Do school-level factors influence the educational benefits of digital technology? a critical analysis of teachers’ perceptions

The supposed benefits of teachers’ use of information and communications technology(digital technology) are well reported throughout the academic literature—most ofteninvolving issues of enhanced learning outcomes, increased pupil engagement and moreefficient management and organisation of learning. This paper uses survey data from683 teachers in 24 secondary schools across the UK to analyse the factors influencinghow these benefits are being experienced. In particular, the paper explores the complexrelationships between teachers’ perceptions of technology-related benefits and a rangeof individual, classroom, school and system-level issues. A number of mediating issuesand influences are identified and discussed throughout these analyses. In particular, it issuggested that teachers’ perceptions of the benefits of using technology are influencedmore by institutional rather than individual characteristics. A number of possiblereasons are discussed, highlighting the importance of social and cultural contexts ofdigital technology use in education

Pharmacists’ confidence when providing pharmaceutical care on anticoagulants, a multinational survey

Background: Guidelines on the management of orally anticoagulated patients are continuously evolving, leading to an increased need for pharmacists to be fully integrated in care provision.Objective: To identify self-reported gaps in confidence among practicing pharmacists in the area of anticoagulation. Setting Pharmacists in different work settings in different countries.Method: Cross-sectional international survey from October 2015 till November 2016 among pharmacists working in different settings to assess their level of confidence when delivering anticoagulants as well as to identify possible educational needs regarding this medication class. Validation of the survey was ensured.Results: Responses from 4212 pharmacists originating from 18 countries were obtained. Pharmacists’ level of confidence was significantly higher (p < 0.001) when advising patients on vitamin K antagonists (VKAs) versus non-vitamin K antagonists (NOACs). In general, hospital pharmacists displayed higher confidence levels compared to community pharmacists when advising patients on anticoagulation (p < 0.001). Two distinct patterns of confidence levels emerged relating to basic and advanced pharmaceutical care. Confidence levels when providing advanced pharmaceutical care were significantly higher for Oceania and lower for South America (p < 0.005).Conclusions: Pharmacists felt more confident in supporting patients receiving VKAs compared to the more recently introduced NOACs. With the increasing use of NOACs and the risks pertaining to anticoagulation therapy, it is essential to invest in education for pharmacists to address their knowledge gaps enabling them to confidently support patients receiving oral anticoagulants.The project was funded by the Davie-Ratnoff-Macfarlane (DRM) foundation.info:eu-repo/semantics/publishedVersio

Pharmacy patron perspectives of community pharmacist administered influenza vaccinations

The final publication is available at Elsevier via https://doi.org/10.1016/j.sapharm.2018.04.015. © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/One approach to boost influenza vaccination coverage has been to expand immunization authority. In 2012, the province of Ontario gave community pharmacists the authority to administer the influenza vaccine.This study was conducted as part of the Ontario Pharmacy Evidence Network (OPEN) and funded by the Government of Ontario

Awareness campaigns of atrial fibrillation as an opportunity for early detection by pharmacists: an international cross-sectional study

Atrial fibrillation (AF) accounts for up to one third of strokes, one of the lead mortality causes worldwide. The European Society of Cardiology guidelines recommend opportunistic screening as a means to increase the odds of early detection and institution of appropriate treatment according to risk factors identified. However, in most countries there are various barriers to effective uptake of screening, including low awareness. The Atrial Fibrillation Association is a patient association engaged with raising awareness of AF. Establishing a partnership with the International Pharmacists for Anticoagulation Care Taskforce, we set as goals to test a model for raising awareness of AF involving pharmacists globally; and to identify barriers and enablers to its implementation. A cross-sectional study was conducted during the Arrhythmia Alliance World Heart Rhythm Week. Pharmacists from 10 countries invited individuals (≥ 40 years; without anticoagulation therapy of AF) to participate in the awareness campaign. Participants agreeing were engaged in the early detection of AF (EDAF) using pulse palpation. Individuals with rhythm discrepancies were referred and prospectively assessed to have information on the proportion of confirmed diagnosis, leading to estimate the detection rate. Interviews with country coordinators explored barriers and enablers to implementation. The study involved 4193 participants in the awareness campaign and 2762 in the EDAF event (mean age 65.3 ± 13.0), of whom 46.2% individuals were asymptomatic, recruited across 120 sites. Most common CHA2DS2-VASc risk factor was hypertension. Among 161 patients referred to physician, feedback was obtained for 32 cases, of whom 12 new arrhythmia diagnoses were confirmed (5 for AF, 2 for atrial flutter), all among elders (≥ 65 years). Qualitative evaluation suggested a local champion to enable pharmacists’ success; technology enhanced engagement amongst patients and increased pharmacists’ confidence in referring to physicians; interprofessional relationship was crucial in success. This study suggests pharmacists can contribute to greater outreach of awareness campaigns. Effective communication pathways for inter-professional collaboration were suggested enablers to gain full benefits of EDAF

