Experience of Drug Abusers Participating in Community-Based Drug Rehabilitation Services Provided by the Counselling Centres for Psychotropic Substance Abusers (CCPSAs) in Hong Kong

Despite the official statistics showing that the number of drug users has been declining, the problem of drug abuse remains serious in Hong Kong. This problem is evidenced by the trend of hidden and prolonged drug abuse. The recovery of drug abusers is an important process, because the misuse of drugs can cause many bio-psycho-social complications. Therefore, 11 Counselling Centres for Psychotropic Substance Abusers (CCPSAs) in different districts in Hong Kong play an important role on those drug abusers [1]. As a core community-based drug rehabilitation service in Hong Kong, studies about CCPSAs are limited. This study uses a descriptive qualitative approach to explore the experience of drug abusers participating in community-based drug rehabilitation services provided by CCPSAs. Five CCPSA users, who utilized the services for more than two months, participated in the semi-structured face-to-face interviews. Data collected were then analysed by thematic analysis, and five themes were generated: 1) receiving supportive counselling service in CCPSAs, 2) revealing variance towards nonmandatory services in CCPSAs, 3) encountering intrapersonal conflicts when participating in CCPSAs, 4) expanding social network through integration in group activities and 5) wishing to be a companion to other drug abusers. Findings of this study provide valuable insights towards services modification and the enhancement of drug rehabilitation and drug abusers’ wellbeing over the collaboration of healthcare workers, services providers and the media. However, this study has some limitations, and it presents suggestions for future research.

Roles of Community Pharmacists in Screening and Disseminating of Information about Non-Steroidal Anti-Inflammatory Drugs Risks: Implications for Drug Safety Assessment

Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.

Stroke Patients’ Reintegration into Normal Living Post-Discharge from Inpatient Rehabilitation: An Integrative Review

Background: Stroke rehabilitation professionals have historically focused rehabilitation on physical functions and overlooked the concept of community reintegration after discharge from inpatient rehabilitation. The lack of focus on psychosocial functions post-stroke may lead to lower levels of satisfaction during community reintegration. Methods: This integrative review synthesized findings from research literature on stroke patients’ reintegration into the community after inpatient rehabilitation to address three research questions: a) What specific physical and psychosocial functions have been identified as predictors of successful reintegration into normal living after stroke?, b) How do physical and psychosocial functions promote successful reintegration into normal living after stroke?, and c) What factors have been identified that hinder stroke patients’ reintegration into normal living after stroke? Results: A systematic search of literature identified sixteen studies that provided significant context for the research questions. What physical and psychosocial functions of stroke patients included, for example, improved mobility, independence in daily activities, reduced disability, psychological well-being, self-efficacy, social support, and personal relationships. How physical and psychosocial functions promote reintegration included, for example, disability management, emotional well-being, self-care independence, sense of purpose, and employment influence. Factors that hinder stroke patients’ reintegration consisted of longer stride time, impaired balance/mobility, activities limitation, severe stroke, presence of comorbidity, depressive symptoms, speech and language challenges, inadequate self-efficacy, fear of falling, older age, low educational level, lack of social support, and social isolation. Conclusion: Successful community reintegration after stroke requires a shift of focus from rehabilitation interventions that target physical functions to include interventions that address psychosocial functions.

Participatory Land Rehabilitation Strategies in Angacha District, Kembata Zone, Central Ethiopia Region

