An efficient in vivo-inducible CRISPR interference system for group A Streptococcus genetic analysis and pathogenesis studies.

While genome-wide transposon mutagenesis screens have identified numerous essential genes in the significant human pathogen Streptococcus pyogenes (group A Streptococcus or GAS), many of their functions remain elusive. This knowledge gap is attributed in part to the limited molecular toolbox for controlling GAS gene expression and the bacterium's poor genetic transformability. CRISPR interference (CRISPRi), using catalytically inactive GAS Cas9 (dCas9), is a powerful approach to specifically repress gene expression in both bacteria and eukaryotes, but ironically, it has never been harnessed for controlled gene expression in GAS. In this study, we present a highly transformable and fully virulent serotype M1T1 GAS strain and introduce a doxycycline-inducible CRISPRi system for efficient repression of bacterial gene expression. We demonstrate highly efficient, oligo-based single guide RNA cloning directly to GAS, enabling the construction of a gene knockdown strain in just 2 days, in contrast to the several weeks typically required. The system is shown to be titratable and functional both in vitro and in vivo using a murine model of GAS infection. Furthermore, we provide direct in vivo evidence that the expression of the conserved cell division gene ftsZ is essential for GAS virulence, highlighting its promise as a target for emerging FtsZ inhibitors. Finally, we introduce SpyBrowse (https://veeninglab.com/SpyBrowse), a comprehensive and user-friendly online resource for visually inspecting and exploring GAS genetic features. The tools and methodologies described in this work are poised to facilitate fundamental research in GAS, contribute to vaccine development, and aid in the discovery of antibiotic targets. IMPORTANCE: While group A Streptococcus (GAS) remains a predominant cause of bacterial infections worldwide, there are limited genetic tools available to study its basic cell biology. Here, we bridge this gap by creating a highly transformable, fully virulent M1T1 GAS strain. In addition, we established a tight and titratable doxycycline-inducible system and developed CRISPR interference (CRISPRi) for controlled gene expression in GAS. We show that CRISPRi is functional in vivo in a mouse infection model. Additionally, we present SpyBrowse, an intuitive and accessible genome browser (https://veeninglab.com/SpyBrowse). Overall, this work overcomes significant technical challenges of working with GAS and, together with SpyBrowse, represents a valuable resource for researchers in the GAS field.

Evaluation of Clinical Communication in Pharmacy Undergraduates in Brazil: A Multicentric Study.

OBJECTIVE: To assess the clinical communication characteristics of pharmacy undergraduates, estimate differences in this specific competency, and produce recommendations for further education and training. METHODS: Analysis of communication competence between 110 pharmacy students in the last graduation year from each of the 5 Brazilian regions and a simulated patient with complaints of mild allergic rhinitis passive of resolution with non-prescription medicines. The simulated appointment was recorded, and the video was analyzed using the 2 main elements: biomedical/task-focused and socio-emotional exchange of the Roter Interaction Analysis System. RESULTS: The total of utterances/speech from the pharmacist to the patient was 183.4; there was a statistically significant difference according to the Brazilian region. In the consultation, the frequency with which pharmacy students returned to the segment was evaluated, with a total mean clinical history segment 2 of mean 5.60; in segment 4, which is the counseling phase, an average of 4.80. In the task codes and the socio-emotional codes, there was a statistically significant difference between the codes when compared by region. We compare by sex because it is said that women talk more than men. There was a statistically significant difference in socio-emotional code and biomedical/focused and task being higher for women. CONCLUSION: The level of communication competence of students should be that desired for graduation, in all regions. There seems to be a difference between training and level of competence. Considering gender, although the consultation time is similar, it appears that the quality of communication is higher for women.

Type III-B CRISPR-Cas cascade of proteolytic cleavages.

The generation of cyclic oligoadenylates and subsequent allosteric activation of proteins that carry sensory domains is a distinctive feature of type III CRISPR-Cas systems. In this work, we characterize a set of associated genes of a type III-B system from Haliangium ochraceum that contains two caspase-like proteases, SAVED-CHAT and PCaspase (prokaryotic caspase), co-opted from a cyclic oligonucleotide-based antiphage signaling system (CBASS). Cyclic tri-adenosine monophosphate (AMP)-induced oligomerization of SAVED-CHAT activates proteolytic activity of the CHAT domains, which specifically cleave and activate PCaspase. Subsequently, activated PCaspase cleaves a multitude of proteins, which results in a strong interference phenotype in vivo in Escherichia coli. Taken together, our findings reveal how a CRISPR-Cas-based detection of a target RNA triggers a cascade of caspase-associated proteolytic activities.

