Search Results (30)

Background/Objectives: How to best assist people living with dementia (PLWD) and their care partners to maximize quality of life and quality of living, through appropriate and effective non-pharmaceutical approaches, remains a focus of dementia societies and organizations worldwide. This scoping review explored the types, opportunities, benefits and challenges of outdoor-based care and support programs for community-dwelling PLWD and their care partners. Methods: The methodological framework proposed by Arksey & O’Malley (2005) and modified by Levac et al. (2010) was followed. Four research databases were searched from January 2000 to November 2024; 2817 articles were retrieved and 20 met inclusion criteria and underwent data extraction. Results: Program types included the following: nature-based, care farm, green care farm, and farm-based dementia care programs, representing more than half of the included articles; health walks; and outdoor horticulture/garden/gardening programs. The number of PLWD participants ranged from 4 to 136. The total number of care partner participants was 151 and the total number of service provider participants was 87. The essence of, and connections with, nature and the outdoors had notable relevance and value for PLWD. Reported benefits, assessed quantitatively and qualitatively, were numerous and those in the social domain were reported most often. Identified challenges and barriers were related to risks and safety and program development, and implementation and delivery. Conclusions: The noteworthy potential of outdoor-based care and support programs to promote and enhance the quality of life and quality of living of community-dwelling PLWD and their care partners was elucidated. As most PLWD prefer to, and do, continue to reside in their homes, including those with advancing symptoms, the findings have significant relevance and implications for real-world practice and policy. Future research addressing current gaps will strengthen this growing field of dementia research. Full article

This review aims to increase attention on present water quality issues on Central Asia, finding gaps in the literature on ways to address treatment needs, and help ensure future use of Central Asia surface waters and groundwater for all beneficial uses. Central Asia is a landlocked region known for its harsh climatic conditions and scarce water resources, despite being home to some of the world’s largest internal drainage basins. The available literature suggests that increasing salinity has rendered water unsuitable for irrigation and consumption; hazardous trace elements are found throughout Central Asia, most often associated with mining and industrial sources; and that legacy pesticides influence water quality, particularly in agriculturally influenced basins. This study also focuses on the effects of municipal and industrial wastewater discharge. Additionally, the impact of inadequately treated wastewater on water resources is analyzed through a review of available data and reports regarding surface and groundwater quantity and quality. Given the challenges of water scarcity and accessibility, the reuse of treated wastewater is becoming increasingly important, offering a valuable alternative that necessitates careful oversight to ensure public health, environmental sustainability, and water security. However, due to insufficient financial and technical resources, along with underdeveloped regulatory frameworks, many urban areas lack adequate wastewater treatment facilities, significantly constraining their safe and sustainable reuse. Proper management of wastewater effluent is critical, as it directly influences the quality of both surface and groundwater, which serve as key sources for drinking water and irrigation. Due to their persistent and biologically active nature even at trace levels, we discuss contaminants of emerging concern such as antibiotics, pharmaceuticals, and modern agrochemicals. This review thus highlights gaps in the literature reporting on impacts of wastewater inputs to water quality in Central Asia. It is recommended that future research and efforts should focus on exploring sustainable solutions for water quality management and pollution control to assure environmental sustainability and public health. Full article

The objective of this study was to examine the impact of varying levels of non-pharmaceutical interventions (NPIs) on COVID-19 transmission in nursing homes during the first wave of the pandemic. Background/Objectives: The primary aim involved exploring qualitative insights from staff and management regarding the implementation of NPIs. The secondary aim was to determine the cumulative incidence of PCR-confirmed COVID-19 cases among residents. Incident rate ratios (IRRs) were the calculated levels of NPI restrictiveness. Methods: We used a mixed methodology to identify factors that might have affected COVID-19 expansion in nursing homes in the canton of Geneva, Switzerland. For the qualitative component, we interviewed the Attending Physicians and/or Director of each nursing home. In the quantitative component, we calculated incident rate ratios (IRRs) for infection between the three levels of COVID-19-related measures taken in these nursing homes, and the cumulative incidence of PCR-confirmed COVID-19 cases in their resident population. This study was conducted in 12 nursing homes located in the canton of Geneva, Switzerland, between 1 March 2020, and 1 June 2020. Results: Most nursing homes mandated NPIs for their staff and residents during the first wave of COVID-19. We found an equal distribution of maximally (n = 4), moderately (n = 4), and minimally (n = 4) restrictive NPIs for nursing home workers and residents. The extent of NPIs implemented was not shown to be significantly associated with the cumulative incidence of COVID-19 cases among residents (maximally restrictive IRR = 3.90, 95%CI 0.82–45.54, p = 0.184; moderately restrictive IRR = 3.55, 95%CI 0.75–41.42, p = 0.212; minimally restrictive IRR = reference). Conclusions: Nursing homes in our study showed high variability in which NPIs, and to what extent, they implemented, with no significant relationship between the restrictiveness of NPIs and COVID-19 incidence among nursing home residents. This suggests that other factors influence the transmission of COVID-19 in these settings. Future research should explore additional determinants and the balance between strict NPIs and the overall well-being of residents. Full article

