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

Defining community-engaged health professional education: A step toward building the evidence

The Global Strategy for Health Workforce 2030 (WHO, 2016) outlines a set of milestones and strategies to expand and strengthen the health workforce that could better position countries to achieve universal health coverage and relevant sustainable development goals (SDGs). The Strategy underscores a need to counter the global shortage of health workers (expected to be 17 million by 2030) and ensure the workforce is appropriately trained to address the evolving health needs of the population. This training would ideally produce health professionals who are responsive to the population, socially accountable, both person- and population-centered, and supportive of empowered and engaged communities. Community-engaged health professional education is a mechanism for learning how to work in and with communities while obtaining the attributes just listed. Developing socially accountable individuals and institutions within a health system is key to improving the health and well-being of present and future societies

Twelve Tips for Inclusive Practice in Healthcare Settings

This paper outlines practical tips for inclusive healthcare practice and service delivery, covering diversity aspects and intersectionality. A team with wide-ranging lived experiences from a national public health association’s diversity, equity, and inclusion group compiled the tips, which were reiteratively discussed and refined. The final twelve tips were selected for practical and broad applicability. The twelve chosen tips are: (a) beware of assumptions and stereotypes, (b) replace labels with appropriate terminology, (c) use inclusive language, (d) ensure inclusivity in physical space, (e) use inclusive signage, (f) ensure appropriate communication methods, (g) adopt a strength-based approach, (h) ensure inclusivity in research, (i) expand the scope of inclusive healthcare delivery, (j) advocate for inclusivity, (k) self-educate on diversity in all its forms, and (l) build individual and institutional commitments. The twelve tips are applicable across many aspects of diversity, providing a practical guide for all healthcare workers (HCWs) and students to improve practices. These tips guide healthcare facilities and HCWs in improving patient-centered care, especially for those who are often overlooked in mainstream service provision.Brahmaputra Marjadi, Joanne Flavel, Kirsten Baker, Kristen Glenister, Melissa Morns, Mel Triantafyllou, Penelope Strauss, Brittany Wolff, Alexandra Marie Procter, Zelalem Mengesha, Scott Walsberger, Xiaoxi Qiao, and Paul A. Gardine

The self-regulated learning of medical students in the clinical environment – a scoping review

Abstract Background Self-regulated learning is the individual’s ability to effectively use various strategies to reach their learning goals. We conducted this scoping review to explore what has been found regarding self-regulated learning in the clinical environment and how this was measured. Methods Using Arksey and O’Malley’s five-stage framework, we searched three medical and educational databases as well as Google Scholar for literature on the self-regulated learning of medical students in the clinical environment published between 1966 and February 2017. After results were screened and relevant studies were identified, the data was summarised and discursively reported. Results The search resulted in 911 articles, with 14 articles included in the scoping review after the inclusion criteria was applied. Self-regulated learning was explored in these studies in various ways including qualitative, quantitative and mixed methods. Three major findings were found: 1) levels of self-regulated learning change in the clinical environment, 2) self-regulated learning is associated with academic achievement, success in clinical skills and mental health and 3) various factors can support self-regulated learning levels in medical students. Conclusions Most of articles exploring the self-regulated learning of medical students during the clinical years have been published in the last 5 years, suggesting a growing interest in the area. Future research could explore the self-regulated learning levels of medical students during the clinical years using a longitudinal approach or through the use of novel qualitative approaches

Diverse Metabolic Capacities of Fungi for Bioremediation

Bioremediation refers to cost-effective and environment-friendly method for converting the toxic, recalcitrant pollutants into environmentally benign products through the action of various biological treatments. Fungi play a major role in bioremediation owing to their robust morphology and diverse metabolic capacity. The review focuses on different fungal groups from a variety of habitats with their role in bioremediation of different toxic and recalcitrant compounds; persistent organic pollutants, textile dyes, effluents from textile, bleached kraft pulp, leather tanning industries, petroleum, polyaromatic hydrocarbons, pharmaceuticals and personal care products, and pesticides. Bioremediation of toxic organics by fungi is the most sustainable and green route for cleanup of contaminated sites and we discuss the multiple modes employed by fungi for detoxification of different toxic and recalcitrant compounds including prominent fungal enzymes viz., catalases, laccases, peroxidases and cyrochrome P450 monooxygeneses. We have also discussed the recent advances in enzyme engineering and genomics and research being carried out to trace the less understood bioremediation pathways