bluuebunny/crossref_metadata_2025_split huggingface dataset:
SOBREPESO E OBESIDADE INFANTIL: CONHECIMENTOS E PERCEPÇÕES DOS PROFESSORES DE CRECHES PÚBLICAS
Authors: FECHINE ALVARO DIOGENES LEITE , MACHADO MÁRCIA MARIA TAVARES , LINDSAY ANA CRISTINA , CARDOSO MARLY AUGUSTO , BEZERRA JOSÉ ARIMATÉA BARROS , ARRUDA CARLOS ANDRÉ MOURA 
Published: January 2018

A obesidade e o sobrepeso em crianças vêm se tornando um sério problema de saúde pública no Brasil e no mundo, afetando crianças de todas as idades, classes sociais, raças e etnias. Objetivou-se identificar o conhecimento e a percepção de professores de creches públicas sobre o sobrepeso e a obesidade infantil e as implicações de tais alterações de peso na prática diária. Tratou-se de pesquisa qualitativa que utilizou a técnica do grupo focal com 14 professores da zona rural e urbana de um município cearense. O processamento desse material foi conduzido pela análise do discurso. Os resultados apontaram que os professores apresentaram-se como fortes aliados no desenvolvimento de estratégias que visaram à educação alimentar e ao estímulo de hábitos de vida saudáveis, compreendendo que existe uma correlação positiva entre aluno saudável, peso adequado e alimentação correta. Ao lado disso, reclamaram da baixa preocupação dos pais em relação aos aspectos da educação dos filhos matriculados. Concluiu-se que professores de creches públicas conheciam e percebiam o sobrepeso e a obesidade como problemas de saúde e reconheciam que simples ações que envolvessem a participação conjunta entre pais, professores e profissionais da saúde podiam ser de grande valia para o início de práticas alimentares e de vida mais saudáveis.
Palavras-chave: Transição nutricional. Obesidade. Sobrepeso. Creches.
ANALISIS KELAYAKAN EKONOMI BERBAGAI SISTEM SADAP PADA PANEL BO TANAMAN KARET (STUDI KASUS KEBUN BATUJAMUS JAWA TENGAH)
Authors: Widyasari Titik , Nugrahani Mudita Oktorina , Rouf Akhmad , Setya Aji Yoga Bagus , Rinojati Nofitri Dewi 
Published: January 2018

Fluktuasi harga karet merupakan fenomena yang tidak dapat dihindari, namun pebisnis karet senantiasa berusaha bertahan agar biaya produksi rendah dan produktivitas kebun meningkat. Salah satu usaha yang dilakukan adalah penurunan frekuensi sadap. Penelitian ini bertujuan untuk menganalisis kelayakan ekonomi berbagai sistem sadap di panel BO dengan variasi frekuensi sadap dan stimulansia yang diharapkan mampu menurunkan biaya penyadapan dan penggunaan tenaga penyadap. Penelitian dilaksanakan di Kebun Batujamus milik perusahaan negara mulai Oktober 2015 hingga Oktober 2016. Penelitian disusun dengan Rancangan Acak Kelompok Lengkap dengan 11 perlakuan sistem sadap dan 3 ulangan. Analisis anggaran parsial digunakan untuk menilai kelayakan ekonomi. Hasil penelitian menunjukkan bahwa sistem sadap yang layak untuk diterapkan adalah sistem sadap S/2d3.ET2.5%.Ga.1.m/3, S/2 d3.ET2.5%.Ga.1.2w, S/2 d3.ET4.0%.Ga.1.2w, S/2 d4.ET4.0%.Ga.1.2w dan S/2 d4.ET5.0%.Ga.1.2w. Adapun sistem sadap S/2 d3.ET5.0%.Ga.1.2w, frekuensi sadap d5 dan d6 tidak layak secara ekonomi.
Desacoplamiento para Sistemas Continuos en el Tiempo mediante la Técnica Matriz Función de Transferencia
Authors: Granizo Montalvo Evelio Alfredo , Ayala Taco Jaime Paúl , Barragán Marco 
Published: January 2018