Community participation has become widely incorporated into policies of many soil and water conservation organizations. The purpose of this study was to assess the community participation in the rehabilitation of degraded land. In order to achieve the objective of the study, both primary and secondary data were generated by employing qualitative and quantitative data. Purposive sampling was employed to select three study kebeles (the smallest administrative structure of the country) from 16 rural kebeles in Angecha District. Simple random sampling technique was used to select 183 household heads from the lists of farmers in the selected kebeles for detailed household survey. In addition to household survey, field observation and key informant interview were also conducted to collect the necessary data. The data were presented using descriptive statistic such as percentage, frequency, tables and figure. The data collected through the use of household survey questionnaires were analyzed using logit regression while data collected through field observation and key informant interview were analyzed and interpreted using qualitative description. The findings of the present study revealed that population pressure, soil erosion, deforestation, overgrazing, and over cultivation were the major causes for land degradation. Moreover, the results of this study indicated that the main causes of the low productivity of farmland were farmers’ involvement in off-farm activities, increase in size of human population, lack of full cooperation of family members to involve in land rehabilitation practices. Households participated in rehabilitation practices at different levels, with 43.7% respondents showing intermediate participation. However, 22.4% of the farm households clarified that there is low experience sharing and motivation to participate in the process of implementation of rehabilitation programs. It is recommended that, continuous training and experience sharing program, immediate action to increase the number of literate persons, to practicing compatible practices for the agro climatic zone such as soil bund, Fanyaaju, stone bunds, and tree planting, extending effective practices, create opportunities for alternative means of livelihood and promoting NGOs effort to involve in land rehabilitation practices in the highly degraded area.

Characterization of α-conotoxin TxIB and TxID for smoking cessation and drug rehabilitation

Nicotinic acetylcholine receptors(nAChRs) are widely distributed ligand gated ion channels throughout the peripheral and central nervous systems of mammals.There are 16 different n AChR subunits,α1-α7,α9,α10 and β1-β4,as well as γ,δ,and ε,which assemble into pentamers to form different nAChR subtypes with distinct pharmacological properties in mammals.Among them α6β2*(*designates other possible subunit),α3β4 and α4β2 nAChR subtypes are potential therapeutic targets for the treatment of addiction.However,various n AChR subtypes are very difficult to pharmacologically distinguish from each other.The α6* n AChRs are expressed by dopaminergic neurons in the central nervous system,which modulate the release of dopamine and are believed to be important in mediating tobacco,morphine,cocaine and ethanol addiction.The α3β4 nAChRs present in the medial habenula with important role in influencing nicotine addiction.Blockage of α3β4 nAChRs in the medial habenula decreased the dose of nicotine that rodents would self-administer.Thus,new antagonists of α6β2* or α3β4 nA ChR subtypes are of considerable interest,which would give strategies to selectively modulate α6β2* or α3β4 nA ChR function.We characterized an α-conotoxin(α-CTx)TxIB with 16 amino acids and an α-CTx TxID with 15 amino acids from Conus textile.The sequence of TxIB is GCCSDPPCRNKHPDLCamide.The sequence of TxID is GCCSHPVCSAMSPIC with C-terminal amidation too.Both peptides with a Ⅰ-Ⅲ and Ⅱ-Ⅳ disulfide con-nectivity were chemically synthesized.The residues between Cys-Ⅱ and Cys-Ⅲ and Cys-Ⅲand Cys-Ⅳ of α-CTx are commonly referred to as loops 1 and 2,respectively.The number of residues in each of these loops is used to further classify the α-CTx.So TxIB is classified as a 4/7α-CTx,whereas the α-CTx TxIB has a 4/6 spacing.Both peptides were tested on rat nAChRs heterologously expressed in Xenopus laevis oocytes.The α-CTx TxIB blocked α6/α3β2β3 nAChR with an IC50 of 28 nmol·L^(-1),which showed little or no block of all the other tested subtypes at concentrations up to 10 μmol·L^(-1).TxIB blocking α6/α3β2β3 nAChR is rapidly reversed after toxin washout.The ability ofα-CTx TxIB to discriminate between α6/α3β2β3 and the other nAChR receptors is unique.There are no small molecules have this selectivity profile.Previously described α-CTx that potently blockα6/α3β2β3 nA ChR s also block either α6/α3β4 nAChRs,α3β2 nAChRs and(or) other nAChRs subtypes.TxID was the very potent α3β4 nAChR antagonists blocking rat α3β4 n AChRs with an IC-50 of 12.5 nmol·L1.However,TxID also blocked the closely related α6/α3β4 with an IC50 of 94 nmol·L^(-1).In fact,the expression profile ofα3β4 nAChRs and α6/α3β4 nAChRs overlap in a variety of tissues.So TxI D can′t differentiate α3β4 nA ChR from α6/α3β4 nA ChR effectively.To distinguish between these two close subtypes,positional-scanning mutagenesis of TxID was performed to identify critical residues that confer potency for α3β4 nAChRs,and hope to obtain more selective mutant to discriminate between these two close subtypes.The effects of 15 analogues and TxID were tested on both α3β4 and α6/α3β4 nAChRs.An analogue,ie [S9 A]TxID had46-fold greater potency for α3β4 versus α6/α3β4 nAChRs,which showed significantly improved selectivity for α3β4 versus α6/α3β4 nAChRs.Both TxI D and [S9 A]TxI D had little activity on other nA ChR subtypes.The three-dimensional solution structures of TxIB,TxID and [S9 A]TxID were determined using NMR spectroscopy.α-CTx TxI B,TxID and [S9 A]TxID represent uniquely selective ligand for probing the structure and function of α6β2*and α3β4 nA ChR s respectively.It is known about20% people have used drugs recreationally resulting in a substance use disorder finally.Therefore,structural insights derived from these ligands may facilitate the development of novel therapeutics for addiction involving α6β2* and α3β4 nA ChR s.

