Pharmacist Role In Developing Countries Health And Social Care Essay

Pharmacist Role In Developing Countries Health And Social Care Essay Introduction: Since last decades despite tremendous advancements in medical technology, the global health status needs to be revamped. The commitment of the majority of World Health Organization (WHO) member countries to the Declaration of Alma-Ata in 1978 advocates the concept of health for all. Unfortunately the fundamental doctrine of the declaration is failed to be reaffirmed by some of the developing countries.1 The developing nations harbor 80% of the worlds population and it been estimated that 2.7 billion people living in this part of the world thrive on less than US$2 a day.2,3,4 This, in turn, contributed to lack of access to efficient healthcare services among these populations. Moreover, in most of these developing countries, the deliveries of effective healthcare services are compromised due to incompetent and non-qualified healthcare providers. Apart from the need to understand the pathophysiology of disease and their treatment modalities, healthcare providers necessitate to comprehend the local environment or/and culture in order to achieve the desired therapeutic outcomes. Therefore, the reorientation and reconstruction of healthcare professionals education and training to generate socially motivated healthcare providers is the need of time. Pharmacist role in developing countries: In the beginning of the 6th century BC, humans started a several-centuries-process of compiling pharmacological knowledge that contributed towards public health.5 The scope of pharmacy practice encompasses areas of compounding and dispensing medications, services related to patient care including clinical services, reviewing medications for safety and efficacy, and providing drug information. Generally, the existing medical education system produces professionals which have a tendency towards clinical practice or either specialization. Preference is more towards treatment rather than prophylaxis. Moreover, professional training emphasized on subject-centered curriculum linked with high technology and therefore, trainees come in contact with patients usually at the end of the training. As a result, the role of pharmacists in healthcare system is generally bleak, but perhaps more so in developing and transitional economies. Still in some places pharmacists are increasingly assuming their role as health care workers. Their services include more patient-oriented, administrative and public health functions. This successful transition in pharmacy practice is the result of the implementation of educational programs aimed at making them responsive to the needs of the majority of the population6. In the context of developing countries, pharmacy profession only captured the imagination of only a small segment of the population as a vibrant healthcare profession. For instance, although HIV/AIDS is rampantly prevalent in many developing countries in Asia, Africa and South America, still pharmacist in these countries is underutilized as healthcare workforce in prophylactic campaigns. Furthermore, issues of public health dimensions that need collective action via intensive efforts of pharmacists and other healthcare team members are nearly non-existent in developing countries. This might be due to the fact that both public and other healthcare practitioners perceived that pharmacists are not well positioned to take such an active role in public health initiatives that are generally considered to be the domains of doctors and nurses preferably7. Lately, with the tremendous evolution of pharmacy practice in developed nations such as the UK, Australia and US, it thus becomes evident that pharmacists can contribute more towards Health for All agenda. Furthermore, there has been a great move by health policy makers and educators in developing skills and attitudes which are necessary to meet the healthcare needs of the majority of the people. This change has also influenced many developing countries to follow the trend. Therefore, within the last two decades extensive transitions had been observed in pharmacy curricula globally, mainly with the incorporation of social and behavioral sciences at many pharmacy schools Although a complete discussion linking social sciences with pharmacy is not possible in a single document, we try to provide a brief historical background on social pharmacy and pharmacy practice as well as the importance of social sciences in health. In the current document the authors discuss few case studies from developed countries which establish the relevant link of social and behavioral sciences to pharmacy curricula and, therefore, the importance of social sciences in pharmacy curriculum can thus be ascertained. The authors will also enumerate the achievements of the Universiti Sains Malaysia in incorporating social pharmacy subjects in undergraduate pharmacy education. Recent history of social sciences and pharmacy education: Since the early 1980s, efforts were undertaken to find out which areas of pharmacy practice can greatly contribute in pharmacy training. Among many recommendations, an independent committee of inquiry established under the aegis of the Nuffield Foundation advocated that social and behavioral science should be incorporated into the pharmacy undergraduate curriculum. Defined as the scientific study of human behavior, behavioral science is