Improving patient access to hepatitis C antiviral medicines in Switzerland: Understanding the financial risks for community pharmacies.

RATIONALE: As observed in other countries, some patients may experiment difficulties in obtaining their hepatitis C antiviral medicines (HCVm) in Swiss community pharmacies. There is a lack of data related to access to HCVm at the patient level and notably related to the potential financial risks for the community pharmacies. AIMS: (a) To evaluate the potential financial risks for community pharmacist associated with the delivery of HCVm in the Swiss healthcare system; (b) to explore the attitudes and experiences of community pharmacists related to these risks and their consequences for the patients. METHOD: A three-step approach was chosen as follows: (a) estimation of costs, incomes, and gross financial results directly related to 3-month treatment with Harvoni based on the drug delivery process (data from 68 patients over 2 years); (b) sensitivity analyses; (c) exploration of local community pharmacists' attitudes and experiences related to the delivery of HCVm in the canton of Vaud (Western Switzerland). RESULTS: Two main risks were identified: (a) Incomes do not always cover costs; (b) reimbursement issues could lead to an increase in the requirement for working capital. According to the survey, 23% (14/60) of pharmacies refused to deliver HCVm to at least one patient, and these patients had to find a solution mostly on their own. CONCLUSIONS: The scenario analysis clarifies the causes of the possible refusal to deliver HCVm. With the growing number of high-priced medicines, the healthcare systems should have a clear strategy to encourage their delivery by community pharmacies by ensuring seamless and collaborative care for patients. The community pharmacists could be accountable to provide such services-if they get the education, training, and remuneration.

[Development of the short version of the informal caregiver burden assessment questionnaire]. / Desenvolvimento de uma versão reduzida do Questionário De Avaliação Da Sobrecarga do Cuidador Informal.

OBJETIVE: to create a reduced version of the QASCI, which is structurally equivalent to the long one and meets the criteria of reliability and validity. METHOD: Through secondary data from previous studies, the participants were divided into two samples, one for the development of reduced version and the second for study of the factorial validity. Participants responded to QASCI, the SF 36, the ADHS and demographic questions. RESULTS: A reduced version of 14 items showed adequate psychometric properties of validity and internal consistency, adapted to a heptadimensional structure that assesses positive and negative aspects of care. CONCLUSION: Confirmatory factor analysis revealed a good fit with the advocated theoretical model.

Development of the short version of the informal caregiver burden assessment questionnaire / Desarrollo De Una Versión Reducida Del Cuestionario De Evaluación De La Sobrecarga Del Cuidador Informal / Desenvolvimento de uma versão reduzida do Questionário de Avaliação da Sobrecarga do Cuidador Informal

OBJETIVE to create a reduced version of the QASCI, which is structurally equivalent to the long one and meets the criteria of reliability and validity. METHOD Through secondary data from previous studies, the participants were divided into two samples, one for the development of reduced version and the second for study of the factorial validity. Participants responded to QASCI, the SF 36, the ADHS and demographic questions. RESULTS A reduced version of 14 items showed adequate psychometric properties of validity and internal consistency, adapted to a heptadimensional structure that assesses positive and negative aspects of care. CONCLUSION Confirmatory factor analysis revealed a good fit with the advocated theoretical model. .

OBJETIVO Crear una versión reducida del Cuestionario de Evaluación de la Sobrecarga del Cuidador Informal (CESCI) que sea estructuralmente equivalente y que reúna criterios de fidelidad y validez. MÉTODO Mediante datos secundarios a estudios anteriores se constituyeron dos muestras, la primera para el desarrollo de la versión reducida y la segunda para estudiar la validez factorial. Los participantes respondieron al CESCI, el SF 36, la HAD y a preguntas sociodemográficas. RESULTADOS La versión reducida de 14 ítems demostró adecuadas propiedades psicométricas de validez y consistencia interna adaptadas a una estructura heptadimensional que evalúa los aspectos negativos y positivos del cuidar. CONCLUSIÓN El análisis factorial confirmatorio reveló un buen ajuste al modelo teórico preconizado. .

