bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using a Secret Shopper to Evaluate Pharmacist Provision of Emergency Contraception
Authors: Cohen Marsha M. , Dunn Sheila , Cockerill Rhonda , Brown Thomas E.R. 
Published: June 2013

Introduction: Commonly known as “the morning-after pill,” hormonal emergency contraception or the emergency contraceptive pill (ECP) is most effective if used within 72 hours of unprotected sex. In this paper we review a pilot project in Toronto, Ontario, that aimed to increase accessibility by allowing pharmacists to dispense ECP through a pharmacist-physician collaborative agreement, using a predefined protocol. Participating pharmacists received training in the pilot protocol and about ECP. To evaluate whether participating pharmacists were following the project protocol (i.e., giving accurate information to women requesting ECP and dispensing ECP appropriately), and to determine the quality of the pharmacist-patient encounter, we sent “secret shoppers” to participating pharmacies. Method: Five trained “secret shoppers,” using one of two predefined scripts (Script One, where ECP was clearly appropriate, and Script Two, where ECP was not appropriate) visited 34 participating pharmacies to request ECP. At the end of the visit, the secret shopper filled in a questionnaire about the encounter and provided comments. Percentages were calculated for all variables. Results: For Script One encounters (n=17), most pharmacists followed the protocol correctly to dispense ECP. For Script Two encounters (n=17), 71.4% provided alternatives to ECP, but three pharmacists did not follow protocol and provided ECP. For Script One, 52.9% of pharmacists and for Script Two, 71.4%, provided a community referral for follow-up care. The majority of pharmacists (97%) treated the shopper with respect and 85% communicated clearly. Most of the shoppers' comments were positive and the main negative comment about the encounter was lack of privacy. Conclusions: The use of a secret shopper allowed the examination of the pharmacist-customer interaction to delineate issues of importance to the pilot project and provide feedback on areas that may require improvement in the pharmacy provision of emergency contraception, namely, dealing with women who do not qualify for ECP and providing women with community referrals for sexually transmitted infections or ongoing contraception.
Competency Assessment of Pharmacists Providing Emergency Contraception
Authors: Neubauer Shannan L. , Suveges Linda G. , Phillips Kimberly A. , Kolodziejak Lynette R. 
Published: June 2013

Emergency contraceptive pills (ECPs; levonorgestrel or combination oral contraceptives) are used in unique regimens soon after failed contraception or unprotected intercourse to prevent pregnancy. Prompt access to these products is important, as efficacy diminishes with time since intercourse. The availability of EC from pharmacists (either as prescribed Schedule F products or via a rescheduling to Schedule II pharmacist-supervised sale) would greatly increase access. In Saskatchewan, pharmacists have received independent prescribing authority for ECPs. This article describes the process for assessing competency to prescribe EC in that province. A faculty of pharmacy developed a workshop to educate pharmacists about emergency contraceptive products, their mechanism of action, the necessary assessment and documentation processes, ethical issues related to emergency contraception, and counselling techniques. It also offered participants an opportunity to explore a variety of clinical cases in small groups. Participants completed a test before and after the training and were required to attain a score of 80% or greater on the latter test to become certified to prescribe. The average scores on the pre- and post-training tests were 14.4/25 (57.6%) and 22.1/26 (85.0%), respectively ( p < 0.05). Over a series of three workshops, 17.2% of Saskatchewan's 1182 pharmacists became certified to prescribe ECPs. The workshop was offered again in June and September 2003, in anticipation of the September 1, 2003, legislative changes.
Physician Perceptions of Enhanced Community Pharmacist Care in Cholesterol Management
Authors: Simpson Scot H. , Johnson Jeffrey A. , Farris Karen B. , Lau Tim T.Y. , Majumdar Sumit R. , Cave Andrew , Tsuyuki Ross T. 
Published: June 2013