Background: On-demand personalized drug production is currently not addressed with large-scale drug manufacturing. In our study, we focused primarily on identifying possible active pharmaceutical ingredients (APIs) for 3D Printing (3DP) in the current healthcare setting. Methods: We conducted a retrospective cross-sectional study in the Netherlands using three different sources; community pharmacies (n = 5), elderly care homes (n = 3), and the Erasmus MC Sophia Children’s Hospital. The primary endpoint was the percentage of prescriptions of medication manipulated before administration, thereby being a candidate for 3DP. Around a million prescriptions were analyzed in our study. Results: This study shows that around 3.0% of the prescribed drugs dispensed by Dutch community pharmacies were manipulated before administration, while around 10.5% of the prescribed drugs in the Erasmus MC Sophia Children’s Hospital were manipulated prior to administration. Conclusions: With our study, we show that the most manipulated drugs come from the groups of constipation, psychopharmaceutical, cardiovascular, and anti-infectant drugs. Successful introduction of a compounded API drug by 3DP does not only rely on the API, but it also comes with an optimal balance between technical, economic as well as societal impact factors. Our study gives direction for potential future research on the introduction of 3DP of medicine in the healthcare setting. Full article

A high prevalence of chronic diseases exposes diverse healthcare pain points due to the limited effectiveness of pharmaceutical drugs and biologics, sedentary lifestyles, insufficient health literacy, chronic stress, unsatisfactory patient experience, environmental pollution and competition with commercial determinants of health. To improve patient care and long-term outcomes, the impact of the home environment is overlooked and underutilized by healthcare. This cross-disciplinary work describes perspectives on (1) the home environment as a therapeutic target for the prevention and treatment of chronic diseases and (2) transforming health-centric household goods e-commerce platforms into digital health interventions. We provide a rationale for creating therapeutic home environments grounded in biophilic design (multisensory, environmental enrichment) and supporting physical activities, quality sleep, nutrition, music, stress reduction, self-efficacy, social support and health education, hence providing clinical benefits through the modulation of the autonomic nervous system, neuroplasticity and behavior change. These pleiotropic “active non-pharmacological ingredients” can be personalized for people living with depression, anxiety, migraine, chronic pain, cancer, cardiovascular and other conditions. We discuss prospects for integrating e-commerce with digital health platforms to create “therapeutic home environment” interventions delivered through digital therapeutics and their combinations with prescription drugs. This multimodal approach can enhance patient engagement while bridging consumer spending with healthcare outcomes. Full article

Background: Chronic non-cancer pain (CNCP) is one of the leading causes of disability. The use of strong opioids (SOs) in the management of CNCP is increasing, although evidence supporting their use remains limited. Primary care (PC) plays a key role in this context. Objectives: Our objectives were to determine the prevalence and profile of patients using SOs for CNCP in PC consultations in Valladolid in 2022, and to describe the consumption of SO prescribed for CNCP from 2020 to 2023. Methods: We conducted a descriptive and retrospective study using data extracted from the Pharmaceutical Consumption Information System of Castilla y León. Patients in Valladolid with SO use for more than three months due to CNCP were analyzed. Sociodemographic and clinical characteristics of these patients in 2022 were described. The number of defined daily doses (nº DDDs) and costs from 2020 to 2023 were analyzed. Results: A total of 3642 patients were included (0.7% of the population of Valladolid), 71.8% of whom were women. Of the patients, 62.4% were aged 70 or older, 39.8% lived in rural areas, and 9.9% resided in nursing homes. The most frequently prescribed SOs in nº DDDs were fentanyl and tapentadol. The highest consumption in nº DDDs was in patients who lived in nursing homes, were over 70 years old and were resident in rural areas. The number of DDDs from 2020 to 2023 for SOs in DCNO increased by 41%. Conclusions: In total, 0.7% of the population of Valladolid consumes SOs for CNCP, mostly women and people over 70 years old. The consumption of strong opioids in DDDs grew by 41% from 2020 to 2023. Full article

