Personnel Practices Research Articles

Pharmacists' Knowledge and Practice of Issues Related to Using Psychotropic Medication in Elderly People in Ethiopia: A Prospective Cross-Sectional Study.

Purpose This study is aimed at assessing pharmacists' knowledge and practice of issue related to usage of psychotropic medications in elderly people, in Gondar town Northwest, Ethiopia. Methods A cross-sectional study was conducted among pharmacists working in community, health center, and hospital pharmacies in Gondar town from March 1 to May 30, 2020. A total of 73 medication retail outlets (40 pharmacies and 33 drug stores) were included in this study. Pharmacy personnel's knowledge and practice were assessed using self-administered validated questionnaires. Binary and multivariable logistic regression analyses were used to assess the association between different variables. P < 0.05 was used to declare the association. Result A total of 144 pharmacists were included in the study; the mean age was 30.13 (SD ±5.87), ranging from 20 to 55years. The mean knowledge score was 7.789 (SD ±2.98), and 75 (52.1%) of them had poor knowledge. The mean practice score was 2.32 ± 0.912 (mean ± SD), and 77 (53.5%) of the respondents had poor practice. All participants had not taken on-the-job training about psychotropic medication. Work experience (P < 0.029) and personal monthly income (P < 0.046) were significantly associated with pharmacists' knowledge. There was a significant association between work experience and practice level (P < 0.043). Conclusion The knowledge and practice of pharmacy personnel were low for issues related to the use of psychotropic medication in the elderly. This result indicates the need for training for pharmacists on pharmacotherapy of psychotropic medication.

Initial Impact of COVID-19 on Radiology Practices: An ACR/RBMA Survey.

PurposeThe coronavirus disease 2019 (COVID-19) pandemic affected radiology practices in many ways. The aim of this survey was to estimate declines in imaging volumes and financial impact across different practice settings during April 2020.MethodsThe survey, comprising 48 questions, was conducted among members of the ACR and the Radiology Business Management Association during May 2020. Survey questions focused on practice demographics, volumes, financials, personnel and staff adjustments, and anticipation of recovery.ResultsDuring April 2020, nearly all radiology practices reported substantial (56.4%-63.7%) declines in imaging volumes, with outpatient imaging volumes most severely affected. Mean gross charges declined by 50.1% to 54.8% and collections declined by 46.4% to 53.9%. Percentage reductions did not correlate with practice size. The majority of respondents believed that volumes would recover but not entirely (62%-88%) and anticipated a short-term recovery, with a surge likely in the short term due to postponement of elective imaging (52%-64%). About 16% of respondents reported that radiologists in their practices tested positive for COVID-19. More than half (52.3%) reported that availability of personal protective equipment had become an issue or was inadequate. A majority (62.3%) reported that their practices had existing remote reading or teleradiology capabilities in place before the pandemic, and 22.3% developed such capabilities in response to the pandemic.ConclusionsRadiology practices across different settings experienced substantial declines in imaging volumes and collections during the initial wave of the COVID-19 pandemic in April 2020. Most are actively engaged in both short- and long-term operational adjustments.

Methacrylate perspective in current dental practice.

To provide a current perspective concerning dental personnel sensitivity to methacrylate materials. Methacrylate related sensitivity and allergies are currently beyond traditional thoughts concerning denture base resins and methyl methacrylate provisional materials. Methacrylates are now ubiquitous in current dental practice and dental personnel should be aware that dental adhesives contain potent sensitizers that may also cross-sensitize individuals to other methacrylates not experienced. The growing sensitivity to 2-hydroxyethyl methacrylate (HEMA) has been described to be epidemic in nature due to the artificial nail industry with dental patients and dental personnel may be more susceptible to dental methacrylate sensitization. While contact dermatitis remains the most prevalent methacrylate-related clinical presentation, respiratory complications and asthma are increasing associated with methacrylate exposure. While additional personal protective equipment (PPE) is thought to be first protective choice, the National Institute for Occupational Safety and Health (NIOSH) considers PPE overall largely ineffective and should be considered only as a last resort. Dental personnel need to be more aware of methacrylate sources and use workplace control measures to limit methacrylate exposures to both dental personnel and patients. Sensitivity to methacrylate materials is a growing dental workplace major concern and dental personnel should be aware of both the methacrylate content of current materials and the products that contain ingredients with the most sensitization potential.