New Insights on the Mechanisms of Myocardial Injury in Hypertensive Patients With COVID-19.

PURPOSE: Myocardial injury is common in hypertensive patients with 2019 coronavirus disease (COVID-19). Immune dysregulation could be associated to cardiac injury in these patients, but the underlying mechanism has not been fully elucidated. METHODS: All patients were selected prospectively from a multicenter registry of adults hospitalized with confirmed COVID-19. Cases had hypertension and myocardial injury, defined by troponin levels above the 99th percentile upper reference limit, and controls were hypertensive patients with no myocardial injury. Biomarkers and immune cell subsets were quantified and compared between the two groups. A multiple logistic regression model was used to analyze the associations of clinical and immune variables with myocardial injury. RESULTS: The sample comprised 193 patients divided into two groups: 47 cases and 146 controls. Relative to controls, cases had lower total lymphocyte count, percentage of T lymphocytes, CD8+CD38+ mean fluorescence intensity (MFI), and percentage of CD8+ human leukocyte antigen DR isotope (HLA-DR)+ CD38-cells and higher percentage of natural killer lymphocytes, natural killer group 2A (NKG2A)+ MFI, percentage of CD8+CD38+cells, CD8+HLA-DR+MFI, CD8+NKG2A+MFI, and percentage of CD8+HLA-DR-CD38+cells. On multivariate regression, the CD8+HLA-DR+MFI, CD8+CD38+MFI, and total lymphocyte count were associated significantly with myocardial injury. CONCLUSION: Our findings suggest that lymphopenia, CD8+CD38+MFI, and CD8+HLA-DR+MFI are immune biomarkers of myocardial injury in hypertensive patients with COVID-19. The immune signature described here may aid in understanding the mechanisms underlying myocardial injury in these patients. The study data might open a new window for improvement in the treatment of hypertensive patients with COVID-19 and myocardial injury.

A qualitative study on female executive pharmacists with convergent roles.

BACKGROUND: Although women's participation is relatively high in the pharmacist workforce, women remain underrepresented in executive positions. The rate of executive female pharmacists in diversified pharmaceutical areas, from education and research to politics, is recognized as being disproportionately low. OBJECTIVES: In this study, we aimed to explore female executive pharmacists' roles and identify reasons for their being underrepresented in such executive positions in Turkey. METHODS: Semistructured in-depth interviews were conducted from a feminist standpoint with female executive delegates working in the Grand National Assembly of Turkey, pharmacy chambers, and public pharmacy faculties. A thematic data analysis of transcriptions was conducted using MAXQDA 2020 software and was reported according to Consolidated Criteria for Reporting Qualitative Research. RESULTS: The researchers interviewed 19 participants. Three primary themes emerged: gender roles, being an executive, and being a pharmacist. Eight roles came to the surface: mother, child, wife, pharmacist, manager, homemaker, cook, and planner. Taking the responsibility for an executive position involves a continued and simultaneous performance of all other roles as well. CONCLUSION: In this context, female pharmacists' views on gender roles in relation to motherhood, inequalities, and their dedication to their profession came to the fore. This study can be considered as a starting point for studying the underlying causes of the limited representation of female pharmacists in executive positions.

Long-term care professionals' views on pharmacists: a qualitative study using Role Theory.

