A perspectiva do consumo de plantas medicinais porpacientes idosos em tratamento quimioterápico / The perspective of the consumption of medicinal plants byelderly patients undergoing chemotherapy treatment

O câncer, frequentemente relacionado ao envelhecimento, impulsiona pacientes a buscarem tratamento hospitalar ou métodos alternativos, como plantas medicinais. Este estudo visou avaliar os perfis sociodemográfico e clínico e o consumo de plantas para fins medicinais entre pacientes idosos em tratamento oncológico no Hospital Araújo Jorge (HAJ). Dados de 55 pacientes foram analisados, abrangendo informações sociodemográficas, tipos de câncer, tratamento, a utilização de plantas medicinais, o objetivo de uso, as fontes de informações sobre plantas e se notaram alguma reação adversa após o consumo. A faixa etária mais encontrada foi 61 a 70 anos (67,27%), a maioria dos pacientes eram homens (63,64%), com ensino fundamental incompleto (32,73%), casados (56,36%) e que moram no interior de Goiás (43,64%). Quanto ao tratamento, a maioria realizava quimioterapia (40,00%) e o câncer gástrico foi mais relatado (14,54%). Sobre o uso de plantas medicinais, a maioria relatou simpatizar com o consumo (58,18%), e acredita em sua segurança devido à origem natural (59,37%). Informações sobre o uso de plantas medicinais eram obtidas com amigos, vizinhos e familiares (21,81%). Ao relatar sobre o consumo de plantas medicinais durante a quimioterapia, a maioria não percebeu nenhum efeito (40,63%). Foram citadas 17 plantas, que eram utilizadas no tratamento anticâncer (29,00%) e preparadas como infusões (18,75%) pelo uso das folhas frescas (60,00%), principalmente para uso interno (46,87%). Diante disso, a atenção farmacêutica se mostra vital para guiar pacientes nas práticas seguras e eficazes de consumo. Isso inclui direcionar sobre doses adequadas, efeitos colaterais e interações, garantindo bem-estar e prevenindo riscos à saúde.

Cancer, which is often related to ageing, drives patients to seek hospital treatment or alternative methods such as medicinal plants. This study aimed to evaluate the sociodemographic and clinical profile and the consumption of plants for medicinal purposes among elderly patients undergoing cancer treatment at the Araújo Jorge Hospital (AJH). Data from 55 patients was analyzed, covering sociodemographic information, types of cancer, treatment, the use of medicinal plants, the purpose of use, the source of information about plants and whether they noticed any adverse reactions after consumption. The most common age group was 61 to 70 years (67.27%), the majority of patients were men (63.64%), had incomplete primary education (32.73%), were married (56.36%) and lived in the interior of Goiás (43.63%). With regard to treatment, the majority were undergoing chemotherapy (40,00%) and gastric cancer was the most frequently reported (14.54%). With regard to the use of medicinal plants, the majority were sympathetic to their consumption (58.18%) and believed them to be safe due to their natural origin (59.37%). Information on the use of medicinal plants was obtained from friends, neighbors and family members (21.81%). When reporting on the consumption of medicinal plants during chemotherapy, the majority did not notice any effect (40.63%). Seventeen plants were mentioned, which were used for anticancer treatment (29,00%) and prepared as infusions (18.75%) with fresh leaves (60,00%), mainly for internal use (46.87%). In view of this, pharmaceutical care is vital to guide patients in safe and effective consumption practices. This includes guidance on appropriate doses, side effects and interactions, ensuring well-being and preventing health risks.

Effectiveness of teaching and evaluation methods of clinical competencies for pharmacy: A systematic review.