Implementation of pharmaceutical care for the benefit of patients and health services has been highlighted worldwide. Interprofessional collaboration between nurses, pharmacists, and physicians may contribute to raising awareness of pharmacological challenges, increasing quality, and minimising errors in pharmaceutical care. This study aimed to investigate how nurses, pharmacists, and physicians experience interprofessional collaboration in pharmaceutical care within community healthcare in Norway. The study had an explorative and descriptive design with a qualitative approach. Individual interviews were conducted with 12 healthcare personnel with key roles in pharmaceutical care within community healthcare services. The data were analysed using systematic text condensation. The results revealed three categories and four subcategories: The category “Professional challenges” contained the subcategories “Blurred responsibilities” and “The importance of trust and continuity”. The category “Organisational barriers” contained the subcategories “Lack of information exchange and suitable communications channels” and “Lack of time and meeting places”. The third category was “Nurses—the important link”. This study reveals challenges to and factors of success in increasing high-quality and safe pharmaceutical care, knowledge that can be used in quality work in the community health services and as input in curriculum development for the three professions. Full article

Oral chemotherapy (OC) has been increasingly used in pediatric patients diagnosed with cancer, which is primarily managed in the outpatient setting. Different from adults, pediatric patients face unique challenges in administering these hazardous medications at home. Because of the complexity of pediatric pharmaceutical care and the hazardous nature of chemotherapy agents, comprehensive patient education is imperative to mitigate the potential safety risks associated with OC administration at home. Pharmacists play a vital role in patient education and medication consultations. However, the lack of practice guidelines and limited resources supporting OC counseling are noted. Additional barriers include insufficient knowledge and training on OC, which can be improved by continuing education. In a regional children’s hospital, a comprehensive OC education checklist was developed for pediatric patients and their caregivers to standardize consultations led by pharmacists. An infographic OC handout was also formulated to improve patient knowledge and awareness. Moreover, innovative approaches such as using telepharmacy, smartphone applications, and artificial intelligence have been increasingly integrated into patient care, which can help optimize OC consultations for children and adolescents. Further studies are warranted to enhance oral chemotherapy education specifically tailored for pediatric patients in outpatient settings. Full article

The exploitation of unavoidable food supply chain wastes resulting from primary and secondary processing for chemicals, materials, and bioenergy is an important concept in the drive towards circular-based, resource-efficient biorefineries rather than petroleum refineries. The potential production of hydrogels (materials) from unavoidable food supply chain wastes, which are naturally rich in biopolymers such as cellulose, hemicellulose, pectin, and lignin, represents an interesting opportunity. However, these intertwined and interconnected biopolymers require separation and deconstruction prior to any useful application. Thus, this study aims to explore the formation of hydrogels from defibrillated celluloses (MW-DFCs) produced via acid-free stepwise microwave hydrothermal processing of blackcurrant pomace residues. Initially, pectin was removed from blackcurrant pomace residues (MW, 100–160 °C), and the resultant depectinated residues were reprocessed at 160 °C. The pectin yield increased from 2.36 wt.% (MW, 100 °C) to 3.07 wt.% (MW, 140 °C) and then decreased to 2.05 wt.% (MW, 160 °C). The isolated pectins were characterized by attenuated total reflectance infrared spectroscopy (ATR-IR), thermogravimetric analysis (TGA), and ¹³C NMR (D₂O). The cellulosic-rich residues were reprocessed (MW, 160 °C) and further characterized by ATR-IR, TGA, and Klason lignin analysis. All the MW-DFCs contained significant lignin content, which prevented hydrogel formation. However, subsequent bleaching (H₂O₂/OH⁻) afforded off-white samples with improved gelling ability at the concentration of 5% w/v. Confocal laser microscopy (CLSM) revealed the removal of lignin and a more pronounced cellulosic-rich material. In conclusion, the microwave-assisted defibrillation of blackcurrant pomace, an exploitable unavoidable food supply chain waste, affords cellulosic-rich materials with the propensity to form hydrogels which may serve useful applications when put back into food products, pharmaceuticals, cosmetics, and home and personal care products. Full article

Among the challenges to the 21st-century health care industry, one that demands special mention is the transport of drugs/active pharmaceutical agents across the blood–brain barrier (BBB). The epithelial-like tight junctions within the brain capillary endothelium hinder the uptake of most pharmaceutical agents. With an aim to understand more deeply the intricacies of cell-penetrating and targeted peptides as a powerful tool for desirable biological activity, we provide a critical review of both CPP and homing/targeted peptides as intracellular drug delivery agents, especially across the blood–brain barrier (BBB). Two main peptides have been discussed to understand intracellular drug delivery; first is the cell-penetrating peptides (CPPs) for the targeted delivery of compounds of interest (primarily peptides and nucleic acids) and second is the family of homing peptides, which specifically targets cells/tissues based on their overexpression of tumour-specific markers and are thus at the heart of cancer research. These small, amphipathic molecules demonstrate specific physical and chemical modifications aimed at increased ease of cellular internalisation. Because only a limited number of drug molecules can bypass the blood–brain barrier by free diffusion, it is essential to explore all aspects of CPPs that can be exploited for crossing this barrier. Considering siRNAs that can be designed against any target RNA, marking such molecules with high therapeutic potential, we present a synopsis of the studies on synthetic siRNA-based therapeutics using CPPs and homing peptides drugs that can emerge as potential drug-delivery systems as an upcoming requirement in the world of pharma- and nutraceuticals. Full article

Citrus is one of the main fruit crops cultivated in tropical and subtropical regions worldwide. Approximately half (40–47%) of the fruit mass is inedible and discarded as waste after processing, which causes pollution to the environment. Essential oils (EOs) are aromatic compounds found in significant quantities in oil sacs or oil glands present in the leaves, flowers, and fruit peels (mainly the flavedo part). Citrus EO is a complex mixture of ~400 compounds and has been found to be useful in aromatic infusions for personal health care, perfumes, pharmaceuticals, color enhancers in foods and beverages, and aromatherapy. The citrus EOs possess a pleasant scent, and impart relaxing, calming, mood-uplifting, and cheer-enhancing effects. In aromatherapy, it is applied either in message oils or in diffusion sprays for homes and vehicle sittings. The diffusion creates a fresh feeling and enhances relaxation from stress and anxiety and helps uplifting mood and boosting emotional and physical energy. This review presents a comprehensive outlook on the composition, properties, characterization, and mechanism of action of the citrus EOs in various health-related issues, with a focus on its antioxidant properties. Full article

Over the past several years, the adoption of HealthCare Monitoring Systems (HCS) in health centers and organizations like hospitals or eldery homes growth significantly. The adoption of such systems is revolutionized by a propelling advancements in IoT and Blockchain technologies. Owing to technological advancement in IoT sensors market, innovations in HCS to monitor patients health status have motivated many countries to strength their efforts to support their citizens with such care delivery systems under the directives of a physician who has access to patient’s data. Nevertheless, secure data sharing is a principal patient’s concern to be comfort to use such systems. Current HCS are not able to provide reassuring security policies. For that, one of our focus in this work, is to provide security countermeasures, likewise cost-efficient solution for HCS by integrating storage model based on Blockchain and Interplanetary File Systems (IPFS). Blockchain technology is an emerging solution in pharmaceutical industry and starts to take place for HCS and allows HealthCare providers to track connected devices and control access to shared data, hence protecting patients’ privacy. Furthermore, the addition of Edge and Fog computing has improved HCS to react in real-time and enhance their reliability. A variety of communication protocols can connect sensor devices to edge/Fog layer and the best choice will depend upon connectivity requirements: range, bandwidth, power, interoperability, security, and reliability. Instead, systems efficiency would decline and hurt if communication protocol is inconsistent. LoRa (Long Range) communications technology is emerging as the leader among Low-Power Wide-Area Networks (LPWANs) entering the IoT domain benefiting from many features such as long-range distances and low power consumption. This work proposes LoRaChainCare, an architecture model for HCS which combines the technologies Blockchain, Fog/Edge computing, and the LoRa communication protocol. A real implementation of LoRaChainCare system is presented and evaluated in terms of cost, run time and power consumption. Full article

