Evaluating the role and integration of general practice pharmacists in England:a cross-sectional study

Background Since 2015, NHS England has facilitated the recruitment of pharmacists in general practice (GP) to reduce workload of general practitioners. The role of pharmacists is therefore expected to become more clinical and patient oriented. However, little is known about the current roles performed and the integration of GP pharmacists. Objective To assess the role performed by GP pharmacists and their integration into practice exploring facilitators and barriers to integration. Setting A cross-sectional survey of GP pharmacists in England. Method This study used both online and paper-based questionnaires for a period of six months. Survey items included demographics, roles performed, integration including available support and practice environment. Quantitative data were analysed using descriptive statistics and 95% confidence intervals. Open comments were analysed thematically to identify pharmacists’ perceptions of barriers and facilitators to their integration into practice. Main outcome measure Current role and integration of pharmacists into GP. Results 195 participants completed the questionnaire. Three quarters of pharmacists (76%) had only been in GP since 2015. Most pharmacists (81%) were independent prescribers (PIPs). The most reported pharmacists’ roles were medicine reconciliation (95%), telephone support for patients (95%) and face-to-face medication review (91%). 82% (95% CI: 76% to 86.8%) were satisfied with their overall integration into practice. Half of pharmacists (45%) were working in a shared office or at a hot desk and 9% had no designated workspace. PIPs had more access to a convenient workplace (p = 0.016) compared to non-IPs. Conclusion Practice pharmacists are fulfilling a wide range of clinical and non-clinical roles in England. Findings highlight relatively a satisfactory level of pharmacists’ integration into practice and shed the light on their integration issues. These findings could be significant for the development of future roles of pharmacists in GP

Impact of the COVID-19 Pandemic on Learning: Assessing Cognitive, Affective, and Psychomotor Skills

The acquisition of cognitive, affective, and psychomotor skills is highly important for successful learning outcomes. This article aims to evaluate the Three-Domain Model (TDM) of learning (cognitive, affective, and psychomotor) during the COVID-19 online classes for tertiary students in Bangladesh. This current study aims at the psychometric evaluation and validation of tertiary students' learning loss during the pandemic. A survey questionnaire is administered using the Likert scale. The components of the questionnaire are based on the Three-Domain Model reflecting the cognitive, affective, and psychomotor skills of the students. The article informs of the learning loss due to the pandemic while suggesting the benefits of online classes. The major finding of the article is that learners lost their skills mainly related to the cognitive domain during the pandemic due to online classes. However, at the same time, their skills related to affective and psychomotor domains increased. Therefore, recommendations for minimizing learning loss are also provided to guide future empirical work in the post-pandemic era

Exploration of gaps and challenges in managing burn injury at district and sub-district government health care facilities in Bangladesh

Background: Burn injury is one of the leading cause of mortality and morbidity worldwide. In developing countries like Bangladesh, burn is one of the leading causes of illness, disabilities and deaths. More than 365,000 people are injured every year by electrical, thermal and other causes of burn injuries where 27,000 people needed hospital admission and over 5600 people died. Emergency management of burn at the facility level can reduce the severity of burn injuries and improve overall survival. The study has explored the health care providers’ views on gaps and challenges in management of burn injury at the facilities district and sub district health facilities in Bangladesh. Methodology: A qualitative study was conducted during the period in July 2015. In-depth interviews (n = 19) were performed with the doctors and nurses working in the three district government hospitals and seven sub-district (upazila) government health facilities. Thematic analysis was performed on different themes. Results: Health care providers mentioned that the people are coming to the facilities usually, hours after the incidence. Before visiting the facilities, the burn victims mostly seek treatment from the traditional healers or form village doctors (quack) or from the local pharmacy, over the counter. Family waited until they felt that the patient may not survive. It has identified that delaying in decision making and transferring the patient to the health facility are the key challenges identified by the doctors and nurses when they attended any burn patients in their facility. Moreover, use of different traditional infectious agent in burnt areas from their home make the burn surface more damage. While as, deficiency of adequate supplies, logistics and adequate trainings for the health workers in the facility create much more difficulties to treat a burn patient at primary or secondary health care centers. Conclusion: Burn patients are maltreated in the community before coming to the healthcare facility in most of the cases. The community has misperceptions on burn management which delay the proper management in the facility. Readiness of the facility on the other hand is a big challenge. In order to consistent in burn care in Bangladesh, its equally important to build knowledge and awareness among the community on burn prevention and their role. Like this, readiness of the facilities in time will build confidence in community, thus in turns, will save thousands of lives from burn injury in Bangladesh

Pharmacist management of atrial fibrillation in UK primary care:a cross-sectional study

Background: Atrial Fibrillation (AF) increases the risk of stroke by a factor of five, leading a significant cost burdens on healthcare system. Pharmacists, especially those based in a primary care environment are well placed to support patients in this therapeutic area.Objectives: To assess primary care pharmacists’ actual knowledge on the management of AF symptoms and anticoagulation. Furthermore, to investigate the resources used by pharmacists.Methods: A cross-sectional study using survey was conducted, targeting UK-based registered pharmacists employed within primary care settings. Quantitative data were analysed utilising descriptive univariate and bivariate statistics.Results: 349 pharmacists completed the adapted 19-questions of the pharmacists’ knowledge. Out of a maximum of 19 points, the mean score was 14.34 ± 2.2 (75 ± 11.6%). The questionnaire revealed several significant gaps in pharmacists’ knowledge. Most of the surveyed pharmacists (62.8%) reported that they used sources of information to support their consultations. Half reported that they used the National Institute for Health and Care Excellence (NICE) guidance (52.4%) and the British National Formulary (BNF) (50.7%).Conclusions: Primary care pharmacists are knowledgeable about AF and its management; however, some gaps exist which may require addressing. Although pharmacists use a variety of information resources, it is the traditional resources that remain the most frequently used

