Patient and pharmacist perspectives on pharmacist-prescribed contraception: A systematic review.

OBJECTIVE: Increasingly, states authorize pharmacists to prescribe hormonal contraception to patients without a prescription from another healthcare provider. The purpose of this review is to investigate pharmacist and patient perspectives on pharmacist-prescribed contraception in the United States. STUDY DESIGN: We searched Medline, Embase, PsycInfo, CINAHL, Scopus, and the Cochrane Library from inception through July 10, 2019. We included qualitative and mixed-methods studies, quantitative surveys, observational studies, and randomized trials in the United States. Risk of bias was assessed using tools for quantitative and qualitative studies. RESULTS: Fifteen studies met inclusion criteria, including studies on pharmacists and student pharmacists (n = 9), patients (n = 5), and both (n = 1). Study samples ranged from local to national. Studies had moderate to high risk of bias, primarily due to low response rates and lack of validated instruments. Most pharmacists (57-96%) across four studies were interested in participating in pharmacist-prescribed contraception services. Among patients, 63-97% across three studies supported pharmacist-prescribed contraception, and 38-68% across four studies intended to participate in these services. At least half of pharmacists across four studies felt comfortable prescribing contraception, though pharmacists identified additional training needs. Pharmacists and patients identified several reasons for interest in pharmacist-prescribed contraception services, including increasing patient access, reducing unintended pregnancies, and offering professional development for pharmacists. They also identified barriers, including payment, time and resource constraints, liability, and patient health concerns. CONCLUSIONS: Most pharmacists and patients across 15 studies were interested in expanded access to contraception through pharmacist-prescribed contraception. Findings on facilitators and barriers may inform implementation efforts. IMPLICATIONS: Pharmacist-prescribed contraception is a strategy to expand patient access to contraception. Reducing barriers to implementation could improve participation among pharmacists and patients.

Absolute intensity calibration of the 32-channel heterodyne radiometer on experimental advanced superconducting tokamak.

This paper presents the results of the in situ absolute intensity calibration for the 32-channel heterodyne radiometer on the experimental advanced superconducting tokamak. The hot/cold load method is adopted, and the coherent averaging technique is employed to improve the signal to noise ratio. Measured spectra and electron temperature profiles are compared with those from an independent calibrated Michelson interferometer, and there is a relatively good agreement between the results from the two different systems.

Genome sequences of wild and domestic bactrian camels.

Bactrian camels serve as an important means of transportation in the cold desert regions of China and Mongolia. Here we present a 2.01 Gb draft genome sequence from both a wild and a domestic bactrian camel. We estimate the camel genome to be 2.38 Gb, containing 20,821 protein-coding genes. Our phylogenomics analysis reveals that camels shared common ancestors with other even-toed ungulates about 55-60 million years ago. Rapidly evolving genes in the camel lineage are significantly enriched in metabolic pathways, and these changes may underlie the insulin resistance typically observed in these animals. We estimate the genome-wide heterozygosity rates in both wild and domestic camels to be 1.0 × 10(-3). However, genomic regions with significantly lower heterozygosity are found in the domestic camel, and olfactory receptors are enriched in these regions. Our comparative genomics analyses may also shed light on the genetic basis of the camel's remarkable salt tolerance and unusual immune system.

Comparison of anomalous Doppler resonance effects with molybdenum and graphite limiters on HT-7.

The material of limiter in HT-7 tokamak was changed from graphite to molybdenum in the last experimental campaign. The pitch angle scattering of runaway electrons due to anomalous Doppler resonance effects was observed. The experimental results agree very well with the stable boundary condition expected from the linear resistive theory but only agree with that from the nonlinear evolutionary of runaway-electron distribution theory in low electric field region. The current carried by runaway electrons is the same under different limiter conditions.