This study aimed to assess pharmacy students’ knowledge about doping substances used in sport, explore their attitudes toward doping and investigate their misuse of doping drugs. A questionnaire was developed and employed to collect data from bachelor of pharmacy (BPharm) students at the International University for Science and Technology (IUST). Two-hundred and eighty students participated in this self-administrated, paper-based survey. Around 90% of the students did not appear to know that narcotics, β-blockers and diuretics were used in sport as doping agents. Additionally, proportions between 60% and 80% considered vitamins, energy drinks and amino acids as substances that possess performance-enhancing effects. The main reason for doping, based on students’ response, was to improve muscular body appearance. The vast majority of students agreed that pharmacists should play a major role in promoting awareness about risks of doping. While students showed negative attitudes toward doping, approximately 15% of them, primarily males, had already tried a doping drug or might do so in the future. More than 60% of the students believed that sports-mates and friends are the most influential in encouraging them to take a doping agent. The study highlights the need to provide pharmacy students with advanced theoretical background and practical training concerning doping. This can be achieved by adopting simple, but essential, changes to the current curricula. Full article

The need for a well-prepared public health workforce to prepare for and respond to threats of terrorism, infectious diseases, and other public health emergencies is well documented, as is the reality that the public health workforce in the United States is under-trained and unprepared to handle public health emergencies. The impact of training on the public health workforce is often measured by the volume of training completed and post-course evaluation data. A survey of current, high-volume users (n = 759) of the University of North Carolina Center for Public Health Preparedness Training Web Site, defined as individuals who had completed 12 or more training modules was conducted in order to determine if measurable changes in preparedness and response knowledge and capacity were brought about by the trainings. Two-hundred and seventy respondents completed the survey (response rate = 36%), with 52% reporting employment in governmental public health. Individual changes reported as a result of training included increased personal satisfaction (71%), increased job satisfaction (38%), and recognition by supervisors for training completion (23%); Organizational changes included updates to training plans (19%), making trainings mandatory (19%), and revising standard operating procedures (13%). Results from this survey indicate that the knowledge learned from completing online trainings led to changes in individuals and, to a lesser extent, changes in organizations. Full article

Palliative care involves helping patients to achieve best possible quality of life by alleviating symptoms and suffering. The aim of the study was to describe and analyze staff member’s experience of working with evidence-based guidelines for pain management in palliative care. The study comprised a total of eight group interviews and 93 narratives from 22 staff members, all of who worked in palliative care. Data was analyzed using manifest qualitative content analysis and deductive perspectives according to SOC (sense of coherence). Three categories, “Awareness of Pain Management”, “Participation in Pain Management”, and “Safety at Pain Management”, were identified. The result showed an increased awareness of the value of a deeper understanding of policy documents and local guidelines. A key factor in improvement work was that team members were given the opportunity to repeat and continuously reflect on their performed work together within the team in dialog form. Teamwork may contribute to a better knowledge and understanding of how to develop high quality in healthcare by learning from each other in everyday work and by using evidence-based practices. Consistency in the working group could improve healthcare by using the espoused theory and theory-in-use for develop procedures and guidelines at work. Full article

Experiences with online learning in higher education have grown due to advancements in technology, technological savviness of students, changes in student expectations, and evolution of teaching approaches in higher education. Blended learning, the thoughtful fusion of face-to-face instruction with online learning, can enhance student learning and provide rewarding teaching experiences for faculty members. Pharmacy educators are beginning to employ blended learning across the continuum of professional education from entry-to-practice programs to continuing professional education programs. The objectives of this paper are to describe our early experiences with blended learning and how it has enhanced our teaching experiences. Possibilities for blended learning are considered as new curricula for pharmacy programs are developed at our institution. Full article