Exercise Is Medicine? The Cardiorespiratory Implications of Ultra-marathon.

Regular physical activity decreases the risk of cardiovascular disease, type II diabetes, obesity, certain cancers, and all-cause mortality. Nevertheless, there is mounting evidence that extreme exercise behaviors may be detrimental to human health. This review collates several decades of literature on the physiology and pathophysiology of ultra-marathon running, with emphasis on the cardiorespiratory implications. Herein, we discuss the prevalence and clinical significance of postrace decreases in lung function and diffusing capacity, respiratory muscle fatigue, pulmonary edema, biomarkers of cardiac injury, left/right ventricular dysfunction, and chronic myocardial remodeling. The aim of this article is to inform risk stratification for ultra-marathon and to edify best practice for personnel overseeing the events (i.e., race directors and medics).

A Survey on Knowledge, Attitude and Practice of Personnel Regarding Hospital Waste Management in Imam Hossein Educational Hospital of Kermanshah

A Survey on Knowledge, Attitude and Practice of Personnel Regarding Hospital Waste Management in Imam Hossein Educational Hospital of Kermanshah

IMPROVEjob \u2013 Participatory intervention to improve job satisfaction of general practice teams: a model for structural and behavioural prevention in small and medium-sized enterprises \u2013 a study protocol of a cluster-randomised controlled trial

BackgroundPerceived high chronic stress is twice as prevalent among German general practitioners (GPs) and non-physician medical staff compared to the general population. The reasons are multi-factorial and include patient, practice, healthcare system and societal factors, such as multi-morbidity, the diversity of populations and innovations in medical care. Also, practice-related factors, like stressful patient-staff interactions, poor process management of waiting times and lack of leadership, play a role. This publicly funded study evaluates the effectiveness of the newly developed participatory, interdisciplinary, and multimodal IMPROVEjob intervention on improving job satisfaction among general practice personnel. The intervention aims at structural stress prevention with regard to working conditions and behavioural stress prevention for leaders and other practice personnel.MethodsIn this cluster-randomised controlled trial, a total of 56 general practices will be assigned to either (1) participation in the IMPROVEjob intervention or (2) the waiting-list control group. The IMPROVEjob intervention consists of the following elements: three workshops, a toolbox with supplemental material and an implementation period with regular contact to so-called IMPROVEjob facilitators. The first workshop, addressing leadership issues, is designed for physicians with leadership responsibilities only. The two subsequent workshops target all GP and non-physician personnel; they address issues of communication (with patients and within the team), self-care and team-care and practice organisation. During the 9-month implementation period, practices will be contacted by IMPROVEjob facilitators to enhance motivation. Additionally, the practices will have access to the toolbox materials online. All participants will complete questionnaires at baseline and follow up. The primary outcome is the change in job satisfaction as measured by the respective scale of the validated German version of the Copenhagen Psychosocial Questionnaire (COPSOQ, version 2018). Secondary outcomes obtained by questionnaires and - qualitatively - by facilitators comprise psychosocial working conditions including leadership aspects, expectations and experiences of the workshops, team and individual efforts and organisational changes.DiscussionIt is hypothesised that participation in the IMPROVEjob intervention will improve job satisfaction and thus constitute a structural and behavioural prevention strategy for the promotion of psychological wellbeing of personnel in general practices and prospectively in other small and medium sized enterprises.Trial registrationGerman Clinical Trials Register: DRKS00012677. Registered on 16 October 2019. Retrospectively, https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID = DRKS00012677.