BACKGROUND: Qualitative research investigating pharmacists' participation in Long-Term Care (LTC) within interdisciplinary teams is scarce. AIM: To characterize how pharmacists' participation in a national network of LTC is perceived by healthcare professionals and other key stakeholders. METHOD: Individual, in-depth, semi-structured interviews of participants (nurses, physicians, pharmacists, and LTC researchers) enrolled purposively or through snowballing sampling techniques, with the final sample being comprised of fourteen participants. Data analysis followed a deductive coding approach framed by Role Theory and supplemented with an inductive coding for additional themes. RESULTS: Four Role Theory constructs were identified from the primary data-role identity, overqualification, ambiguity, underqualification. Clinical pharmacy services, logistics and educational activities were pointed out as representing the identity of pharmacists' interventions. Despite the clear identification of LTC pharmacists' interventions, pharmacist expertise on medicine optimization seemed to be underused (role overqualification), as a result of lack of time, lower proactivity in healthcare teams' integration, and the absence of a legal framework targeted to LTC pharmacy practice (role ambiguity). Additional clinical training, including in the management of older people's health conditions, nutrition, and palliative care were missing (role underqualification). CONCLUSION: LTC pharmacists can provide essential services (e.g., clinical pharmacy, logistics, educational interventions), although additional training and a clearer legal framework are missing to better define pharmacists' roles in LTC pharmacy practice.

2FAST2Q: a general-purpose sequence search and counting program for FASTQ files.

Background: The increasingly widespread use of next generation sequencing protocols has brought the need for the development of user-friendly raw data processing tools. Here, we explore 2FAST2Q, a versatile and intuitive standalone program capable of extracting and counting feature occurrences in FASTQ files. Despite 2FAST2Q being previously described as part of a CRISPRi-seq analysis pipeline, in here we further elaborate on the program's functionality, and its broader applicability and functions. Methods: 2FAST2Q is built in Python, with published standalone executables in Windows MS, MacOS, and Linux. It has a familiar user interface, and uses an advanced custom sequence searching algorithm. Results: Using published CRISPRi datasets in which Escherichia coli and Mycobacterium tuberculosis gene essentiality, as well as host-cell sensitivity towards SARS-CoV2 infectivity were tested, we demonstrate that 2FAST2Q efficiently recapitulates published output in read counts per provided feature. We further show that 2FAST2Q can be used in any experimental setup that requires feature extraction from raw reads, being able to quickly handle Hamming distance based mismatch alignments, nucleotide wise Phred score filtering, custom read trimming, and sequence searching within a single program. Moreover, we exemplify how different FASTQ read filtering parameters impact downstream analysis, and suggest a default usage protocol. 2FAST2Q is easier to use and faster than currently available tools, efficiently processing not only CRISPRi-seq / random-barcode sequencing datasets on any up-to-date laptop, but also handling the advanced extraction of de novo features from FASTQ files. We expect that 2FAST2Q will not only be useful for people working in microbiology but also for other fields in which amplicon sequencing data is generated. 2FAST2Q is available as an executable file for all current operating systems without installation and as a Python3 module on the PyPI repository (available at https://veeninglab.com/2fast2q).

Archetype and epigenetics - approximations: contributions of epigenetics to the clinical practice of analytical psychology.

In this paper we address the question of epigenetics by evidencing some mechanisms related to gene expression, which, we understand, can in a way be used as metaphors for movements occurring during the psychotherapeutic process. The possibility of a dialogue between epigenetics and analytical psychology begins with the hereditary and archetypal question and takes shape in the dimension of the analytical encounter. Through the Jungian attitude model, we propose a way of moving between the two sciences. This paper provides a brief review of the concept of archetype, covering recent publications. It then describes the main mechanisms of epigenetics and, finally, addresses the analytical process and presents the authors' proposal to consider the archetypal expression in the light of epigenetics.

Dans cet article nous étudions la question de l'épigénétique en montrant quelques mécanismes en lien avec l'expression d'un gène. Nous pensons que, d'une certaine manière, ces mécanismes peuvent être utilisés en tant que métaphores des mouvements qui se produisent durant le processus thérapeutique. La possibilité d'un dialogue entre l'épigénétique et la psychologie analytique commence par la question héréditaire et archétypale, et prend forme dans la dimension de la rencontre analytique. A travers le modèle de l'attitude Jungienne nous proposons une manière de circuler d'une science à l'autre. Cet article offre un bref examen du concept d'archétype, couvrant les publications récentes. Il décrit ensuite les mécanismes principaux de l'épigénétique et s'occupe finalement du processus analytique en présentant la proposition de l'auteur qui est de considérer l'expression archétypale à la lumière de l'épigénétique.