The effect of modifiable risk factors on geographic mortality differentials: a modelling study

Background Australian mortality rates are higher in regional and remote areas than in major cities. The degree to which this is driven by variation in modifiable risk factors is unknown. Methods We applied a risk prediction equation incorporating smoking, cholesterol and blood pressure to a national, population based survey to project all-causes mortality risk by geographic region. We then modelled life expectancies at different levels of mortality risk by geographic region using a risk percentiles model. Finally we set high values of each risk factor to a target level and modelled the subsequent shift in the population to lower levels of mortality risk and longer life expectancy. Results Survival is poorer in both Inner Regional and Outer Regional/Remote areas compared to Major Cities for men and women at both high and low levels of predicted mortality risk. For men smoking, high cholesterol and high systolic blood pressure were each associated with the mortality difference between Major Cities and Outer Regional/Remote areas--accounting for 21.4%, 20.3% and 7.7% of the difference respectively. For women smoking and high cholesterol accounted for 29.4% and 24.0% of the difference respectively but high blood pressure did not contribute to the observed mortality differences. The three risk factors taken together accounted for 45.4% (men) and 35.6% (women) of the mortality difference. The contribution of risk factors to the corresponding differences for inner regional areas was smaller, with only high cholesterol and smoking contributing to the difference in men-- accounting for 8.8% and 6.3% respectively-- and only smoking contributing to the difference in women--accounting for 12.3%. Conclusions These results suggest that health intervention programs aimed at smoking, blood pressure and total cholesterol could have a substantial impact on mortality inequities for Outer Regional/Remote areas. Background: Australian mortality rates are higher in regional and remote areas than in major cities. The degree to which this is driven by variation in modifiable risk factors is unknown. Methods. We applied a risk prediction equation incorporating smoking, cholesterol and blood pressure to a national, population based survey to project all-causes mortality risk by geographic region. We then modelled life expectancies at different levels of mortality risk by geographic region using a risk percentiles model. Finally we set high values of each risk factor to a target level and modelled the subsequent shift in the population to lower levels of mortality risk and longer life expectancy. Results: Survival is poorer in both Inner Regional and Outer Regional/Remote areas compared to Major Cities for men and women at both high and low levels of predicted mortality risk. For men smoking, high cholesterol and high systolic blood pressure were each associated with the mortality difference between Major Cities and Outer Regional/Remote areas - accounting for 21.4%, 20.3% and 7.7% of the difference respectively. For women smoking and high cholesterol accounted for 29.4% and 24.0% of the difference respectively but high blood pressure did not contribute to the observed mortality differences. The three risk factors taken together accounted for 45.4% (men) and 35.6% (women) of the mortality difference. The contribution of risk factors to the corresponding differences for inner regional areas was smaller, with only high cholesterol and smoking contributing to the difference in men - accounting for 8.8% and 6.3% respectively - and only smoking contributing to the difference in women - accounting for 12.3%. Conclusions: These results suggest that health intervention programs aimed at smoking, blood pressure and total cholesterol could have a substantial impact on mortality inequities for Outer Regional/Remote areas