Based on educational considerations, the European Society for Paediatric Endocrinology (ESPE) e-learning portal has been developed, providing an interactive learning environment for up-to-date information in pediatric endocrinology. From March 2011 to January 2012, five small-scale pilot studies were completed to assess the usefulness of the structure and content by senior experts, fellows, residents and medical students. Altogether, 8 cases and 4 chapters were studied by a total of 71 individuals: 18 senior experts, 21 fellows, 10 medical students, 9 regional pediatricians and 13 residents, resulting in a total of 127 evaluations. Participants considered the portal content interesting and appreciated the way of learning compared to traditional learning from literature and textbooks. Special attention was paid to assess the personalized feedback given by experts to fellows and residents who completed the portal. Feedback from experts included both medical understanding and communication skills demonstrated by fellows and residents. Users highly appreciated the feedback of the medical experts, who brought perspectives from another clinic. This portal also offers educational opportunities for medical students and regional pediatricians and can be used to develop various CanMEDS competencies, e.g., medical expert, health advocate, and scholar. Full article

A bibliometric study of 25 EU pharmacy departments showed that the top two department members (in terms of the number of articles in which the two top staff members are author (or co-author) over a 14-year period from 1998 through 2012) had h-indices of 14 (mean) / 9 (median) and 12 (mean) / 8.5 (median). These were similar to values published for pharmacy department members in the USA. Global data for departments showed lower values as they were affected by the very skewed nature of the distribution with 16% of department members accounting for 76% of the department’s publications. Full article

Poorer people are more likely to use antibiotics; inappropriate antibiotic use causes resistance, and health campaigns attempt to change behaviour through education. However, fuelled by the media, the public think antibiotic resistance is outside their control. Differences in the attribution of blame for antibiotic resistance in two genres of UK newspapers, targeting distinct socioeconomic groups, were examined using a mixed methods approach. Firstly, depiction of blame was categorised as either external to the lay public (outside their control) or internal (lay person accountable) and subjected to a chi-square test. Secondly, using critical discourse analysis, we examined the portrayal of the main agents through newspaper language. Data from 597 articles (307 broadsheets) analysed revealed a significant association between newspaper genre and attribution of blame for antibiotic resistance. While both newspaper types blamed antibiotic resistance predominantly on factors external to the lay public, broadsheets were more likely to acknowledge internal factors than tabloids. Tabloids provided a more skewed representation, exposing readers to inaccurate explanations about antibiotic resistance. They highlighted ineptitude in health professionals, victimising patients and blaming others, while broadsheets used less emotive language. Pharmacists should take special care to communicate the importance of appropriate antibiotic use against this backdrop of distortion. Full article

Hormone replacement therapy has been proven efficacious for controlling vasomotor symptoms such as hot flushes associated with menopause. Drospirenone is a progestin with antiandrogenic and antimineralocorticoid activity that may be used in combination with estrogen to control hot flushes and offers the potential benefit of minimizing breast tenderness, blood pressure elevations and weight gain. Six clinical trials were reviewed. Of these, four trials explicitly listed hot flushes as a primary outcome. Efficacy with regards to hot flushes was found to range from modest to large (i.e., 37.5% to 94.6%), and four of the studies utilized diary cards to assess hot flushes. Results from these studies must be interpreted cautiously as quite a few limitations existed such as small population sizes involving specific ethnic groups, lack of p values with regards to baseline characteristics lending question to homogeneity, and inclusion of mostly healthy participants. Additionally, while the studies were long enough to see an effect, the long term effects of drospirenone-containing hormone replacement therapy (HRT) is unknown. The available data supports the use of drospirenone-containing HRT for the treatment of hot flushes associated with menopause. Full article

The development of graduate attributes through health professional courses requires the opportunity to engage with learning and teaching activities that reflect the work-based role to which the student aspires. Such activities allow the contextualisation of discipline-specific knowledge, forging a critical understanding of the underpinning theory, and providing a firm foundation for the development of lifelong learning skills. A blended learning approach can be particularly valuable in supporting achievement of the learning outcomes in modules where performance is measured in terms of competency in work-based scenarios. An action research approach was taken to develop and evaluate a cardiovascular risk assessment as the basis for clinically and professionally relevant problem-based learning. Support for this was provided by means of blended learning including a number of online activities. Talking wall focus groups were used to evaluate the student experience, and this was combined with quantitative data regarding student examination performance. Student performance in the cardiovascular section of the examination paper was significantly higher than in other sections. Students reported very favorably on the use of this approach to support not only examination preparation, but also in terms of developing professional identity and enhancing employability skills. Full article

