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“Until they know how much you care”: A qualitative analysis of an innovative practice in community pharmacy
Michael Melczak, PhD,Janice Pringle, PhD
INNOVATIONS in Pharmacy , 2011,
Abstract: Purpose: This qualitative study was concerned with investigating community pharmacists’ thoughts on the use of two brief scales to measure patient outcomes and therapeutic alliance in the context of their Medication Therapy Management (MTM) services. The scales were originally developed for use in behavioral healthcare, but were used in a novel (community pharmacy) setting as part of a previous parent study. We describe this practice (using these scales in a novel setting) as an innovative practice, report on the pharmacists’ experiences with the practice, and discuss relative advantages and disadvantages for integrating the use of the scales as part of routine practice.Methods: Six community pharmacy practitioners participated in a semi-structured interview pertaining to the use of the scales in their MTM services. Pharmacist interviews were transcribed, analyzed according to qualitative content analysis methodology, and presented in relation to the guiding interview questions.Results: Pharmacists had varying opinions on the use of the scales as part of their practice. Initial concerns included patient (mis)understanding about the purpose and proper completion of the scales, as well as apprehension about the use of the information. These concerns were largely resolved through education, repeated use, and routinization. Pharmacists, in general, saw a value to using these scales in clinical practice, for clinical and professional reasons, although there was variability on the degree to which pharmacists integrated the scales into practice after the study completion. Pharmacists had varied opinions as well as on the degree to which the use of the scales would impact medication adherence. Pharmacists were most surprised by how much participation in this study prompted them to reflect on their interactions with patients.Conclusions: Pharmacists, in general, were receptive to participating in the parent study and using two brief scales to measure patient outcomes and therapeutic alliance. Pharmacists had varying opinions on the degree to which the use of these scales could impact patient medication adherence, although they perceived other value and benefits secondary to the interactions. While most pharmacists did not maintain formal use of the scales after study end, they took away general principles of patient-centered care and individualized feedback.
Medication adherence and its relationship to the therapeutic alliance: Results from an innovative pilot study within a community pharmacy MTM practice
Janice Pringle, PhD.,Michael Melczak, PhD,Arnie Aldridge, MS,Margie Snyder, PharmD, MPH
INNOVATIONS in Pharmacy , 2011,
Abstract: Objectives: To determine whether patients who received Medication Therapy Management (MTM) from community pharmacists using a brief scale to measure Therapeutic Alliance (i.e., MTM + TA) would show better medication adherence than patients whoreceived MTM without use of the TA scale (MTM only). Design: Quasi-experimental, using a direct intervention group (MTM + TA) and a comparison group of randomly selected claims records from patients who received only the MTM service (MTM only). We used a doubly robust propensity score approach to estimate the average effect of therapeutic alliance on medication adherence. The analysis was limited to the following broad medication categories: antihypertensives, antidiabetic agents, and antihyperlipidemics. Setting: The direct intervention group included patients receiving MTM services from pharmacists in a community pharmacy chain setting. Participants: After matching with claims data, the direct intervention group was n=117, with an average age of 76.4. The comparison group was n=146, with an average age of 76.2. Intervention: Administration of two brief scales designed to measure general health outcomes and TA within the context of MTM (with focus on TA scale administration). Main Outcome MeasuresProportion of Days Covered (PDC) and PDC80. Results: Using the therapeutic alliance scales in the context of community pharmacistprovided MTM was associated with a 3.1 percentage point increase in patients’ overall PDC (p<.001) and an increase of 4.6 percentage points in PDC80 (p=.02) as compared to patients receiving MTM without use of the therapeutic alliance scales. Conclusion: Measuring therapeutic alliance in the context of MTM is associated with improved medication adherence and represents one strategy for enhancing the effectiveness of MTM encounters. Furthermore, administration of the therapeutic alliance scales used very little time; therefore it is likely feasible for pharmacists to routinely use the scales in their practice.