Objectives: The Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP) was a randomized controlled trial that demonstrated that community pharmacist intervention improved cholesterol management for patients at high risk for cardiovascular disease. The objective of this sub-study was to describe physician perceptions of the intervention program. Design: Surveys were mailed to all physicians contacted as part of the enhanced pharmacist care program within SCRIP. Physician opinions were collected on pharmacist participation in cholesterol management and the impact of the program on patient management and outcomes. Results: We received 141 usable surveys from 239 eligible physicians, a response rate of 59%. Of those who responded, 110 (78%) remembered components of the enhanced pharmacist care program, and 77 (55%) were in favour of the pharmacist's recommendations. Of the 110 physicians who recalled the intervention, 27 (25%) agreed that the program improved cholesterol management, and 11 (10%) felt the program had a major effect on patient outcomes; however, only 41 (37%) felt the program was helpful or useful. Written comments reflected opinions that the program duplicates current services and that physicians have reservations about the expanding role of pharmacists. Despite these general comments, similar interventions for other medical conditions were welcomed. Conclusions: Physicians had mixed attitudes toward the enhanced pharmacist care program. Despite these opinions, the main results of SCRIP were very positive. Indeed, if the physician opinions of the program had been more positive, the impact might have been even greater. The effectiveness of future programs may be enhanced through improved communication of the program's goals and collaboration of all stakeholders early in the program's implementation.
Promoting Cardiovascular Health among Older Adults: A Pilot Study with Community Pharmacists
Authors: Pora Virginia V. , Farrell Barbara , Dolovich Lisa , Kaczorowski Janusz , Chambers Larry 
Published: June 2013

This project enabled us to develop procedures for organizing and running successful pharmacy blood pressure sessions. The knowledge gained from this pilot was used in the multicentred Community Health Awareness Program (CHAP). Running blood pressure sessions in community pharmacies and using a multidisciplinary approach, including volunteer health educators and support from public health, was a feasible way to raise awareness of cardiovascular health among the older adults who participated in our project. This pilot project included pharmacist involvement at several stages, from the planning of the blood pressure sessions and development of the documentation forms, to participation in the pilot and feedback after project completion. With its multidisciplinary approach, the pilot showed that it is feasible for a community pharmacist to be involved in research projects that can benefit patient care and enhance their professional roles.
Implementing and Assessing the Benefits and Feasibility of a “Safe Sampling” Pilot Project
Authors: Gene Lana , Nguyen Anne , Kanji Zahra 
Published: June 2013

Background: “Traditional” medication sampling occurs when pharmaceutical companies promote products by providing free samples to physicians, who then pass these on to patients. Limitations of this type of sampling include no pharmacist involvement, limited documentation on patients' medication profiles, limited inventory control in physicians' offices, and lack of patient-specific labeling. We present an improved method called “safe sampling” to mitigate these limitations. Objective: To implement a safe sampling pilot project and to assess its benefits and feasibility from the perspectives of patients, pharmacists, and pharmaceutical company employees. Methods: Physicians provided rabeprazole vouchers to patients in lieu of samples. Patients redeemed the vouchers at the pharmacy for a complimentary seven-day supply. The pharmacist processed the voucher like a prescription. Patients, pharmacists, and pharmaceutical company employees were surveyed after the intervention. Results: The pharmacy received 59 vouchers, which were redeemed by 43 patients and issued by 7 physicians (September 2004—January 2005). The pharmacy filled all vouchers. Of the 42 patients who completed the questionnaires, up to 95% agreed with the various benefits of safe sampling. All pharmacists ( n = 5) and pharmaceutical company employees ( n = 2) agreed that safe sampling was in the patient's best interest and was feasible to implement. Recommendations to enhance safe sampling included involving more than one pharmacy, dispensing medication from existing pharmacy inventory, using online billing, and determining who will pay for safe sampling. Conclusion: All participants acknowledged the benefits of safe sampling. Survey results suggest that pharmaceutical companies may not be willing to absorb the medication cost and/or professional fee involved in dispensing medication samples through pharmacies. Currently, pharmaceutical companies are paying for sample medications and their packaging and distribution. We suggest transferring these funds to the pharmacist's professional fee and sample medication costs. Our surveys suggest that safe sampling is beneficial to patients and is feasible to implement in community practice once the logistics of reimbursement are addressed. Safe sampling provides the groundwork for the creation of a safer, more sustainable method of medication sampling. Additional studies involving a larger patient population, more complex drugs, and a wider selection of pharmacies are needed to further quantify the benefits of safe sampling.
Living MedsCheck
Authors: Grindrod Kelly , Sanghera Niki , Rahmaan Israa , Roy Meghna , Tritt Michael 
Published: June 2013