The world is experiencing a global pandemic with COVID-19, for which few measures have proven their efficiency. Prevention through lockdown belongs to the portfolio of Non-Pharmaceutical Intervention (NPI). The implementation of a lockdown comes with a potential health care benefit balanced with an economic and human cost: people are constrained to stay in their homes. Households hence have to live together in what we call “zero-space”, which means within the walls of their flat or house. The loss of “space-domain” freedom, preventing them to move in “free” space is accompanied by a continued “time-domain” freedom with the possibility to allocate their time, and what they do with it, within the location they are not permitted to leave (with very defined exceptions). We study the microeconomics framework in such a setting, starting from the rules shaping such a “nano-market” with very few agents (the members of the household), and its consequence for nano-economic interaction. Since the behaviour of the agents is hyperconstrained in the space domain and relatively free in the time domain, behavioral economics is used to describe decisions made in the home, for the actions remaining possible during lockdown. A minimal set of rules is introduced and illustrated to describe efficiently the agents at play in this new and particular context, which has been replicated worldwide during the pandemic. Hypotheses for this model are presented and discussed, so as to allow future variations and adaptations for other specific cases with different options chosen. Such hypotheses concern agents, their interests, behaviours, and the equivalent of non-financial “nano-market transactions and contracts”. Full article

More than 40% of the deaths recorded in the first wave of the SARS-CoV-2 pandemic were linked to nursing homes. Not only are the residents of long-term care facilities (LTCFs) typically older and more susceptible to endemic infections, the facilities’ high degree of connection to wider communities makes them especially vulnerable to local COVID-19 outbreaks. In 2008, in the wake of the SARS-CoV-1 and MERS epidemics and anticipating an influenza pandemic, we created a stochastic compartmental model to evaluate the deployment of non-pharmaceutical interventions (NPIs) in LTCFs during influenza epidemics. In that model, the most effective NPI by far was a staff schedule consisting of 5-day duty periods with onsite residence, followed by an 4-to-5 day off-duty period with a 3-day quarantine period just prior to the return to work. Unlike influenza, COVID-19 appears to have significant rates of pre-symptomatic transmission. In this study, we modified our prior modeling framework to include new parameters and a set of NPIs to identify and control the degree of pre-symptomatic transmission. We found that infections, deaths, hospitalizations, and ICU utilization were projected to be high and largely irreducible, even with rigorous application of all defined NPIs, unless pre-symptomatic carriers can be identified and isolated at high rates. We found that increasingly rigorous application of NPIs is likely to significantly decrease the peak of infections; but even with complete isolation of symptomatic persons, and a 50% reduction in silent transmission, the attack rate is projected to be nearly 95%. Full article

Nowadays, humanity is confronted with one of the most difficult challenges. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified for the first time in Hubei, China in December 2019 and produced the COVID-19 pandemic, a devastating disease that led to many complications and deaths. The authorities and the global healthcare system have been alerted regarding the prevention and treatment of this pathology. Even though worldwide quarantine was declared, health care professionals, including pharmacists, have been at the frontline in this war. Since the beginning of the pandemic, the authorities relied on the involvement of the community, hospital, or clinical pharmacists in offering support to the entire population. Also, the authorities implemented measures for emergency authorization of the vaccines, or the drugs used in COVID-19 treatment. In order to facilitate the population’s access to healthcare services, the authorities have established regulations regarding, the extension of prescriptions by pharmacists, working hours, prevention of shortages and price-increase, drive-thru services, etc. However, several countries have taken financial measures to support the pharmacies’ activity. At the same time, pharmaceutical associations elaborated guidelines for the protection of pharmacists and patients alike. Additionally, the pharmacies have come to support the health system and patients by adapting pharmaceutical care to the new needs like preparation and supply of disinfectants, patient care, information, and counseling, especially to COVID-19 patients, as well as the implementation of home drugs-delivery systems. The important roles played by pharmacists were to perform COVID-19 tests and further vaccines, as well as to combat the abundance of misinformation and fake news. The clinical and hospital pharmacy services have also been adapted. Strengthening the role of the pharmacist in the medical team was important for the purpose of providing correct and complete information regarding drugs used in the COVID-19 pathology. In all these activities, pharmacists needed creativity and professionalism, but also the support of pharmacy owners and managers. With this crisis, pharmaceutical care has entered a new phase, demonstrating the ability of pharmacists to be competent and accessible providers of public health. Based on this information, we conducted a narrative review whose purpose was to identify the impact of the authorities’ decisions on pharmaceutical practice, the involvement of professional associations, and the responsibilities of the pharmacy owners and management. On the other hand, we performed a global assessment on the pharmaceutical care services provided by community pharmacists as well as by clinical or hospital pharmacists during the COVID-19 pandemic. Full article