En este trabajo abordamos el tema de la epigenética al evidenciar algunos mecanismos relacionados con la expresión genética, la cual puede ser utilizada como metáforas para los movimientos que suceden durante el proceso terapéutico. La posibilidad de un diálogo entre epigenética y psicología analítica comienza con la pregunta sobre la herencia y el arquetipo y toma forma en la dimensión del encuentro analítico. A través del modelo de actitud analítica, proponemos una forma de movimiento entre dos ciencias. El presente trabajo ofrece una breve revisión del concepto de arquetipo, abarcando publicaciones recientes. Luego describe los mecanismos principales de la epigenética y finalmente, aborda el proceso analítico y presenta la propuesta de las autoras de considerar la expresión arquetípica a la luz de la epigenética.

Neste artigo, abordamos a questão da epigenética evidenciando alguns mecanismos relacionados à expressão gênica, que, entendemos, podem de certa forma ser usados como metáforas para movimentos que ocorrem durante o processo terapêutico. A possibilidade de um diálogo entre epigenética e psicologia analítica começa com a questão hereditária e arquetípica e toma forma na dimensão do encontro analítico. Através do modelo de atitude junguiana, propomos uma maneira de nos mover entre duas ciências. Este artigo fornece uma breve revisão do conceito de arquétipo, abrangendo publicações recentes. Em seguida, descreve os principais mecanismos da epigenética e, finalmente, aborda o processo analítico e apresenta a proposta do autor de considerar a expressão arquetípica à luz da epigenética.

CRISPRi-seq for genome-wide fitness quantification in bacteria.

CRISPR interference (CRISPRi) is a powerful tool to link essential and nonessential genes to specific phenotypes and to explore their functions. Here we describe a protocol for CRISPRi screenings to assess genome-wide gene fitness in a single sequencing step (CRISPRi-seq). We demonstrate the use of the protocol in Streptococcus pneumoniae, an important human pathogen; however, the protocol can easily be adapted for use in other organisms. The protocol includes a pipeline for single-guide RNA library design, workflows for pooled CRISPRi library construction, growth assays and sequencing steps, a read analysis tool (2FAST2Q) and instructions for fitness quantification. We describe how to make an IPTG-inducible system with small libraries that are easy to handle and cost-effective and overcome bottleneck issues, which can be a problem when using similar, transposon mutagenesis-based methods. Ultimately, the procedure yields a fitness score per single-guide RNA target for any given growth condition. A genome-wide screening can be finished in 1 week with a constructed library. Data analysis and follow-up confirmation experiments can be completed in another 2-3 weeks.

"A Autoestrada do Sul": movimento e paralisação / The Southern Highway: movement and stoppage / La carretera del sur: movimiento y paralización

Basado en el ensayo "Un capítulo sobre el sueño" del escritor escocés Robert Louis Stevenson, el artículo analiza las reflexiones del autor sobre el mundo onírico y el proceso creativo literario contenido en el ensayo y teje correlaciones entre las ideas de Stevenson y las ideas de Jung sobre el trabajo con sueños, psique y creatividad. La relación de la conciencia con la vida onírica, las reflexiones sobre la dualidad de la conciencia, la identidad y la creación literaria son temas abordados por Stevenson en el mencionado ensayo. Son ideas precursoras de una comprensión de la influencia onírica en la creatividad análogas a las concepciones desarrolladas posteriormente por Jung, sobre complejos creativos de la psique, la imaginación y el trabajo con los sueños. En este entrelazamiento de la perspectiva literaria y la perspectiva psicológica, con la teoría junguiana como referencia, tengo la intención de destacar las aproximaciones que el método junguiano de comprender y trabajar con la psique tiene con la imaginación literaria como se describe por Stevenson.

In this text, I intend to work symbolically on some intersections between Júlio Florêncio Cortázar's short story "The Southern Highway" and analytical psychology, thereby discussing concepts such as ego and persona. I make some approximations and associations between aspects explored by Cortázar in this short story and the challenges of our contemporary life, which allow for a reflection on the ephemeral yet intense encounters that can define and structure our relationships and the profound need for contact that is becoming increasingly important and challenging. I end the text with an approximation between aspects of the story and the movements of isolation and stoppage that we also compulsorily experienced during the recent pandemic.