BACKGROUND: This review aimed to analyze the effectiveness of the teaching and assessment methodologies used to develop fundamental clinical skills in pharmacist who are training in patient care. METHODS: SCOPUS, EMBASE, ERIC, and PubMed were searched for original studies that featured randomized controlled trials as the study design published until March 2024. The search and extraction process followed PRISMA Guidelines. RESULTS: The database search resulted in 2954 articles, of which 14 met the inclusion criteria. Four studies developed and tested interactive web-based software as the teaching methodologies. Eight studies applied simulation to their teaching and/or evaluation strategies. Two articles used high fidelity simulation, and the remaining studies used standardized patients associated with other teaching and evaluation techniques. The simulation methodologies were more effective than the conventional ones in three studies. In the other studies, the interventions were as effective or better than the control, albeit there no meaningful differences between the methods. In the studies that focused on the assessment methods, immediate feedback was preferred by students over delayed feedback. Additionally, the tested assessment tool, General Level Framework, proposed a pragmatic assessment from which the individual's training needs were identified. CONCLUSION: Few studies involved the objective quantification of learning beyond pre- and post-intervention knowledge tests. Proper assessment in pharmaceutical education requires expansion beyond the administration of student satisfaction, self-efficacy research tools, and knowledge assessments, and should encompass an examination of clinical performance and critical thinking.

Interdisciplinary teaching squares enhance reflection and collegiality: A collaborative pedagogical approach.

AIM: To explore the experiences of interdisciplinary Higher Educational Academics within Nursing, Midwifery, Pharmacy and Biomedical Science in the use of teaching squares as a formative, collaborative pedagogical tool to promote reflection. BACKGROUND: One approach to enhancing academic teaching practice involves the provision of feedback to individual academics. This approach can be challenging for the reviewer, hence other less intimidating approaches are popular. One such approach is the teaching square. In this approach typically 4 other teaching staff are involved in observing their peers' teaching methods (synchronous or asynchronous) and then engaging in a cycle of personal reflection. Reflection on teaching practices of their peers can provide opportunity to improve their own teaching. Typically teaching squares involve participants from the same academic discipline, however, in this study participants from related yet different disciplines were purposely connected and the benefits of this approach assessed. DESIGN: A qualitative descriptive design was used to explore the participants' experiences of undertaking interdisciplinary teaching squares through online questionnaires and focus group feedback opportunities. METHODS: This study was undertaken between August 2022 to June 2023 at an Australian university. Sixteen academic staff members from Nursing, Midwifery, Pharmacy & Pharmaceutical science and Biological science expressed an interest in the project. Five participants elected not to continue citing time pressures and 11 staff members participated in the project. Participation involved completing the teaching square experience and a subsequent focus group that were held to explore their experiences of undertaking a teaching square. The demographic survey data were presented and the focus group interviews were recorded, transcribed and analysed thematically. RESULTS: Triangulation of the findings resulted in the identification of four main themes: Teaching squares for professional networks; Perceptions of Safety; Stepping in and out of a reflective cycle; and Time Constraints vs. Time Value. CONCLUSIONS: The study aimed to explore the effectiveness of teaching squares in encouraging academic reflection on teaching and fostering a collaborative teaching culture within interdisciplinary higher education academics. An unexpected finding was the value and promotion of interdisciplinarity professional relationships and networks. The findings from this research project offer valuable insights into the benefits of adopting teaching squares in health education and contributes to evidence-based pedagogical practices.

Unveiling the Therapeutic Potential and Conservation Strategies for Rare and Endangered Medicinal Plants in Traditional Chinese Medicine: A Comprehensive Review.

