A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan

Background In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. Methods A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Results Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Conclusion Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan

The mechanism of impact of summative assessment on medical students’ learning

It has become axiomatic that assessment impacts powerfully on student learning, but there is a surprising dearth of research on how. This study explored the mechanism of impact of summative assessment on the process of learning of theory in higher education. Individual, in-depth interviews were conducted with medical students and analyzed qualitatively. The impact of assessment on learning was mediated through various determinants of action. Respondents’ learning behaviour was influenced by: appraising the impact of assessment; appraising their learning response; their perceptions of agency; and contextual factors. This study adds to scant extant evidence and proposes a mechanism to explain this impact. It should help enhance the use of assessment as a tool to augment learning

Conceptions of learning factors in postgraduate health sciences master students: a comparative study with nonhealth science students and between genders

Background: The students’ conceptions of learning in postgraduate health science master studies are poorly understood. The aim of this study was to compare the factors influencing conceptions of learning in health sciences and non-health sciences students enrolled in postgraduate master programs in order to obtain information that may be useful for students and for future postgraduate programs. Methods: A modified version of the Learning Inventory Conception Questionnaire (COLI) was used to compare students’ conception learning factors in 131 students at the beginning of their postgraduate studies in health sciences, experimental sciences, arts and humanities and social sciences. Results: The present study demonstrates that a set of factors may influence conception of learning of health sciences postgraduate students, with learning as gaining information, remembering, using, and understanding information, awareness of duty and social commitment being the most relevant. For these students, learning as a personal change, a process not bound by time or place or even as acquisition of professional competences, are less relevant. According to our results, this profile is not affected by gender differences. Conclusions: Our results show that the overall conceptions of learning differ among students of health sciences and non-health sciences (experimental sciences, arts and humanities and social sciences) master postgraduate programs. These finding are potentially useful to foster the learning process of HS students, because if they are metacognitively aware of their own conception or learning, they will be much better equipped to self-regulate their learning behavior in a postgraduate master program in health sciences.Supported by CTS-115 (Tissue Engineering Group of the University of Granada). The funding body did not took part in the design of the study and collection, analysis and interpretation of data and in writing the manuscript

ERGONOMIA E SEGURANÇA EM ATIVIDADES EXTRATIVISTAS NO ESTADO DO ACRE

A ergonomia é a ciência que estuda a adaptação do trabalho ao homem, tendo como objetivo a melhoria das condições de saúde, segurança e bem estar do trabalhador. Apesar de existirem diversos estudos de ergonomia em vários setores, ao que tange atividades extrativistas, ainda são poucas as informações obtidas. Esta pesquisa teve como objetivo analisar e compreender as condições de trabalho, saúde e segurança das atividades na coleta e transporte de castanha e açaí na Reserva Extrativista Cazumbá - Iracema no Estado do Acre, a fim de propor sugestões à referida categoria a partir da análise dos fatores ergonômicos. As variáveis analisadas foram os fatores humanos, ambientais (clima e iluminação), carga física, posturas adotadas e o manuseio de cargas. Foram avaliados ao total 40 trabalhadores. De acordo com os resultados, os trabalhadores tinham idade média de 35 anos, peso médio de 69 kg, baixo índice de analfabetismo (2,3%), de origem predominantemente rural (94,1%), tendo um consumo alto de bebidas alcoólicas (49%) e tabaco (15%). A maioria dos trabalhadores já tiveram acidentes em suas atividades. A exposição ao calor e a iluminância foram considerados elevados e inadequados entre os horários de 12 e 13:30 horas. A carga física foi considerada moderadamente pesada na maioria das operações, destacando-se o transporte de castanha e a coleta do açai, sendo considerados pesados. As posturas mais prejudiciais foram observadas na coleta do açaí e no transporte de castanha. O manuseio de cargas apresentou alto risco de lesão nas atividades de transporte de castanha. Para melhoria das condições de trabalho, saúde, bem estar e segurança, deve haver uma conscientização a fim de diminuir os vícios e fiscalização para que haja o uso devido dos equipamentos de proteção individual. Ainda assim, os trabalhadores devem ser treinados e conscientizados para utilizar medidas adequadas de controle onde os níveis de exposição a iluminância são elevados. Também necessita-se de adoção de tempo de repouso por hora efetiva de trabalho nas atividades de coleta do açaí e transporte de castanha. A fim de evitar danos a coluna do trabalhador, é necessário a adoção de pausas durante as atividades de coleta e transporte de ambas as cadeias analisadas. E com relação ao manuseio de cargas é necessária uma reorganização ergonômica a fim de reduzir o peso manuseado para execução da atividade de transporte de castanha. Palavra - chave: Processo Produtivo, Unidades de Conservação, Condições de Trabalho

Fertility Regulation

In the past two centuries the proportion of couples using some form of conscious pregnancy-prevention has risen from close to zero to about two-thirds. In European populations this radical change in behaviour occurred largely between 1870 and 1930 without the benefit of highly effective methods. In Asia, Africa and Latin America, the change took place after 1950 since when the global fertility rate has halved from 5.0 births to 2.5 births per woman. In this chapter we describe the controversies surrounding the idea of birth control and the role of early pioneers such as Margaret Sanger; the advances in contraceptive and abortion technologies; the ways in which family planning has been promoted by many governments, particularly in Asia; trends in use of specific methods; the problems of discontinuation of use; and the incidence of unintended pregnancies and abortions

Discovery of novel heart rate-associated loci using the Exome Chip

Resting heart rate is a heritable trait, and an increase in heart rate is associated with increased mortality risk. Genome-wide association study analyses have found loci associated with resting heart rate, at the time of our study these loci explained 0.9% of the variation. This study aims to discover new genetic loci associated with heart rate from Exome Chip meta-analyses. Heart rate was measured from either elecrtrocardiograms or pulse recordings. We meta-analysed heart rate association results from 104 452 European-ancestry individuals from 30 cohorts, genotyped using the Exome Chip. Twenty-four variants were selected for follow-up in an independent dataset (UK Biobank, N = 134 251). Conditional and gene-based testing was undertaken, and variants were investigated with bioinformatics methods.We discovered five novel heart rate loci, and one new independent low-frequency non-synonymous variant in an established heart rate locus (KIAA1755). Lead variants in four of the novel loci are non-synonymous variants in the genes C10orf71, DALDR3, TESK2 and SEC31B. The variant at SEC31B is significantly associated with SEC31B expression in heart and tibial nerve tissue. Further candidate genes were detected from long-range regulatory chromatin interactions in heart tissue (SCD, SLF2 and MAPK8). We observed significant enrichment in DNase I hypersensitive sites in fetal heart and lung. Moreover, enrichment was seen for the first time in human neuronal progenitor cells (derived from embryonic stem cells) and fetal muscle samples by including our novel variants.Our findings advance the knowledge of the genetic architecture of heart rate, and indicate new candidate genes for follow-up functional studies