OBJETIVO Criar uma versão reduzida do Questionário de Avaliação da Sobrecarga do Cuidador Informal (QASCI), que seja estruturalmente equivalente e que reúna critérios de fidelidade e validade. MÉTODO Através de dados secundários a estudos anteriores constituíram-se duas amostras, uma para o desenvolvimento da versão reduzida e a segunda para estudar a validade fatorial. Os participantes responderam ao QASCI, ao SF 36, à EADH e a perguntas sociodemográficas. RESULTADOS A versão reduzida de 14 itens mostrou adequadas propriedades psicométricas de validade e consistência interna adaptada a uma estrutura heptadimensional que avalia aspetos negativos e positivos do cuidar. CONCLUSÃO A análise fatorial confirmatória revelou um bom ajustamento ao modelo teórico preconizado. .

Gestão da qualidade dos cuidados de enfermagem prestados ao idoso em contexto domiciliário: adesão ao regime terapêutico / Managing the quality of nursing care provided to the elderly in a home setting: adherence to the therapeutic regime

O presente relatório visa descrever as atividades desenvolvidas durante o estágio efetuado no âmbito do Curso de Mestrado em Enfermagem, com o tema (Gestão da qualidade dos cuidados de enfermagem prestados ao idoso em contexto domiciliário: adesão ao regime terapêutico). Este estágio decorreu de 14 de Fevereiro a 24 de Junho de 2011, no Centro de Saúde de Mourão e teve como principal objetivo ajudar o individuo a alcançar um maior nível de saúde e bem-estar, ou a controlar e a aceitar a sua situação e conseguir maior independência, potenciando ao máximo as suas capacidades de autocuidado. Desenvolveram-se intervenções com o objetivo de envolver o cliente no seu processo de saúde/doença e de o capacitar a tomar decisões informadas. Este contexto de cuidados permitiu individualizar um plano de intervenção de cuidados de enfermagem a um total de 10 idosos. Verificou-se que a adesão ao regime terapêutico é um indicador sensível aos cuidados de enfermagem, onde a intervenção da enfermeira, numa unidade de cuidados de saúde primários, privilegia a qualidade da comunicação e relação com os idosos, ajudando-os a melhorar a adesão e gestão do seu tratamento e do seu estado de saúde, sendo por eles reconhecida.

This report aims to describe the activities developed during the internship made under the Master's Degree in Nursing, with the theme (Management of quality of nursing care provided to the elderly in domiciliary context: adherence to the therapeutic regimen). This internship took place from February 14th to June 24th 2011, on the Health Center of Mourão and aimed to help the individual achieve a higher level of health and well-being, or to control and accept their situation and achieve greater independence, enhancing to the maximum their capabilities of self-care. Interventions have been developed in order to engage the customer in his process of health/illness and train them to make informed decisions. This context allowed individualized care plan intervention of nursing care to a total of 10 seniors. It was found that the adherence to therapy is a sensitive indicator of nursing care, where the intervention of the nurse, in a unit of primary care, focuses on the quality of communication and relationship with the elderly, helping them to improve adherence and management of their treatment and their health status, being recognized by them.

Compounds from Vitex polygama active against kidney diseases.

Vitex polygama Cham. (Lamiaceae, formerly Verbenaceae) is a familiar Brazilian species popularly known as Tarumã whose leaf tea has been used by population to treat kidney diseases. The aim of this research was to investigate the hydroalcoholic extract of leaves in order to isolate the active compounds. Hydroalcoholic extract of leaves was obtained by stirring the previous hexane and methanol extracted leaves residue with 50% aqueous MeOH solution by ultra-sonic mixing. The obtained extract was partitioned with n-butanol. The yielded fraction was subsequently submitted to several chromatographic procedures to lead to the isolation of O-glycosidicflavones orientin and isoorientin as well as C-glycosylflavones schaftoside and carlinoside along with their isomers, known as potent anti-inflammatory, antinociceptive and antioxidant agents, then identified as the active constituents, justifying the folk use of the plant to combat and prevent kidney stone and inflammation.

Percutaneous drainage of infected pancreatic fluid collections in critically ill patients: correlation with C-reactive protein values.

The objective of this study was to assess the efficacy of percutaneous catheter drainage, of early infected pancreatic fluid collections, in critically ill patients with severe acute pancreatitis. The patients in our series had a mean Ranson's score of 5.4. Nineteen (63.3%) of the 30 patients were cured with percutaneous drainage. In this group, the mean C-reactive protein value at the beginning of treatment was 172.8 U/l and 102.5 U/l at the end (P<.001). Cultures yielded multiple organisms in 23 patients (76.7%). The most frequently seen organisms were Escherichia coli, Staphylococcus aureus, and Enterococcus faecium.