INTRODUCTION: Incorporating rare and threatened healing plants from Traditional Chinese Medicine (TCM) into modern medicine is a hopeful way to expand treatment choices and encourage the long-term use of plant resources. These plants have been used in Traditional Chinese Medicine for a long time. They have powerful healing properties, including the ability to reduce inflammation and fight cancer. They also protect nerves and the heart. METHOD: A thorough study of all the scientific studies, clinical trials, ethnobotanical surveys, and conservation reports that were found were all looked at in relation to rare and threatened medical plants used in TCM. We looked through databases like PubMed, Scopus, and Web of Science for relevant pieces. Studies published in peer-reviewed journals, reports from reputable conservation organisations, and written down traditional knowledge were all considered to be relevant. RESULTS: Key results show that plants like Dendrobium, Panax notoginseng, Taxus chinensis, and Cistanche deserticola can be used as medicines and that there are good ways to protect them. Some of the conservation methods that have been named are agroforestry, community-based management, current breeding techniques, and sustainable gathering. Collaboration in research, clinical trials, personalised medicine, regulatory harmonisation, and public education programs are all part of the integration with modern medicine. These programs try to solve problems like scientific proof, protection, and cultural integration. CONCLUSION: When rare and threatened medical plants from Traditional Chinese Medicine (TCM) are used in modern medicine, it can improve health and help protect wildlife. Using both old information and new science discoveries together can lead to new treatments and long-term uses for these plant materials. Large-scale clinical studies, new ways of growing plants, and looking into how TCM herbs and regular drugs can work together should be the main topics of future study. For global healthcare to improve and for these important plant resources to be used in the long term, academics, healthcare workers, lawmakers, and local communities must work together.

The transformation of Jordan's healthcare system in an area of conflict.

BACKGROUND: The Jordanian healthcare system has evolved over the past decades expanding its services, technological, and educational resources. A comprehensive view of this system is lacking. The objective of this report is to describe the structure of the Jordanian healthcare system, the challenges facing it, and the current and recommended health policies. MATERIALS AND METHODS: This study reviewed the current status of the Jordanian healthcare system. The following parameters were analyzed: health indicators, infrastructure, human resources, insurance system, pharmaceutical expense, health education system, and medical tourism. Data were collected from various relevant official institutions and related published literature. RESULTS: Jordan has a young population with a median age of 23.8 years. Life expectancy is 78.8 years for females and 77.0 years for males. The Jordanian healthcare system is divided into three major categories: (1) Governmental Insurance (i.e., the Ministry of Health (MOH), the Royal Medical Services (RMS) and semi-governmental insurance); (2) Private Insurance; and (3) Refugee Insurance, including the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the United Nations High Commissioner for Refugees (NHUR). The Governmental Insurance covers 64.30% of the total population. Health expenditure is 6.37% of the gross domestic product (GDP). Pharmaceutical expenses make up 26.6% of the total national healthcare budget. Human resource assessment shows a high ratio of medical staff per 10.000 inhabitants, especially concerning physicians (31.7), dentists (7.9), and pharmacists (15.1). However, the ratio of nursing staff per 10.000 inhabitants is considered low (37.5). The Hospital bed/1000 population ratio is also relatively low (1.4). Healthcare accreditation is implemented through the Joint Commission International (JCI) accreditation which was achieved by 7 hospitals and by the National Health Care Accreditation Certificate (HCAC) achieved by 17 hospitals and 42 primary healthcare centers. Postgraduate medical education covers almost all medical and surgical fields. Medical tourism is currently well-established. CONCLUSIONS: Assessment of the Jordanian healthcare system shows high ratios of physicians, dentists, and pharmacists but a low ratio of nursing staff per 10.000 inhabitants. The hospital bed/1000 population ratio is also relatively low. Pharmaceutical expenses are significantly high and medical tourism is well-developed.

2023 Global Survey of Optometry: Defining Variations of Practice, Regulation and Human Resources Between Countries.

Purpose: To provide information on the demographics of optometrists and regulation of the optometry profession in countries who were members of the World Council of Optometry (WCO) during the period 2022-2023. Methods: A non-random, purposive sampling and a key informant strategy was employed to conduct a survey-based cross-sectional study on the professional landscape and distribution of optometrists; educational landscape; legislative aspects of the profession; and the scope of optometry practice in countries who were members of WCO during the period 2022-2023. Key informants were identified by WCO country members' leadership. Results: In the 39 countries surveyed, one optometrist serves 23,200 persons on average. Only 46.2% of the countries met the internationally suggested 1:10,000 optometrist-to-population ratio. The average male-to-female ratio was 45% males/55% females, with a division of average age as follows: under 45 years of age 46% as compared to above 45 years of age 54%. It was reported that optometry is not regulated in France, Portugal, India, Kenya and Cameron. Thirteen countries (33%) do not require a Bachelor's degree as a minimum to practice optometry. Use of diagnostic drugs is prohibited in 20% of the countries, with 25% of the countries limiting the use of therapeutic pharmaceutical agents. Conclusion: Many countries where optometry is recognized struggle to have an adequate number of optometrists; this hinders access to eye care. This is compounded by unregulated minimum levels of education for entry-level optometric practitioners. In addition, several countries limit or prohibit many optometric procedures that restrict the ability of optometrists to provide eye care and vision health services at the primary care level.

