Interest in and use of person-centred pharmacy services - a Swiss study of people with diabetes

BACKGROUND: Diabetes is one of the most important chronic diseases and affects 9% of the world's population. To support these people in the day-to-day management of their treatments, pharmacies can offer professional pharmacy services. These are defined as one or more actions organized or provided in a pharmacy to optimize the process of care, with the goal of improving health outcomes and the value of healthcare. Such services have to be tailored to the needs and interests of patients. This study aimed to evaluate interest in and use of pharmacy services among people with diabetes in the canton of Vaud, Switzerland. METHODS: This cross-sectional study analysed self-reported data from 790 people with diabetes included in the CoDiab-VD cohort. Questions focused on sociodemographic and economic characteristics, diabetes and its management, and interest in and use of pharmacy services related to (1) medication intake and adherence and (2) diabetes and general health. Descriptive analyses were first conducted. Logistic regression analyses were then performed for pharmacy services that were of interest to ≥50% of respondents. RESULTS: The mean age of participants was 66 years, and the sample included more males (59%) than females. The pharmacy services that interested the most respondents were individual interview, pill boxes or weekly pill boxes, treatment plans, checks of all medications, first medical opinions from pharmacists and counselling on devices. Factors significantly associated with interest in pharmacy services were being older, having a lower self-efficacy score, taking more than three medications and having a positive opinion about pharmacists. CONCLUSIONS: This study provides key information on interest in and use of pharmacy services among patients with diabetes in Switzerland; it should help pharmacists individualize their services for patients

Adolescent drug use escalation and de-escalation: a 3-year follow-up study [Abstract]

This study aims to assess adolescents drug use with a longitudinal perspective in order to identify factors interacting with drug use onset and course. Supported by the Swiss Federal Office of Public Health, the study was initiated in 1999 with a follow-up in 2001 and 2002. The first objective was to measure risk factors for substance use initiation. The second objective was to analyse the co-variation of substance use with environmental, social, relational, medical and psychological factors. A total of 102 adolescents, aged 14-19 years, were recruited for the study in the French-speaking part of Switzerland. Results clearly show that substance use is not a disorder per se in adolescence, but that it is part of a multidimensional complex of problems that some adolescents may encounter: increase and decrease in substance use is paralleled with an increase or decrease in the other areas. This implies that prevention of substance use should not be focused mainly on substances but should consider the adolescent's environment and significant life area

Awareness and practices regarding eye diseases among patients with diabetes: a cross sectional analysis of the CoDiab-VD cohort.

The increasing prevalence of diabetes is leading to a rise of eye diseases, augmenting the risk of sight-threatening complications. The aim of this study was to evaluate prevalence, awareness and practices regarding eye diseases among patients with diabetes in the canton of Vaud, Switzerland. A cohort of 323 patients with diabetes completed a self-administered questionnaire assessing prevalence, awareness and practices regarding eye diseases, besides health status and quality of care measures. Descriptive analyses followed by exploratory subgroup analyses and linear regressions were performed to investigate factors associated with awareness and practices. While diabetic retinopathy was reported by 40.9% of patients with type 1 diabetes and 9.8% of patients with type 2 diabetes, 35.8% and 12.6% of all participants reported cataract and glaucoma, respectively. Awareness that diabetes could damage the eyes was reported by almost all participants; the majority was also aware of the importance of glycemic control and regular eye examination in preventing eye diseases. In contrast, only 70.5% of participants underwent an eye examination by an ophthalmologist during the past year. Eye examination was associated with better patients' awareness. Barriers mentioned by patients revealed a lack of knowledge about screening guidelines, in particular regarding the preventive nature of eye examinations. Despite high levels of awareness regarding diabetic eye diseases, a significant proportion of patients with diabetes did not report annual eye examination. Both healthcare strategic efforts targeting the promotion of regular eye examination and initiatives aiming at improving knowledge of screening guidelines should be encouraged. ClinicalTrials.gov on 9th July 2013, identifier NCT01902043 (retrospectively registered)

Conduite automobile et diabète: Prise en charge multidisciplinaire du diabète : recommandations pour la pratique clinique

L’élaboration et la mise en œuvre de ces recommandations pour la pratique clinique (RPC) visent à promouvoir l’application pertinente et coordonnée de pratiques de soins optimales d’un diabète par l’ensemble des professionnels des soins concernés. Ces RPC ont également pour but de fédérer et d’harmoniser la prise en charge du diabète, qui est actuellement très variable dans le canton de Vaud. L’ESSENTIEL Devoir d’information des soignants chez une personne diabétique traitée par un hypoglycémiant - Informer la personne sur la conduite et le diabète et documenter la transmission de ces informations

Évolution des comportements et des représentations sociales liés à la consommation de cannabis chez les adolescents. Résumé