Social Validity Perceptions of the Self-Regulation Empowerment Program (SREP): A Qualitative Investigation

The overall purpose of the current paper was to examine the social validity perceptions of middle school students and school personnel (i.e., school psychologist, counselors, assistant principal) regarding the importance of effects and appropriateness of an academic, self-regulated learning (SRL) intervention called the Self-Regulation Empowerment Program (SREP). Based on qualitative data gathered from a free-response question with students and multiple focus groups with SREP coaches (i.e., school personnel), the study provided support for the premise that SREP has a positive effect on middle school students’ motivational and strategic skills. Although the coaches noted a few important logistical and contextual challenges when implementing SREP, they underscored three essential components (i.e., planning, strategy training, reflection) but focused most heavily on the value of reflection activities. This study highlights the importance of gathering social validity data from key stakeholders within school contexts, as well as the relevance of using multi-source, multi-method social validity assessment approaches. Implications for school personnel and school-based assessment practices are underscored.

Poultry shop based hygiene practices: a knowledge, attitudes, and practices study on poultry shop personnel of selected districts of Bangladesh

Background: Food-borne disease outbreaks remain a major global health problem, and cross-contamination from raw meat is a major cause in developed countries due to inadequate handling. The goal of this study was to assess the poultry shop personnel's knowledge, attitudes, and practices (KAP) in the selected districts of Bangladesh.Methods: 103 poultry shop personnel were involved in this cross-sectional study.Results: A significant association was observed between the poultry shop personnel and the knowledge (p&lt;0.05), attitudes (p&lt;0.05), and practices (p&lt;0.05) of safe meat-handling. The 68.3% of poultry shop personnel had good, 26.9% had moderate, while only 4.8% of poultry shop personnel had poor knowledge about hygiene practices. The 5.8% of poultry shop personnel showed poor, 19.2% showed moderate and 75% of poultry shop personnel showed good attitude towards hygiene practices. But the poultry shop personnel 36.5% had poor, 44.2% had moderate and only 20% showed good practice of hygiene practices. The knowledge, attitude and practice Mean±SD score of poultry shop personnel was 7.38±2.04, 7.87±2.24 and 4.41±2.38 respectively, indicating that poultry shop personnel had good knowledge and attitude but poor practice. We also found that 42% of poultry shops and poultry shop personnel had maintained totally unhygienic workplace, 56% had moderately hygienic, and while only 2% poultry shops and poultry shop personnel had maintained fully hygienic workplace. Further, linear regression analysis revealed that KAP levels have been significantly associated with age, education, and the majority of knowledge, attitudes, and practice related questions (p&lt;0.05).Conclusions: Public health awareness about safe poultry meat handling and hygiene among poultry shop personnel, in general, should be at the front burner.

How prepared are Myanmar's health care professionals in their response to gender-based violence?

PurposeGender-based violence (GBV) has negative impact on the health and well-being of the survivors. The initial response can lessen the magnitude of the effect, and thus the health care sector's readiness to respond to GBV cases is important. This study aimed to explore the knowledge, attitude and its association to practice regarding GBV response among health care personnel.Design/methodology/approachA cross-sectional study was conducted in 48 public hospitals in Yangon, Myanmar, involving 398 participants including doctors and nurses, by a self-administered structured questionnaire.FindingsAmong 398 participants, most of the participants had moderate level of knowledge, attitude and supportive environmental factors. Only 12.8% had experienced GBV management. The respondents with a bachelor's degree were more likely to practice on health care management towards GBV cases than those who finished with a diploma degree. The medical officers and senior medical officers were more likely to practice than the junior nurses. The participants who had already attended the trainings had more practice than those who had not. Those who work in the regional hospitals were less likely to practice than those who work in the station-level hospital.Originality/valueThis paper explored the associated factors to health care personnel's practice of health care management towards GBV survivors in Myanmar which contains information about knowledge, attitude and supportive environmental factors. The study results can be used for a supportive data for health system strengthening the response of GBV cases in Myanmar.

