Ethics: A Problem in Pharmacy?

Ethics, or the lack or attenuation thereof, is an important issue facing practicing pharmacists today. There are both statutory and regulatory provisions to support the requirement of ongoing education and training in ethics. Evidence of formal disciplinary actions by the California State Board of Pharmacy faced requiring pharmacists to take a formal course in ethics as a condition of retention of licensure is sufficient to demonstrate that pharmacists are deviating from the expectations consistent with ethical behavior. Periodic review of the principles of beneficence, non-malfeasance, autonomy, and justice would benefit pharmacists in practice, as evidence infers that a pharmacist’s moral reasoning erodes with time. Additional training in ethics may be beneficial to the practicing pharmacist, particularly since there is evidence to support that pharmacists with a higher capacity for moral reasoning demonstrated a higher level of clinical performance. Faced with professionals committing ethical breaches compromising their license and the dilemmas created by the commercialization of healthcare, the California State Board of Pharmacy is warranted in their requirement that a portion of the 30 hours of continuing education required for continued licensure be grounded in the training of ethics

microRNA-222 の発現抑制は骨分化、軟骨分化、血管新生作用でラット大腿骨難治性骨折モデルにおいて骨形成を促進する

広島大学(Hiroshima University)博士(医学)Doctor of Philosophy in Medical Sciencedoctora

Developing an Exoskeleton Test Plan for the TALOS Program

As America’s global adversaries increase their capabilities on the battlefield, US military forces must enhance warfighter’s survivability, lethality, and mobility. These needs can be met by augmenting warfighters with additional equipment. The increased use of equipment, however, creates an additional need for an exoskeleton that can support the added equipment, while also augmenting the warfighter’s mobility. Traditionally, exoskeletons have had acceptance issues related to poor operational mobility. USSOCOM is building the Tactical Assault Light Operator Suit (TALOS) as the next generation of these armored exoskeletons.  This paper explains the methodology for developing a test plan to ensure adequate mobility for the warfighter wearing the TALOS system. Operational missions were decomposed into tasks which were further broken down into individual movements.  Motion capture data was used to determine the angles and angular velocities imposed on relevant joints during these movements. This information was mapped to a set of exercises that were then compiled into a test plan, which can be used during the testing phase to ensure proper mobility for operators utilizing the system

Co-located Retail Clinics and Pharmacies: An Opportunity to Provide More Primary Care.

This paper proposes that co-located retail clinics (RCs) and community pharmacies can increase opportunities to provide more accessible, affordable, and patient-friendly primary care services in the United States. RCs are small businesses of about 150-250 square feet with a clientele of about 10-30 patients each day and most frequently staffed by nurse practitioners (NPs). Community pharmacies in the U.S. at ~67,000 far outnumber RCs at ~2800, thereby opening substantial opportunity for growth. Community pharmacies and pharmacists have been working to increase on-site clinical services, but progress has been slowed by the relative isolation from other practitioners. An ideal merged facility based on an integrated platform is proposed. NPs and pharmacists could share functions that fulfill documented consumer preferences and still maintain separate practice domains. Potential benefits include a broader inventory of clinical services including laboratory tests, immunizations, patient education, and physical assessment, as well as better patient access, interprofessional training opportunities, and economies related to the use of resources, day-to-day operations, and performance metrics. Challenges include the availability of sufficient, appropriately trained staff; limitations imposed by scope of practice and other laws; forging of collaborative relationships between NPs and pharmacists; and evidence that the merged operations provide economic benefits beyond those of separate enterprises

Inserting Pharmacists in Primary Care Roles in an Ambulatory Care Setting

In this report, we suggest how pharmacy personnel may be used to alleviate some of the pressures currently impacting health system administrators. We look back to the role(s) of the hospital pharmacy and the hospital pharmacist historically and outline changes that have occurred and how these changes may be helpful to address several problem areas in the ambulatory care venue

Standardized Field Sobriety Test: False Positive Test Rate among Sober Subjects

The Standardized Field Sobriety Test (SFST) is a series of exercises that a law enforcement officer gives to a driver suspected of driving under the influence of alcohol. The original research that demonstrated a high correlation between failure of the SFST and a high blood alcohol concentration did not utilize a standard control group to validate that the failure of the SFST was not a characteristic of the population at large. This study examined a series of drug naive subjects to determine the rate of failure of the SFST to accurately distinguish a suspect with high blood alcohol content from the general public. Of the 185 subjects tested, 26% of the drug naïve subjects failed the SFST