Objective: To share the experiences of graduating students as they learn to deliver a new medication review service in community pharmacies in Ontario, Canada. Practice description: Four graduating pharmacy students volunteered in different community pharmacies to learn how to navigate a new provincial program called MedsCheck, which pays pharmacists to do medication reviews. Each student selected his or her own practice site, including 2 independent community pharmacies, a grocery store chain pharmacy and a hospital outpatient pharmacy. Practice innovation: To help the students learn to deliver the new MedsCheck services, a faculty mentor met with them on a weekly basis. To reflect on doing MedsChecks in the “real world” and to elicit feedback from the online community, each student blogged about his or her experiences. Results: All 4 students felt that peer mentoring improved their ability to deliver MedsCheck services. They also identified a number of barriers to delivering the MedsChecks and helped each other try to overcome the barriers. Conclusion: MedsCheck is a new service in Ontario and is not easily implemented in the current pharmacy model of practice. Peer mentoring is a helpful way to share successes and overcome barriers to delivery. Can Pharm J 2013;146:33-38.
Women in pharmacy
Authors: Janzen Donica , Fitzpatrick Kerry , Jensen Karen , Suveges Linda 
Published: June 2013

Background: Women have historically been attracted to pharmacy because it is widely perceived as a profession that offers them an opportunity to combine a professional career with a family. Women now make up the majority of practising pharmacists in Canada, yet the literature demonstrates disparities such as gender segregation and underrepresentation of women in senior positions. This study was intended to identify the attitudes and beliefs of pharmacy students about women’s issues in pharmacy and raise awareness of these issues. Methods: First- and fourth-year University of Saskatchewan pharmacy students were invited to share their overall impressions of the status of female pharmacists and the impact of women on the pharmacy profession through an online questionnaire. Results: Of the 60 respondents, the majority disagreed that there is segregation of men and women in pharmacy. More fourth-year students than first-year students recognized the underrepresentation of women in pharmacy management. Many students believed the number of women in pharmacy would have no negative impact on the profession. Forty students (67.8%) agreed that it is important to maintain a significant proportion of men in pharmacy. Conclusion: Most pharmacy students in this study do not recognize gender disparities present in pharmacy or the impact the disproportionate number of women could have on the profession. Can Pharm J 2013;146:109-116.
“I Went to a Fight the Other Night and a Hockey Game Broke Out”
Authors: Goldschmied Nadav , Espindola Samantha 
Published: June 2013

Background: The current study explored the relationship between fighting behavior and passage of time, across games and seasons, in an attempt to assess if violent behavior in hockey is impulsive or intentional. Hypothesis: Before engaging in fighting behavior, players assess the utility of their actions and thus will fight less when the game is on the line (third period) and when champions are crowned (postseason). Methods: An archival exploration utilizing open access databases from multiple Internet sources. Results: During the 2010-2011 National Hockey League (NHL) season, players were significantly less likely to be involved in a fight as the game was coming to a close than in its early stages. In addition, data from the past 10 NHL seasons showed that players were significantly more violent in preseason games than during the regular season. They were also least likely to be involved in a fight during the postseason. Conclusion: The converging evidence suggests that players take into account the penalties associated with fighting and are less likely to engage in violence when the stakes are high, such as at the end of a game or a season. This implies, in turn, that major acts of aggression in the league are more likely to be calculated rather than impulsive. The findings suggest that a more punitive system should diminish fighting behavior markedly.
Increased number and altered phenotype of lymphatic vessels in peripheral lung compartments of patients with COPD
Authors: Mori Michiko , Andersson Cecilia K , Graham Gerard J , Löfdahl Claes-Göran , Erjefält Jonas S 
Published: June 2013

Abstract

Background

De novo lymphatic vessel formation has recently been observed in lungs of patients with moderate chronic obstructive pulmonary disease (COPD). However, the distribution of lymphatic vessel changes among the anatomical compartments of diseased lungs is unknown. Furthermore, information regarding the nature of lymphatic vessel alterations across different stages of COPD is missing. This study performs a detailed morphometric characterization of lymphatic vessels in major peripheral lung compartments of patients with different severities of COPD and investigates the lymphatic expression of molecules involved in immune cell trafficking.