Influenza vaccination among Dutch general practitioners and their attitude toward influenza vaccination in the elderly

ABSTRACT Knowledge, attitudes and beliefs (KABs) toward influenza vaccination (IV) play a key role in HCWs’ decisions to receive vaccination and can strongly influence patients’ IV uptake. We examined the knowledge, attitudes and beliefs of GPs toward IV, exploring their opinion on IV in the elderly, mandatory HCW vaccination and the desirability of an IV trial in the elderly with hospitalization/mortality as effect measure. From November 2018 to March 2019, surveys were emailed to GPs and GP-practices (n = 1676) in three regions of the Netherlands. We assessed the self-reported IV in GPs, reasons for (not) advising IV to personnel, (not) supporting mandatory IV for personnel and (not) desiring a trial on IV in the elderly on hospitalization/mortality. Multivariable logistic regression models were used to determine predictors for GP IV. A total of 552 surveys were completed and 71.9% of the GPs reported receiving IV. Determinants for IV in GPs were male sex (aOR 1.62, 95%CI 1.06–2.49, p = .03) and age ≥60 y (aOR 5.25, 95%CI 1.51–18.32, p = .01). Seventy-nine percent of the GPs recommend IV for their practice personnel. Mandatory IV for personnel was supported by 41.2% of the GPs with GP self-reporting IV being the only determinant (aOR 10.03 (95%CI 5.69–17.70 p = .00)). An IV trial on hospitalization and/or mortality was desired by 60.5% of the GPs. We concluded that the majority of Dutch GPs receives IV and recommends IV to their personnel. These high rates along with the hesitancy of GPs toward mandatory HCW IV should be considered when policymakers decide on a mandate for IV in HCW in general.

Evaluating the sustained effectiveness of a multimodal intervention aimed at influencing PIVC insertion practices in the emergency department

IntroductionMultimodal interventions (MMI) are frequently used in various healthcare settings to encourage change in healthcare personnel practices and improve patient safety. In 2013, an MMI conducted in an Australian metropolitan...

Health care personnel\u2019s perception of guideline implementation for musculoskeletal imaging: a process evaluation

BackgroundThe increasing complexity and variability in radiology have significantly fueled the need for guidelines. There are many methods for disseminating and implementing guidelines however; and obtaining lasting changes has been difficult. Implementation outcome is usually measured in a decrease in unwarranted examinations, and qualitative data are rarely used. This study’s aim was to evaluate a guideline implementation process and identify factors influencing implementation outcome using qualitative data.MethodsSeven general practitioners and five radiological personnel from a Norwegian county participated in four focus group interviews in 2019. The data were analyzed using qualitative content analysis, where some categories were predetermined, while most were drawn from the data.ResultsFour main categories were developed from the data material. 1) Successful/unsuccessful parts of the implementation, 2) perceived changes/lack of changes after the implementation, 3) environment-related factors that affected guideline use, and 4) User related factors that affect guideline use.ConclusionsOur findings show that clinical guideline implementation is difficult, despite the implementation strategy being tailored to the target groups. Several environment- and user-related factors contributed to the lack of changes experienced in practice for both general practitioners and radiological personnel.

Assessing knowledge, attitude, and practice of healthcare personnel regarding biomedical waste management: a systematic review of available tools.

