Information du patient par le pharmacien en officine

The pharmacist, practicing in city pharmacy, has a duty of information of the patient, what is not easy within the framework of a sale of medicine in the presence of other customers. His duty exists that the medicine was prescribed or not, and his responsibility can be committed in both cases. These last years, the profession evolves with new perspectives as for the missions and for the role of the pharmacist. Since the law Hospital patients health territory (HPST) of 2009, in particular, the pharmacists mobilize to widen their missions with the patients so that their activity overtakes the simple dispensation of medicine. The pharmacist has to participate in the cooperation between healthcare professionals, in the mission of public service of the office of the care, in the therapeutic education and in the actions of support of the patients. So numerous novelties spread within pharmacies, either by a political will, through new regulations, or by initiatives appropriate to the pharmacists, in particular in the ordinal plan, with the pharmaceutical file.     

L’acceptation située des technologies dans et par l’activité : premiers étayages pour une clinique de l’usage

The aim of this paper is to consider that a complementary way to evaluate the acceptance of technology in the work is possible; the acceptance situated. From a critical review of the classical models of acceptability (social and practical) on the one hand, and relying on models of the activity and theories of appropriation on the other hand, we show that it is necessary to insert the ICT in its social thickness, that is to say in a more comprehensive and complex as richer activity system (real). We will discuss the four dimensions to be considered to evaluate this acceptance situated. We also indicate how this approach can become an instrument of the development of activity and can contribute to a process of (re)creation of technical instruments, laying the foundations of what we have named a clinical usage.     

Religious and spiritual struggle: prevalence and correlates among older adults with depression in the BRIGHTEN Program

Older adults (OA) are more religious and/or spiritual (R/S) than younger adults, but some experience R/S struggle which is associated with poorer quality of life. Little is known about R/S struggle in community dwelling OA. This study examines prevalence, correlates, the association with depression for R/S struggle, and a desire for spiritual care in community dwelling OA with depression. In a programme for integrating care for these OA, 188 participants provided demographic information along with the Geriatric Depression Scale and a tool screening for potential R/S struggle. Prevalence of potential R/S struggle was 50%. The younger OA and Caucasian individuals vs. Hispanic individuals were more likely to experience potential R/S struggle. A relationship of potential R/S struggle with depression persisted with the inclusion of controls. Of those with potential struggle, 52% wanted to see a chaplain. Screening for potential R/S struggle can play an important role in choosing specific interventions for OA with depression.     

An Application of the Complier Average Causal Effect Analysis to Examine the Effects of a Family Intervention in Reducing Illicit Drug Use among High‐Risk Hispanic Adolescents

The Complier Average Causal Effect (CACE) method has been increasingly used in prevention research to provide more accurate causal intervention effect estimates in the presence of noncompliance. The purpose of this study was to provide an applied demonstration of the CACE analytic approach to evaluate the relative effects of a family‐based prevention intervention, Familias Unidas, in preventing/reducing illicit drug use for those participants who received the intended dosage. This study is a secondary data analysis of a randomized controlled trial designed to evaluate the relative efficacy of Familias Unidas with high‐risk Hispanic youth. A total of 242 high‐risk Hispanic youth aged 12–17 years and their primary caregivers were randomized to either Familias Unidas or Community Practice and assessed at baseline, 6 months and 12 months postbaseline. CACE models were estimated with a finite growth mixture model. Predictors of engagement were included in the CACE model. Findings indicate that, relative to the intent‐to‐treat (ITT) analytic approach, the CACE analytic approach yielded stronger intervention effects among both initially engaged and overall engaged participants. The CACE analytic approach may be particularly helpful for studies involving parent/family‐centered interventions given that participants may not receive the intended dosage. Future studies should consider implementing the CACE analysis in addition to ITT analysis when examining the effects of family‐based prevention programs to determine whether, and the extent to which, the CACE analysis has more power to uncover intervention effects.     

