Toronto and Ottawa seeking nPEP for sexual HIV exposures. We used validated screening tools to estimate the prevalence of depression (CES-D score ≥16), harmful alcohol use (AUDIT ≥8), problematic drug use (DUDIT ≥6 men/≥2 women), and sexual compulsivity (SCS ≥24) among men who have sex with men (MSM) respondents. In exploratory analyses, we examined the relationships between syndemic conditions using univariable logistic regression models, and the relationship between syndemic count (total number of syndemic conditions per participant) and HIV risk, as estimated by the HIRI-MSM score, using linear regression models. RESULTS: The 186 MSM included in the analysis had median age 31 (IQR = 26-36), including 87.6% having a college/undergraduate degree or higher. Overall, 53.8% screened positive for depression, 34.4% for harmful alcohol use, 30.1% for problematic drug use, and 16.1% for sexual compulsivity. Most participants (74.2%) had at least one syndemic condition and 46.8% had more than one. Exploratory analyses suggested positive associations between depression and harmful alcohol use (OR = 2.11, 95%CI = 1.13, 3.94) and between harmful alcohol use and problematic drug use (OR = 1.22, 95%CI = 0.65, 2.29). Syndemic count was associated with increased HIRI-MSM risk scores in univariable (2.2, 95%CI = 1.0, 3.3 per syndemic condition) and multivariable (2.1, 95%CI = 0.6, 3.6) linear regression models. CONCLUSIONS: The prevalence of syndemic conditions in MSM seeking nPEP for sexual exposure is alarmingly high, and is associated with underlying HIV risk. Routine screening for these conditions may identify opportunities for intervention and could alleviate future vulnerability to HIV

Enhancing healthcare at home for older people in rural and regional Australia: A protocol for co-creation to design and implement system change.

BackgroundWorld-wide, health service providers are moving towards innovative models of clinical home-based care services as a key strategy to improve equity of access and quality of care. To optimise existing and new clinical home-based care programs, evidence informed approaches are needed that consider the complexity of the health care system across different contexts.MethodsWe present a protocol for working with health services and their partners to perform rapid identification, prioritisation, and co-design of content-appropriate strategies to optimise the delivery of healthcare at home for older people in rural and regional areas. The protocol combines Systems Thinking and Implementation Science using a Consensus Mapping and Co-design (CMC) process delivered over five workshops.DiscussionThe protocol will be implemented with rural and regional healthcare providers to identify digital and non-digital solutions that have the potential to inform models of service delivery, improve patient experience, and optimise health outcomes. The combination of system and implementation science is a unique approach for optimising healthcare at home for older populations, especially in the rural context where need is high. This is the first protocol to integrate the use of systems and implementation science into one process and articulating these methods will help with replicating this in future practice. Results of the design phase will translate into practice through standard health service planning methods to enhance implementation and sustainability. The delivery of the protocol will include building capacity of health service workers to embed the design, implementation, and evaluation approach into normal practice. This protocol forms part of the DELIVER (Delivering Enhanced heaLthcare at home through optImising Virtual tools for oldEr people in Rural and regional Australia) Project. Funded by Australia's Medical Research Future Fund, DELIVER involves a collaboration with public health services of Western Victoria, Australia