Curriculum, competency development, and assessment methods of MSc and PhD pharmacy programs: a scoping review.

BACKGROUND/OBJECTIVES: We aim to systematically review and evaluate the current landscape of postgraduate pharmacy education to a) identify current evidence, best practices, challenges, recommendations, and solutions; and b) develop a framework to optimize postgraduate pharmacy programs. METHODS: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Electronic databases, including PubMed, Scopus, EMBASE, ProQuest, Web of Science, and Google Scholar were utilized. The search covered studies published from January 2011 to September 2023. Following the principles of Arksey and O'Malley's framework, data charting and extraction were performed using a pre-designed data collection tool, followed by the synthesis and grouping of studies based on common themes. RESULTS: Of the 5542 articles found, the review included 36 eligible ones focusing on pharmacy postgraduate education (PhD and MSc), grouped into three themes: 1) courses and curriculum; 2) training and skills development; 3) assessment and mentorship methods. Utilized methodologies included descriptive analyses, questionnaires, surveys, trials, and focus groups/interviews. The studies underscored the need for competency-based curricula with regular evaluations, career planning, and diverse course offerings. Identified key skills and competencies in the studies included soft skills, communication, research, desperate skills (e.g., leadership and management), and critical thinking. The studies also emphasized the value of comprehensive evaluation and peer review methods. Challenges included balancing academic and real-world requirements, training, limited resources, time constraints, and faculty workload. CONCLUSION: Evidence-based suggestions to improve postgraduate pharmacy education include the implementation of practice-oriented courses, value of tailored/or comprehensive assessments, focus on real-world skills, effectiveness of advanced teaching methods, and mentorship role. The proposed framework can guide program enhancement and highlight the need to improve programs holistically, entailing the three themes.

Perception, experience, and practice of Iraqi community pharmacists towards customers with substance use disorder.

Background: Pharmacists are healthcare professionals who frequently encounter individuals struggling with addiction in their day-to-day practice. Studies critique pharmacists' competence in the detection, prevention, and management of substance use disorder. Objective: This study aimed to get in-depth information about the perception, experience, and practice of Iraqi pharmacists towards substance use disorder. Methods: A qualitative-study was performed through face-to-face individual-based interviews with community pharmacists in Baghdad/Iraq. Interviews were conducted from July 2023 till the saturation point (September 2023). Data analyzed by thematic-analysis approach. Results: Interviews were conducted with 21 pharmacists. Most participants reported that substance use disorder is common among young males. Pregabalin is the most commonly requested drug. Availability, euphoric-effect, and low cost are the main reasons for favoring a drug by persons with substance use disorder. Moreover, poverty and social problems are the main reasons for substance use disorder. Drug intoxication signs are the main clues in recognizing substance use disorder. Most participants refuse dispensing drugs without prescription and reported that the barriers for implementing regulations on drugs with high potential for dependence are related to the limited follow-up to pharmacists, presence of outsiders, and fear from reactions of persons with substance use disorder. Pharmaceutical services to persons with substance use disorder were performed by few pharmacists and limited to patient education about the risks of misusing drugs. Most participants reported that enhancing pharmacists' competence in substance use disorder is necessary. Conclusion: Substance use disorder is common among young Iraqi males. Pregabalin is a commonly requested drug. The current Iraqi regulations are not sufficient to prevent substance use disorder. Pharmaceutical services to persons with substance use disorder are weak and limited to patient education. Enhancing pharmacists' knowledge through educational courses is necessary to improve their role in facing substance use disorder.

Perspectives on a peer-driven intervention to promote pre-exposure prophylaxis (PrEP) uptake among men who have sex with men in southern New England: a qualitative study.

BACKGROUND: Pre-exposure prophylaxis (PrEP) is a highly effective pharmaceutical intervention that prevents HIV infection, but PrEP uptake across the US has been slow among men who have sex with men (MSM), especially among Black/African American (B/AA) and Hispanic /Latino (H/L) MSM. This study investigates the acceptability and essential components of a peer-driven intervention (PDI) for promoting PrEP uptake among MSM, with a specific focus on B/AA and H/L communities. METHODS: We conducted 28 semi-structured, qualitative interviews with MSM in southern New England to explore the components of a PDI, including attitudes, content, and effective communication methods. A purposive sampling strategy was used to recruit diverse participants who reflect the communities with the highest burden of HIV infection. RESULTS: Of 28 study participants, the median age was 28 years (interquartile range [IQR]: 25, 35). The sample comprised B/AA (39%, n = 11) and H/L (50%, n = 14) individuals. Notably, nearly half of the participants (46%) were current PrEP users. We found that many participants were in favor of using a PDI approach for promoting PrEP. Additionally, several participants showed interest in becoming peer educators themselves. They emphasized the need for strong communication skills to effectively teach others about PrEP. Moreover, participants noted that peer education should cover key topics like how PrEP works, how effective it is, and any possible side effects. CONCLUSIONS: Our study shows that effective PDIs, facilitated by well-trained peers knowledgeable about PrEP, could enhance PrEP uptake among MSM, addressing health disparities and potentially reducing HIV transmission in B/AA and H/L communities.

[Verification of Pharmaceutical Education System Reform].

The pharmaceutical education system underwent major changes in 2006 by extending the period of completion to six years. The decision was made by a resolution in the Diet, but a supplementary resolution was submitted at that time. In this paper, we discussed whether on-site pharmaceutical education complies with the accompanying resolution. As a result, current pharmaceutical education generally complies with what is stated in the supplementary resolutions.

The experiences of medical and pharmacy students participating in a collaborative online international learning on social accountability and global health: a qualitative study.

BACKGROUND: Social accountability aims to promote a collective ethic that upholds the fundamental values of equity, efficiency, solidarity, and social justice in healthcare and is now considered as a critical mission of academic health centers. Collaborative Online International Learning (COIL) is a pedagogical approach that uses digital technology to provide experiential international learning, specifically for increasingly diverse and multicultural healthcare work environments. The SOLID'AIRS program is an innovative French-language COIL that aims to set up international exchanges and workshops on social accountability between health sciences students. The aim of our study was to assess the impact of participation in the SOLID'AIRS program on medical and pharmacy students. METHOD: Five universities in four different countries were involved in SOLID'AIRS. We conducted a qualitative study by performing individual, semi-directed interviews with students who participated in the program from 2021 to 2022. A thematic analysis was conducted in five chronological phases: (1) reading, (2) descriptive coding, (3) conceptual coding, (4) identification of themes and (5) production of a coherent thematic structure. RESULTS: After including sixteen student participants, 13 medical and 3 pharmacy students, we identified four main themes related to the impact of participation: (1) previous experiences in social accountability and international learning, (2) perception of the program, (3) perceived impacts of the program, and (4) difficulties encountered and avenues to improve the program. Overall, the program was well received by all participants who reported the advantages and limitations of the online learning format. The primary advantage of this format was its feasibility. The participants noted both professional and personal benefits of the program for their current and future practice, including greater reflexivity towards health sciences practice. Based on the challenges faced during the program, particularly in coordinating group work and communication, participants suggested increased supervision of group projects by collaborators, and organizing at least one in-person meeting for future editions. The participants reported encountering difficulties during the COIL and suggested ways of improvement. CONCLUSION: Participating in a COIL on social accountability appears to be an effective way to adopt a reflective approach to medical practice and should be implemented and evaluated in other educational contexts.

The Dutch Citizen's Understanding and Perception of the Actors Involved in the Netherlands' COVID-19 Pandemic Response: A Focus Group Study During the First Pandemic Wave.