Work as An Effective Intervention Strategy and Rehabilitation Treatment Program for People Who Abuse Drugs And Alcohol

Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of life. Current American societal expectations are that individuals who identify!they are involved in substance abuse will go to treatment, eventually recover, get off public assistance straightaway, and return to work. Most rehabilitation professionals also maintain the same expectations. The reality is that efforts of prevention do not appear to diminish the number of people with substance abuse. Traditional treatment appears to have minimal, if any, influence upon the cessation of substance abuse, and traditional vocational rehabilitation practices appear unsuited for the unique problems and types of symptoms experienced by substance abusers. Creative, yet sound, alternatives that combine effective treatment strategies and non-traditional vocational rehabilitation methods need to be exqlored and tested for effectiveness, and applied.

BCI+VR Rehabilitation Design of Closed-Loop Motor Imagery Based on the Degree of Drug Addiction

After abusing drugs for long,drug users will experience deteriorated self-control cognitive ability,and poor emotional regulation.This paper designs a closed-loop virtual-reality(VR),motorimagery(MI)rehabilitation training system based on brain-computer interface(BCI)(MI-BCI+VR),aiming to enhance the self-control,cognition,and emotional regulation of drug addicts via personalized rehabilitation schemes.This paper is composed of two parts.In the first part,data of 45 drug addicts(mild:15;moderate:15;and severe:15)is tested with electroencephalogram(EEG)and near-infrared spectroscopy(NIRS)equipment(EEG-NIRS)under the dual-mode,synchronous signal collection paradigm.Using these data sets,a dual-modal signal convolutional neural network(CNN)algorithm is then designed based on decision fusion to detect and classify the addiction degree.In the second part,the MIBCI+VR rehabilitation system is designed,optimizing the Filter Bank Common Spatial Pattern(FBCSP)algorithm used in MI,and realizing MI-EEG intention recognition.Eight VR rehabilitation scenes are devised,achieving the communication between MI-BCI and VR scene models.Ten subjects are selected to test the rehabilitation system offline and online,and the test accuracy verifies the feasibility of the system.In future,it is suggested to develop personalized rehabilitation programs and treatment cycles based on the addiction degree.

