A systematic review of the outcome data supporting the Healthy Living Pharmacy concept and lessons from its implementation

Background The Healthy Living Pharmacy (HLP) project, launched in England, UK in 2009 was a novel approach of introducing public health services within community pharmacy to tackle local health inequalities. A national roll-out followed a reported successful pilot; subsequent local evaluations ensued. Objectives To summarise reported outcomes and investigate contextual factors that indicate the presence, absence and maturity of implementation determinants, thus offering useful lessons to stakeholders in implementing future initiatives to achieve successful outcomes. Methods A systematic review was conducted to identify all publications reporting on the HLP project. All HLP articles and conference abstracts were considered for inclusion and were assessed for methodological quality. The Consolidated Framework for Implementation Research (CFIR) was utilised to identify potential implementation determinants reported. Each article was then analysed to identify reported economic, humanistic or clinical outcomes. Results The review included six peer-reviewed journal articles and 12 conference abstracts. Joanna Briggs Institute Qualitative Assessment and Review Instrument indicated deficiencies in methodological quality. Through adoption of the CFIR framework, the implementation determinants relevant to the implementation of HLP into community pharmacy were identified. A resonating issue emerged in that the absence of adopting an evidence-based implementation process limited the ability to capture meaningful outcome data. This resulted in a lack of evidence to support sustainability and the failure to address many of the well cited barriers, e.g. lack of awareness amongst patients, public and other healthcare professionals, and weak support for future investment in resource for training and dissemination. Conclusions Healthcare systems are increasingly called on to adopt evidence-based interventions that improve quality, control costs, and maximize value, thus offering opportunity to accelerate the implementation of clinical pharmacy services and programs aimed at improving patient care. Interventions, such as the HLP project require focused efforts on implementation and evaluation of those implementation efforts to produce effective and lasting changes in complex health care systems

THE ASEAN-5 FUTURE CURRENCY: MAASTRICHT CRITERIA

In this recent decade, many of the economists and policymakers attempted to investigate the suitability of the East Asian region to form a currency union and based on the European countries experience as a benchmark. This study aims to investigate the long-run real convergence in GDP per capita growth among Malaysia, Thailand, Singapore, Indonesia, and the Philippines, over 1978 to 2004. The Dickey-Fuller (DF) and Augmented Dickey-Fuller (ADF) unit root tests were conducted at first difference of GDP per capita for each country; the results demonstrated that all countries GDP per capita are stationary at first difference. The results of the Bound Testing Approach (Auto-Regression Distributed Lag (ARDL)) indicated that there is a long run relationship between variables in the Maastricht Criteria. The results showed that interest rate, inflation rate and the debt ratio experience that negative relationship to the GDP per capita. However, the exchange rate and surplus (or deficit) ratio shown the positive related to the GDP per capita. Therefore, the findings showed the ASEAN 5 countries have fulfilled the Maastricht Criteria with consistent to expected sign(s) except for Singapore’ exchange rate and Indonesia’s debt ratio. Hence, those ASEAN 5 countries in this study have potential to form a single currency.Monetary Union (MU), Bound Test (ARDL), Maastricht Criteria, Single Currency

Patient and public perception and experience of community pharmacy services post-discharge in the UK: a rapid review and qualitative study

OBJECTIVES: To investigate the perception and experience of patients and the public (PP) about community pharmacy (CP) services and other primary care services after hospital discharge back home. DESIGN AND SETTING: A rapid review and qualitative study exploring PP perceptions of primary care, focusing on CP services in the UK. METHODS: A mixed-methods approach was adopted including a rapid review undertaken between 24 April and 8 May 2019 across four databases (MEDLINE, EMBASE, PsycINFO and CINAHL). Semistructured interviews were then conducted investigating for shifts in current PP perception, but also nuanced opinion pertaining to CP services. A convenience sampling technique was used through two online PP groups for recruitment. Thematic framework analysis was applied to interview transcripts. PARTICIPANTS: Any consenting adults ≥18 years old were invited regardless of their medical condition, and whether they had used post-discharge services or not. RESULTS: Twenty-five studies met the inclusion criteria. Patients were generally supportive and satisfied with primary care services. However, some barriers to the use of these services included: resource limitations; poor communication between healthcare providers or between patient and healthcare providers; and patients' lack of awareness of available services. From the 11 interviewees, there was a lack of awareness of CP post-discharge services. Nevertheless, there was general appreciation of the benefit of CP services to patients, professionals and wider healthcare system. Potential barriers to uptake and use included: accessibility, resource availability, lack of awareness, and privacy and confidentiality issues related to information-sharing. Several participants felt the uptake of such services should be improved. CONCLUSION: There was alignment between the review and qualitative study about high patient acceptance, appreciation and satisfaction with primary care services post-discharge. Barriers to the use of CP post-discharge services identified from interviews resonated with the existing literature; this is despite developments in pharmacy practice in recent times towards clinical and public health services

Exploring experiences, behaviours and associated behavioural determinants of healthcare professionals in Qatar regarding medically related social media use.