Methods
Peripheral lung resection samples obtained from patients with mild (GOLD stage I), moderate-severe (GOLD stage II-III), and very severe (GOLD stage IV) COPD were investigated for podoplanin-immunopositive lymphatic vessels in distinct peripheral lung compartments: bronchioles, pulmonary blood vessels and alveolar walls. Control subjects with normal lung function were divided into never smokers and smokers. Lymphatics were analysed by multiple morphological parameters, as well as for their expression of CCL21 and the chemokine scavenger receptor D6.

Results
The number of lymphatics increased by 133% in the alveolar parenchyma in patients with advanced COPD compared with never-smoking controls (p < 0.05). In patchy fibrotic lesions the number of alveolar lymphatics increased 20-fold from non-fibrotic parenchyma in the same COPD patients. The absolute number of lymphatics per bronchiole and artery was increased in advanced COPD, but numbers were not different after normalization to tissue area. Increased numbers of CCL21- and D6-positive lymphatics were observed in the alveolar parenchyma in advanced COPD compared with controls (p < 0.01). Lymphatic vessels also displayed increased mean levels of immunoreactivity for CCL21 in the wall of bronchioles (p < 0.01) and bronchiole-associated arteries (p < 0.05), as well as the alveolar parenchyma (p < 0.001) in patients with advanced COPD compared with never-smoking controls. A similar increase in lymphatic D6 immunoreactivity was observed in bronchioles (p < 0.05) and alveolar parenchyma (p < 0.01).

Conclusions
This study shows that severe stages of COPD is associated with increased numbers of alveolar lymphatic vessels and a change in lymphatic vessel phenotype in major peripheral lung compartments. This novel histopathological feature is suggested to have important implications for distal lung immune cell traffic in advanced COPD.
Using concept mapping to explore why patients become lost to follow up from an antiretroviral therapy program in the Zomba District of Malawi
Authors: Rachlis Beth , Ahmad Farah , van Lettow Monique , Muula Adamson S , Semba Medson , Cole Donald C 
Published: June 2013

Abstract

Background
Retention in antiretroviral therapy (ART) programmes remains a challenge in many settings including Malawi, in part due to high numbers of losses to follow-up. Concept Mapping (CM), a mix-method participatory approach, was used to explore why patients on ART are lost to follow-up (LTFU) by identifying: 1) factors that influence patient losses to follow-up and 2) barriers to effective and efficient tracing in Zomba, Malawi.

Methods
CM sessions (brainstorming, sorting and rating, interpretation) were conducted in urban and rural settings in Zomba, Malawi. Participants included ART patients, ART providers, Health Surveillance Assistants, and health managers from the Zomba District Health Office. In brainstorming, participants generated statements in response to “A specific reason why an individual on ART becomes lost to follow-up is…” Participants then sorted and rated the consolidated list of brainstormed items. Analysis included inductive qualitative methods for grouping of data and quantitative cluster identification to produce visual maps which were then interpreted by participants.

Results
In total, 90 individuals brainstormed 371 statements, 64 consolidated statements were sorted (participant n = 46), and rated on importance and feasibility (participant n = 69). A nine-cluster concept map was generated and included both patient- and healthcare-related clusters such as: Stigma and Fears, Beliefs, Acceptance and Knowledge of ART, Access to ART, Poor Documentation, Social and Financial Support Issues, Health Worker Attitudes, Resources Needed for Effective Tracing, and Health Worker Issues Related to Tracing. Strategies to respond to the clusters were generated in Interpretation.