Plant and necrotrophic fungal pathogen interaction: mechanism and mode of action

Necrotrophic fungal pathogens cause major losses to fruit, vegetable, and cereal crops annually and the economic impact is more than that of diseases caused by biotrophic pathogens. These pathogens are devastating because they kill as they colonize through production of cell wall-degrading enzymes and phytotoxins, obtaining nutrients for growth and reproduction from the dead plant cells. They explore a wide variety of virulence strategies and based on these the pathogens are classified into host-specific and broad host-range necrotrophs. Plants are equipped with an immune system as a defense mechanism while the necrotrophic fungal pathogenic arsenal suppresses the immune responses for disease manifestation. Plant defense response involves the interplay of signaling molecules which include various phytohormones like jasmonic acid, ethylene, salicylic and abscisic acid which also serve as regulators of the immune response. Coordination at the transcriptional level of genes for the production of defense molecules including antimicrobial phytoalexins and pathogenesis-related proteins by transcription factors such as WRKY33 and ERF which are responsive to the signaling molecules has been observed. The roles for several important transcription factors already unveiled through studies of mutants in the model plant, Arabidopsis thaliana and some of the information translatable to crop plants. The present chapter shows the interconnection between cell wall integrity and the action of signaling molecules in the expression of defense-related genes. Moreover, the epigenetic mechanism through DNA and histone modification is also discussed

Delicar: A smart deep learning based self driving product delivery car in perspective of Bangladesh

The rapid expansion of a country’s economy is highly dependent on timely product distribution, which is hampered by terrible traffic congestion. Additional staff are also required to follow the delivery vehicle while it transports documents or records to another destination. This study proposes Delicar, a self-driving product delivery vehicle that can drive the vehicle on the road and report the current geographical location to the authority in real-time through a map. The equipped camera module captures the road image and transfers it to the computer via socket server programming. The raspberry pi sends the camera image and waits for the steering angle value. The image is fed to the pre-trained deep learning model that predicts the steering angle regarding that situation. Then the steering angle value is passed to the raspberry pi that directs the L298 motor driver which direction the wheel should follow. Based upon this direction, L298 decides either forward or left or right or backwards movement. The 3-cell 12V LiPo battery handles the power supply to the raspberry pi and L298 motor driver. A buck converter regulates a 5V 3A power supply to the raspberry pi to be working. Nvidia CNN architecture has been followed, containing nine layers including five convolution layers and three dense layers to develop the steering angle predictive model. Geoip2 (a python library) retrieves the longitude and latitude from the equipped system’s IP address to report the live geographical position to the authorities. After that, Folium is used to depict the geographical location. Moreover, the system’s infrastructure is far too low-cost and easy to install.publishedVersio

Effects of Plastering and Ferrocement on the Shear Properties of Masonry Triplets

Masonry triplet is formed by three and half bricks keeping the same type of bond exhibited in a brick wall.  The triplet has been investigated by researchers as an indicator of lateral loading capacity of masonry wall.  Although strength is an important parameter in determining the property of triplet, displacement capacity is significant specially for the cases of lateral loads such as wind load or earthquake load.  Experimental investigations carried out to determine the effect of plastering and ferrocement in masonry triplets in terms of both shear strength and strain at maximum stress.  The study identified several parameters that affect these properties e.g. mortar strength, mortar thickness, compressive strength of brick, plastering layer thickness, diameter of the wire mesh, and amount of wire mesh.  Equations have been proposed to determine the shear strength and strain at maximum stress of the triplet based on these factors.  Bond strength was found to be the key factor for the failure of the triplets.  It can be inferred that the construction in Bangladesh lack the bond strength in the horizontal bed surface, decreasing both the load and displacement capacity of the brick wall.  Ferrocement can be used as a retrofitting technique as it has been found from the tests that laminating the triplet surface with ferrocement prevents sudden collapse and confines the triplet so that the shear strength and strain at maximum stress increase.

Biocontrol of plant parasitic nematodes by fungi: efficacy and control strategies

Increasing knowledge and growing concern about the elevated cost of inorganic fertilizers or chemical pesticides with their vast applications on various crop plants has raised interest in the alternative method of plant disease protection caused by plant parasitic nematodes. These alternative methods are not only cost-effective but also eco-friendly to the environment and human health. Among the various rhizospheric microorganisms, opportunistic fungi like Paecilomyces lilacinus, Pochonia chlamydosporia, and arbuscular mycorrhizal (AM) fungi have the potential to reduce the severity of diseases caused by plant parasitic nematodes and also improved the plant growth and biomass production. This chapter provides an overview on the biocontrol potential of opportunistic as well as AM fungi on the growth and development of various crop plants. The details about the interactions between these fungi and plant parasitic nematodes have been discussed. An overview of the recent cost-effective technologies used for the mass propagation of these beneficial rhizospheric microorganisms is also discussed