Busco en este texto trabajar simbólicamente algunas intersecciones entre el cuento de Julio Florencio Cortázar "La carretera del sur" y la psicología analítica, discutiendo conceptos como el ego y la persona. Hago algunas aproximaciones y asociaciones entre aspectos explotados por Cortázar en este cuento y los desafíos de nuestra vida contemporánea, discutiendo encuentros efímeros pero fuertes que pueden definir y estructurar nuestras relaciones y la profunda necesidad de contacto, cada vez más importante y desafiante. Termino el texto con una aproximación entre los aspectos del cuento y los movimientos de aislamiento y paralización que vivimos de manera obligatoria durante el reciente período de pandemia.

Prescribing-Assessment Tools for Long-Term Care Pharmacy Practice: Reaching Consensus through a Modified RAND/UCLA Appropriateness Method.

Medicines are the most used health technology in Long-Term Care. The prevalence of potentially inappropriate medicines amongst Long-Term Care patients is high. Pharmacists, assisted by prescribing-assessment tools, can play an important role in optimizing medication use at this level of care. Through a modified RAND/UCLA Appropriateness Method, 13 long-term care and hospital pharmacists assessed as 'appropriate', 'uncertain', or 'inappropriate' a collection of commonly used prescribing-assessment tools as to its suitability in assisting pharmacy practice in institutional long-term care settings. A qualitative analysis of written or transcribed comments of participants was pursued to identify relevant characteristics of prescribing-assessment tools and potential hinders in their use. From 24 different tools, pharmacists classified 9 as 'appropriate' for pharmacy practice targeted to long-term care patients, while 3 were classified as 'inappropriate'. The tools feature most appreciated by study participants was the indication of alternatives to potentially inappropriate medication. Lack of time and/or pharmacists and limited access to clinical information seems to be the most relevant hinders for prescribing-assessment tools used in daily practice.

A Single Dose of a Hybrid hAdV5-Based Anti-COVID-19 Vaccine Induces a Long-Lasting Immune Response and Broad Coverage against VOC.

Most approved vaccines against COVID-19 have to be administered in a prime/boost regimen. We engineered a novel vaccine based on a chimeric human adenovirus 5 (hAdV5) vector. The vaccine (named CoroVaxG.3) is based on three pillars: (i) high expression of Spike to enhance its immunodominance by using a potent promoter and an mRNA stabilizer; (ii) enhanced infection of muscle and dendritic cells by replacing the fiber knob domain of hAdV5 by hAdV3; (iii) use of Spike stabilized in a prefusion conformation. The transduction with CoroVaxG.3-expressing Spike (D614G) dramatically enhanced the Spike expression in human muscle cells, monocytes and dendritic cells compared to CoroVaxG.5 that expressed the native fiber knob domain. A single dose of CoroVaxG.3 induced a potent humoral immunity with a balanced Th1/Th2 ratio and potent T-cell immunity, both lasting for at least 5 months. Sera from CoroVaxG.3-vaccinated mice was able to neutralize pseudoviruses expressing B.1 (wild type D614G), B.1.117 (alpha), P.1 (gamma) and B.1.617.2 (delta) Spikes, as well as an authentic P.1 SARS-CoV-2 isolate. Neutralizing antibodies did not wane even after 5 months, making this kind of vaccine a likely candidate to enter clinical trials.

Probing pharmacists' interventions in Long-Term Care: a systematic review.

PURPOSE: Long-Term Care (LTC) systems have experienced recent developments driven by changes in healthcare and demography (e.g. population ageing). As well, pharmacists are changing from traditional roles to more patient-oriented services. The present study aimed to identify and assess pharmacists' and/or pharmacy-based interventions in institutional LTC settings, also mapping relevant medications. METHODS: The review was undertaken in general accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using three main literature databases (PubMed, Scopus, and Web of Knowledge). A set of 16 keywords, divided into three domains (professional, type of care and type of setting), were combined into search equations. Selected studies were assessed through the Quality Assessment Tool for Quantitative Studies. RESULTS: Twenty-six studies met the inclusion criteria, out of 794 initial hits. Most studies (12) described pharmacist/pharmacy-driven interventions assessing Medication Management Reviews' impact in different endpoints or outcomes. Other studies (3) assessed pharmacists' interventions on specific medication groups. Good Administration Practices, new pharmaceutical care models, antibiotic stewardship programs, and studies assessing other pharmacists' interventions, such as pharmacy-managed informatics and education, were addressed by 11 other papers. Six studies were classified as Strong after quality assessment. CONCLUSION: LTC is a clinically complex type of care benefiting from interdisciplinary work. Despite the overall lower quality of the identified studies, pharmacists perform in a wide array of LTC areas. The broad implementation of pharmaceutical activities in institutional LTC settings opens opportunities to optimise medicines' use.