Biomedical waste (BMW) management is an important commitment of hospitals both in terms of the possible infectious risk and from the financial point of view. Monitoring the knowledge, attitude, and practice (KAP) of healthcare professionals on this topic represents a source of information on BMW management. The aim of this study is to perform a systematic review to identify the reliable and valid tools able to assess the KAP of professionals in healthcare centers to manage BMW. Two databases (PubMed and Scopus) were searched on 10 May 2018 for cross-sectional studies with tools on BWM management, including original research studies from peer-reviewed journals, case studies, and review studies. Information on validation and reliability were collected. Methodological quality was assessed using the Newcastle-Ottawa scale for cross-sectional studies. Fifty-three articles were included, of which 19 presented a questionnaire on BMW for healthcare workers. Nine proposed a validated questionnaire: four reported Cronbach's alpha, which ranged from 0.62 to 0.86. Results further emphasize the prevalence of Asian studies facing the problem of assessing KAP about BMW management using specific tools. Overall, 14 questionnaires were designed in Asia, two in Africa, one in America, one in Australia, and one questionnaire was elaborated in Europe, in Spain. This systematic review highlighted the need of creation of validated and methodologically high-quality questionnaires. Therefore, there is the need of new cross-sectional studies to investigate these problems, improving generalization, and facilitating international comparison of research findings.

Joy in Work for Clinicians and Staff: Identifying Remedial Predictors of Burnout from the Mini Z Survey.

The CMS Transforming Clinical Practice Initiative (TCPI) provided coaching and learning support to practices during transition to new models of value-based care. Maryland ambulatory practices participated in the Garden Practice Transformation Network (GPTN) as a part of the TCPI. During practices assessment, we measured prevalence of burnout and identified its remediable predictors among GPTN-Maryland practices. A modified Mini Z tool survey was distributed among clinicians and staff in November 2018 - July 2019. Association between presence of burnout and burnout drivers was assessed using a Generalized Estimating Equation regression model for ordinal outcome. Data from 166 responses were analyzed. Prevalence of burnout symptoms was 22%, with 35% enjoying their work. A 100-point Time Constraints/Teamwork (T/T) score was constructed using factors significantly associated with burnout symptoms. T/T score increase by 1 unit was associated with 10% increase in the odds of moving from the group experiencing burnout or stress to the group who found 'joy in work' (OR = 1.1, 95% CI 1.07, 1.13, p < 0.0001). The Mini Z-derived T/T score could be useful for quick assessment of the degree of burnout and identifying burnout drivers related to effective organizational structure and supportive teamwork in practice personnel.

An Application of Time-Driven Activity-Based Costing in an Interventional Radiology Practice.

Central venous catheter (CVC) placement is a high-volume procedure performed by various personnel, including physicians and advanced practice providers (APPs), and placed in various settings, including operating rooms, intensive care units, and ambulatory surgical centers. Of these locations, CVC placements performed in the hospital-based interventional radiology (IR) suite represent a high-volume setting with presumed high capital costs. We applied time-driven activity-based costing (TDABC) methodology to estimate the cost of performing a tunneled CVC placement in a hospital-based IR suite and ultimately building a flexible cost model that can be easily extrapolated to accurately estimate the costs of performing other minimally invasive procedures in different sites by different operators.

MANAGING FUNCTIONAL EDUCATION AT SECONDARY SCHOOL LEVEL FOR SUSTAINABLE NATIONAL DEVELOPMENT THROUGH EFFECTIVE LEADERSHIP PRACTICES IN ANAMBRA STATE, NIGERIA

This study therefore investigated ways of managing functional secondary education for sustainable national development through effective leadership practices in Anambra State. Four research questions guided the study. The researcher employed a descriptive survey research design. The population of the study comprised 6,230 principals and teachers from all public secondary schools in the six education zones of Anambra State. Nine hundred and eight (908) respondents comprising two hundred and twenty (220) principals and six hundred and eighty-eight (688) teachers selected through the use of simple random sampling techniques constituted the sample size for the study. The instrument for data collection was a - 36 item questionnaire tagged Managing Functional Secondary Education for Sustainable National Development Questionnaire” (MFSESNDQ). The instrument was duly validated by three experts in the Department of Educational Foundations and Management and all from Chukwuemeka Odumegwu Ojukwu University, Anambra State. The reliability of the instrument was determined through a pilot-testing that was carried out in selecting a sample of 6 principals and 24 teachers from 6 public secondary schools in Delta State. Thereafter, the scores were measured using Cronbach Alpha method to obtain an internal consistency reliability value of 0.72 and were considered adequate for the study. Findings from the study showed that: the principals' applied little instructional leadership practices, students' personnel practices and teacher collaborative practices for managing functional secondary education for sustainable national development in Anambra State. Out of these findings, recommendation were made which include: Anambra State Government in Collaboration with Post-Primary Education Board (PPEB) should mandated to support and strengthen external collaborative practices between principals and the local communities as a way of improving managing functional secondary education for sustainable development in Anambra State. Article visualizations:

