Information Leaflets Research Articles

Improving Self-care Behavior and Removing Barriers by Structured Diabetes Education Program in Primary Health-care Settings of Puducherry: Evidence from a Mixed-method Intervention Study

Context: Diabetes self-management education (DSME) improves patients’ clinical outcomes and quality of life by encouraging self-care behavior. Aims: This study aimed to find out the effectiveness of a DSME by comparing changes in stages of self-care behavior and to explore perceived barriers in diet, exercise, and foot care among patients with type 2 diabetes mellitus in an urban primary health center (PHC) of Puducherry. Settings and Design: A mixed-method intervention study was conducted among 314 patients with type 2 diabetes mellitus in two urban PHCs randomly allocated to intervention and control arm. Subjects and Methods: The stages of behavior change and barriers perceived in the domains of diet, physical activity, and foot care were captured using a pretested questionnaire. Intervention consisted of DSME along with information leaflets and self-care kits for the intervention group. At the end of 6 months, end-line assessment and in-depth interviews were conducted. Statistical Analysis Used: Quantitative data were analyzed in STATA while manual coding and deductive thematic analysis were done for qualitative data. Results: Footcare showed an improvement of 31%, while diet and exercise domains saw an improvement of 5% each from preaction to action stage when compared with control arm. The main barriers perceived in dietary modification and foot care were lack of awareness. For exercise, the main barriers were lack of perceived need and being physically unfit. Foot-care barriers witnessed maximum resolution (27%) following the intervention. Conclusions: DSME intervention helps in improving stages of behavior change while resolving self-care barriers. Culturally-oriented DSME and patient-tailored interventions are key to empower people living with diabetes by improving self-care.

Patient perspective on observation methods used in seclusion room in an Irish forensic mental health setting: A qualitative study.

WHAT IS KNOWN ON THE SUBJECT?: Nurses' observation of patients in seclusion is essential to ensure patient safety. Patient observation in seclusion assists nurses in adhering to the requirements of mental health legislation and hospital policy. Direct observation and video monitoring are widely used in observing patients in seclusion. Coercive practices may cause distress to patient-staff relations. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We add detailed information on specific observation methods in seclusion and compare them from the perspective of patients. Nurses communicating with patients ensures relational contact and that quality care is provided to patients even in the most distressed phase of their illness. Providing prior information to patients on observation methods in seclusion and the need for engaging patients in meaningful activities, while in seclusion are emphasized. Observation via camera and nurses' presence near the seclusion room made patients feel safe and gave a sense of being cared for in seclusion. Pixellating the video camera would give a sense of privacy and dignity. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The overarching goal is to prevent seclusion. However, when seclusion is used as a last resort to manage risk to others, it should be done in ways that recognize the human rights of the patient, in ways that are least harmful, and in ways that recognize and cater to patients' unique needs. A consistent approach to relational contact and communication is essential. A care plan must include patient's preferred approach for interacting while in seclusion to support individualized care provision. Viewing panels (small window on the seclusion door) are important in establishing two-way communication with the patient. Educating nurses to utilize them correctly helps stimulate relational contact and communication during seclusion to benefit patients. Engaging patients in meaningful activities when in seclusion is essential to keep them connected to the outside world. Depending on the patient's presentation in the seclusion room and their preferences for interactions, reading newspapers, poems, stories, or a book chapter aloud to patients, via the viewing panel could help ensure such connectedness. More focus should be placed on providing communication training to nurses to strengthen their communication skills in caring for individuals in challenging care situations. Patient education is paramount. Providing prior information to patients using a co-produced information leaflet might reduce their anxiety and make them feel safe in the room. When using cameras in the seclusion room, these should be pixelated to maintain patients' privacy. ABSTRACT: Introduction A lack of research investigating the specific role that various observational techniques may have in shaping the therapeutic relations in mental health care during seclusion warranted this study. Aim The aim of the study was to explore patients' experience of different methods of observation used while the patient was in seclusion. Method A retrospective phenomenological approach, using semi-structured interviews, ten patients' experiences of being observed in the seclusion room was investigated. Colaizzi's descriptive phenomenological method was followed to analyse the data. Results Communicating and engaging patients in meaningful activities can be achieved via the viewing panel. The camera was considered essential in monitoring behaviour and promoting a sense of safety. Pixelating the camera may transform patient view on privacy in seclusion. Discussion The mental health services must strive to prevent seclusion and every effort should be made to recognise the human rights of the patient. The study reveals numerous advantages when nurses actively engage in patient communication during the process of observation. Implications for Practice Different observation methods yield different benefits; therefore, staff education in using these methods is paramount. Empowering the patient with prior information on seclusion, engaging them in meaningful activities and proper documentation on patient engagement, supports the provision of individualised care in seclusion.