This article presents an innovative approach to interprofessional education that places learning in the context of a specific clinical area that is relevant to pharmacy students as well as students from a number of other health professions; in this case pain management. Interprofessional pain education that teaches a team approach to pharmacy students is essential for improving pain management practices. The interprofessional education model presented, based on a pilot of a series of interprofessional pain management modules, is designed to be flexible, using a modular format that incorporates both online and face-to-face learning. The model was developed as a means of overcoming some of the challenges, such as scheduling, which make the integration of interprofessional education into curricula difficult. This technology enabled education model has been piloted and implemented with groups of pharmacy students who were placed into teams with students from other disciplines such as medicine, nursing, and social work. This article presents the educational strategy and its development; describes the interprofessional pain management modules; discusses findings from three pilot evaluations of the modules; shares lessons learned; and highlights the strengths of the approach. Full article

This concept paper discusses the untapped promise of often overlooked humanistic skills to advance the practice of pharmacy. It highlights the seminal work that is, increasingly, integrated into medical and nursing education. The work of these educators and the growing empirical evidence that validates the importance of humanistic skills is raising questions for the future of pharmacy education and practice. To potentiate humanistic professional competencies, e.g., compassion, empathy, and emotional intelligence, how do we develop a more holistic model that integrates reflective and affective skills? There are many historical and current transitions in the profession and practice of pharmacy. If our education model is refocused with an emphasis on pharmacy’s therapeutic roots, the field has the opportunity to play a vital role in improving health outcomes and patient-centered care. Beyond the metrics of treatment effects, achieving greater patient-centeredness will require transformations that improve care processes and invest in patients’ experiences of the treatment and care they receive. Is layering on additional science sufficient to yield better health outcomes if we neglect the power of empathic interactions in the healing process? Full article

Several jurisdictions throughout the world, such as the UK and Canada, now have independent prescribing by pharmacists. In some areas of Canada, initial access prescribing can be done by pharmacists. In contrast, Australian pharmacists have no ability to prescribe either in a supplementary or independent model. Considerable research has been completed regarding attitudes towards pharmacist prescribing from the perspective of health care professionals, however currently no literature exists regarding pharmacy student views on prescribing. The primary objective of this study is to examine pharmacy student’s opinions and attitudes towards pharmacist prescribing in two different settings. Focus groups were conducted with selected students from two universities (one in Canada and one in Australia). Content analysis was conducted. Four main themes were identified: benefits, fears, needs and pharmacist roles. Students from the Australian University were more accepting of the role of supplementary prescribing. In contrast, the Canadian students felt that independent prescribing was moving the profession in the right direction. There were a number of similarities with the two groups with regards to benefits and fears. Although the two cohorts differed in terms of their beliefs on many aspects of prescribing, there were similarities in terms of fears of physician backlash and blurring of professional roles. Full article

The aim of the study was to assess Polish community pharmacists’ knowledge about the health consequences of smoking and the abilities they need in professional advice-giving during the smoking cessation process. Therefore, we use a self-answered questionnaire to assess pharmacists’ knowledge about the health consequences of smoking and his/her abilities in NRT advice-giving. In total, the pharmacists could earn 20 points, 14 in the knowledge section and 6 in the abilities section. One hundred and nine pharmacists from community pharmacies were included, 87 of whom were women (79%). The average age of respondents was 38 years (24–72). The mean knowledge rating of pharmacists regarding the health risk factors connected with smoking was 7.7 points (SD = 2.2), the maximum was 14. None of the respondents obtained the maximum possible score in the test. Only 2.7% of pharmacists correctly identified all four factors important in selecting the form of NRT. Analysis showed that pharmacists’ knowledge about tobacco dependence and tobacco-related diseases is insufficient for an effective tobacco control interventions. It seems necessary to undertake systematic training to improve their knowledge about nicotine addiction and abilities in NRT and smoking cessation advice-giving. Full article