There is an accumulation of evidence that healthcare professionals are increasingly using social media to provide services to patients, share and disseminate information, and develop their professional skills. Research originating from the Middle East is rare and guidelines for healthcare professionals on appropriate use have only recently emerged. The objective of this study was to explore the experiences, behaviours and associated behavioural determinants of healthcare professionals in Qatar regarding medically related social media use and recently issued national guidelines. Doctors and pharmacists in Qatar posting medically related information at least once per month on social media platforms and who had more than 300 followers were identified. Potential participants for qualitative interviews were selected through purposive and snowball sampling to provide a range of professions, sexes, and clinical specialities. A semi-structured interview scheduled was developed underpinned by the Theoretical Domains Framework (TDF), and piloted. Interviews were conducted via Zoom, transcribed, and independently analysed by two researchers using a framework approach. The study received ethics approval prior to data generation. Identified themes related to experiences, behaviours and associated behavioural determinants. Eight interviews have been conducted (five physicians and three pharmacists), with additional interviews planned until data saturation. Emerging themes at this stage relating to behaviours are that the choice of platform and nature of posting vary with intended use (e.g., social versus professional). Associated determinants align to several TDF domains, largely belief of consequences (e.g., likely improvement in knowledge of others), professional role, social influences of others, and behavioural regulation (e.g., feedback on posts). Positive (rewarding) and negative (responses of others) experiences of social media use were described. Most were unaware of the specific content of the national guidelines, and although largely supportive of their introduction, they identified multiple issues (e.g., the need to include professional registration details in biography). A range of determinants influence medically related social media use. While there may be potential to align behaviour to the guidelines, there may be merit in review of the guidelines

Evaluation of fatty acid profile with special reference to hypertension intake from marine edible fishes

The present study describes the changes in fatty acid profile in hypertension patients by up taking the marine edible fishes Elutherenema tetradactylum, Sphyraena obtusata and Siganus javus because these marine edible fishes are rich in ? –fatty acids.  In this study the total cholesterol, HDL and LDL were significantly decreased from 211.9 – 202.1 mg/dl, 177-159.6 mg/dl. The palmitic acid (C16:0) was found significantly higher in all of peoples compared with other SFAs. This study revealed that the most abundant in individual FAs 16:0,18:0,18:1 n9 and 20:2 n6 were present in blood in both before and after dietary intake. The minimal changes of SFAs levels were decreased averagely from 59.2 to 52.2%. In addition to above PUFAs also increased from 27.7-30.5%. The essential FAs like ALA (C18:3n3), EPA (C20:5n3) and DHA (C22:6n3) were accounting in the range of 2.64-2.92%, 3.67-3.94% and 3.65-4.38%. Omega – 6/3 ratio were recorded from 1.77-2.45%. This study proves the marine edible fishes reduce the hypertension of the patients. Keywords: Edible fishes, ? –fatty acids, SFAs, HDL and LD

Study on the performance of two topology multilevel inverter

It has been accepted that conventional inverters have limitation dealing with high voltage and high power applications. Lately, multilevel inverters are popular for high power applications due to its improved harmonic profile and increased power ratings. There are various literatures regarding topology and control techniques of multilevel inverters. This paper presents the performance of two Flying Capacitor Multilevel Inverter (FCMI) topologies particularly a 3-level and 5-level multilevel inverters. Besides that, concept of the topologies and its modulation techniques were described. Sinusoidal pulse width modulation (SPWM) techniques were utilized in this paper as the topologies control strategy. Two control parameters, namely the amplitude modulation index, ma and the frequency modulation index, mfwere varied in order to control the output voltage of the inverters. The model and simulation study were carried out using Matlab/Simulink software. Analyses on the performance of the two topologies were based on the fundamental voltage, output voltage waveform, output harmonic spectrum and total harmonic distortion (THD). It’s found that the five level FCMI have shown better performance in terms of THD compared to the three level FCMI in all conditions of varied ma and mf. Based on the study also, five level FCMI shows a better voltage output waveform; close to a sinusoidal waveform compared to the three level FCMI

Study on feed-in-tariff (FiT) for BIPV system, a Malaysia scenario

Feed-In Tariff (FiT) was introduced in Malaysia in 2004 and has been undergone many stages to make its implementation in Malaysia successful. The first Building Integrated Photovoltaic (BIPV) introduced in Malaysia is Suria 1000 under the supervision of Pusat Tenaga Malaysia (PTM). The aim of this paper was to study the FiT and BIPV implementation in Malaysia. It is observed that Malaysian did not invest in BIPV due to its expensive investment. The FiT Calculator was developed to prove the benefits of FiT in BIPV by practically calculating the investment and profit in the long run which was after 21 years of implementation. FiT Calculator was developed using Microsoft Visual Basic 2010 and variable parameter such as the solar irradiation, types of solar panel and inverter were studied to obtain the estimation of power output, the annual income, net income and the payback period of BIPV. Results of all case studies were verified with MBIPV mileage report and the built FiT Calculator has shown up to 96.89% accuracy against the case study done