To be accepted into the medical profession, pharmacy students should fulfill various evaluation criteria while in school, pass pharmaceutical common achievement tests, complete practical training, ...and attain a diploma. Pharmacy schools allow students to attend practical trainings and take the national examination for pharmacists. Therefore, pharmacy schools carry out their social responsibility by promising to deliver high-quality graduates. In recent times, there has been increasing requirement for reasonable accommodation to support students with developmental difficulties. What are the boundaries of reasonable accommodation? Where does “pass” end and “fail” begin in diversification of learning strategies and evaluations? How can we maintain a high quality of pharmacists? To discuss these problems, we taught classes and led practical training sessions as pharmacy school teachers, and also invited three speakers.First, a pharmacist who is both a certified tutorial pharmacist and a mother of children with developmental difficulties spoke about reasonable accommodations. Next, a professor who was also a counselor explained the process of counseling students. Finally, a professor who is the general manager of a carrier support office reported on the system of his college. After the talks, we held a discussion with the audience. In this review, we describe the presentations and discussions.
The preliminary trial began with the exchange of reports between pharmacy pharmacists and nurses from home-visit nursing stations in Tempaku-ku, Nagoya-city, and then the collection of survey results ...to investigate the transition of mutual credibility, opinions on maintaining alignments, and the effect of collaboration. It was established that there were distinct viewpoints based on professions, even when the cases belonged to the same category in the sharing reports. For instance, in terms of pharmacotherapy, the reports by pharmacists were focused on suggesting pharmaceutical management such as left-over medicines or prescriptions, whereas the reports by nurses were targeted on how to finish up all prescribed medicines and described more vital signs, treatments, and cognitive ability in the category of symptom. In the survey results, 86.7% of the respondents answered that sharing information between pharmacists and nurses should strengthen the synergistic effect. It was suggested that the working relationship between pharmacists and nurses would develop by sharing information with each other. And, ultimately, each pharmacist’s and nurse’s viewpoint will be expected to play a significant role in providing a stronger support for an ideal life according to the patient’s will, fostering a very intense relationship across different professions alongside all assessments and proposals based on expertise, and improving the quality of each work.
Pharmacy education must consider a balance between the two social requirements of quality assurance and reasonable accommodation. As a long-term effort toward achieving this purpose, we have created ...a forum to discuss the balance between quality assurance and reasonable accommodation in pharmacy education. In this study, we held a workshop for deeper discussion and sharing, with examples of medical education, leading up to professional education/unprofessional evaluation, and of actively working on inclusion/reasonable accommodation. Several problems were highlighted, including issues concerning reasonable accommodation, how to proceed with practical training, evaluation and credit recognition, and recognition of problems varies among educators. However, it is difficult to form a consensus on the necessary considerations and standards, and even if they are established, the situation and characteristics of students, who face difficulty, are diverse and cannot be applied to individual students. Therefore, values need to be formed through continuous discussions and sharing of experience in order to provide reasonable accommodations tailored to individual students.
Xanthine oxidase (XO) produces reactive oxygen species (ROS) and has been associated with vascular endothelial dysfunction. While the effects of xanthine oxidoreductase (XOR) inhibitors on inhibiting ...the generation of uric acid from xanthine have been reported, much less is known about their effects on XO-induced ROS. The mechanisms of action of each XOR inhibitor vary, but it is not known whether XOR inhibitors’ effects on oxidative stress also vary. The purpose of this study is to compare the effects of different XOR inhibitors on XO-induced ROS. We used an in vitro chemiluminescence assay with clinically relevant doses of XOR inhibitors (allopurinol, oxypurinol, febuxostat, and topiroxostat) to investigate their effects on circulating XO-derived ROS. All XOR inhibitors significantly inhibited ROS production, with febuxostat and topiroxostat showing strong effects. These results confirm differences in the effects at clinical did among XOR inhibitors on XO, with topiroxostat demonstrating a strong suppression of ROS production. This study should help guide clinical practice in using XOR inhibitors to improve patient care and management.
Pharmacy school students were trained in a program simulating medication administration and giving adherence instructions. Following the training, the educational effects were evaluated. Students ...were separated into two groups. One group of students played the role of pharmacists and instructed simulated patients on medication adherence. Another group of students played the role of patients receiving simulated drug therapy; they were instructed on medication adherence by the students playing the role of pharmacists. The educational effects were evaluated using a questionnaire. The scores for “recognition of factors that influence medication adherence” tended to increase after the simulation, and they increased significantly after practical training. The scores for “self-evaluation of technique for instructing patients on medication adherence” increased significantly after the simulation, and they increased even more after practical training. The students' understanding of the effects on patients who were being instructed also increased significantly after the simulation, and these changes were maintained after practical training. In particular, students became more aware of the influence of pharmacists' attitudes. In practical training, the simulation training was helpful for bedside practice at hospital pharmacies and over-the-counter service at community pharmacies. Thus, the use of role play and simulated patients was an effective method for training pharmacy students to instruct patients on medication adherence.