often associated with disciplines which deal with people and society including psychology, sociology and anthropology. Sociology studies an individuals actions as a social phenomenon, whereas behavior is explained and shaped by the society in which we evolve; reason for which, sociologists prefer to use the term social action in place of behavior. Behavioral science also includes social psychology and interpersonal communication. According to Morrall,8 the discipline of sociology demystifies the nature of health and illness, determines the social causes of disease and death, exposes power-factors and ethical dilemmas in the production of health care, and either directly or indirectly helps to create a discerning practitioner capable of more focused and competent decision making. Such a sociologically informed approach to health care is basically needed by all health workers including pharmacists. Due to this importance, institutions such as the schools of pharmacy and the Royal Pharmaceutical Society of Great Britain suggested that aspects of sociology should be incorporated into the pharmacy undergr aduate curriculum for adequately preparing pharmacy students for their future practice. In a related opinion, the Royal Pharmaceutical Societys Education Committee advocated that all schools of pharmacy in their undergraduate programs should include teaching on the social science aspects of pharmacy.9 Why sociology for pharmacists? : Inadequacies and disparities in health care systems are still a major threat to global public health. In response to this, the last decades had witnessed an increasing number of changes in the activities of pharmacists. In primary care activities compounding and formulation of medicines are not practiced anymore. As technological progresses have made the dispensing of medicines a more routine task, how much time pharmacists spend on this activity is questioned. In addition, the number of highly effective proprietary medicines available for sale from a pharmacy, which were previously only available on prescription, has increased and thus expected to increase still further. As such, it is predicted that in near future pharmacists will be able to prescribe medicines as supplementary prescribers in developing countries. These facts have led pharmacists to re-evaluate their roles, and to promote themselves as health professionals as they must consider them selves as experts in medicines capable to take the lead of patients health status and the outcomes of different therapeutic regimen. In secondary care, clinical and ward pharmacy have become important concepts, with pharmacists increasingly being integrated into the health care teams alongside acquiring specializations i.e. in drug information, oncology, paediatrics and radiopharmacy. The contribution of social science to pharmacy practice: Pharmacy services in developing countries could make a greater contribution to health care. Steps to ensure that pharmacy education provides students with the knowledge and skills to contribute to public health priorities of their local populations are increasingly seen as an important goal of pharmacy education. Clearly, in developing their professional skills in social and clinical pharmacy, students need to appreciate that patients will have their own beliefs, views, and perspectives about their health and use of medicines which might be important determinants of the success of any health promotion activities. These activities include development effective counseling and communication skills, enhancing medication compliance, improving the understanding of ones disease, encouraging patients to seek professional care, assisting patients in making informed decision, and enhancing pharmacy professionalism and leadership qualitie s. Global Case Studies Developed Countries In 1975, the study commission on pharmacy identified the need to incorporate the behavioral and social sciences in pharmacy alongside clinical practice. In the same year, the Council on Pharmaceutical Education included pharmacy administration, social and behavioral sciences in their indicative curriculum. As per 2004, the American Association of College of pharmacy10 incorporates many social and behavioral topics as required outcomes of pharmacy programs in the USA. In UK, the Nuffield Committee of inquiry into pharmacy decided behavioral sciences to be incorporated into undergraduate pharmacy curriculum in 1986. To date, social pharmacy is now taught in all schools of pharmacy and forms part of the Royal Pharmaceutical Society ¢s indicative curriculum. A number of Northern and Eastern European countries introduced social pharmacy into their curricula in the mid-1970 ¢s11. In Sweden, courses were taught since 1957, dealing with social pharmacy and low/regulations in pharmacy which in 1970 transformed to social pharmacy. In Denmark, the first social pharmacy course was introduced in 1972-73 and by 1980 the course appeared in the course catalogue as social pharmacy with social science. In 1992, a chair in social pharmacy was established at Royal Danish School of Pharmacy. In Belgium, the concept of communication skills was introduced into the pharmacy fourth year students. A variety of methods that are used to assess pharmacy practice students , including a 6-month pharmacy internship, in which students are assessed by a preceptors report; a week-long workshop on communication and pharmacotherapy; a multiple choice exam