INTRODUCTION: The COVID-19 pandemic was a public health emergency (PHE) of unprecedented magnitude and impact. It provided the possibility to investigate the Dutch citizens' understanding and perception of the actors involved in the Dutch pandemic response as a PHE unfolded. METHODS: Three focus groups (FGs) were held with 16 Dutch citizens in June 2020. Citizens were recruited using the Dutch Health Care Consumer Panel. During the FGs, participants were asked to fill in a table with actors they thought were involved in the management of the COVID-19 pandemic. They also received information on actors involved in Dutch outbreak responses. Then, the actors named and omitted by the participants were discussed. RESULTS: An analysis of the FGs suggests that the Dutch citizens participating in the study were not fully aware of the scope of actors involved in the Dutch COVID-19 pandemic response. Some participants would have appreciated more information on the actors involved. This would help them have an informed opinion of the actors involved in the decision-making process, and accept non-pharmaceutical interventions implemented. Lastly, most participants recognised that they played a role in limiting the spread of the COVID-19 pandemic. Yet, very few spontaneously mentioned themselves as actors within the COVID-19 pandemic response. CONCLUSION: This study suggests that early in the COVID-19 pandemic, the Dutch citizens participating in this study's FG did not have a complete understanding of the scope of actors involved in the Dutch COVID-19 pandemic response, or the potential role of the citizen. Future research can build on these results to explore the citizen's perception of their role during PHEs of another origin, as well as other geographical and historical contexts. PATIENT OR PUBLIC CONTRIBUTION: The public participated in the focus groups and received a non-expert report summarising the outcomes of the focus groups.

An automated dispensing cabinet alert influences anesthesia provider medication preparation in a remifentanil waste reduction initiative.

STUDY OBJECTIVE: To decrease the occurrence of remifentanil waste of 1 mg or more (1 full vial) by 25 % in our surgical division while maintaining satisfaction of 60 % of providers by using a remifentanil mixing workflow. DESIGN: A time series-design quality improvement initiative targeted preventable remifentanil waste. A period of active interventions, followed by a pause and reinstatement of a system intervention, was used to validate its effectiveness. SETTING: An academic medical center in the US with 1219 inpatient beds, performing 144,418 surgical cases in 2019 and 127,341 surgical cases in 2020, in 148 operating rooms. INTERVENTIONS: Individual- and system-level interventions provided education on the issues of preventable waste, access to a remifentanil dose calculator, and an automated dispensing cabinet (ADC) alert to halt wasteful practice. MEASUREMENTS: Preventable remifentanil waste was identified as disposing of intravenous infusion bags containing 1 mg or more or 1 full vial or more of unused medication. Data were retrieved from ADC reports. A preimplementation and postimplementation survey of anesthesia providers assessed workflow attitudes, perceptions, and satisfaction surrounding remifentanil mixing. MAIN RESULTS: Preventable remifentanil waste (≥1 mg or ≥ 1 full vial) decreased significantly from 22.0 % of cases using remifentanil at baseline to 16.7 % of cases using remifentanil (odds ratio, 0.71; 95 % CI, 0.60-0.84; P < .001) during the final data collection. Individual-level interventions of education, remifentanil dose calculator, and practice champions did not significantly affect waste while unpaired from the system intervention of the ADC alert. CONCLUSIONS: The implementation of an ADC alert reduced preventable remifentanil waste among anesthesia providers.

Exploring pharmacists' attitude, willingness and barriers to provide extended community pharmacy services: Implications for improved pharmacy services.