Self-medication consultations in community pharmacy: an exploratory study on teams' performance, client-reported outcomes and satisfaction.

BACKGROUND: Community pharmacy teams (CPTs) have an established role in assisting self-medication, contributing to the safe and effective use of non-prescription medicines. OBJECTIVE: The study aimed to describe CPTs' performance in self-medication consultation, client-reported outcomes, and satisfaction. A secondary purpose was to develop an explanatory model for better understanding clients' satisfaction with this service. METHODS: Descriptive, cross-sectional exploratory study. Data were collected in a purposive sample of pharmacy clients recruited in six community pharmacies in Portugal. CPTs adopted a structured approach to self-medication consultations, encompassing 11 quality criteria (five for case evaluation and six for counselling). An evaluation score, a counselling score and an overall quality score were estimated. Client-reported outcomes and satisfaction were ascertained via a follow-up telephone interview. Besides descriptive statistics, the association with several independent variables on the clients' overall satisfaction was explored, using linear regression. RESULTS: Product-based dispensing was more frequent for lower educated clients. Reported compliance with the criteria by CPTs was overall high (93.95% of maximum compliance), mostly missing the 'other medication' questioning. Most clients (93%) reported improvement after the consultation. Clients' satisfaction score was 4.70 out of 5. The variables that seem to better explain clients' overall satisfaction are pharmacy loyalty, the evaluation score, and the female gender. CONCLUSIONS: Clients' reported outcomes were favourable, as well as satisfaction with the service. Clients' satisfaction appears to be determined by consultation quality (evaluation score), suggesting the advancement of the pharmacists' clinical role. A larger study is warranted to confirm these findings.

CONAN: a web application to detect specificity determinants and functional sites by amino acids co-variation network analysis.

SUMMARY: CONAN is a web application developed to detect specificity determinants and function-related sites by amino acids co-variation networks analysis, emphasizing local coevolutionary constraints. The software allows the characterization of structurally and functionally relevant groups of residues and their relationship with subsets of sequences by automatic cross-referencing with GO terms, UniprotKb annotations and INTERPRO. AVAILABILITY AND IMPLEMENTATION: CONAN is free and open-source, being distributed in the terms of the GPLV3 license. The software is available as a web application and python script versions and can be accessed at http://bioinfo.icb.ufmg.br/conan. We also provide running instructions, the source code and a user guide.

Training and standardization of simulated patients for multicentre studies in clinical pharmacy education.

OBJECTIVE: To evaluate the training and standardization methods of multiple simulated patients (SPs) performing a single scenario in a multicenter study. METHODS: A prospective quasi-experimental study, using a multicenter approach, evaluated the performance of five different individuals with the same biotype during a simulation session in a high-fidelity environment. The SPs training and standardization process consisted of four steps and six web or face-to-face mediated: Step 1: simulation scenario design and pilot test. Step 2: SPs selection, recruitment and beginning training (Session 1: performance instructions and memorization request.) Session 2: check the SPs' performances and adjustments). Step 3 and session 3: training role-play and performance's evaluation. Step 4: SPs' standardization and performances' evaluation (Sessions 4 and 5: first and second rounds of SPs' standardization assessment. Session 6: Global training and standardization evaluation. SPs performance consistency was estimated using Cronbach's alpha and ICC. RESULTS: In the evaluation of training results, the Maastricht Simulated Patient Assessment dimensions of SPs performances "It seems authentic", "Can be a real patient" and "Answered questions naturally", presented "moderate or complete agreement" of all evaluators. The dimensions "Seems to retain information unnecessarily", "Remains in his/her role all the time", "Challenges/tests the student", and "Simulates physical complaints in an unrealistic way" presented "moderate or complete disagreement" in all evaluations. The SPs "Appearance fits the role" showed "moderate or complete agreement" in most evaluations. In the second round of evaluations, the SPs had better performance than the first ones. This could indicate the training process's had good influence on SPs performances. The Cronbach's alpha in the second assessment was better than the first (varied from 0.699 to 0.978). The same improvement occurred in the second round of intraclass correlation coefficient that was between 0.424 and 0.978. The SPs were satisfied with the training method and standardization process. They could perceive improvement on their role-play authenticity. CONCLUSIONS: The SPs training and standardization process revealed good SPs reliability and simulation reproducibility, demonstrating to be a feasible method for SPs standardization in multicenter studies. The Maastricht Simulated Patient Assessment was regarded as missing the assessment of the information consistency between the simulation script and the SPs provision.