Conclusions
Multiple patient- and healthcare focused factors influence why patients become LTFU. Findings have implications particularly for programs with limited resources struggling with the retention of ART patients.
Special issue on advances in 4G wireless and beyond
Authors: Saxena Navrati , Sengupta Shamik , Wong Kai-Kit , Roy Abhishek 
Published: June 2013

Abstract

Abstract
4G cellular systems envisions a comprehensive all-IP-based solution, including voice, data, and streamed multimedia at much higher data rates and spectral efficiency. Emerging standards and technologies like LTE and M-WiMAX are actually leading towards this vision. The objective of this special issue is to address specific research research issues and solutions on different aspects of 4G wireless systems and beyond. The total six papers included in this special issue demonstrates research outcomes in different aspects of 4G wireless, like scheduling, resource allocation, cognitive and cooperative communications, multicast services and coverage and planning of small cells. We hope that the research results included in this special issue will serve as an important step for further research and development in 4G wireless communication systems.
Prospective investigation of autism and genotype-phenotype correlations in 22q13 deletion syndrome and SHANK3 deficiency
Authors: Soorya Latha , Kolevzon Alexander , Zweifach Jessica , Lim Teresa , Dobry Yuriy , Schwartz Lily , Frank Yitzchak , Wang A Ting , Cai Guiqing , Parkhomenko Elena , Halpern Danielle , Grodberg David , Angarita Benjamin , Willner Judith P , Yang Amy , Canitano Roberto , Chaplin William , Betancur Catalina , Buxbaum Joseph D 
Published: June 2013

AbstractBackground22q13 deletion syndrome, also known as Phelan-McDermid syndrome, is a neurodevelopmental disorder characterized by intellectual disability, hypotonia, delayed or absent speech, and autistic features.SHANK3has been identified as the critical gene in the neurological and behavioral aspects of this syndrome. The phenotype ofSHANK3deficiency has been described primarily from case studies, with limited evaluation of behavioral and cognitive deficits. The present study used a prospective design and inter-disciplinary clinical evaluations to assess patients withSHANK3deficiency, with the goal of providing a comprehensive picture of the medical and behavioral profile of the syndrome.MethodsA serially ascertained sample of patients withSHANK3deficiency (n = 32) was evaluated by a team of child psychiatrists, neurologists, clinical geneticists, molecular geneticists and psychologists. Patients were evaluated for autism spectrum disorder using the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule-G.ResultsThirty participants with 22q13.3 deletions ranging in size from 101 kb to 8.45 Mb and two participants withde novo SHANK3mutations were included. The sample was characterized by high rates of autism spectrum disorder: 27 (84%) met criteria for autism spectrum disorder and 24 (75%) for autistic disorder. Most patients (77%) exhibited severe to profound intellectual disability and only five (19%) used some words spontaneously to communicate. Dysmorphic features, hypotonia, gait disturbance, recurring upper respiratory tract infections, gastroesophageal reflux and seizures were also common. Analysis of genotype-phenotype correlations indicated that larger deletions were associated with increased levels of dysmorphic features, medical comorbidities and social communication impairments related to autism. Analyses of individuals with small deletions or point mutations identified features related toSHANK3haploinsufficiency, including ASD, seizures and abnormal EEG, hypotonia, sleep disturbances, abnormal brain MRI, gastroesophageal reflux, and certain dysmorphic features.ConclusionsThis study supports findings from previous research on the severity of intellectual, motor, and speech impairments seen inSHANK3deficiency, and highlights the prominence of autism spectrum disorder in the syndrome. Limitations of existing evaluation tools are discussed, along with the need for natural history studies to inform clinical monitoring and treatment development inSHANK3deficiency.
Packet charge dynamic in thin polyethylene under high dc voltage
Authors: Gargouri Amal , Boukhris Imed , Belgaroui Ezzeddine , Kallel Ali 
Published: June 2013

Abstract
In this paper, we present a bipolar transport model in low-density polyethylene under high direct-current voltage in order to investigate the charge packet dynamic generated under high injection. These charge packets, observed by our model for the first time, have already been seen in some previous experimental works for a long time. Our model results show that applied electric field and sample thickness play important roles on the apparition of space charge packets.