OBJECTIVE: This study aimed to evaluate pharmacists' attitude and willingness to provide extended community pharmacy services (ECPS), the barriers to ECPS, and the factors associated with attitude and willingness to implement ECPS. METHODS: In this cross-sectional study, a validated, self-administered questionnaire was distributed online to community pharmacists across the United Arab Emirates between September and November 2023. In addition to sociodemographic data, the questionnaire evaluated attitudes toward ECPS, willingness to provide ECPS, and barriers to its implementation. Binary logistic regression was conducted to explore the factors associated with attitude and willingness to implement ECPS. RESULTS: The study included 409 pharmacists. Over half of the participants reported below the median attitude (58.7%) and willingness (59.4%) scores. Female pharmacists had a lower attitude towards ECPS (OR = 0.425, 95%CI: 0.242-0.747). Higher number of daily prescriptions (OR = 1.066, 95%CI: 1.029-1.105) and being a Pharm D graduate (OR = 2.664, 95%CI: 1.439-4.932) were associated with higher willingness to provide ECPS, while an increased number of employed pharmacists (OR = 0.518, 95%CI: 0.397-0.676) was associated with a lower willingness (OR = 0.049, 95%CI: 0.004-0.660). Patients' preoccupation (76.5%), lack of specific training (76.3%), lack of clinical problem-solving skills (74.6%) and lack of a private consultation room (74.6%) were the most commonly reported barriers to ECPS. CONCLUSIONS: Community pharmacists demonstrated unsatisfactory levels of attitude and willingness towards ECPS provision. Therefore, providing training and education programs that enhance pharmacists' perception and willingness to implement ECPS and emphasize improving clinical problem-solving skills, as well as setting up specific private consultation rooms, is deemed necessary. Female pharmacy graduates, pharmacists dispensing fewer daily prescriptions, and those working with a higher number of employed pharmacists should be specifically targeted when implementing these strategies.

Improving asthma self-management education through inhaler labeling.

Objective: Improper use and poor understanding of asthma medications can lead to poorly controlled asthma, emergency department visits, and hospitalizations for children with asthma. Pharmacists play a critical role in improving asthma medication adherence through education on asthma self-management. The use of color-coded labels applied at pharmacies to help patients differentiate between rescue and maintenance inhalers has not been explored. Methods: Pharmacies were recruited to join a community pharmacy asthma coalition. Pharmacists provided patient education and labeled inhalers with two types of color-coded stickers. A red sticker labeled "RESCUE" was used for short-acting ß-2 agonist medication inhalers. A green sticker labeled "USE EVERY DAY" was used for inhaled corticosteroids (ICS) or combination ICS/long-acting ß-2 agonist medication inhalers. Results: During the two years of the pilot program, 25 pharmacy locations participated. Pharmacies labeled over 6000 rescue and 9000 controller medications using color-coded labels. Over 1000 children and 7000 adults were served by the coalition. Conclusion: Color-coded asthma medication labels can be successfully utilized by pharmacies. This low-cost tool provides vital information regarding the proper use of asthma medications. Innovation: The color-coded labeling of asthma medications is a novel innovation that can be successfully used by pharmacists to improve asthma self-management education.

Traditionally used medicinal plants for human ailments and their threats in Guraferda District, Benchi-Sheko zone, Southwest Ethiopia.

BACKGROUND: The field of traditional medicine encompasses a wide range of knowledge, skills, and practices that are deeply rooted in the theories, beliefs, and experiences of different cultures. The research aimed to identify traditional medicinal plants used in Guraferda District and assess the threats they face. METHOD: A total of 96 individuals, 80 males and 16 females, were interviewed to gather ethnobotanical data. Statistical tests like independent t tests, ANOVA, correlation, and regression were conducted using R software version 4.3.2 to compare informant groups. RESULT: The study found 81 medicinal plant species in the district from 71 genera and 38 families, with Asteraceae and Solanaceae families having the most species. Leaves were the most commonly used plant part for medicine. Significant differences in plant knowledge were observed across genders, age groups, education levels, and experiences. The highest ICF value was for Dermal and Cutaneous ailments, and Cissampelos mucronata A. Rich and Bidens pilosa L. had the highest fidelity levels. CONCLUSION: The study highlighted the importance of traditional medicinal plants in treating ailments but noted threats like overharvesting, habitat destruction, and climate change. Conservation efforts and sustainable harvesting practices are crucial to ensure the availability of these plants for future generations. Further research is needed to explore their potential for modern medicine and develop sustainable use strategies.