Asthma and the Diversity of Fungal Spores in Air
Anne Pringle
PLOS Pathogens , 2013, DOI: 10.1371/journal.ppat.1003371
Clinical Evaluation of an Oral Electrolyte Solution Formulated Based on Strong Ion Difference (SID) and Using Propionate as the Organic Anion in the Treatment of Neonatal Diarrheic Calves with Strong Ion Acidosis  [PDF]
Henry Stampfli, Olimpo Oliver, John K. Pringle
Open Journal of Veterinary Medicine (OJVM) , 2012, DOI: 10.4236/ojvm.2012.21006
Abstract: Background: It is postulated that the concentrations of the major strong ions (Na, K, and Cl) in oral electrolyte solutions play a major role in clinical efficacy of these solutions for rehydration and corrections of metabolic acid base derangements. Objectives: The purpose of this study was to test prospectively the efficacy of an OES (OESexp) formulated based on concentration of strong ion difference (SID) and propionate in a group of calves with naturally occurring neonatal diarrhea and clinically detectable dehydration and acid base abnormalities. Animals: Ten client owned calves of varying breeds, 2 - 22 days old, presented to a veterinary teaching hospital with a history of naturally occurring acute undifferentiated diarrhea, progressive depression and dehydration for treatment. Methods: Clinical and laboratory parameters were measured pre and post two oral electrolyte treatments to assess efficacy of the experimental OES to correct clinical and clinico pathological parameters. For the clinical trial the calves served as their own controls. For control of safety of medication 4 normal calves were force fed 4 L of OESexp and followed over a 24 hour period. Results: All calves had severe diarrhea and metabolic acidosis. The metabolic acidosis observed in the plasma of these calves and reflected by pH, HCO3- SID and base deficit was corrected significantly towards reference ranges (p < 0.05) with two 2 L feedings 12 hours apart. Dehydration was significantly corrected and all calves were discharged 1 - 3 days post admission. Conclusion and Clinical Importance: The use of SID is a valid approach when formulating oral electrolytes solutions for use in calves with acute diarrhea and metabolic derangement. Sodium propionate is valid substitute for commonly used sodium base equivalents in North America in oral electrolyte solutions.
Evaluation of alternative methods for estimating reference evapotranspiration  [PDF]
Daniel K. Fisher, H. C. Pringle III
Agricultural Sciences (AS) , 2013, DOI: 10.4236/as.2013.48A008

Evapotranspiration is an important component in water-balance and irrigation scheduling models. While the FAO-56 Penman-Monteith method has become the de facto standard for estimating reference evapotranspiration (ETo), it is a complex method requiring several weather parameters. Required weather data are oftentimes unavailable, and alternative methods must be used. Three alternative ETo methods, the FAO-56 Reduced Set, Hargreaves, and Turc methods, were evaluated for use in Mississippi, a humid region of the USA, using only measurements of air temperature. The Turc equation, developed for use with measured temperature and solar radiation, was tested with estimated radiation and found to provide better estimates of FAO-56 ETo than the other methods. Mean bias errors of 0.75, 0.28, and -0.19 mm, mean absolute errors of 0.92, 0.68, and 0.62 mm, and percent errors of 22.5%, 8.5%, and -5.7% were found for daily estimates for the FAO-56 Reduced Set, Hargreaves, and Turc methods, respectively.

The role that oilseeds, including new hi-oleic varieties can play in improving the profile of fat intake by the UK population  [PDF]
Janice Irene Harland
Agricultural Sciences (AS) , 2014, DOI: 10.4236/as.2014.53024

The production in the EU of the oilseeds, rapeseed and sunflower, has increased dramatically over the last 20 years. Much of the oil produced after crushing is used for culinary purposes; this enhanced intake of vegetable oil has led to a substantial change of fatty acid (FA) supply. This has been conclusively demonstrated by taking the UK oil supply data and by use of the FA profile of the key oils converting the supply data into a FA profile of the UK market place for 2008-2012. The most marked changes are a reduction in saturated fat (SFA) and an increase in monounsaturated fatty acids (MUFA) available for consumption. Furthermore the introduction of varieties of hi-oleic sunflower oil can further affect the market FA profile. The fat profiles of rapeseed and sunflower oils are considered healthy and they can have a positive impact when included in the diet, particularly as a replacement for oils or fats rich in SFA. In the UK and much of Europe, adult SFA intake continues to exceed recommendations. While reductions in the UK population’s SFA intake have occurred over the last 20 years, these are modest and it may be timely to identify ways in which SFA intake can be further reduced. To do this, the UK market FA supply data has been analysed alongside the profile of FA intake from adults recording their intake in national dietary surveys in order to identify if the market supply affects overall FA consumption. There is an indication that market oil supply is reflected in adults dietary intake of the main groups of FA. Consequently changes made to the oil profile of oilseeds by plant breeders and use of the resulting healthier oils by food manufacturers could have important roles to play in helping adults to achieve the recommended intake of SFA and also improve the overall fat quality in their diet leading to enhanced long-term health and well-being. Thus changes made in pri

Economic Justice and the 2003-2010 Recession: Lessons Learned for Multi-Level Social Work Practice  [PDF]
Janice Gasker, Jia Yu
Advances in Applied Sociology (AASoci) , 2014, DOI: 10.4236/aasoci.2014.412030
Abstract: The pursuit of social justice is a defining value of the social work profession, and its economic component is widely perceived to be an essential component of this quest. Consequently, social workers will practice to their fullest capacities if they understand the contemporary economic phenomena needed to promote social justice on all levels of practice, and discipline-specific knowledge in an accessible format is required to do so. In response, this paper provides a social work perspective on the world-wide recession of 2003-2010 along with implications for micro, mezzo and macro practice.