Improving health literacy of antibiotic use in people with cystic fibrosis (CF)-comparison of the readability of patient information leaflets (PILs) from the EU, USA and UK of 23 CF-related antibiotics used in the treatment of CF respiratory infections.

Antibiotic adherence is poor amongst people with cystic fibrosis (CF). Low-quality patient information leaflets (PILs), which accompany prescription antibiotics, with poor readability may contribute to poor antibiotic adherence, with the potential for antimicrobial resistance (AMR) development. The aim of this study was to examine the readability of antibiotic PILs used to treat CF lung infections. CF-related antibiotics (n = 23; seven classes: aminoglycosides, β-lactams, fluoroquinolones, macrolides/lincosamides, oxazolidinones, tetracyclines, trimethoprim/sulfamethoxazole) were investigated. Readability of PILs (n = 141; 23 antibiotics) from the EU (n = 40), USA (n = 42) and UK (n = 59) was calculated. Mean [± standard error of mean (SEM)] values for the Flesch Reading Ease (FRE) for EU, USA and UK were 50.0 ± 1.1, 56.2 ± 1.3 and 51.7 ± 1.1, respectively (FRE target ≥60). Mean (± SEM) values for the Flesch Kinkaid Grade Level (FKGL) for the EU, USA and UK were 9.0 ± 0.2, 7.5 ± 0.2 and 9.6 ± 0.2, respectively (FKGL target ≤8). US PILs were significantly shorter (P < 0.0001) in words (mean ± SEM = 1365 ± 52), than either UK or EU PILs, with fewer sentences (P < 0.0001), fewer words per sentence (P < 0.0001) and fewer syllables per word. The mean ( ± SEM) reading time of UK PILs (n = 59) was 12.7 ± 0.55 mins . Readability of antibiotic PILs is poor. Improving PIL readability may lead to improved health literacy, which may translate to increased antibiotic adherence and AMR avoidance. Authors preparing written materials for the lay/patient CF community are encouraged to employ readability calculators, so that final materials are within recommended readability reference parameters, to support the health (antibiotic) literacy of their readers.

Carbimazole patient information leaflet improves rate of educating patients on agranulocytosis

Carbimazole patient information leaflet improves rate of educating patients on agranulocytosis

Peristomal skin changes: therapeutic education on prevention and nursing interventions on management

Introduction: for the person with an ostomy it is very important to have intact peristomal skin, because there is a certainty that the ostomy pouching system adheres to the skin; on the other hand, with altered skin there is a greater risk that the ostomy pouching system detaches with consequent infiltration of the effluents and contact with the peristomal skin, showing skin alterations and further compromising the person's quality of life. Materials and methods: the bibliographic research conducted on PubMed detecting 47 publications that answered to the 2 research questions, under 10 years, with a sample of more than 50 adult participants and in English language. Results: to define therapeutic education strategies to prevent peristomal skin complications and the most appropriate nursing interventions and dressing to manage peristomal skin complications. Conclusion: a preventive therapeutic education with detailed, simple, adequate information and perhaps supported by printed information leaflets regarding peristomal skin complications will be able to reduce the incidence of peristomal skin changes, because the person with an ostomy will be able to recognize early the signs and symptoms of altered skin and manage them at home, thanks to the guidelines provided by the specialist nurse. In addition, the specialist nurse can effectively put to good use the expertise acquired through the treatment of peristomal skin complications, preventing the patient from suffering further side effects and speeding up the healing process, which is the main goal.

A Good Medical Practice of the Patients' Right to Information: An Audit Cycle of Patient Understanding and Satisfaction With Information Provided to Patients With Acute Pancreatitis.

Introduction Acute pancreatitis (AP),characterized by the inflammation of the pancreas, is a common acute surgical conditionaccounting for approximately 3% of all surgical admissions with abdominal pain and has an incidence of approximately 56 cases per 100,000 population every year. The General Medical Council (GMC), National Institute for Health and Care Excellence (NICE), andRoyal College of Nursing best practice guidelines recommend that such patients and their family membersshould be provided with both verbal and written information about acute pancreatitis and its management in a way that they can understand.The aim of this audit cycle was to find out the compliance with information provided to patients with acute pancreatitis as perthe GMC good medical practice and NICE guidelines and assess their satisfaction. Method A closed-loop audit consisting of two cycles was carried out. Thirty patients who were admitted to the department of general surgery with acute pancreatitis were provided with a questionnaire containing 11 questions asking about the information provided to them about their condition by healthcare professionals; then, interventions were carried out in the form of developing patientinformation leaflets (PILs) and encouraging healthcare professionals to distribute them and provide information to the patients and theirfamily members. Results Overall, improvements were seen in all aspects of the information being provided to patients, and particularly, more than 100% improvement was seen inpatientsatisfaction related to the information provided to them in the second cycle after the implementation of interventions. Conclusions This study concludes that patients should be given all the information they require in accordance with their right to information, in line with GMC best practice, NICE, and Royal College of Nursing best practice guidelines. A very effective way to improve the health outcomes and satisfaction of patients is to give them access to a patient information leaflet, which canallowpatients to consider their options and understand what can happen during treatment, especially when doctors have limited time to carry out detailed discussions with the patient.

A Community Based Interventional Study to Assess the Knowledge, Attitude and Practice of Disposal of Medicines in Dakshina Kannada

The use of pharmaceuticals is increasing every year worldwide. Proper storage of medicines is essential for the stability of medications. Each medicine should be stored on the specified storage condition, otherwise leading to many harmful impacts and affects the drug stability. An interventional study was carried out among the voluntary participants of Dakshina Kannada with a sample size of 150 with the help of Questionnaire and patient information leaflets (PIL). Informed consent has been obtained from voluntary study participants and the collected data was analyzed using Chi Square test and MS Excel 2017. During the pre-interventional study, it was observed that improper storage of medications was found to be high which were found to be reduced during post intervention. The study emphasizes on bringing awareness to the community and to educate people about the proper storage of medications. Keywords: PIL (Patient Information Leaflet), storage, pre-intervention, post-intervention

Development and evaluation of patient information leaflet for liver cirrhosis patients

Problem consideredThe present study aimed at developing and validating patient information leaflet (PIL) for liver cirrhosis patients. MethodologyPIL was prepared using canvas (an online design graphic tool). Up-to-date and Micromedex were used to gather information on liver cirrhosis. Before user testing, PIL readability was assessed by using the Flesch Reading Ease Score (FR-ES). Additionally, user opinion on the legibility and content of the PIL was also determined. Baker Able Leaflet Design (BALD) method was employed to assess the layout and design characteristics of the PIL. ResultsA total of 52 participants with liver cirrhosis with a mean age of 53.04 ± 11.89 were enrolled in the study. A score of 22.2 was achieved for Flesch Reading Ease Score (FR-ES). The BALD scores for English and Kannada PIL were 25 and 23, respectively. User testing showed significant improvement (p-value: <0.05) in disease knowledge from 12 (6–20) to 16 (12–22). Spearman's correlation showed the disease duration as a significant factor affecting disease knowledge (rs:0.498; p-value: <0.001). Concerning user opinion, 48.1% (n,25) of patients reported the legibility and content of PIL as good. ConclusionPIL met the standard criteria of readability and layout design. Pictogram-based PIL was found to be an effective patient education tool in improving patient disease knowledge in liver cirrhosis patients.

Retrospective survey of colposcopy experience for wāhine Māori across two time periods (2016 and 2021) in Waitematā and Auckland districts, New Zealand.

To examine wāhine Māori experiences of colposcopy services in New Zealand based on surveys conducted in 2016 and 2021. The surveys included a total of 201 wāhine Māori who had attended one of the three colposcopy clinics in the Waitematā and Auckland districts. Participants were retrospectively surveyed about their experience via telephone using a pre-tested questionnaire. Pre-defined responses were analysed quantitatively, and narrative comments were analysed thematically. Response rates were 27.6% in 2016 and 34.2% in 2021. Prior to their appointment, most women reported receiving the information leaflet and a reminder. At the clinic visit, overall interaction with staff, comfort, listening and explanation of the procedure all scored highly, with maintenance or improvements from 2016 to 2021. Wāhine reported feeling culturally safe. Areas for improvement included content of information, access to Māori community liaison, appointment waiting time and delivery of colposcopy results. The findings indicated that wāhine Māori had overall excellent experiences of colposcopy services, maintained over a five-year period with some suggested improvements to context of information and communication. This provides reassurance for wāhine Māori in the diagnostic and treatment part of the cervical screening pathway ahead of the upcoming change to HPV primary screening.

Patient and Context Factors in the Adoption of Active Surveillance for Low-Risk Prostate Cancer

Although active surveillance for patients with low-risk prostate cancer (LRPC) has been recommended for years, its adoption at the population level is often limited. To make active surveillance available for patients with LRPC using a research framework and to compare patient characteristics and clinical outcomes between those who receive active surveillance vs radical treatments at diagnosis. This population-based, prospective cohort study was designed by a large multidisciplinary group of specialists and patients' representatives. The study was conducted within all 18 urology centers and 7 radiation oncology centers in the Piemonte and Valle d'Aosta Regional Oncology Network in Northwest Italy (approximate population, 4.5 million). Participants included patients with a new diagnosis of LRPC from June 2015 to December 2021. Data were analyzed from January to May 2023. At diagnosis, all patients were informed of the available treatment options by the urologist and received an information leaflet describing the benefits and risks of active surveillance compared with active treatments, either radical prostatectomy (RP) or radiation treatment (RT). Patients choosing active surveillance were actively monitored with regular prostate-specific antigen testing, clinical examinations, and a rebiopsy at 12 months. Outcomes of interest were proportion of patients choosing active surveillance or radical treatments, overall survival, and, for patients in active surveillance, treatment-free survival. Comparisons were analyzed with multivariable logistic or Cox models, considering centers as clusters. A total of 852 male patients (median [IQR] age, 70 [64-74] years) were included, and 706 patients (82.9%) chose active surveillance, with an increasing trend over time; 109 patients (12.8%) chose RP, and 37 patients (4.3%) chose RT. Median (IQR) follow-up was 57 (41-76) months. Worse prostate cancer prognostic factors were negatively associated with choosing active surveillance (eg, stage T2a vs T1c: odds ratio [OR], 0.51; 95% CI, 0.28-0.93), while patients who were older (eg, age ≥75 vs <65 years: OR, 4.27; 95% CI, 1.98-9.22), had higher comorbidity (Charlson Comorbidity Index ≥2 vs 0: OR, 1.98; 95% CI, 1.02-3.85), underwent an independent revision of the first prostate biopsy (OR, 2.35; 95% CI, 1.26-4.38) or underwent a multidisciplinary assessment (OR, 2.65; 95% CI, 1.38-5.11) were more likely to choose active surveillance vs active treatment. After adjustment, center at which a patient was treated continued to be an important factor in the choice of treatment (intraclass correlation coefficient, 18.6%). No differences were detected in overall survival between active treatment and active surveillance. Treatment-free survival in the active surveillance cohort was 59.0% (95% CI, 54.8%-62.9%) at 24 months, 54.5% (95% CI, 50.2%-58.6%) at 36 months, and 47.0% (95% CI, 42.2%-51.7%) at 48 months. In this population-based cohort study of patients with LRPC, a research framework at system level as well as favorable prognostic factors, a multidisciplinary approach, and an independent review of the first prostate biopsy at patient-level were positively associated with high uptake of active surveillance, a practice largely underused before this study.

Evaluation of the readability levels of patient information leaflets of frequently prescribed drugs in rheumatology practice

The development and use of new drugs have accelerated in proportion tothe increase in understanding of the pathogenesis of rheumatological diseases. In the treatment of rheumatological diseases, regular and proper use of drugs prevents disease progression and protects the patient from potential exacerbations and complications. The readability of patient information leaflets (PILs) increases treatment compliance. In this study, it was aimed to evaluate the readability levels of PILs of frequently prescribed drugs in rheumatology practice. A total of 182 frequently prescribed medications in rheumatology practice were randomly selected. The PILs of these drugs were scored according to Ateşman and Bezirci-Yılmaz readability scales and their readability levels were thus determined. It was determined that the PILs could be read with 11-12 years of education and high school education on average according to Ateşman and Bezirci-Yılmaz readability scales respectively. Considering the fact that the mean schooling level in Türkiye is 6.5 years, the readability levels of the PILs of frequently prescribed medications in rheumatology practice are well above this level. It is suggested that the current readability of the PILs is adjusted in accordance with the patients’ level of understanding and education and arrangements to increase the readability levels are made.

