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Perez Breen posted an update 1 month ago
67% and 11.94%, are significant, the turnover generated from their sale remains low. CONCLUSION Supporting local producers with appropriate funding and adequate promotion of herbal medicines is still needed to boost the share of the national herbal medicines market. OBJECTIVES To analyze attitudes and beliefs of community pharmacists and pharmacy technicians about depression and treatment in older patients. METHODS A qualitative study was conducted with community pharmacists and pharmacy technicians. The first step of the study was to develop an interview guide to conduct semi-directive interviews. A thematic analysis was conducted based on the transcripts of the recording of audio interviews. RESULTS Eight pharmacists and 5 pharmacy technicians were included. The mean duration of semi-directive interviews was 14.8±4.6minutes. The main identified themes were as follows 1/the depression beliefs about depression and its risk factors in older patients; how to talk about depression with older patients at the counter; 2/the management of depression how to talk about antidepressant with older patients at the counter, including treatment duration, dosage, efficacy and adverse effects of treatment, but also alternative therapies and advices; 3/barriers and facilitators of antidepressant adherence in older patients. CONCLUSIONS Barriers to conduct pharmaceutical care focusing on depression among older patients in community pharmacy have been identified disease stigmatization, lack of privacy at the counter and lack of communication with the prescribing physician; but also a lack of knowledge concerning the specific therapeutic strategy for depression in the elderly. Thus, strengthening the pharmacy student teaching and the community pharmacist and pharmacy technician training regarding the posture to adopt and the therapeutic management of older patients with mental illness would be beneficial. In the hospital, all the reprocessed reusable medical devices (RMD) are conditioned with a sterile barrier system and a protection package and they expire after three months. The objective of this study is to reevaluate this shelf life via a risk-analysis study focusing on the steps whose malfunction can fail RMD sterility. The first step is analysing current conditions of packaging, transportation and storage of RMD. The risk-analysis study has been built on French National Authority for Health template. Risks are prioritized in three categories non critical risks, risks that need to be kept track of and risks to manage as a priority. Storage conditions have been evaluated in 52 wards in ten different structures. All of the wards respect the paper side of the pouches. They were stored in a dedicated storage unit in 85 % of the units. They were closed at the moment of the observation in 58 % of the cases. RMD were stacked in 81 % of the units and 36 % of them had at leat one expired RMD in their storage unit. The risk-analysis study identified two risks to manage as a priority. Some RMD were damaged during transportation to a subcontractor hospital. This step is barely manageable due to the human factor but the transport rules have been reminded in order to lower the risks on the materials. The operating rooms common storage include shelves that alter pouches and wraps, but a replacement of equipments is under discussion. CDK assay Thanks to a better understanding of RMD circuit current conditions, allowing a better control of sensitive steps, their shelf life is reevaluated up to 6 months for containers and 4 months for other pouches. OBJECTIVE To date, few adapted pharmaceutical forms are available for infants leading to multiple steps of preparation and medicines dilution before administration. The main purpose of this study was to assess the risks on the steps of preparation and administration of medicines in a neonatal care unit and to propose corrective actions to ensure the medicines safety. METHODS A global risk analysis was performed, conducted by a multidisciplinary working group of 9 experts, that is 9 meetings. RESULTS We identified 57 scenarios 59,6% of scenarios had an initial criticality C1, 31,6% C2 and 8,8% C3. The most risky phases were phases of needs identification including the step of doses calculation and phases of preparation. The strategic management together with the human factor were the most risky dangers. Nineteen corrective actions were proposed. After implementing those actions, 82,5% of scenarios had residual criticality C1, 17,5% C2 and no scenario had residual criticality C3. Follow-up actions have been implemented to control the residual risk as in service training. CONCLUSION Neonatal unit care is a risky service and should be a priority in the risk management policy. This analysis joins the quality policy implemented in the hospital and similar risk analysis is on process. Glucocorticoids are steroid hormones that are of pivotal importance in human physiology. Glucocorticoid signaling is complex in nature and dependent on many interacting factors. As glucocorticoids exhibit sexually dimorphic effects on several key processes including in metabolism, crosstalk with the sex steroid hormones (androgens and estrogens) is relevant. In this review, we highlight the state-of-the-art knowledge on glucocorticoid sexual dimorphism and sex hormone crosstalk. We include current insight in the molecular mechanisms that underlie nuclear steroid receptor crosstalk, and sex hormone effects on glucocorticoid metabolism. Finally, we show how these findings translate to humans exposed to excess glucocorticoid signaling, and we propose future avenues in the emerging field of steroid hormone crosstalk. INTRODUCTION The coexistence of food insecurity and excess body weight has been well documented in women. Both food insecurity and excess body weight have multiple consequences for physical and mental health. Concerns have been raised about interventions aimed to reduce food insecurity because these interventions might contribute to excess body weight, particularly in adult women. The purpose of this study was to develop, implement, and evaluate an intervention to simultaneously reduce food insecurity and body weight through alleviating discouragement-which women described as feeling sad, depressed, hopeless, and lacking drive to do important activities, such as finding a job or studying more-by increasing women’s empowerment. STUDY DESIGN This 2-armed cluster RCT was conducted from February to December 2017. Data were analyzed from January to July 2018. SETTING/PARTICIPANTS Participants were food-insecure women with excess body weight in the Central Canton of the province of Alajuela, Costa Rica. INTERVENTION The intensive intervention arm consisted of activities at the individual (12 sessions lasting 2 hours each, 3 follow-up monthly sessions, and 1 closing session), household (1 workshop with the participants’ household and community members and homework with family participation), and community (2 brochures and 1 workshop) levels.