This study explored how a sample of Australian pharmacists would convey information about the side effects of a medicine, if they were to counsel a patient. A qualitative method was selected and written responses to a case-based scenario were analysed using inductive thematic analysis. The grounded theory approach elicited a fluid and dynamic model for side effect counselling. The study identified strategies for counselling, such as encouraging adherence through emphasising the benefits of the medication, referral to the prescriber, and providing empathy and reassurance to ease anxiety and address concerns. Pharmacists acknowledged the potential for risk, although only a minority used numerical descriptors. The final themes or outcomes were that pharmacists aim to allay fears, minimise harm and promote medication use when counselling about side effects. Professional empathy, the acknowledgment of patient concerns, and the importance of providing tailored information to promote medication adherence, emerged as features of the quality use of medicines. This study contributes to existing literature by identifying the role of allaying patients’ fears when conveying side effect information. It also describes a process to convey tailored information. Implications for practice include the importance of effective use of communication strategies to encourage adherence, as the appropriate use of medication can lead to positive health outcomes. Full article

The integumentary system (skin) is the first line of defence in the body and part of the innate immune system. Within first year modules on Pharmaceutical Biology and Integrative Physiology in the Masters of Pharmacy degree at Robert Gordon University (RGU) several software tools were used to support both lecture and coursework material for the immune and integumentary systems. However, students had difficulty visualizing the various layers of the skin and how they become affected by different skin lesions. As a response to these identified learning difficulties, a just-in-time teaching 3-Dimensional elearning object was developed using free-to-use 3D CAD packages alongside common elearning software. The outcome was a virtualised human arm equipped to illustrate and label primary or secondary skin lesions whilst allowing spatial manipulation of the arm. This allowed students to manipulate and identify the specific skin layers involved. Evaluation of student engagement and learning was favourable, with students reflecting that they had a better understanding of the topic. Initial findings from this study highlight the benefits of quick, low-cost 3D production processes as just-in-time teaching elearning tools that have a positive impact on students’ performance. Full article

Prescribing guidelines do not recommend the long-term use of benzodiazepines since their effectiveness with chronic use is out-weighed by risks including dependence, memory and cognitive impairment, hip fractures and traffic accidents. Despite these guidelines, historical data points to an increasing proportion of inappropriate, repeat prescribing of benzodiazepines in Ireland and elsewhere, with up to 33% of patients who use these drugs doing so long-term. The typical long-term benzodiazepine user is an older, socio-economically disadvantaged patient who has been prescribed these medicines by their general practitioner (GP) and dispensed them by their community pharmacist. Misuse of benzodiazepines in nursing homes and psychiatric institutions is also of concern, with one Irish study indicating that almost half of all admissions to a psychiatric hospital were prescribed these drugs, usually despite a lack of clear clinical need. Discontinuation of benzodiazepines has proven to be of benefit, as it is followed by improvements in cognitive and psychomotor function, particularly in elderly patients. It is obvious that an inter-professional effort, focusing on the primary care setting, is required to address benzodiazepine misuse and to ensure appropriate pharmaceutical care. Pharmacists must be an integral part of this inter-professional effort, not least because they are uniquely positioned as the health professional with most frequent patient contact. There is already some supporting evidence that pharmacists’ involvement in interventions to reduce benzodiazepine use can have positive effects on patient outcomes. Here, this evidence is reviewed and the potential for pharmacists to play an expanded role in ensuring the appropriate use of benzodiazepines is discussed. Full article

Levonorgestrel emergency contraception and other contraceptive methods are available over-the-counter (OTC); however youth continue to face a number of barriers in accessing healthcare services, including lack of knowledge of the method, fear of loss of privacy, difficulties in finding a provider, and cost. A descriptive, nonexperimental, cross-sectional study of a sample of 112 community pharmacies in San Diego, California was conducted between December 2009 and January 2010 to assess community pharmacy practices related to the availability and accessibility of family planning health pharmacy services and products, particularly to youth. A majority (n = 79/112, 70.5%) of the pharmacies carried a wide selection of male condoms; however, the other OTC nonhormonal contraceptive products were either not available or available with limited selection. A majority of the pharmacies sold emergency contraception (n = 88/111, 78.6%). Most patient counseling areas consisted of either a public or a semi-private area. A majority of the pharmacy sites did not provide materials or services targeting youth. Significant gaps exist in providing family planning products and services in the majority of community pharmacies in San Diego, California. Education and outreach efforts are needed to promote provision of products and services, particularly to the adolescent population. Full article