on pharmacotherapy; and an open book oral exam. In the academic year 2000-01, the strongest correlations were between internship and oral exam performance. This trend continued in 2001-02, in addition to multiple choice exam correlating with both oral and internship performance. Developing Countries In the scenario of developing countries the contribution of pharmacy education in Malaysia is worth mentioning. The Universiti Sains Malaysia (USM) is the first public university to offer a Bachelors degree in Pharmacy in Malaysia since 1972. To date, it has produced more than 2,000 pharmacy graduates which serve as local pharmacy workforce. The School of Pharmaceutical Sciences has a multi-disciplinary pharmacy curriculum designed to provide holistic training to  prepare students for life-long learning, and to equip them with broad scientific knowledge and essential skills. The integrated pharmacy program consists of basic science and pharmaceutical science subjects in the first two years of study, and progresses towards patient care and clinical pharmacy. In the third and fourth years, the students professional skills are linked to an advanced clinical and pharmacy practice. Hence the curriculum inculcates a high standard of pharmacy training in practical knowledge and profession al skills. The 4-year program covers 6 disciplines of study, namely Pharmaceutical Chemistry, Physiology, Pharmaceutical Technology, Pharmacology, Clinical Pharmacy and Social and Administrative Pharmacy. Social and Administrative Pharmacy subjects were first incorporated in the curriculum in 1992-93 academic sessions and has been designed to prepare students for responsible leadership positions in academia, industry or public service.12 Hence this course equips the students for careers in governmental agencies, pharmaceutical firms, community pharmacies, universities, professional bodies and health insurance companies, all of which have a direct and indirect impact on the social fabric of the country. Students learn to give optimum services to the patients, as well as to make them aware about the prevention and cure of diseases. The Discipline of Social and Administrative Pharmacy (DSAP) at USM is committed to promote research in drug use problems in developing countries.13 At present more than fifty postgraduate students from more than ten developing countries are being guided by the faculty members in carrying out drug-related research in their countries as well as in Malaysia. The priority areas of research of DSAP are multidisciplinary and include pharmacoeconomics, pharmacoepidemiology/ pharmacovigilance, socio-behavioral aspects of health and pharmacy, pharmaceutical care, outcomes research, quality of life assessment, decision analysis, and pharmaceutical management and marketing. Additional domains of research include pharmaceutical public policy, pharmaceutical education, pharmacoinformatics and pharmaceutical anthropology. Another striking example is the case of Ghana, where pharmacists are often the most easily accessible health professionals to give consultation on health problems14. The incorporation of a landmark health promotional module in pharmacy course in Kumasi, Ghana comprises of both classroom activity as well as outdoor field work. This field work component enables the student to prepare health promotional materials by visiting and observing their local population and thus identify and explore their local compromised resources. This module thus serves to prepare Challenges for social pharmacy: A good example of how social pharmacy faces challenges can be gained from the recent review by Puspitasari et al 15 , which focused on counseling given to patients who purchase prescription medicines from community pharmacies. Their data showed that the nature of researchers relationships with the profession, measures to improve community pharmacy practices, the importance of learning from other disciplines, and the need to internationalize our discipline challenge social pharmacy research works. In addressing the role of a pharmacy, some authors16, 17 have previously suggested that pharmacists should have an increasing role in patient care and that patient counseling is one of the cornerstones of this new role. The very wide variation in counseling rates found by Puspitasari and the colleagues (8 to 80% of patients received verbal counseling) suggests that this new role is carried out more in some settings than others. Social pharmacy research had pla yed and still continues to play an important role in documenting this practice variation. Based on these reports, one of the major challenges is how to improve the practice of those settings and practitioners who are currently lagging behind. Clearly, researchers dealing with social pharmacy and pharmacy practice tread a delicate line. In order to accomplish the research findings of social pharmacy into practice the relationship of the social pharmacist with the practitioners must be close and positive enough that practitioners must listen to and involve themselves in the implementation of findings in the hope of improvements in pharmacy practice. In addition, researchers need to be independent enough so that they can identify the need for improvement, and advocate in the interest of public health. Non-pharmacists social pharmacy researchers face an additional set of challenges and pressures which mainly include their own recognition within social pharmacy.18 