Association of Pharmacist Interventions With Adverse Drug Events and Potential Adverse Drug Events.

BACKGROUND: Adverse drug events (ADEs) are a frequent cause of injury in patients. Our aim was to assess whether pharmacist interventions compared with no pharmacist intervention results in reduced ADEs and potential adverse drug events (PADEs). METHODS: We searched MEDLINE, Embase, and two other databases through September 19, 2022 for any RCT assessing the effect of a pharmacist intervention compared with no pharmacist intervention and reporting on ADEs or PADEs. The risk of bias was assessed using the Cochrane tool for RCTs. A random-effects model was used to pool summary results from individual RCTs. RESULTS: Fifteen RCTs met the inclusion criteria. The pooled results showed a statistically significant reduction in ADE associated with pharmacist intervention compared with no pharmacist intervention (RR = 0.86; [95% CI 0.80-0.94]; p = 0.0005) but not for PADEs (RR = 0.79; [95% CI 0.47-1.32]; p = 0.37). The heterogeneity was insignificant (I2 = 0%) for ADEs and substantial (I2 = 77%) for PADEs. Patients receiving a pharmacist intervention were 14% less likely for ADE than those who did not receive a pharmacist intervention. The estimated number of patients needed to prevent one ADE across all patient locations was 33. CONCLUSIONS: To our knowledge, this is the first systematic review and meta-analysis of RCTs seeking to understand the association of pharmacist interventions with ADEs and PADEs. The risk of having an ADE is reduced by a seventh for patients receiving a pharmacist care intervention versus no such intervention. The estimated number of patients needed to be followed across all patient locations to prevent one preventable ADE across all patient locations is 33.

Beyond homogenization discourse: Reconsidering the cultural consequences of globalized medical education.

INTRODUCTION: Global medical education standards, largely designed in the West, have been promoted across national boundaries with limited regard for cultural differences. This review aims to identify discourses on cultural globalization in medical education literature from non-Western countries. METHODS: To explore the diversity of discourses related to globalization and culture in the field of medical education, the authors conducted a critical review of medical education research from non-Western countries published in Academic Medicine, Medical Education and Medical Teacher from 2006 to 2014. Key discourses about globalization and culture emerged from a preliminary analysis of this body of literature. A secondary analysis identified inductive sub-themes. RESULTS: Homogenization, polarization and hybridization emerged as key themes in the literature. These findings demonstrate the existence of discourses beyond Western-led homogenization and the co-existence of globalization discourses ranging from homogenization to syncretism to resistance. CONCLUSIONS: This review calls attention to the existence of manifold discourses about globalization and culture in non-Western medical education contexts. In refocusing global medical education processes to avoid Western cultural imperialism, it will also be necessary to avoid the pitfalls of other globalization discourses. Moving beyond existing discourses, researchers and educators should work towards equitable, context-sensitive and locally-driven approaches to global medical education.

Analysis of menstrual diary data across the reproductive life span applicability of the bipartite model approach and the importance of within-woman variance.

The nature of variability in menstrual function has not been adequately described or quantified across the reproductive life span. This article evaluates the applicability of the bipartite model approach to the analysis of menstrual data and the relative importance of within-woman variability across the reproductive life span using data from the Tremin Trust data, a large prospective study in which women maintained menstrual diaries throughout their reproductive life. We first consider how the boundaries of the Gaussian portion of the distribution change with age, and reflect upon the implications of these distribution changes for definitions of normal cycling. We next estimate the change in mean cycle length, in between- and within-woman variance and in the probability of having a nonstandard cycle across the reproductive life span. Finally, we characterize the dynamics of menstrual cycling within women over time at various points in the reproductive life span.

Health-seeking patterns among Chinese immigrant patients enrolled in the directly observed therapy program in New York City.