Cerrado physiognomies in Chapada das Mesas National Park (Maranhão, Brazil) revealed by patterns of floristic similarity and relationships in a transition zone.

The Chapada das Mesas National Park is a federal reserve located in the State of Maranhão, in an ecotonal region of the Brazilian Northeast Cerrado. Aiming to assess the influence of biogeographic patterns and support restoration actions for regions where information is scarce, we analyzed the floristic composition of savanna and forest Cerrado physiognomies, the floristic relationships with other Brazilian Cerrado areas and investigated the floristic relationships between the Cerrado and the Amazon, and the Caatinga and Atlantic Forest biomes. A total of 242 species in 181 genera and 64 families are recorded in our study. Fabaceae was the most representative family. We report 50 new records of species for Maranhão, four new records for the Cerrado biome and one vulnerable species. The separation of the gallery forest from cerradão and typical cerrado by ordination shows the influence of water availability and soil characteristics on floristic composition. In Cerrado ecotonal regions, such as Mato Grosso and Maranhão, the presence of species shared with the Amazon is expressive. In addition to the Amazon, physiognomies had greater floristic connection with the Caatinga flora. Our data demonstrates that the marginal areas of the Brazilian Cerrado may present high species diversity.

Establishing trustworthiness and authenticity in qualitative pharmacy research.

Spurred by the value it can add, the use of qualitative research methods has been steadily growing by social pharmacy researchers around the globe, either separately or as part of mixed methods research projects. Given this increase, it is important to provide guidance to assist researchers in ensuring quality when employing such methods. This commentary addresses both theoretical fundamentals as well as practical aspects of establishing quality in qualitative social pharmacy research. More specifically, it provides an explanation of each of the criteria of trustworthiness proposed by Lincoln and Guba (credibility, transferability, dependability and confirmability) and different techniques used in establishing them. It also provides a brief overview of authenticity, a more recent and less widely used set of criteria that involve demonstrating fairness, ontological authenticity, educative authenticity, catalytic authenticity, and tactical authenticity. For each of these terms, the commentary provides a definition, how it applies to social pharmacy research, and guidance on when and how to use them. These are accompanied by examples from the pharmacy literature where the criteria have been used. The commentary ends by providing a summary of competing viewpoints of establishing quality in the published literature while inviting the reader to reflect on how the presented criteria would apply to different qualitative research projects.

Communication skills in Brazilian pharmaceutical education: a documentary analysis.

OBJECTIVE: To characterize the inclusion of the teaching of communication skills in the curriculum of Pharmacy Schools of Federal Institutions of Higher Education. METHODS: An exploratory study of documental analysis of curriculum of Pharmacy Schools was carried out. A convenience sample was selected from undergraduate pharmacy courses of Federal Institutions of Higher Education (IFES). The variables collected were related to the identification of the course, its nature (elective or mandatory), workload, semester, and program content. RESULTS: Among the 49 undergraduate pharmacy courses of IFES, 35 (71.4%) had their curriculum available online. The teaching of communication in health was identified in 26 (74.3%) curriculum. In this study, three courses (7.2%) specifically aimed at teaching communication skills, while 39 (92.9%) had content related to this subject. Most courses (22; 52.4%) belonged to the field of Social, Behavioral, and Administrative Sciences. As for the course period, there was a concentration in the third (19%) and fourth (28.6%) years. The main content present in the curriculum was related to the principles and techniques of health communication (42.8%). CONCLUSIONS: Data obtained enabled the identification of gaps in the curricula of undergraduate courses in pharmacy concerning the inclusion of the teaching of communication skills. These results can be used to reflect the current models adopted in Brazil for the teaching of this skills, especially after the recent publication of the new curricular guidelines for undergraduate pharmacy courses.