As pointed out by Puspitasari et al,15 studies on improvements in community pharmacy practice are urgently needed. Previous studies highlighted that motivated, innovative pharmacists can provide effective secondary services, which are undoubtedly important; 19, 20 however, interventional research studies in order to assess or improve the performance of the present pharmacist or pharmacy assistants are the need of time. Substantial information on how to improve present pharmacy practice exists in other professions also, and this can be instrumental in bringing changes in social pharmacy. For instance, the Cochrane Effective Practice and Organization of Care Review Group have a long-term experience in dealing with practice improvement.21,22 Overall, the major outcome of these works is the passive dissemination of information, i.e. written materials and lectures are not effective in changing practice. However, reminders and interactive educational meetings are effective strategies as they promote discussion and educational outreach. Multifaceted interventions tend to be more effective than single ones. Reviews of evidence on specific issues, such as interventions aimed at improving the use of antimicrobials have produced similar findings.23 Strategies for improving practice are a key concern in most health professions such as pharmacy, medicine, nursing, but are dealt with separately in each profession. Although differences may exist between professions and countries, practice researchers in each discipline can learn considerably by interacting with each other. Social pharmacy research is done in few developed countries: USA, UK, the Netherlands, Finland, Australia, and Canada. According to Ryan et al,11 social pharmacy is taught in seventeen countries those above plus four more Scandinavian countries, more European countries, New Zealand, and very few countries in the developing world. Thus the dissemination of social pharmacy research still remains a major challenge, especially in developing countries where there are documented problems in the purchase, distribution, and use of medicines. To overcome these problems, one possibility would be to establish strategic alliances with countries already working in these areas or with organizations such as the World Health Organization and Management Sciences for Health (www.msh.org) that have expertise, experience, and commitment to improve access to and use of medicines in developing countries. Conclusion: Social pharmacy program can be approached globally through various course types and formats. These courses make the students expose and explore societal concerns and health inequalities in their respective resource-deficient settings. Practical application of some components makes the student aware of the impact of sociodemographic on health and illness and inculcates sound understanding of the culture as well as social and moral obligations towards society in general and individual in particular. With regard to Universiti Sains Malaysia, constructive discussion to incorporate social-behavioral concepts and principles into other courses throughout the pharmacy curriculum can make the future prospects bright for social pharmacy. Students should be taught social pharmacy concepts and principles in every subject as pharmacoeconomics, pharmacoepidemiology, socio-behavioral aspects of health and ethical issues could and should be discussed during lectures and prior to clinical rotations. This shift in pharmacy practice from a product- to an information- and patient-based orientation affects patient knowledge, and increases liability and health care costs, which continue to place pharmacists in a position of great responsibility.

Powering Houses Worldwide With Hydroelectricity Environmental Sciences Essay

Hydroelectricity is used as a renewable energy beginning that is viewed as a ‘green ‘ and safe option to fossil fuels and coal combustion workss. However, the environmental impact of building dikes and the after effects of edifice dike has been minimize to let hydroelectricity to look as a safe alternate resource.How Does Hydroelectricity Work?Once the dike is constructed and able to work the system itself to make hydroelectricity is comparatively simple. Water from the reservoir goes down into the consumption, so through the consumption where it so drives the turbine to power the generator. This converts gravitative possible energy into electricity since the jurisprudence of preservation of energy must be followed. The energy from the generator will so be stored in the human dynamo and when needed, will be transferred through power lines to the desired location. The Three Gorges Dam in China which is the largest dike in the universe works precisely like this but has been constructed with 26 turbines which go along the 2,335m long and 18 m high dike.Environmental ImpactWhen a reservoir is created, considerable decomposition of organic stuff occurs. Besides, O depletion in the reservoir occurs. This causes the release of nursery gases ( CHa‚„ and COa‚‚ ) to leach into our environment. The Bacterial decomposition of the organic stuff is a consequence of the after consequence of fundamental law of the dike which contributes to greenhouse gases and furthermore, planetary clime alteration. Looking at the Three Gorges Dam in China, the environmental impacts are inordinate. The dike has submerged 100s of mills, mines and waste mopess. Located merely