Multiple-Perspective Data-Driven Analysis of Online Health Communities.

The growth of online health communities and socially generated health-related content has the potential to provide considerable value for patients and healthcare providers alike. For example, members of the public can acquire medical knowledge and interact with others online. However, the volume of information-and the consequent 'noise' associated with large data volumes-can create difficulties for users. In this paper, we present a data-driven approach to better understand these data from multiple stakeholder perspectives. We utilise three techniques-sentiment analysis, content analysis, and topic analysis-to analyse user-generated medical content related to Lyme disease. We use a supervised feature-based model to identify sentiments, content analysis to identify concepts that predominate, and latent Dirichlet allocation strategy as an unsupervised generative model to identify topics represented in the discourse. We validate that applying three different analytic methods highlights differing aspects of the information different stakeholders will be interested in based on the goals of different stakeholders, expert opinion, and comparison with patient information leaflets.

Efficacy of a Decision Aid in Breast Cancer Patients Considering Immediate Reconstruction: Results of a Randomized Controlled Trial.

Breast cancer patients face complex decisions about immediate breast reconstruction (BR) after mastectomy. The authors evaluated the efficacy of an online decision aid in improving the decision-making process, decision quality, and health outcomes in breast cancer patients considering immediate BR. In a multicenter, randomized, controlled trial, patients were allocated to either the intervention group, receiving care as usual with access to an online decision aid, or the control group, receiving care as usual with an information leaflet. The primary outcome was decisional conflict. Secondary outcomes assessed the process of decision-making (eg, preparation for decision-making, satisfaction with information), decision quality (decision regret, knowledge), and health outcomes (eg, satisfaction with BR outcomes, body image). Patients completed questionnaires at time (T) 0 (baseline); T1 (1 week after consultation with a plastic surgeon); and T2 (3 months) and T3 (12 months) after surgery. The authors included 250 patients. Decisional conflict decreased over time in both groups, with no between-group differences. Intervention participants felt better prepared for decision-making than controls ( P = 0.002). At T2, 87% of intervention participants were very satisfied with the information about BR, compared with 73% of control participants ( P = 0.011). No significant between-group differences were observed in any other outcome. The authors' online decision aid was as effective in reducing decisional conflict as an information leaflet about immediate BR after mastectomy. However, the decision aid substantially improved the decision-making process by better preparing breast cancer patients for decisions about immediate BR. Therapeutic, II.

Evidence for benefits and risks of tadalafil as a non-prescription medicine: review and evaluation using the Group Delphi technique to achieve consensus amongst clinical experts.

An evidence-based consensus meeting was held with urologists, a pharmacist and a cardiologist to perform a structured benefit-risk analysis of reclassifying tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor for treatment of erectile dysfunction (ED), to be available without prescription in Germany. As per the Brass process endorsed by regulatory authorities, an evidence-based Brass value tree was developed, which identified the incremental benefits and risks that should be considered above the safety and efficacy evidence required for prescription medicines. During the Group Delphi consensus meeting, the expert panel rated the likelihood and clinical impact of each benefit and risk on a scale of 0 (none) to 3 (high). Overall attribute scores were calculated from the product of the mean likelihood and mean clinical impact scores giving a possible score of 0-9. The overall benefit attribute scores ranged from 2.8 to 5.4. The overall risk attribute scores ranged from 0.2 to 2.2 though most were 1.0 or less (3 or more is generally considered to be of concern). On balance, the independent meeting scored the benefits of reclassification of tadalafil higher than the risks and considered the risk mitigation strategies of the packaging label and patient information leaflet (PIL) sufficient.