Ultraviolet Radiation Exposure, Risk, and Protection in Military and Outdoor Athletes.

Overexposure to ultraviolet radiation (UVR) from the sun is associated with deleterious health effects including, but not limited to, increased risk of skin cancers. Military personnel and those who participate in outdoor exercise or sports represent two potential populations at elevated risk of negative health consequences of UVR exposure due to large amounts of time spent outdoors, often in harsh UVR environments. Despite exposure to high and/or frequent doses of UVR in recreational and tactical athletes, adequate sun-protection practices are often disregarded or not well understood by many within these at-risk populations, resulting in heightened risk of negative UVR effects. The focus of this review is to examine the available literature regarding UVR exposure, risk of adverse health effects of UVR exposure, and sun protection practices in outdoor exercisers, athletes, and military personnel.

The qualitative study of disease cognition, treatment compliance and community services evaluation of community patients with schizophrenia, family members and disease control personnels

Objective To investigate the evaluation of disease perception, treatment compliance and community follow-up services of community schizophrenia patients, family members and personnel in Shantou City, and to provide a reference basis for improving the quality of management treatment. Methods With the method of stratified sampling qualitative research, a community sample of 17 198 patients with schizophrenia in seven districts or county in Shantou City were sampled from February to August 2019, with 2 towns being drawn from each district or county, and 10 patients, 10 family members and 3 personnel were selected in each town. The evaluation of disease perception, treatment compliance and community follow-up services were investigated and analyzed. Respondents were eventually included in 137 patients, 138 family members and 41 personnel.The interviewees were conducted with semi-structured interviews, the data were collected according to traditional methods, and the descriptive statistical analysis was carried out with SPSS 12.0. Results (1)34.3% of patients and 32.6% of the family members were not fully aware of the disease.22.6% of the patients and 23.2% of the family members had a sense of ill shame. (2)26.3% of patients did not comply with treatment, 29.9% of patients had not insight, 53.3% of patients and 24.6% of family members on the side effects of drugs and addiction understood improperly, and, 35.0% of patients and 13.0% of the family had a misunderstanding of illness and using drugs. (3)29.2% of patients and 31.2% of their families were tired of taking long-term medication, 24.8% of patients and 21.0% of their families felt socially isolated, and, 17.5% felt unsupported and 18.8% of their families admitted that they did not care enough about patients. (4)31.4% of patients did not actively receive follow-up services, 37.2% of patients and 20.3% of family members did not cooperate with follow-up doctors, and, 21.2% of patients and 10.1% of family members were not satisfied with follow-up services. (5)The personnel of psychiatric care could basically grasp the conditions of patients in the jurisdiction and carried out follow-up services on a regular basis (90.2%), master emergency disposal methods (92.7%), and have carried out training (97.6%). However, the psychiatric practice of the personnel were lower than (58.5%) and most lying part-time (78.0%), the average length of service was 5.7±1.4 years. The personnel satisfaction with the community follow-up service was higher (95.1%), but most of them thought that the psychiatric care was more difficult (36.6%), and were dissatisfied with the multi-functional staff to undertake a number of public services (31.7%). Conclusion The management treatment project of mental disorders services in Shantou City show initial results.The patients were satisfied with the community follow-up service, but the patients and their families still have low level of cognition, poor compliance, obvious negative emotions, and have concerns about drug treatment.It is necessary to strengthen the professionalization of personnel, to carry out early mental health education and rational emotional behavior training for patients and their families. Key words: Schizophrenia; Disease cognition; Therapeutic compliance; Community management; Qualitative research

Inadequate Knowledge and Practice of Pharmacovigilance affecting Adverse Drug Reaction Reporting by Health Professionals in Private Healthcare Facilities in Lusaka, Zambia

Background:&#x0D; There is currently insufficient information regarding the levels of knowledge and practice of Adverse Drug Reactions (ADRs) reporting among healthcare professionals in Zambia.&#x0D; Aim:&#x0D; The study examined knowledge, attitude and reporting practices among medical doctors, pharmacists and nurses in private healthcare facilities in Lusaka, Zambia.&#x0D; Methods:&#x0D; A descriptive cross-sectional study was undertaken. Data was collected using a selfadministered questionnaire assessing general knowledge, attitudes and practice of ADR reporting. A rated score was used to categorize knowledge as poor, average, or good. A Kruskal-Wallis H test followed by Bonferroni test was used to compare knowledge levels among medical doctors, pharmacists and nurses, respectively. To assess practice and attitude towards the ADR reporting,proportions were used to analyze responses to items in each of the respective domain.&#x0D; Results:&#x0D; General knowledge of ADR reporting among the medical doctors, pharmacists and nurses in the private sector was relatively low. A Kruskal-Wallis H test showed that there was a statistically significant difference in total score between thedifferent occupations, ÷ 2 (2) = 10.839, p = 0.004, with a mean rank score of 34.08 for pharmacists (n =18), 22.17 for doctors (n = 24) and 16.19 for nurses (n = 8). Low knowledge levels of ADR reporting were attributed to lack of pharmacovigilancetraining, with thirty nine (78%) of the participants indicating that they had never received any training on ADR reporting and thirty seven participants (74%) indicated that they had never reported an ADR. Factors that discouraged ADR reporting included: practitioner concern that the information reported may be wrong (46.8%); the level of clinicalknowledge to decide whether an ADR had occurred (46.8%); lack of time to complete the ADR report forms (36.2%); reporting generating extra work load (25.5%); and the perceived unimportance of reporting a recognized ADR believing it would make little difference to knowledge and practice (19.1%). The major factors that encouraged ADR reporting included: seriousness of the ADR (98%); unusual reactions (77.6%); adverse reaction to a new product (83.7%); confidence in diagnosis of an ADR (73.5%), and if the reaction was well recognized for a particular drug (67.3%). The training of personnel in private practice was major indicator for improvement of ADR reporting.&#x0D; Conclusion:&#x0D; Despite the relative positive attitudes indicated, low levels of knowledge due to lack of training was the main driver of ADR underreporting practice among private health practitioners that participated in this study.Addressing the knowledge and practice gaps identified will go a long way to further improveADR reporting rates and medication safety in private healthcare practice settings.

The model of meditation course suitable for the sociocultural background of Americans

The objectives of this research were 1) to analyse sociocultural background of Americans 2) to analyse current American meditation practices and 3) to form the model of meditation course suitable for the sociocultural background of Americans. By nature, Americans are adaptable and open to new traditions and ideas. There are four widespread meditation schools in the United States, which are Goenka, Plum Village, Shambhala and TM. According to the results of analysis based on the concept of Sappāya 4 or Four Favorable Conditions, which are place, meal, personnel and meditation practice; the researcher synthesized the meditation course suitable for the sociocultural background of Americans thus; 1) Place (Meditation Center): Americans generally live hasty lives, and as such, they tend to use an easy location for daily meditation and choose a peaceful place for long retreat. 2) Meal: provision of two or three healthy vegetarian or non-vegetarian meals a day for long retreats. 3) Personnel: both meditation teachers and mentors should be local people who are systematically trained to the same standard and certified. 4) Meditation: focus on teaching meditation techniques, avoid religious instruction and sensitive issues.