upstream of the dike is a big industrial centre which is making a bog of sewerage, silt and industrial pollutants and waste in the reservoir. Landslides around the reservoir are caused by eroding of the reservoir itself. Not merely is this massively impacting the environment around this country, but worldwide and is besides jeopardizing one of the universe ‘s biggest piscaries in the East China Sea. ( Before and after at the dike site ) ( Before and after upstream of the dike site ) ( Three Gorges Dam – China )Impact on societyThe effects of nursery gas emanations from the reservoirs contribute to planetary clime alteration. The societal effects of planetary clime alteration are complex and instead bad. Extreme conditions events have been linked to planetary clime alteration which indicates that the effects of clime alteration will happen at a much broader graduated table. Hydroelectric workss contribute to greenhouse gases are little compared to other major beginnings such as fossil fuels and coal combustion workss. In 1996 Pearce estimated that COa‚‚ emanations from reservoirs entire to 7 % world-wide semisynthetic COa‚‚ emanations. Canada ‘s emanations entirely add up to 12 % of their ain nursery gas emanations over the following 50 old ages. This high sum will go even more of import when renewable beginnings deplenish.Methylmercury BioaccumulationMethymercury is an organic molecule produced mincingly by bacteriums from in organic quicksilver of course present in stuff flooded during the creative activity of a reservoir. The effects of this bacterial are found when worlds consume fish found in the reservoirs and 100km distance downstream. The bacterial is a neurolysin which affects human foetus ‘ because they are peculiarly sensitive to methymercury. The taint of the reservoir with methymercury can temporally last from 20-30 old ages or more. Alternate Form of Energy – Powering Houses With Ocean Thermal Energy Conversion ( OTE ) OTE uses the temperature difference that exists between deep and shallow Waterss to run a heat engine. As with any heat engine, the greatest efficiency and power is produced with the largest temperature difference. OTE can finally be used to power places precisely how hydroelectric workss do with a big lessening of environmental impact. OTE is a renewable energy that produces really small waste and can be made cost effectual on a big graduated table.How Does Ocean Thermal Energy Conversion Work?The Earth ‘s oceans are heated through the Sun which creates a temperature difference which contains a huge sum of solar energy. OTC takes the hot surface H2O and uses it to boil another liquid like propane which has a really low boiling point, it so becomes a gas. The propane within the system is ne'er burned. The boiling propane so turns a turbine which generates the electricity which is carried to set down though an underwater overseas telegram dispersed through power lines in order t o power houses.A pipe is used to make the cold ocean H2O which is used to chill and distill the propane back to liquid signifier. This is similar to steam turbines. This method converts solar radiation to electricity which follows the jurisprudence of preservation of energy. Hawaii has been the premier location for the United States for proving OTE because of its warm surface H2O and entree to deep, cold H2O.Will Ocean Thermal Energy Conversion Work?This alternate energy is still being perfected due to the challenge of efficiency. OTE has to travel a really big measure of H2O in order to bring forth electricity. The existent efficiency is around 2-3 % due to the demand to pump the H2O and the thermic loss. All designs have been made on a little graduated table and are largely experimental. One of which is in Hawaii, bring forthing 50 kW of electricity. The largest is in Japan and produces double the sum of Hawaii ‘ OTE. However, if a successful OTC is built, it is expected to bring forth 2 megawatts of electricity. Nevertheless, a full graduated table OTC would be a big sum of money and would be instead hard to construct until it can be made cost efficient.Advantages of Ocean Thermal Energy ConversionOTC is a dependable, clean and safe energy beginning which can be used to bring forth electricity in all conditions conditions. Fresh H2O production is merely one of the possible good byproducts of OTEC. The cold deep ocean H2O can be used for aqua-culture ( fish agriculture ) .Emissions towards nursery gases are about 4 % but OTC does non foul H2O around the system unlike dikes. Effectss can besides be minimized by dispatching the cold H2O at deepnesss greater than 50m.Benefits from OTC on YourselfOTC will extinguish the demand for coal and fossil fuel combustion workss which will assist forestall the full effects of planetary clime alteration. OTC can assist supply a cleaner Earth for coevalss due to its clean system with small pollutants. Switch overing t o this safer option will lend to a better tomorrow.Comparing Dams to OTCEfficiencyDue to OTC being still in the test phase, the efficiency is highly low compared to China ‘s extremely efficient dike. However, if OTC can be perfected in a big graduated table, the efficiency will increase and may go more efficient than the Three Gorges Dam. 94 % 3 %EmissionsComparing OTC nursery gas emanations versus the worldwide reservoirs, the reservoirs have significantly more emanations than OTC. OTC proves to be the cleaner and better beginning of energy.