An Exploratory Study on the Meaning of Using Community Psychiatric Rehabilitation among Persons with Psychiatric Disabilities

This study explores the meaning of the use of community psychiatric rehabilitation(CPR)services to gain knowledge to improve services and shed more light on how to facilitate recovery.The topics explored included:the motivation for participation,perception and expectation towards CPR,the interactions with professionals in the CPR Center,and the feelings towards activities.A qualitative approach was adopted,and 30 consumers were interviewed face-to-face by using semi-structured interview guide.Data were analyzed using the open coding method of grounded theory.The consumer accounts provided information on the eight aspects of CPR services.The findings revealed that the CPR Center created a lifeworld,a friendly place similar to home with structure and activities.Professional relationship was the key change agent for rehabilitation.Most professionals adopted recovery-oriented approach to empower participants by giving opportunities and choices.The essential ingredients of this lifeworld covered rehabilitation goals,physical exercises,psychological impact,social interactions,learning,and economic gains.The services were venues for interpersonal interactions and provided structure for daily life,which helped consumers reach their rehabilitation goals and brought existential meaning to their lives.Yet,the accounts also revealed negative phenomena in the CPR center.Suggestions were made to improve services.

Study on the feasibility of five tones combined with electric acupuncture therapy for drug rehabilitation

Objective:To explore the feasibility of five tones combined with electro-acupuncture for drug rehabilitation.Methods:Search and screen the literature related to drug rehabilitation with musical electrico-acupuncture in PubMed,CNKI,CQVIP and Wanfang data to May 2019,and summarize and analyze the literature.Results:Either music therapy or acupuncture therapy has therapeutic responses respectively,and the combined use of both is more effective than the single-use.Conclusion:The combination of five tones and acupuncture is highly feasible for drug rehabilitation.

Positioning and function of secondary general hospital in community rehabilitation of disabled persons-a case study of a secondary general hospital in Changsha city

Objective:the positioning of secondary hospitals in the community rehabilitation work system and the status of community medical rehabilitation ser-vices for the disabled in Changsha were clarified through investigation and study of the 2019 income of a second-ary general hospital in Changsha.Suggestions from var-ious parties were integrated to provide feasible ideas for expanding the role of secondary hospitals in community rehabilitation.Methods:the 2019 income of a secondary general hospital in Changsha was statistically analyzed,a community rehabilitation questionnaire was designed,and a field survey was carried out focusing on 19 issues including rehabilitation service items,rehabilitation facil-ities and equipment,and the satisfaction of rehabilitation practitioners.Results:in the total hospitalization expenses of a secondary general hospital in Changsha city in 2019,rehabilitation physiotherapy expenses accounted for 7%,and drug treatment expenses accounted for 25%.In addi-tion,in the survey of community rehabilitation service sat-isfaction for the disabled,the difference between the very dissatisfied and very satisfied groups was statistically sig-nificant(P<0.05).Conclusion:taking a secondary gener-al hospital in Changsha city as an example,the treatment methods in secondary general hospitals are still dominated by traditional drug therapy,and the disabled are not sat-isfied with community rehabilitation services.Therefore,rehabilitation treatment projects to meet the rehabilitation needs of the disabled should be promoted in hospitals.

Comprehensive therapeutic effect of the stroke rehabilitation unit in a medium-sized comprehensive community hospital