Artificial Intelligence in Medical Affairs: A New Paradigm with Novel Opportunities.

The advent of artificial intelligence (AI) revolutionizes the ways of working in many areas of business and life science. In Medical Affairs (MA) departments of the pharmaceutical industry AI holds great potential for positively influencing the medical mission of identifying and addressing unmet medical needs and care gaps, and fostering solutions that improve the egalitarian and unbiased access of patients to treatments worldwide. Given the essential position of MA in corporate interactions with various healthcare stakeholders, AI offers broad possibilities to support strategic decision-making and to pioneer novel approaches in medical stakeholder interactions. By analyzing data derived from the healthcare environment and by streamlining operations in medical content generation, AI advances data-based prioritization and strategy execution. In this review, we discuss promising AI-based solutions in MA that support the effective use of heterogenous information from observations of the healthcare environment, the enhancement of medical education, and the analysis of real-world data. For a successful implementation of such solutions, specific considerations partly unique to healthcare must be taken care of, for example, transparency, data privacy, healthcare regulations, and in predictive applications, explainability.

Assessment of conflicts of interest in literature on monoclonal antibodies for chronic rhinosinusitis with nasal polyposis using the Open Payments Database.

BACKGROUND: Accurate conflict of interest (COI) information is essential for promoting transparency and trust in research. We aim to assess COI disclosure patterns in monoclonal antibodies (MABs) research for chronic rhinosinusitis with nasal polyposis (CRSwNP) using the Open Payments Database (OPD). METHODS: Studies on FDA-approved MABs for CRSwNP (dupilumab, omalizumab, mepolizumab) published between 2019 and 2021 with at least one US author were identified through PubMed. Industry-reported payments from the manufacturers (Sanofi, Regeneron, Genentech, Novartis, and GlaxoSmithKline) between 2018 and 2021 in OPD's General Payments category were collected. Authors were cross-checked against OPD metadata using a previously published ChatGPT-based algorithm. Additionally, this novel algorithm analyzed COI statements for relevant author‒company specific disclosures, identifying disclosed and undisclosed payments made 3‒15 months prior to publication. RESULTS: A total of 214 unique authors from 76 studies were included. Of 30 articles that received at least one relevant payment, 21 (70%) were found to have an undisclosed COI, with a mean total undisclosed payment of $4890 and a median of $10,331. Fifty-six authors had relevant OPD payments and 40 (71.4%) authors did not declare a potential COI. Interestingly, 158 authors had no relevant payments and 62 (39.2%) declared a potential COI. Author order was not significantly associated with potential under- or over-disclosure. CONCLUSION: This study characterizes COI disclosure patterns in rhinosinusitis-relevant MABs research using a novel automated approach. Given the discrepancy between disclosures and industry-reported payments, our findings suggest a need for improved disclosure education and practices.

Evaluation of the effectiveness of Washington State's digital COVID-19 exposure notification system over one pandemic year.

Introduction: Digital exposure notifications are a novel public health intervention used during the COVID-19 pandemic to alert users of possible COVID-19 exposure. We seek to quantify the effectiveness of Washington State's digital exposure notification system, WA Notify, as measured by the number of COVID-19 cases averted during a 1-year period. Methods: While maintaining individuals' privacy, WA Notify collected data that could be used to evaluate the system's effectiveness. This article uses these and other data and builds on a previous model to estimate the number of cases averted by WA Notify. Novel estimates of some model parameters are possible because of improvements in the quality and breadth of data reported by WA Notify. Results: We estimate that WA Notify averted 64,000 (sensitivity analysis: 35,000-92,000) COVID-19 cases in Washington State during the study period from 1 March 2021 to 28 February 2022. During this period, there were an estimated 1,089,000 exposure notifications generated and 155,000 cases reported to WA Notify. During the last 78 days of the study period, the median estimated number of daily active users was 1,740,000. Discussion: We believe WA Notify reduced the impact of the COVID-19 pandemic in Washington State and that similar systems could reduce the impact of future communicable disease outbreaks.