Hobbes And Kant s Theory Of Morality - 1447 Words

Hobbes and Kant both give a different account of the foundations of morality. Drawing from Hobbes’ Leviathan and Kant’s Grounding for the Metaphysics of Morals, I will compare their understanding of the foundations of morality. I will discuss the conflicting accounts of the role played by reason versus the role played by desire and inclination in the determination of what is good, evil, right or wrong. Hobbes claims that ordinary experiences establish human beings as self-interested and are driven by desire or aversion and that is why morality is grounded by subjective self-interests. On the other hand, Kant provides a purely rational principle for ordinary views about unconditional moral value, morality has a universal law that applies to all rational beings at all times. The following paper will identify and explain the key points and sources of difference between Hobbes and Kant. First, I will explain both understandings of morality. Second, I will describe how the a ccount of the foundations of morality differs in human nature, rationality and conceptions of morality. I will, in conclusion, argue that Hobbes’ account of morality best works with our ordinary experiences and moral convictions. According to Kant, morality has foundation in legislation by pure reason. Further, morality consists of categorical imperatives that must be obeyed for their own sake, regardless of the consequences. The categorical imperative underpins morality. It is only possible to have a moralShow MoreRelatedMilton Friedman And Richard Freeman Essay932 Words   |  4 Pagesdifference between the two is on the issues of corporation’s responsibilities to the society and the obligations to different groups. To whom does the corporation owe much responsibility? Friedman offers his views based on the shareholders theory. 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Silent Spring A Book Review - 1810 Words

‘SILENT SPRING’ – A BOOK REVIEW By Pratikshya Mahapatra (pm2535) â€Å"Pen is mightier than sword†- I think we all are aware of these famous words coined by Edward Bulwer-Lytton. Rachael Carson’s Silent Spring totally justifies the purpose of the metaphor word by word. Although they always get the critical judgments and are less celebrated, books sometimes bear the most significant role in changing the social atmosphere. Rachael Carson’s Silent Spring, which was published on 1962, exposed the potential of chemical hazards of the pesticides like DDT. It slammed the truth in front of the people, questioned the human faith in technologies and helped on to start an environmental movement bigger than ever. Carson’s love of nature coupled with love of writing and poetry made the Silent Spring possible. Her determination and courage to make the people aware on chemical industry and its products actually gave the boost to the success of the book and it raised an important point about the extent of the human’s impact on nature. The book Silent Spring provides us an effective descriptive ecological view of the nature which is beautifully described in precisely complex, yet poetic language. It took four years for the completion of the book but the result was marvelous and also was important to make people aware of environmental issues. Rachael Carson’s motive of writing the book was to send a general image of the impact which the chemicals like DDT are having on our nature. 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Baldwin s The Biological Weapons Program During World War II1112 Words   |  5 PagesIra L. Baldwin Review Ira Baldwin was born in the state of Indiana in 1895. His youth was spent on a 40 acre farm that his family owned. Growing up on a farm gave Baldwin a unique perspective. He saw the devastation of what insects and pest could do to their crops. To pay his way through college, he did what many farmers’ sons would do. He sold ducks and husked corn in order to get the money he needed. Baldwin had many accomplishments during his lifetime. He attended Purdue and then the UniversityRead MoreSocial And Governmental Norms On The Lives Of Millions Of Americans By Rachel Carson1437 Words   |  6 Pagesaltered the lives of millions of Americans. 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Her book was a polarization, pointing out that we as people were harming the earth and she did a ton of research to prove that. â€Å"The book cataloged the environmental impacts of the indiscriminate spraying of  DDT  in the US and questioned the logic of releasing large amounts of chemicals into the environment withoutRead MoreTuskegee Syphilis Experiment : Tuskegee Experiment1532 Words   |  7 Pagesremaining seven participants from the experiment. Based from this experiments, The Belmont Report Ethical Principles and Guidelines for the Protection of Human Subjects of Research was submitted in April 18,1979 to †¦Ã¢â‚¬ ¦.? (â€Å"Impact,† n.d.). Institutional Review Board. On September 30, 1978, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research submitted its report entitled â€Å"The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects