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Prescription medication used in pregnancy and lactation: A gap to become completed postgrad health care education and learning.
Alumni were surveyed 1-2 years after graduation to determine the importance of the 59 topics to their positions, their impressions about how well the course prepared them in those areas, and whether they referred back to course materials. Feedback was used to adjust the course. The topics alumni rated as most important were similar to those students predicted would be most important. Seventy-five percent of alumni used the course website as a resource in practice.Introduction Medication discrepancies on hospital discharge are common and occur despite the use of technology to generate electronically created discharge (e-discharge) prescriptions, justifying pharmacist involvement. No published studies have focused on medication discrepancies as a risk factor for readmission. The aim was to explore the relationship between medication discrepancies on discharge and readmission rates, and how both are affected by pharmacist intervention. Objectives The primary objective was to establish the relationship between medication discrepancies on the e-discharge prescription and hospital readmissions within 30 days of discharge. Secondary objectives were to determine the 30-day readmission rate with and without pharmacist involvement, and risk factors for 30-day readmission. Methods This was a matched case-control study where cases and controls consisted of patients readmitted and not readmitted to hospital within 30 days of discharge from the general medicine service, respectiveladmission rate with and without pharmacist involvement was similar between the case group (50%) and control group (48.0%). The proportion of discharge prescriptions with discrepancies was 48.8% in the group that had pharmacist involvement and 47.0% in the group that had no pharmacist involvement. Additionally, a LACE score of 12 or greater was identified as a statistically significant risk factor for readmission (OR = 2.13; P less then .001). Conclusions Pharmacist review of the e-discharge prescription did not affect the readmission rate. A LACE score of 12 or greater was associated with a higher risk of readmission. Future studies are needed to identify patient groups at high risk of readmission and to determine pharmacist interventions that could reduce readmission rates.The combination of short days and long cold winter nights, in temperate regions, presents a major challenge for small diurnal birds. Small birds regularly employ heterothermy and enter rest-phase hypothermia during winter nights to conserve energy. However, we know little about how environmental conditions, such as food availability, shape these strategies. We experimentally manipulated food availability in winter to free-living great tits Parus major. A 'predictable' and constant food supply was provided to birds in one area of a forest, while birds in another area did not have access to a reliable supplementary food source. We found that predictability of food affected the extent of nocturnal hypothermia, but the response differed between the sexes. Whereas male nocturnal body temperature was similar regardless of food availability, females exposed to a naturally 'unpredictable' food supply entered deeper hypothermia at night, compared with females that had access to predictable food and compared with males in both treatment groups. We suggest that this response is likely a consequence of dominance, and subdominant females subject to unpredictable food resources cannot maintain sufficient energy intake, resulting in a higher demand for energy conservation at night.Despite major advances in the study of animal tool behaviour, researchers continue to debate how exactly certain behaviours are acquired. While specific mechanisms, such as genetic predispositions or action copying, are sometimes suspected to play a major role in behavioural acquisition, controlled experiments are required to provide conclusive evidence. In this opinion piece, we refer to classic ethological methodologies to emphasize the need for studying the relative contributions of different factors to the emergence of specific tool behaviours. We describe a methodology, consisting of a carefully staged series of baseline and social-learning conditions, that enables us to tease apart the roles of different mechanisms in the development of behavioural repertoires. Experiments employing our proposed methodology will not only advance our understanding of animal learning and culture, but as a result, will also help inform hypotheses about human cognitive, cultural and technological evolution. More generally, our conceptual framework is suitable for guiding the detailed investigation of other seemingly complex animal behaviours.Mammal sex allocation research has focused almost exclusively on maternal traits, but it is now apparent that fathers can also influence offspring sex ratios. Parents that produce female offspring under conditions of intense male-male competition can benefit with greater assurance of maximized grand-parentage. Adaptive adjustment in the sperm sex ratio, for example with an increase in the production of X-chromosome bearing sperm (CBS), is one potential paternal mechanism for achieving female-biased sex ratios. Here, we tested this mechanistic hypothesis by varying the risk of male-male competition that male house mice perceived during development, and quantifying sperm sex ratios at sexual maturity. Our analyses revealed that males exposed to a competitive 'risk' produced lower proportions of Y-CBS compared to males that matured under 'no risk' of competition. We also explored whether testosterone production was linked to sperm sex ratio variation, but found no evidence to support this. CAY10566 mouse We discuss our findings in relation to the adaptive value of sperm sex ratio adjustments and the role of steroid hormones in socially induced sex allocation.While animal bodies are typically bilaterally symmetric on the outside, the internal organs nearly always show an invariant left-right (LR) asymmetry. In comparison, snails are both internally and externally LR asymmetric, outwardly obvious in the shell coiling direction, or chirality. Although some species of snail are naturally variable for chirality, sinistral individuals occur very rarely in most species. The developmental and genetic basis of these rare mirror-imaged individuals remains mysterious. To resolve this issue, the finding of a 'one in a million' sinistral garden snail called 'Jeremy' was used to recruit citizen scientists to find further sinistral snails. These snails were then bred together to understand whether their occurrence is due an inherited condition. The combined evidence shows that rare sinistral garden snails are not usually produced due to a major effect maternal Mendelian locus. Instead, they are likely mainly produced by a developmental accident. This finding has relevance to understanding the common factors that define cellular and organismal LR asymmetry, and the origin of rare reversed individuals in other animal groups that exhibit nearly invariant LR asymmetry.
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