En los sistemas de control multivariables se disponen de varias entradas y varias salidas, donde cada entrada controla más de una salida y cada salida es controlada por más de una entrada, lo cual se denomina acoplamiento, que presenta complicaciones matemáticas para su resolución, lo que dificulta el control de este tipo de sistemas. Este trabajo tiene como objetivo el desarrollo de una técnica de desacoplamiento por matriz función de transferencia para sistemas multivariables de múltiples entradas y salidas, que consiste en determinar un compensador, de tal forma que el sistema acoplado multivariable pueda convertirse en un desacoplado de varios sistemas de una entrada y una salida. Esto permite que cada entrada controle solamente una salida y que cada salida sea controlada por una entrada; lo que facilita la solución del control. El sistema propuesto utiliza una metodología computacional para lograr el objetivo planteado. Para demostrar la eficacia del algoritmo propuesto se realiza una validación experimental mediante simulaciones matemáticas de diferentes plantas de prueba.
Will Translational Science Help Reduce Costs of Illness?
Authors: Kockaya Guvenc , Wertheimer Albert I. 
Published: January 2018

The purpose of this commentary is to (1) review the definition and potential benefits of translational science research, (2) comment on funding trends for translational science, (3) pose a question for scientists to discuss, and (4) propose recommendations for such a discussion.
Type: Commentary
Pharmacist Contributions to the U.S. Health Care System
Authors: Schommer Jon C. , Planas Lourdes G. , Johnson Kathleen A. , Doucette William R. , Gaither Caroline A. , Kreling David H. , Mott David A. 
Published: January 2018

Objective: The overall goal for this study was to conduct a segment analysis of the pharmacist workforce during 2009 based upon time spent in medication providing and in patient care services.
Methods: Data for this study were obtained from the 2009 National Pharmacist Workforce Survey in which a random sample of 3,000 pharmacists was selected. Cluster analysis was used for identifying pharmacist segments and descriptive statistics were used for describing and comparing segments.
Results: Of the 2,667 surveys that were presumed to be delivered to a pharmacist, 1,395 were returned yielding a 52.3% overall response rate. Of these, 1,200 responses were usable for cluster analysis. Findings from this study revealed five segments of pharmacists: (1) Medication Providers, (2) Medication Providers who also Provide Patient Care, (3) Other Activity Pharmacists, (4) Patient Care Providers Who also Provide Medication, and (5) Patient Care Providers. The results showed that, in 2009, 41% of U.S. pharmacists were devoted wholly to medication providing (Medication Providers). Forty-three percent of pharmacists contributed significantly to patient care service provision (Medication Providers who also Provide Patient Care, Patient Care Providers who also Provide Medication, and Patient Care Providers) and the remaining 16% (Other Activity Pharmacists) contributed most of their time to business / organization management, research, education, and other health-system improvement activities.
Conclusions: Based on the findings, we propose that the pharmacy profession currently has, and will continue to build, capacity for contributing to the U.S. health care system in new roles for which they have been identified. However, as shifts in professional roles occur, a great deal of capacity is required related to new service provision. Resources are scarce, so an understanding of the most appropriate timing for making such changes can lead to cost-effective use of limited resources for improving patient care.
Type: Original Research
Assessment of patient perceptions concerning a community pharmacy-based warfarin monitoring service
Authors: Waitzman Jennifer , Hiller Debbie Pruss , Marciniak Macary Weck , Ferreri Stefanie 
Published: January 2018

Objective: To assess patient perceptions of a North Carolina community pharmacy-based warfarin monitoring service.
Methods: Prospective study of patients 18 years of age and older, who filled a prescription for warfarin, in one of five Raleigh area community pharmacies, between May 1, 2010 and October 31, 2010. A 14 item survey, along with a self-addressed stamped envelope, was mailed to 330 identified patients. The survey inquired about details of current anticoagulation monitoring services, interest in utilizing a local community pharmacy for this service, and confidence in a pharmacist-managed program.
Results: 26% of surveys were returned. 48% of surveyed individuals responded that they would be interested in having their warfarin monitoring performed by a trained pharmacist in a community pharmacy setting.
Conclusion: Many participants responded that the community pharmacy would be more convenient than or as convenient as their current location. This may be a new clinical service that could be offered in certain community pharmacies.

Type: Original Research
Extent of Drug Coverage across Generic Drug Discount Programs offered by Community Pharmacies: A look at five Chronic Conditions
Authors: Patel Harshali K. , Akinwunmi Peter O. , Sansgiry Sujit S. 
Published: January 2018

Background: Chronic conditions are expensive to treat because of the ongoing prescription cost burden. Generic drug discount programs (GDDPs) that offer generics at discounted price may prove beneficial to reduce pharmacy costs for the same.
Objective: The objective of this study was to assess the extent to which GDDPs provide drug coverage for five common chronic conditions.
Methods: A content analyses of preexisting information was conducted. Extent of coverage based on top 200 generic drugs prescribed during 2008 for the treatment of chronic conditions such as hypertension, mental disorders, arthritis, pulmonary/respiratory conditions, and diabetes were identified. Commonly prescribed medications for these diseases were identified using published peer reviewed clinical guidelines. List of drugs covered under a GDDP for stores, Wal-Mart, Walgreens, CVS, Kroger, HEB, Target, and Randalls were obtained and compared to assess drug coverage by retail dollar sales and sales volume. Descriptive statistics and frequency/percentage of coverage were reported using SAS 9.2.
Results: GDDPs covered the highest number of drugs for hypertension (21-27 across different GDDPs) and the least (3-5 across different GDDPs) for pulmonary/respiratory conditions. Arthritis (5-11), mental disorders (6-11) and diabetes (5-7) had similar coverage. When compared to the top 200 drugs by retail dollars spent during 2008, hypertension (68%-87%) and diabetes (63%-88%) had the highest coverage followed by respiratory conditions (30%-50%), arthritis (22%-48%), and mental disorders (21%-38%). Similar result was obtained when GDDP coverage was compared with the top 200 generic drugs by sales volume, where diabetes (63-88%) and hypertension (57%-74%) had the highest coverage and mental disorders remained the lowest (23%-37%).
Conclusion/Implications: Drug coverage in GDDPs varied by pharmacies across the five common chronic conditions evaluated which may limit accessibility of these programs for uninformed consumers. Drug coverage was higher for diabetes and hypertension compared to mental disorders, arthritis, and pulmonary/respiratory conditions. Innovative strategies such as a national GDDP formulary list or internet-based technological tools to help consumers identify comparative drug coverage may be useful to improve access to these medications.

Type: Student Project
The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic
Authors: Vanmali Radha S , Mayer Sallie D , Fugit Ann M 
Published: January 2018

Objective: Describe the role and integration of ambulatory care pharmacists in a Human Immunodeficiency Virus (HIV) clinic within a free and bilingual clinic with regards to types of interventions made during the patient-pharmacist visit.
Design: Retrospective, single-centered, chart review.
Setting: Free, bilingual clinic in Richmond, VA.
Participants: Thirty-two adult patients with diagnosed HIV receiving care in the clinic between June 30, 2010 and January 26, 2011.
Main Outcome Measure: Types of interventions documented during the patient-pharmacist visit, categorized as medication review, patient education, or adherence monitoring.
Results: Total of 32 patients accounted for 55 patient-pharmacist visits and 296 interventions. The most common interventions were medication review (66.9%), patient education (23.3%), and adherence monitoring (9.8%). Post-hoc analysis suggests Hispanic patients are more likely to be diagnosed with Acquired Immune Deficiency Syndrome (AIDS) (P = 0.01), have current or history of opportunistic infection (OI) (P=0.01), and have current or history of OI prophylaxis (P = 0.03). Adherence monitoring was less common amongst the non-Hispanics (7.1%) compared to the Hispanic sub-population (16.5%), (P = 0.04).
Conclusion: The role of ambulatory care pharmacists in a free and bilingual clinic goes beyond adherence monitoring. Pharmacists can be a valuable part of the patient care team by providing medication review and patient education for HIV and other co-morbidities within free clinics. Further research is warranted to assess outcomes and to further explore the underlying barriers to early HIV diagnosis and adherence within the Hispanic population.