BACKGROUND： Acute stroke unit （stroke care unit） is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-sized comprehensive community hospital （secondary hospital）, where medical facility is relatively insufficient, is a new pathway to satisfy stroke patients. OBJECTIVE： To observe the comprehensive effect of developing stroke rehabilitation unit based on the facility of secondary hospital and its feasibility. DESIGN： Non-randomized concurrent controlled observation SETTING： Department of Neurology, Beijing Longfu Hospital PARTICIPANTS： Totally 264 stroke reconvalescents who suffered stroke for 7 days and received treatment in the Department of Neurology, Beijing Longfu Hospital during June 2003 to June 2005 were involved in the study. All the involved patients were confirmed by CT or MRI. The patients were scored by using Modified Edinbergh-Scandinavia stroke scale （SSS） 〉 16 points. Written informed consents were obtained from all the patients. The patients were assigned into 2 groups according to the willing of patients and their relatives： （1）treatment group, in which, there were 134 patients, 76 males and 58 females, aged 43 to 74 years; cerebral infarction was found in 116 cases and cerebral hemorrhage in 18 cases;（2） control group, in which, there were 130 patients, 66 males and 64 females, aged 45 to 77 years, cerebral infarction was found in 115 cases and cerebral hemorrhage in 15 cases. There were significant differences in baseline data of the patients between two groups. METHODS： A same basic treatment was conducted in the patients of the two groups. （1） Patients in the treatment group admitted to stroke rehabilitation unit and received comprehensive rehabilitation treatment. The rehabilitation flow-sheet： randomization-letting the patients of treatment group go into the unit-making comprehensive assessment in the initial stage-making therapy plan-talking with patients and their other family members-general rehabilitation-making metaphase assessment-adjusting therapy plan-making final assessment-letting the patients discharge and doing follow-up visits. （2） The patients in the control group admitted to common wards, and they were encouraged to do activities by themselves in the early stage, but did not receive rehabilitation training under the instructions from professional physicians. MAIN OUTCOME MEASURES： The following assessments were conducted on admission and 7 and 28 days after admission： （1） Severity of stroke and motor function： scored as 0 to 45 points by SSS, the higher points, the severer damage. （2）Activities of daily living： Evaluated by Barthel index, 110 points in total, 110 points meant normal, 0 point meant extremely poor. （3）Mental status： evaluated by Hopkin＇s symptom scale with a 5-point scoring. The symptom was scored with low to high points. （4）Cognitive function： Quantification measurement was conducted with LOTCA method. The higher points, the better therapeutic effects. RESULTS： （1） Three cases dropped out and one died in the treatment group, 11 cases dropped out and 4 died in the control group. （2）The neurologic impairment points on 7 and 28 days after therapy in the treatment group were lower than those in the control group separately [7 days：（9.73±6.43） points vs. （12.63± 7.87） points, t =2.28, P〈 0.05;28 days：（7.88±4.81） points vs. （9.84±7.03）points, t =2.04, P〈 0.05]. Barthel index on 7 and 28 days after therapy in the treatment group were higher than those in the control group separately [7 days：（54.28±8.38） points vs. （39.76±7.31） points, t =2.206, P 〈 0.05; 28 days： （89.72±7.94） points vs. （67.34±8.63） points, t =2.812, P 〈 0.01]. （4） Patients were allocated into different age groups based on age and evaluated with LOTCA. Results showed that there were no significant differences among different age groups （P 〉 0.05）. （5） Totally 160 patients in the two groups accomplished the Hopkin＇s test, among them, 94 （58.7%） had different mental disorders; Among the patients with mental disorder, depression, obsessive-compulsive and anxiety were found mostly, being 53.8%, 52.5% and 46.2%, respectively. CONCLUSION： （1） Developing stroke rehabilitation unit therapy in the secondary hospital can obviously improve the motor function and activities of daily living of stroke reconvalescents. （2） More than half of the stroke reconvalescents accompany the symptoms of depression, obsessive-compulsive, anxiety and other mental disorders. （3） The cognitive function of stroke reconvalescents is not related to age.