Construction and evaluation of a self rating scale for stress‐induced Exhaustion Disorder,the Karolinska Exhaustion Disorder Scale

Prolonged stress (≥ six months) may cause a condition which has been named exhaustion disorder (ED) with ICD‐10 code F43.8. ED is characterised by exhaustion, cognitive problems, poor sleep and reduced tolerance to further stress. ED can cause long term disability and depressive symptoms may develop. The aim was to construct and evaluate a self‐rating scale, the Karolinska Exhaustion Disorder Scale (KEDS), for the assessment of ED symptoms. A second aim was to examine the relationship between self‐rated symptoms of ED, depression, and anxiety using KEDS and the Hospital Anxiety and Depression Scale (HAD). Items were selected based on their correspondence to criteria for ED as formulated by the Swedish National Board of Health and Welfare (NBHW), with seven response alternatives in a Likert‐format. Self‐ratings performed by 317 clinically assessed participants were used to analyse the scale's psychometric properties. KEDS consists of nine items with a scale range of 0–54. Receiver operating characteristics analysis demonstrated that a cut‐off score of 19 was accompanied by high sensitivity and specificity (each above 95%) in the discrimination between healthy subjects and patients with ED. Reliability was satisfactory and confirmatory factor analysis revealed that ED, depression and anxiety are best regarded as different phenomena. KEDS may be a useful tool in the assessment of symptoms of Exhaustion Disorder in clinical as well as research settings. There is evidence that the symptom clusters of ED, anxiety and depression, respectively, reflect three different underlying dimensions.     

Personality correlates of risky health outcomes: Findings from a large Internet study

Numerous studies have documented the effects of personality on health outcomes. However, which traits are most relevant to health, and the precise magnitude of their effects, is inconsistent across studies. The present study used a large sample (N = 460,172) to replicate and extend the relations between the Big Five and three health-related outcomes: self-reported health, body mass index, and substance use. Low Conscientiousness predicted all outcomes, indicating that individuals who are less responsible and less self-controlled tend to report poorer health, be more overweight, and engage in more substance use. Individuals who were more emotionally unstable (high Neuroticism) reported poorer health, and individuals prone to seek out social experiences and rewards (high Extraversion) engaged in more frequent substance use.     

La « préparation magistrale » en droit français : un lot exclusif par patient ?

Outpatient pharmaceutical needs are not always met by industrial products and do not necessarily justify hospitals activation. Preparing in advance and storing a batch of compounded drugs for one or more patients with identical/recurrent needs – as part of compound outsourcing in ambulatory sector – raises issues. While the french law does not expressly provide (and according to prevailing interpretations excludes) this hypothesis, it seems to us to be possible – in contrast to the prominent french judicial and administrative courts, as well as to the European Court of justice. We here propose to reset the debate within both the existing laws and a systemic perspective, and call for a normative clarification.     

The Brief Cognitive Impairment Scale (BCIS): preliminary investigation of a severe-stage dementia test emphasizing cognitive processing and interpersonal tolerance

We describe the development and validation of The Brief Cognitive Impairment Scale (BCIS), a cognitive screening instrument designed for persons with severe-stage dementia. Psychometric analyses were performed on neuropsychological data from long-term care residents (N = 247) who completed a brief battery of tests, including the BCIS. A principle component analysis yielded three factors that provide insight into how persons with severe dementia cognitively process information and may tolerate specific aspects of social stimulation, such as during personal care. A BCIS cut score can be used to identify severe dementia with a sensitivity of .82, a specificity of .84, and an area under the curve of .89. It may be used by clinicians or caregivers when advanced dementia is suspected, as an alternative to measures with suspected floor effects, when residents cannot tolerate more demanding assessment tools, and as part of non-pharmacologic treatment plans for behavior disturbances associated with dementia.     

Identifying Students at Risk: An Examination of Computer-Adaptive Measures and Latent Class Growth Analysis

Multitiered systems of support depend on screening technology to identify students at risk. The purpose of this study was to examine the use of a computer-adaptive test and latent class growth analysis (LCGA) to identify students at risk in reading with focus on the use of this methodology to characterize student performance in screening. Participants included 3,699 students in Grades 3–5. Three time points of administration (fall, winter, and spring) of the computer-adaptive reading measure were selected. LCGA results indicated 6–7 classes, depending on grade, informed by level and growth in student performance that significantly predicted failure on the statewide test administered at the end of the year. The lowest-performing classes had failure rates above 90% across all grades. The results indicate that identifying homogeneous groups of learners through LCGA may be valuable as an approach to determining students who need additional instruction. Practical implications and future directions are discussed.