Type: Original Research
Drug shortage management in Alabama hospital pharmacies
Authors: Holmes Oliver W. , Hughes Peter J. 
Published: January 2018

Purpose: The purpose of this study is to identify effective strategies used by Alabama hospitals to manage drug shortages. Moreover, this study aims to determine if there are any relationships among hospital size, utilization of a standard policy for drug shortage management and perceived usefulness of standard procedures for drug shortages.
Methods: A paper survey was mailed to 129 hospital pharmacies in Alabama (per the Alabama Hospital Association directory). The survey consisted of 5 demographic questions, questions involving perception of current medication shortages, sources of information about shorted drugs, and frequency of discussion at P&T committee meetings. Most importantly, the survey contained questions about the use of a standard policy for handling drug shortages, the effectiveness of the policy if one is used, and an open-ended question asking the recipient to describe the policy being used.
Results: A response rate of 55% was achieved as 71 surveys were completed and returned. Approximately 70% of the survey respondents described the current drug shortage issue as a top priority in their pharmacy department. The pharmacy distributor served as the primary source of information regarding drug shortages for 45% of the facilities. There is a direct relationship between size of hospital and likelihood of utilization of a standard policy or procedure for drug shortage management among the sample. The smaller facilities of the sample perceived their management strategies as effective more frequently than the larger hospitals.
Conclusion: Common components of effective management strategies included extensive communication of shortage details and the ability to locate alternative products. The use of portable technology (e.g., Smart phones and tablets) along with mobile applications may emerge as popular means for communicating drug product shortage news and updates within a facility or healthcare system.

Type: Original Research
Transitions in Care: Medication Reconciliation in the Community Pharmacy Setting After Discharge
Authors: Freund Jeff E. , Martin Beth A. , Kieser Mara A. , Williams Staci M. , Sutter Susan L. 
Published: January 2018

Objective: To assess the feasibility of a workflow process in which pharmacists in an independent community pharmacy group conduct medication reconciliation for patients undergoing transitions in care.
Methods: Three workflow changes were made to improve the medication reconciliation process in a group of three independent community pharmacies. Analysis of the process included workflow steps performed by pharmacy staff, pharmacist barriers encountered during the medication reconciliation process, number of medication discrepancies identified, and pharmacist comfort level while performing each medication reconciliation service.
Key Findings: Sixty patient medication reconciliation services met the inclusion criteria for the study. Pharmacists were involved in all steps associated with the medication reconciliation workflow, and were the sole performer in four of the steps: verifying discharge medications with the pharmacy medication profile, resolving discrepancies, contacting the prescriber, and providing patient counseling. Pharmacists were least involved in entering medications into the pharmacy management system, performing that workflow step 13% of the time. The most common barriers were the absence of a discharge medication list (24%) and patient notpresent during consultation (11%). A total of 231 medication discrepancies were identified, with an average of 3.85 medication discrepancies per discharge. Pharmacists' comfort level performing medication reconciliation improved through the 13 weeks of the study.
Conclusions: These findings suggest that medication reconciliation for patients discharged from hospitals and long term care facilities can be successfully performed in an independent community pharmacy setting. Because many medication discrepancies were identified during this transition of care, it is highly valuable for community pharmacists to perform medication reconciliation services.

Type: Original Research
Development and implementation of a community pharmacy medication therapy management-based transition of care program in the managed Medicaid population
Authors: Kelling Sarah E. , Bright David R. , Ulbrich Timothy R. , Sullivan Donald L. , Gartner James , Cornelius Douglas C. 
Published: January 2018

Objective: To describe successes and barriers with the development and implementation of a community pharmacy medication therapy management-based transition of care program in the managed Medicaid population.
Setting: A single supermarket chain pharmacy
Practice description: Community pharmacists provide dispensing and non-dispensing pharmacy services including medication therapy management, biometric wellness screenings, and immunizations.
Practice innovation: Developed and implemented a community pharmacy medication therapy management-based transition of care program for patients with managed Medicaid
Main outcome measures: Feasibility of developing and implementing a transition of care service in a community pharmacy
Results: During the first six months, a total of 17 patients were seen as part of the program. Study pharmacists identified successes and potential strategies for overcoming barriers.
Conclusion: Developing and implementing a community pharmacy transition of care program for patients with managed Medicaid was logistically feasible.