Plant community composition and interspecific relationships among dominant species on a post-seismic landslide in Hongchun Gully, China

The 5.12 Earthquake in 2008 and 8.14 Debris Flow in 2010 resulted in large-scale landslides that disturbed vast areas of vegetation in the Hongchun Gully, Wenchuan County, China. To define the specific characteristics of vegetation restoration during natural recovery after catastrophic events,vegetation species composition and interspecific associations were investigated on this typical landslide. Field survey data selected from a total of 51 sample plots belonged to seven belt transects and were analysed by Schluter's variance ratio, pearson's chi-squared test, Spearman's correlation coefficients and ecological species groups. Plant communities on the landslide consisted of 78 species, 65 genera and52 families. Of the total of 78 species, 25 are identified as dominant species, among which Camptotheca acuminate, Toxicodendron vernicifluum, Coriaria nepalensis, Robinia pseudoacacia, Buddleja alternifolia, Anemone vitifolia and Nephrolepis auriculata play a constructive role during the natural afforestation. Moreover, according to environmental and ecological factors, these 25 dominant species could be divided into four ecological species groups.This study found that even though the landslide had frequently suffered from interference due to heavy rain, the vegetation succession processes are ongoing,and it is now at a shrub–herb community succession stage, which indicates that vegetation can naturally recover in the denuded sites. This study provides a useful insight into the ecological interactions and interdependence between plant species during the natural recovery of vegetation and provides valuable information on vegetation recovery modelling in the landslide area.

Role of Community Health Practitioners in National Development: The Nigeria Situation

This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunity of the community to prevent transmission of disease pathogen to cause a disease. Community Health Practitioners are the frontline Primary Health Care Professionals charged with the responsibility of implementation of immunization programmes in Nigeria and therefore contributing significantly to the prevention and control of targeted vaccine preventable diseases in Nigeria Health System. Our findings on factors militating against Community Health Practitioners’ Roles in National Development as elicited in this paper may form basis for empirical studies to determine the level of significance of each of these factors. In conclusion, it is when the Community Health parameters are adequately addressed that we can ensure sustainable National Development and we can say we have succeeded in our various strategic agenda of government at whatever level that makes up the complex whole. This brings to fore, the importance of the roles of Community Health Practitioners in health care delivery to National Development in the context of our country, Nigeria.

Comparason of Peri-Articular Multimodal Drug Injection with Femoral and Sciatic Nerve Block after Total Knee Arthroplasty

Good perioperative analgesia following total knee arthroplasty facilitates rehabilitation and may reduce hospital stay. We present the patient analgesic requirements and rehabilitation of a prospective single surgeon series after the introduction of a multimodal drug injection during his total knee arthroplasty. Basic epidemiological data as well as analgesic, antiemetic requirements and time to straight leg raised was collected on 27 consecutive patients (group 1) whom received the multimodal drug injection, consisting of levobupivacaine, ketorolac and adrenaline at the time of their total knee arthroplasty under spinal anaesthesia. Their rehabilitation was compared to a retrospective review of patients who were case matched by age and sex (group 2n = 26), whom had received the unit standard of spinal anaesthetic and a femoral and sciatic block at the time of their operation. Patients in group 1 had significantly lower analgesic and antiemetic requirements than group 2. Group 1 also had a significantly shorter hospital stay. We have demonstrated that periarticular multimodal drug injection can improve perioperative analgesia and mobilisation following total knee arthroplasty as well as reducing opioid requirements and side effects.

Do Community Pharmacies in Saudi Arabia Provide Medication-Related Information to Nonbuyers? A Mysterious Shopper Survey

Background: Patient counseling service is an integral component of pharmacy practice in the community pharmacy. Counseling services should be provided to patients regardless of whether the patient has the intention to buy a medication or not. Objective: The aim of this study is to investigate the effect of the conflict between ethics and business objectives in Saudi Arabian private community pharmacies on patient counseling. Methods: Eighty pharmacies were randomly selected in Madinah, Saudi Arabia, and visited by mysterious shoppers following a preplanned scenario. Clients requested information on the correct use of a dry powder inhaler for bronchial asthma. A survey form was filled in by the clients immediately after the visit. Results: seventy-five pharmacies were included in the study. Seventy-seven percent of the pharmacists gave a varying content of information although the client showed no intention to buy the medication. Only 5% of pharmacists gave the full instructions regarding the correct handling of the device and using it for taking the correct dose. Around 68% of the pharmacists focused only on how to take the dose. Four percent of the pharmacists provided insufficient information. Around 23% of the pharmacists refused to give any information and referred the shopper to other sources for obtaining the required information. Conclusions: Although most of the pharmacists provided free counseling, the amount and level of information provided were generally insufficient. This illustrates the need for introducing clear policies and guidelines for providing free professional counseling services to patients in the community pharmacy setting in Saudi Arabia.

A Qualitative Study on What It Means for Patients with Schizophrenia Living in the Community to Remain on Medication

Background: Little is known about what the experience of “taking antipsychotics” means in a patient’s life. Therefore, this study aims to identify what it means for patients with schizophrenia living in the community to remain on medication. Methods: The participants were five residents of communities, who had been discharged from a psychiatric hospital, but were currently visiting a private psychiatric hospital. In this study, we used participants’ narratives as data and analyzed them according to the procedures described in “An Application of Phenomenological Method in Psychology” (Giorgi, 1975), and “Practice of analyzing materials describing experiences” (Giorgi, 2004). Results: The study results are as follows. 1) The drug may be effective, but Subject (below, S) still wants to take it as little as possible. Meanwhile, S has people who care about S and a person who S can rely on nearby, to manage S’s life. The people above tell S to take medicine, and S takes it. 2) S does not know what kind of medication S is consuming, but recently S has been having a hard time walking;S has people who care for S’s foot and look after S. S thinks taking medicine is for living. 3) S feel some drugs is ineffective. However, S met some people S could trust who passionately recommended the medication to S. S started being careful in remembering to take it. 4) S does not think drugs are necessary for S, but S can interact with people and spend S’s days. S has people who accept S as S is. S continues living in the community while taking medicine that a doctor offers. 5) S was skeptical about the drugs. However, S has a person S can trust, who recommended a way to take the medication in a way that S does not feel overwhelmed. S thinks that it may be a good idea to take it. Conclusions: Based on the analysis of the narratives of each of the five participants, the essential structure was read from the perspective of a third party regarding participants’ medication adherence. A generalized reading of the structure common to the above five essential structures reveals a structure that includes the following three opportunities: 1) Patients realize the importance of people;2) They sometimes entrust themselves to people or follow people’s opinions when taking actions;3) They have come to terms with their initial negative feelings about antipsychotic drugs, subsequently continuing to take antipsychotic drugs. This suggests that the following are important attitudes of supporters of patients with schizophrenia who continue to live in the community: To accept what is happening to the patients, to talk to them with encouragement and compassion, and to be there for them. It is also important for supporters to make patients feel comfortable in opening up while the patients reside in the community and to support patients in making decisions.

Research Progress on the Influence of Movement Instruction on Community Life in Patients with Coronary Heart Disease

The incidence of coronary heart disease increases year by year with the material level of our country.It has a harmful effect on the patient’s life health and quality of life.Movement Instruction is an important aspect of the secondary prevention project of cardiac rehabilitation in patients with coronary heart disease.Although it has a history of decades at inland and abroad,the present situation in China is not optimistic.Some studies have shown that the popularization and participation of cardiac rehabilitation is true and lacking.This paper sums up the relevant knowledge of coronary heart disease,coronary heart disease movement instruction and its impact on community life of patients at home and abroad,and reviews the research results of movement instruction on community rehabilitation of coronary heart disease in recent years,which provides a theoretical reference and prospect for the future research of community exercise rehabilitation of coronary heart disease.