SAT438 Nivolumab Induced Endocrinopathies- Outcomes And Learning

Abstract Disclosure: K. Kethireddi: None. S. Jhetam: None. S.B. Parthasarathy: None. Background: Nivolumab is an anti PD-1 mAB (Programmed Cell Death protein) used in the treatment of melanoma, renal, head &amp; neck and other cancers. Use of Nivolumab either as a single therapy or in combination with other immune check point inhibitors (CPI) like Ipilimumab, Pembrolizumab often results in immune mediated endocrinopathies. Existing literature on Nivolumab indicates median time to the onset of hyperthyroidism, hypothyroidism, type 1 diabetes mellitus, and hypophysitis as 1.5 months, 2.9 months, 4.4 months and 4.9 months respectively. Our objective is to add to the existing body of knowledge, compare local data on presentation and other variables of these endocrinopathies with recommendations to improve diagnosis and access to treatment of these endocrinopathies. Design: It is a retrospective analysis of the patients who received Nivolumab (single or combination therapy) between 2019 and 2022 in our hospital. Methodology: A total of 83 patients were treated either with single therapy Nivolumab (n=44) or combination therapy (n=39) and were screened for immune endocrine toxicities. Data was collected mainly from hospital based clinical software for routine use. Data was also collected on prior endocrine tests such as Hba1c and Thyroid function, if done prior to commencement of immunotherapy. Major results: Nineteen patients (23%) developed immune related endocrinopathies which included Thyroiditis/hypothyroidism (n= 12) followed by adrenalitis (n= 6), Type 1 Diabetes (n=1) and hypophysitis (n=3). Onset of thyroid dysfunction occurred between 4 to 8 weeks, adrenalitis between 8 to 32 weeks, hypophysitis between 4 weeks to 12 weeks and 24 weeks for type 1 diabetes mellitus. All patients were appropriately counselled and were provided with Patient Information leaflet. Regular screening bloods (Hba1c, Glucose, Cortisol and Thyroid function tests) were requested in most patients. Emergency presentations of Diabetic ketoacidosis (n=1) and Adrenal insufficiency (n=2) were noted with no mortality. Conclusion: 23% of the patients on Nivolumab had immune mediated endocrinopathy with Thyroiditis/Hypothyroidism being the commonest and the earliest endocrine abnormality. A Standard Operating Procedure for acute endocrine emergencies post Immunotherapy based on Society for Endocrinology guidance, needs to be implemented with education to create greater awareness given the expected high prevalence of these endocrinopathies post Immune CPI therapies. We recommend oral steroid (prednisolone/hydrocortisone) rescue pack and patient education on SMBG (Self-monitoring of blood glucose) as a part of sick day rule management in these patients and we believe this to be lifesaving and resource saving measure given the critical nature of these endocrine emergencies post immune CPI therapies. Presentation: Saturday, June 17, 2023

Peduli Kualitas Kesehatan Masyarakat Setempat Dengan Cegah Stunting

Linear growth failure or as ussually known as stunting is undernutrition problem globally. It is happen in childhood with physical and neurocognitive damage that accompanies stunted growth characterictic. Indonesia as developing country currently trying to solve this problem through government programs. The aims is to improve the quality of young generation. From the results of the Indonesian Nutrition Status Survey (SSGI), the prevalence of stunting in Indonesia is 21.6% in 2022. This high percentage is also supported by poor access to health care in living rural areas. Kampung Sialang Baru also like that. Where it was recorded that this village had poor access to health care. Beside that, the village got the second ranked in most of stunting children in Lubuk Dalam district. There are 18 childs who were infected. This is the result of observations made by Kukerta team. They made socialization stunting program and provide information leaflets about MPASI. The socialization went slowly bring good impact. The participants gained knowledge about MPASI is on of the important thing to prevent stunting. Also, they have leaflets as source of detail information of MPASI menu that is suitable for children.

Counselling customers at risk of the triple whammy effect at community pharmacies – A feasibility study

The combination of diuretics, angiotensin-converting enzyme inhibitors (ACE-i)/angiotensin II receptor blockers (ARBs) and non-steroidal anti-inflammatory drugs (NSAID) involves a risk of acute renal failure known as the triple whammy effect (TWE). NSAID can be provided by prescription or over the counter (OTC) and community pharmacies counsel on this medication every day to contribute to medication safety. The objective of this study is to test the feasibility of an intervention where community pharmacies identify and counsel customers at risk of the TWE.Participating pharmacies were recruited across Denmark and the Faroe Islands. In April to May 2021, all staff at 13 community pharmacies chose 10 workdays to collect data in an electronic tool on their risk assessment, the customers' medication, and counselling about the TWE for customers asking for NSAID. Pharmacy staff were instructed in correct data collection and received learning material and a patient information leaflet on the TWE. These data were analysed descriptively. Staff evaluated the learning material and patient information leaflet in a questionnaire. The quantitative answers from the questionnaire were analysed descriptively and the qualitative answers were analysed using content analysis.According to the pharmacies' risk assessment, 12.1% (n = 215) of customers asking for NSAID were at risk of the TWE. The data on customers' medication showed that only 8.0% (n = 142) were actually at risk of TWE. Of those, 43.0% (n = 61) asked for NSAID on prescription and 57.0% (n = 81) for OTC. In the evaluation of materials pharmacy staff reported overall satisfaction with the learning material, which they reported increased their knowledge of TWE and helped them in their counselling. They also reported satisfaction with the patient information leaflet.Despite pharmacy staff reporting satisfaction with the learning material, it still did not educate staff well enough in assessing the risk of TWE for customers asking for NSAID. More research is needed on TWE interventions in community pharmacies because this study shows that there is a potential for community pharmacies to identify and counsel persons at risk of the TWE.