SETTING: Outreach services and chest clinics of the Department of Health in New York City. OBJECTIVE: To investigate the health-seeking behavior patterns of Chinese immigrant patients enrolled in the directly observed therapy (DOT) program in New York City, and to suggest service provision strategies. DESIGN: Data were collected by means of participant observation, semi-structured interviews, and patient narratives. These data were then analyzed statistically as well as qualitatively, based on grounded theory. RESULTS: Of 60 patient informants, 38 had sought treatment for the relief of symptoms, and 22 were diagnosed by physical examination. Among 125 consultations made by 38 symptomatic patients during the period of their illness, there were more Chinatown physicians, including traditional Chinese practitioners, than other types of health providers, but they proportionally made the fewest referrals to the DOT program. CONCLUSIONS: Chinatown physicians are the main health providers to whom Chinese immigrants with tuberculosis resort. Education and collaboration with Chinese doctors, practitioners of both biomedical and traditional Chinese medicine, in New York City's Chinatown, are essential to reduce enrolment delays in the DOT program. The free services of the DOT program should be made more widely known to the Chinese immigrant population.

A comparison of Sil-K and Epiderm in scar management.

Twenty-six patients with a total of 45 scars were studied to determine the efficacy of the new silicone sheet, Sil-K, in treating hypertrophic scars. Twenty-eight scars were treated with Sil-K and 17 scars were treated with the conventional gel, Epiderm. Evaluation based on the scar's colour, texture, thickness and regularity was done on a monthly interval for 6 months. Preliminary results suggest that both Sil-K and Epiderm are effective in treating hypertrophic scars. All of the four parameters studied showed improvement, with colour, texture and regularity showing higher percentage of improvement than thickness (90, 90, 80 and 50 per cent respectively). Complications such as rashes, pruitus, maceration and dry skin were reported by some subjects. Epiderm and Sil-K were also compared across factors such as cost, durability, conformity and hygiene to assist therapists in choosing the suitable silicone sheet for each individual patient.

Azospirillum rugosum sp. nov., isolated from oil-contaminated soil.

The taxonomic status of a light-orange-coloured bacterial isolate from an oil-contaminated soil sample was characterized by using a polyphasic taxonomic approach. Comparative analysis of 16S rRNA gene sequences demonstrated that the isolate belonged phylogenetically to the genus Azospirillum, with Azospirillum canadense, Azospirillum brasilense and Azospirillum doebereinerae as its closest phylogenetic relatives (97.3, 97.0 and 97.0 % similarity, respectively). DNA-DNA pairing studies showed that the unidentified organism displayed 25.0, 17.0 and 19.0 % relatedness to the type strains of A. brasilense, A. canadense and A. doebereinerae, respectively. The generic assignment was confirmed by chemotaxonomic data, which revealed a fatty acid profile that was characteristic of the genus Azospirillum, consisting of straight-chain saturated and unsaturated fatty acids with C18 : 1 omega 7c as the major fatty acid, and ubiquinone with ten isoprene units (Q-10) as the predominant respiratory quinone. On the basis of both the phenotypic and molecular genetic evidence, it is proposed that the unknown isolate be classified as a representative of a novel species of the genus Azospirillum, for which the name Azospirillum rugosum sp. nov. is proposed. The type strain is IMMIB AFH-6T (=CCUG 53966T=DSM 19657T).

Sphingobium olei sp. nov., isolated from oil-contaminated soil.

The taxonomic status of a yellow-coloured bacterial isolate from an oil-contaminated soil sample was determined using a polyphasic taxonomic approach. Comparative analysis of 16S rRNA gene sequences showed that the novel isolate formed a distinct phyletic line within the genus Sphingobium. The generic assignment was confirmed by chemotaxonomic data, which revealed: a fatty acid profile that is characteristic of the genus Sphingobium consisting of straight-chain saturated and unsaturated as well as 2-OH fatty acids; a ubiquinone with ten isoprene units (Q-10) as the predominant respiratory quinone; a polar lipid pattern consisting of diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylmonomethylethanolamine, phosphatidylcholine and sphingoglycolipid, and spermidine as the major polyamine component. Genotypic and phenotypic data show that the new isolate merits classification as a representative of a novel species of the genus Sphingobium, for which the name Sphingobium olei sp. nov. is proposed. The type strain is IMMIB HF-1T (=DSM 18999T=CCUG 54329T).