Effects of Lifestyle Intervention Performed by Community Pharmacists on Glycemic Control in Patients with Type 2 Diabetes: The Community Pharmacists Assist (Compass) Project, a Pragmatic Cluster Randomized Trial

Background: Community pharmacists should be involved in diabetes care, while there has been less evidence about whether a brief lifestyle intervention is effective for diabetes care in community pharmacies. Objectives: To examine the effects of brief lifestyle intervention on glycemic control in patients with type 2 diabetes mellitus (T2D) by using a coaching style, provided by community pharmacists. Methods: A prospective, cluster-randomized, controlled trial was conducted in 50 groups of community pharmacies in Japan. In all, 132 patients with T2D (age, 20 - 75 years, ≥8.0% of hemoglobin A1c (HbA1c)) were assigned to the intervention group (n = 90) or the usual care group (n = 42). The intervention group (IG) underwent brief lifestyle coaching for self-care of T2D for 6 months. The standard care group (CG) received usual care by pharmacists and was given a general newsletter. The primary outcome was changes in HbA1c levels. Results: After 6 months, the IG had significantly improved HbA1c (IG: -0.6 ± 0.9 vs. CG: -0.2% ± 0.9%;p = 0.021 using the last observation carried forward analysis). Although the number of drugs reduced from 2.3 ± 0.8 to 2.0 ± 1.2 in the IG, the number increased from 2.3 ± 1.1 to 2.5 ± 1.1 in the CG (-0.2 ± 0.9 in IG vs. 0.2 ± 0.6 in CG;p = 0.023). Conclusions: The brief lifestyle intervention by community pharmacists improved glycemic control in patients with T2D. Community pharmacists may more positively participate as lifestyle coaches for diabetes care.

Effect on Patient Safety of Brief Interventions Performed by Pharmacists via Drug Profile Books: VISualization of Treatment Assist by pharmacists (VISTA) Project in Japan

In Japanese pharmacies, Drug Profile Books (DPBs), which are a type of Personal Health Record (PHR), are incorporated in order to prevent duplicate medication and drug interactions in outpatients (patients) through the uniform management of drug administration information. In this study, we tried to clarify the effect on patient safety of brief interventions via DPBs by pharmacists. The study design was a randomized controlled trial on pharmacies as clusters. 65 pharmacies agreed to participate in the study (intervention group (IG): 33;control group (CG): 32). The primary outcomes were: rate of inquiry occurrence, rate of prescription change, and rates of duplicate medications & drug interactions. 56 pharmacies (IG: 29;CG: 27) completed the study. There was a higher tendency for prescription changes in the IG compared to the CG (IG: 0.03%;CG: 0.02%;P = 0.08). In addition, the rate of duplicate medications & drug interactions accounting for the inquiries was significantly higher in the IG than in the CG (IG: 89.2%;CG: 71.9%;P = 0.01). This implied that brief interventions by pharmacists using DPBs had an effect in raising patient safety.

超声药物导入联合腰腹部核心肌力训练对腰椎间盘突出患者康复效果的影响

目的探讨超声药物导入联合腰腹部核心肌力训练对腰椎间盘突出(LDH)患者康复效果的影响。方法选取商丘市第一人民医院2021年1月至2022年12月收治的122例LDH患者,按随机数字表法分为观察组(61例)及对照组(61例)。对照组接受腰背肌训练,观察组接受超声药物导入联合腰腹部核心肌力训练。比较两组康复效果、治疗前后腰椎功能、腰背肌群肌力、炎症因子、疼痛情况。结果观察组治疗总有效率为93.44%,高于对照组的80.33%(P<0.05)。治疗后,观察组日本骨科协会评估治疗(JOA)评分高于对照组,Oswestry功能障碍指数(ODI)评分低于对照组(P<0.05);观察组右侧屈、左侧屈、右旋、左旋、后伸及前屈肌力高于对照组(P<0.05);观察组血清白细胞介素-1β(IL-1β)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)低于对照组(P<0.05);观察组视觉模拟评分(VAS)、血清P物质(SP)及前列腺素E_(2)(PGE_(2))水平低于对照组(P<0.05)。结论超声药物导入联合腰腹部核心肌力训练能提高LDH患者的康复效果,促进腰椎功能及腰腹部肌群肌力恢复,缓解炎症反应,改善疼痛情况。