Audit of IV Pantoprazole: Patterns of Use and Compliance with Guidelines

ABSTRACT Background: Institutional guidelines were developed to promote appropriate use of the IV proton pump inhibitor pantoprazole. The guidelines restricted use of this drug to patients with upper gastrointestinal bleeding who were hemodynamically unstable or at high risk of rebleeding and patients requiring a proton pump inhibitor but designated NPO (unable to receive enteral medication or feeding).Objective: To describe patterns of use of pantoprazole and to determine compliance with the guidelines at a tertiary-care, university-affiliated institution.Methods: Drug utilization and compliance with guidelines were audited retrospectively. The medical records of all patients who received IV pantoprazole during the initial 6 months of use of this drug at the institution (February to July 2000) were reviewed.Results: Fifty-seven patients received IV pantoprazole during the study period: 46 for upper gastrointestinal bleeding and 11 because they were NPO. In the group with upper gastrointestinal bleeding, 30 (65%) of the orders were recommended by the gastroenterology service; however, only 16 (35%) of the cases clearly met the eligibility criteria of hemodynamic instability or high risk of rebleeding. Adherence to the dosing regimen in this group was 70% (32 cases), and mean duration of therapy was acceptable, at 73.0 h. In the NPO group, 6 (55%) of the treatment courses met the criteria set out in the guidelines. Continuous infusion was prescribed inappropriately for 4 (36%) of these patients. Mean duration of therapy was much longer, at over 200 h. Total expenditures for IV pantoprazole were approximately $13 000 over the 6-month audit period.Conclusions: Despite guidelines and prescribing restrictions, this criteria-based audit found that IV pantoprazole was used inappropriately in a substantial proportion of treatment courses. Prospective monitoring and intervention by pharmacists are recommended to ensure cost-effective use of this new therapeutic modality.RÉSUMÉ Historique : Des lignes directrices pour l’établissement de santé ont été élaborées afin de favoriser l’utilisation adéquate de l’inhibiteur de la pompe à protons par voie intraveineuse, le pantoprazole. Les lignes directrices limitaient l’administration de ce médicament aux patients souffrant d’hémorragies digestives hautes et présentant une instabilité hémodynamique ou un risque élevé de récidive hémorragique, et aux patients nécessitant un inhibiteur de la pompe à protons qui ne pouvaient rien prendre par voie orale (chez qui l’alimentation ou la médication entérales étaient impossibles).Objectif : Décrire les habitudes d’utilisation du pantoprazole et déterminer le degré d’observance des lignes directrices dans un établissement de soins tertiaires affilié à une université.Méthodes : L’utilisation du médicament et l’observance des lignes directrices ont été évaluées à posteriori. Les dossiers médicaux de tous les patients qui ont reçu du pantoprazole I.V. au cours des premiers six mois de l’utilisation de ce médicament à l’établissement de santé (de février à juillet 2000) ont été passés en revue.Résultats : Au total, 57 patients ont reçu du pantoprazole I.V., dont 46 pour des hémorragies digestives hautes et 11 parce que l’administration entérale de médicaments était impossible. Dans le groupe hémorragies digestives hautes, 30 (65$ au cours de la période d’étude de six mois.Conclusions : Malgré les lignes directrices et les restrictions d’ordonnance, cette vérification fondée sur les critères a révélé que le pantoprazole I.V. était utilisé de façon non appropriée dans un nombre considérable de schémas thérapeutiques. La surveillance prospective et l’intervention par les pharmaciens sont recommandées pour assurer l’utilisation rentable de cette nouvelle modalité thérapeutique

Pharmacogenetic-guided cannabis usage in the community pharmacy: evaluation of a pilot program

Abstract Background Pharmacists possess a skillset suited to provide evidence-based guidance to current and potential users of cannabis. Clinical pharmacogenomics research has made significant progress in defining which genetic variations are important for influencing inter-patient variability in response to cannabis. This study aims to evaluate the practicality and impact of pharmacogenetic testing in the community pharmacy to help guide in the safe use of cannabis. Methods The pilot program was designed as open-label, non-randomized, and observational. Two busy, urban community pharmacies, operating under the brand Shoppers Drug Mart, in Toronto, Ontario, Canada offered pharmacogenomic testing to cannabis users as part of their professional services program over a period of 2 months. Eligible patients received buccal swabs using a DNA cheek swab kit. De-identified, barcoded samples were then sent by regular mail to an off-site CLIA-certified laboratory for analysis in Mississauga, Canada. A pharmacogenetic testing platform from Lobo Genetics® was utilized for translation of participants’ DNA with respect to CYP2C9, AKT1 and COMT genetic polymorphisms. Following genomic data translation, personalized, evidence-based recommendations were generated. Pharmacists provided a cannabis pharmacogenetic consultation to patients via telephone or in-person. Results Twenty patients enrolled in the study. Pharmacogenetic screening identified 95% as having the CYP2C9*1/*1 genotype (suggesting normal THC metabolism); 35 and 25% had AKT1 genotypes suggesting intermediate risk (C/T genotype) or high risk (C/C genotype), respectively, for cannabis-induced psychosis; and 45 and 10% had COMT genotypes suggesting intermediate risk (Val/Met genotype) or high risk (Val/Val genotype), respectively for cannabis-induced neurocognitive impairment. After the pharmacogenetic consultation, 65% of patients reported an increased comfort level in choosing a specific strength/strain of cannabis for use in the future; 75% considered the consultation of high value providing information potentially vital to their health and wellbeing. Conclusion Although the study did not find any CYP2C9 variants associated with highly diminished THC metabolism, most of these patients do carry genetic variants that may potentially predispose them to the development of psychosis and memory impairment. Similar initiatives can potentially improve patient safety and empower individuals to make informed decisions about cannabis use and possible complications

Synthesis, characterization, magnetic and catalytic properties of a ladder-shaped MnII coordination polymer

[Mn(LH)(H2O)]n {1, where LH2– is the dianion of N-(4-carboxybenzyl)iminodiacetic acid} has been synthesized and its crystal structure has been determined. The crystal of 1 is built from 1D polymeric ladder-shaped chains that extend to a 3D supramolecular architecture through H-bonds. The compound was characterized with spectroscopic and physicochemical techniques. Variable-temperature magnetic data suggest that there are weak antiferromagnetic interactions. Compound 1 has been evaluated as a heterogeneous oxidation catalyst. It catalyzes alkene epoxidation selectively in relatively high yields