In this study, we took continuous measurements of hemoglobin A1c (HbA1c) levels and conducted lifestyle checks in three cases to determine if these parameters were effective in improving overall ...wellness. We selected three young men with relatively high HbA1c levels. During the 12-weeks study periods, we regularly measured each participant's HbA1c levels and monitored their lifestyle habits every two weeks at the community pharmacy once every 2 weeks using specific guidelines. The first participant, a 23-year-old man, had a HbA1c level of 5.7% at his first measurement. His HbA1c level decreased to 5.2% at the last measurement. The second participant, a 19-year-old man, had an initial HbA1c level of 5.7% and a final HbA1c level of 5.4%. The third participant was a 22-year-old man with an initial HbA1c level of 5.4%. His HbA1c level had decreased to 5.1% by the last measurement. The lifestyles of all three men improved with respect to exercise and diet. Based on these results, we surmise that continuous measurements of HbA1c and regular lifestyle checks may contribute to reducing the risk of lifestyle-related disease.
It is reported that statins have inconsistent effects on glycemic status and adiponectin concentrations in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the effect of statins ...on these variables in patients with T2DM and hypercholesterolemia. A control group comprising 24 patients with T2DM but without hypercholesterolemia was observed for more than 12 weeks, while 24 patients with T2DM and hypercholesterolemia were treated with statins for the same period (statin group). The percentage changes in the glycemic status (blood glucose and glycated hemoglobin HbA1c), and levels of plasma adiponectin (total and high molecular weight HMW) were compared between the two groups. The statin group had reduced percentage changes in HbA1c, blood glucose, and total and HMW-adiponectin concentration percentage changes that were similar to those in the control group. However, when matched for sex, age (± 5 years) and HbA1c (± 0.5%) with the control group, the pravastatin group had reduced percentage changes in the plasma HMW-adiponectin concentrations than the matched controls (p = 0.023). However, there were no differences in the percentage changes in the plasma total adiponectin (p = 0.137), HbA1c (p = 0.202), or blood glucose concentrations (p = 0.450) between the two groups. Pravastatin treatment had no effect on the glycemic status of patients with T2DM and hypercholesterolemia, but may reduce the percentage changes in the plasma HMW-adiponectin concentrations. Hence, patients with T2DM and hypercholesterolemia receiving long-term treatment with pravastatin might experience increased insulin resistance.
A complication of diabetes mellitus is the over-production of vascular superoxides, which contribute to the development of arteriosclerosis and peripheral arterial disease (PAD). Hyperglycemia ...induces the formation and accumulation of advanced glycation end-products (AGEs), which in turn stimulate vascular superoxide production. The mechanism underlying AGE-mediated vascular superoxide production remains to be clarified in lower limb complications associated with diabetes. In the present study, we investigated the role of AGEs and the mitochondrial respiratory complex in superoxide production in femoral arteries using the type 2 diabetes model Otsuka Long-Evans Tokushima Fatty (OLETF) rats vs. non-diabetic Long-Evans Tokushima Otsuka (LETO) rats. The effects of in vivo administration of pravastatin on superoxide production in femoral arteries were also examined. Using chemiluminescent assays, luminescence microscopy, and competitive enzyme-linked immunosorbent assay (ELISA), we determined that vascular superoxide production and serum glyceraldehyde-derived AGEs (Glycer-AGEs) increased in OLETF rats. Pravastatin inhibited these responses without changing serum total cholesterol concentrations. The mitochondrial complex II inhibitor thenoyltrifluoroacetone (TTFA) also inhibited vascular superoxide production. Application of Glycer-AGEs in situ increased superoxide production in the vascular wall of femoral arteries from pravastatin-treated OLETF rats, which was then inhibited by TTFA. These results suggest that hyperglycemia increases serum Glycer-AGEs, which subsequently induce superoxide production in the femoral artery of OLETF rats in a mitochondrial complex II-dependent manner. Collectively, our results have partially elucidated the pathological mechanisms leading to diabetes-related PAD, and indicate dual beneficial actions of pravastatin for the prevention of oxidative damage to the vascular wall.
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