Asymmetric, helical and mirror-symmetric travelling waves in pipe flow
Chris Pringle,Rich Kerswell
Physics , 2007, DOI: 10.1103/PhysRevLett.99.074502
Abstract: New families of three-dimensional nonlinear travelling waves are discovered in pipe flow. In contrast to known waves (Faisst & Eckhardt Phys. Rev. Lett. 91, 224502 (2003), Wedin & Kerswell, J. Fluid Mech. 508, 333 (2004)), they possess no rotational symmetry and exist at much lower Reynolds numbers. Particularly striking is an `asymmetric mode' which has one slow streak sandwiched between two fast streaks located preferentially to one side of the pipe. This family originates in a pitchfork bifurcation from a mirror-symmetric travelling wave which can be traced down to a Reynolds number of 773. Helical and non-helical rotating waves are also found emphasizing the richness of phase space even at these very low Reynolds numbers. The delay in Reynolds number from when the laminar state ceases to be a global attractor to turbulent transition is then even larger than previously thought.
The Difference in Calcium Levels in Aspergillus nidulans Grown on Glucose or Pectin  [PDF]
Janice Aparecida Rafael, Suraia Said
Advances in Microbiology (AiM) , 2012, DOI: 10.4236/aim.2012.22016
Abstract: Understanding the growth regulatory mechanisms in filamentous fungi is very important for the production of medicines for antifungal therapies. It is well established that Ca2+ gradient is essential for hyphal growth and that one mechanism responsible for the Ca2+ cellular concentration starts with the hydrolysis of phosphatidylinositol 4,5-bisphosphate (PIP2) by receptor-regulated forms of phosphoinositide-specific phospholipase C (PI-PLC). In the present study the levels of calcium in Aspergillus nidulans wild type (A26) and plcA-deficient mutant (AP27) growing in a carbon source readily assimilated, as glucose or pectin a non-readily assimilated carbon source was investigated. Intracellular calcium levels in A26 were higher in the presence of glucose than in pectin, but lower in AP27 independently of the carbon source and in AP27 the vesicular calcium distribution occurred mainly at the apex of the hyphae. Delay in nuclear division was also observed if A26 and AP27 were grown in pectin presence when compared with growth in glucose. For the first time, it is demonstrated that the levels of intracellular Ca2+ were higher when A. nidulans was growing in glucose than in a non readily assimilated carbon source as pectin. Further, it also showed that the plcA gene, although not essential, may be responsible for high-molecular weight carbon source recongnation, for the intracellular Ca2+ levels maintenance and consequently by the nuclear division in A. nidulans.
S?o Paulo de Ramos de Azevedo: da cidade colonial à cidade romantica
Theodoro, Janice;
Anais do Museu Paulista: História e Cultura Material , 1996, DOI: 10.1590/S0101-47141996000100016
Abstract: the a. analyses through the activily of ramos de azevedo the implicit links between s?o paulo's colonial past and the modernist movement, and the role played by the european "imaginaire" in america, as well as the tecno-scientific traditions with wich he was affiliated.
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