La recherche, dont les résultats principaux sont décrits dans ce résumé, visait trois objectifs différents: a) mieux comprendre l'évolution de la consommation de substances durant l'adolescence; b) mesurer les représentations sociales, par rapport à la consommation, dans une population de consommateurs comparée à une population «tout-venant»; c) valider un instrument de dépistage de la consommation. L'échantillon, sur lequel porte l'observation du suivi, est représentatif d'une population de consommateurs de substances. Le suivi a été réalisé sur une période de quatre ans, l'âge des sujets variant entre 15 et 20 ans au moment du premier entretien. Pour l'évaluation des représentations sociales, une population «tout-venant» a été recrutée, afin de pouvoir comparer les attitudes et opinions des adolescents en relation avec la consommation. Enfin, pour la validation de l'instrument de screening, les deux populations, suivi et «tout-venant», ont été réunies

Ion and fluid transport properties of small airways in cystic fibrosis

Rationale: Small airways constitute amajor site of pathology in cystic fibrosis (CF) and provide most of the surface area of the conducting airways of the lung. Little is known, however, about the impact of CF on ion and fluid transport in small (bronchiolar) airways. Objectives: To describe the ion and fluid transport properties of CF bronchiolar epithelium. Methods: Primary cultures of human bronchial and bronchiolar (non-CF and CF) epithelial cells were obtained. The bioelectric properties were studied in Ussing chambers and the airway surface liquid (ASL) height was measured with confocal microscopy. Main Results: Primary cultures of ΔF508 CF bronchiolar epithelial cells displayed higher transepithelial resistance than non-CF cultures, whereas baseline short circuit current and amiloride-inhibitable short circuit current were similar in both preparations. The ASL height was significantly smaller in CF compared with non-CF preparations. In the presence of amiloride, addition of forskolin increased short circuit current in non-CF but not in CF bronchiolar cultures, and the ATP-induced increase in short circuit current was lower in CF than in non-CF cultures. Non-CF bronchiolar preparations displayed larger short circuit current and fluid secretion in responses to forskolin than non-CF bronchial preparations, suggesting that CFTR-dependent Cl- transport may play a more important role in the regulation of fluid transport in small airways than in large airways. Conclusion: In CF small airways, defective Cl- secretion combined with unregulated (persistent) Na+ absorption results in ASLdepletion

Regulation of Cl- channels in normal and cystic fibrosis airway epithelial cells by extracellular ATP.

The rate of Cl- secretion by human airway epithelium is determined, in part, by apical cell membrane Cl- conductance. In cystic fibrosis airway epithelia, defective regulation of Cl- conductance decreases the capability to secrete Cl-. Here we report that extracytosolic ATP in the luminal bath of cultured human airway epithelia increased transepithelial Cl- secretion and apical membrane Cl- permeability. Single-channel studies in excised membrane patches revealed that ATP increased the open probability of outward rectifying Cl- channels. The latter effect occurs through a receptor mechanism that requires no identified soluble second messengers and is insensitive to probes of G protein function. These results demonstrate a mode of regulation of anion channels by binding ATP at the extracellular surface. Regulation of Cl- conductance by external ATP is preserved in cystic fibrosis airway epithelia

Aérosols de médicaments

L\u27aérosolthérapie a bénéficié ces dernières années de progrès technologiques considérables au niveau des générateurs d\u27aérosols. Les aérosols doseurs liquides HFA avec ou sans chambre d\u27inhalation, les aérosols doseurs de poudre ont vu leurs indications respectives précisées. Les systèmes de nébulisation ont également progressé avec notamment l\u27apparition des nébuliseurs à membranes. La nébulisation permet de traiter les formes les plus sévères des maladies repiratoires, asthme, BPCO, mucoviscidose, par les bronchodilatateurs, les corticoïdes, les antibiotiques et la rhDNase I. L\u27utilisation de la nébulisation trouve depuis peu des applications pour le traitement de maladies systémiques telles que le diabète ou l\u27hypertension artérielle pulmonaire. Des perspectives apparaissent également pour la chimiothérapie antitumorale et la vaccination par aérosols. Les conditions optimales de prescription, d\u27administration et de suivi de l\u27aérosolthérapie ont été définies

The contribution of Swiss scientists to the assessment of energy metabolism

Although Switzerland is considered a small country, it has its share in discoveries, inventions and developments for the assessment of energy metabolism. This includes seminal contributions to respiratory and metabolic physiology and to devices for measuring energy expenditure by direct and indirect calorimetry in vivo in humans and small animals (as well as in vitro in organs/tissues), for the purpose of evaluating the basic nutritional requirements. A strong momentum came during World War II when it was necessary to evaluate the energy requirements of soldiers protecting the country by assessing their energy expenditure, as well as to determine the nutritional needs of the Swiss civil population in time of war when food rationing was necessary to ensure national neutrality and independence. A further impetus came in the 1970s at the start of the obesity epidemics, toward a better understanding of the metabolic basis of obesity, ranging from the development of whole-body concepts to molecular mechanisms. In a trip down memory lane, this review focuses on some of the earlier leading Swiss scientists who have contributed to a better understanding of the field