Type: Original Research
Needle free injection technology - An overview
Authors: Kale Tejaswi R. , Momin Munira 
Published: January 2018

Needle free injection technology was developed to reduce the number of needle stick accidents and associated problems. A comprehensive literature review was completed regarding needle free injection technology and its applications, advantages over needle injections, their components and types such as powder injection, liquid injection, depot or projectile injection. This review describes needle free injection technology involving the generation of force by using compressed gas upon actuation in order to deliver a drug at very high speed through a nozzle. This review also describes injection methods that use a spring load jet injector, battery powdered jet injector, and gas powdered jet injector. An overview of marketed products, recent trends and other needleless drug delivery systems is given. Needle free injection technology is growing and has the potential to make the administration of medicine more efficient, safe and convenient.

Type: Commentary
Incorporating a Continuing Professional Development Process into Residency Training
Authors: Tofade Toyin , Scolaro Kelly L. , Bjerke Lina , Crum Meghan , Ferreri Stefanie P. 
Published: January 2018

Continuing Professional development (CPD) has been defined as a "self-directed, ongoing, systematic and outcomes-focused approach to learning and professional development." CPD is an important process that can be used to achieve a habit of lifelong learning and competence in the profession. The CPD process includes 5 steps - reflect, plan, act, evaluate and document. It has been postulated that introducing CPD early in a pharmacist's career encourages the development of life-long learning habits. Pharmacy residents are an ideal cohort to implement CPD into their program, since their accrediting body, the American Society of Health System Pharmacists (ASHP) already encourages the use of deliberate goal identification and evaluation throughout the resident's training. We describe here the process of integrating a continuing professional development (CPD) model into a residency teaching certificate program, subsequent lessons learned and recommendations for the future.

Type: Idea Paper
Assessment of a pharmacist-led comprehensive medication management and wellness program
Authors: Janovick Daniel L. , Green Tara R. , Bright David R. 
Published: January 2018

Background: Pharmacists are currently providing comprehensive medication management in the outpatient setting. However, there is little documented evidence demonstrating pharmacists are generating further improved health outcomes utilizing non-pharmacologic support, such as fitness and nutrition counseling. The objective of this study is to determine if a pharmacist-led wellness program with medication management and lifestyle modifications through fitness and nutrition coaching can lead to improved biometric markers.
Methods: The wellness program targeted corporate employees and was offered in a corporate headquarters' setting with an on-site workout facility. The program was expected to recruit approximately 15 patients into the wellness program consisting of two treatment arms. The standard group featured nutrition-based classes, medication therapy management and fitness education. The intervention group performed the standard group's activities plus direct, supervised fitness training once weekly. Measured biometric markers were assessed at baseline, 3.5 months, and 7 months and included body mass index (BMI), waist circumference (WC), fasting blood glucose (FBG), systolic and diastolic blood pressure (SBP and DBP), and full lipid panel (TC, TG, HDL, and LDL).
Results: Seventeen patients were enrolled in the study. The standard group (n = 11) and intervention group (n = 6) had relatively similar biometric markers at baseline. Seven total patients completed the study (4 from standard group, 3 from intervention group). The majority of biometric markers improved in both groups, and BP and LDL control was maintained for all who completed the study.
Conclusion: These data suggest that a licensed pharmacist with certified personal trainer credentials may be capable of maintaining biometric markers at healthy levels and improving where necessary in an employee wellness program through one-on-one medication, fitness and nutrition support. Additional, large-scale research is needed to verify the clinical outcomes and feasibility in a larger group setting.

Type: Clinical Experience