Health Education for Chronic Kidney Disease Patients Not on Dialysis Through the Pictorial Patient Information Leaflet

Background: Educating the patient with patient information leaflets is helpful to increase understanding and awareness about chronic kidney disease. Various educational materials are available online, but their quality is mixed. The content was found to be unreliable or incomprehensible. Objective: The study aimed to develop, validate, test the readability, translation, and design of the patient information leaflet and focused on assessing patients’ knowledge levels using questionnaires after providing the validated patient information leaflet. Methods: A prospective study was conducted among chronic kidney disease patients who were not on dialysis. The patient information leaflet was prepared based on experts’ opinions and a thorough review of various resources. Experts validated the content of the patient information leaflet through the content validity index. After being validated, the Baker Able leaflet design scale was used to evaluate the layout and design. Knowledge assessment questions were validated using item-content validity index scores to assess patient knowledge before and after providing the patient information leaflet. Results: A total of 60 randomly selected chronic kidney disease patients were enrolled. The content validity index of the patient information leaflet was found to be 0.9. The Baker Able leaflet design score was found to be 25. Knowledge was assessed and it showed that score had increased from 42 ± 6.95 to 73.5 ± 6.70, respectively, with a P-value &lt;0.000. Conclusion: This study concluded that the patient information leaflet was developed based on standard procedures. Significant improvement was seen in patients’ knowledge after utilizing a validated patient information leaflet.

Translators From German in the Newspaper "Yuzhnoe Obozrenie" At the Turn of the XIX–XX Centuries

While in Moscow and St. Petersburg at the turn of the XIX–XX centuries the leading format of journalistic publications was the magazine, in the regions the main role of informing and entertaining the population was played by the newspaper. The focus of the publication was clear from the title. It could be an information leaflet or news leaflet informing about current local and world events, or a broader edition, a political, economic and literary newspaper, in which, among other things, significant attention was paid to culture and literature. Such newspapers performed not only informational, but also educational functions, informing the reader about the main trends of local and world culture through local and translated works of art, bibliographic and theatre notes. Not last role in this process was played by local writers and translators. The article is dedicated to translators from the German language who published their works in the Odessa newspaper "Yuzhnoe obozrenie" at the turn of the 19th–20th centuries.

Survey of maternal anxiety and perceptions towards foetal MRI and pre-scan education.

Foetal MRI scans can induce feelings of fear, concern and anxiety in pregnant patients. The aim of this research was to determine if providing patients with an information leaflet reduced maternal anxiety regarding foetal MRI. A prospective, three-arm comparative pilot study was performed in the MRI department of a quaternary public hospital in Brisbane, Australia. Three groups of 30 participants (total 90 participants) received differing levels of information about foetal MRI: Group A - no foetal-MRI specific information (current practice at the site); Group B - a basic information leaflet; Group C - a comprehensive information leaflet. All participants completed a survey that explored their pre-scan anxiety immediately after their MRI scan. Over 50% of participants in each group felt anxious before the MRI. Participants expressed anxiety towards the general process of the MRI, the outcome or results of the scan, and the safety of the modality. The basic and comprehensive leaflets were both efficacious in reducing anxiety for the majority of participants. Whilst not all patients express anxiety regarding MRI scans, emotional distress surrounding the entire process is prevalent. Providing patients with comprehensive information about what the MRI scan entails (including the scan environment and duration, positioning, breath-holding requirements, and foetal safety) reduces anxiety for most patients. These findings can be used to determine ways in which reduction of anxiety improves the patient experience.