Daily Archives: 16 May 2024

Rural pharmacists play a crucial role in home-based palliative care

According to new findings, pharmacists are increasingly acknowledged for their essential contributions to supporting patients receiving home-based palliative care in rural areas. This research indicates that these professionals empower patients to remain at home and deliver considerable comfort and reassurance to patients, their caregivers, and their families.

The research, conducted by the University of South Australia with the support of the Pharmaceutical Society of Australia, demonstrates that pharmacists specializing in home palliative care significantly improve medication management, enhance communication between patients and their healthcare teams, and reduce the need for general practitioner visits.

The study focuses on the real-world influence of home palliative care pharmacists in rural South Australia. It evaluates the efficacy of this care model through the lens of healthcare professionals.

Globally, approximately 56.8 million people, including 25.7 million in their final year of life, require palliative care. However, only about 14% of those in need receive these services. As the population ages, the demand for palliative care is rising worldwide.

Tash Downing, the lead researcher and pharmacist, points out that although pharmacists are not traditionally seen as part of home palliative care teams, they hold an invaluable position.

“Many patients in palliative care express a preference for being at home, where they feel most comfortable and close to their loved ones. Nevertheless, home-based care presents numerous challenges, particularly in managing medications,” explains Downing.

Effective medication management can alleviate symptoms and enhance quality of life, but it often burdens patients, caregivers, and other medical professionals.

“Our findings suggest that incorporating a pharmacist into the rural palliative care team can mitigate workforce shortages in these areas and elevate the standard of available care for rural patients,” Downing adds.

Crucially, having a local pharmacist allows patients to make more informed choices about their care. They benefit from trusted, regional coordination of prescriptions and medications, reduced need for travel to appointments, and lower levels of distress.

Health professionals participating in the study also noted that the presence of a home palliative care pharmacist improved communication with the treating team, lightened the workload for other health professionals, and lessened the care disparity between rural and urban patients.

The pilot program, launched by the Pharmaceutical Society of Australia and funded by the South Australian Department for Health and Wellbeing, facilitated a pharmacist to deliver home-based care services in regional South Australia. This study assessed the care model by exploring the experiences of healthcare professionals who had worked with the palliative care patients involved in this initiative.

Dr. Gemma Skaczkowski, a co-researcher from the Department of Rural Health at the University of South Australia, remarks that this rural model of palliative care has been exceedingly effective in the areas participating in the pilot.

“By delineating the benefits and challenges of the pharmacist’s role as perceived by other healthcare professionals, we aim to draw more attention to the necessity of such a care model in rural settings and, ultimately, to enhance the palliative experience for patients, irrespective of their location,” says Dr Skaczkowski.

She emphasizes that further efforts are needed to explore sustainable funding for this model and to determine the best practices for broader implementation.

More information: Natasha J. Downing et al, A qualitative exploration of the role of a palliative care pharmacist providing home-based care in the rural setting, from the perspective of health care professionals, Australian Journal of Rural Health. DOI: 10.1111/ajr.13115

Journal information: Australian Journal of Rural Health Provided by University of South Australia

A study has evaluated the potential risk of mutations arising from the lingering radiation following the Fukushima nuclear disaster

Ionising radiation from nuclear disasters has known detrimental effects on the natural environment. The 2011 Fukushima Dai-ichi Nuclear Power Plant meltdown stands as a stark testament to such catastrophic events in recent history. Even now, a decade after the incident, concerns persist regarding the enduring impact of radiation. Particularly elusive are the ramifications of residual low-dose radiation on living organisms at the genetic level.

The primary brunt of such disasters typically falls upon the flora inhabiting contaminated regions, as they lack mobility. Yet, paradoxically, this immobility renders them ideal subjects for scrutinising the effects of ionising radiation on living organisms. Notably, coniferous species like the Japanese red pine and fir exhibited anomalous branching patterns post-Fukushima. Nevertheless, whether such aberrations signify genetic alterations induced by the prevailing low-dose-rate radiation remains uncertain.

In response to this uncertainty, a team of researchers from Japan devised a novel and cost-effective method to assess the mutation risks engendered by low-dose-rate radiation (ranging from 0.08 to 6.86 μGy h-1) in two commonly cultivated tree species of Japan thriving in the contaminated territory. Using a unique bioinformatics pipeline, they examined de novo mutations (DNMs), i.e., genetic changes or mutations absent in previous generations, within the germline of the gymnosperm Japanese cedar and the angiosperm flowering cherry. The study, led by Dr. Saneyoshi Ueno from the Forestry and Forest Products Research Institute, was a collaboration with Dr. Shingo Kaneko of Fukushima University. Dr Kaneko explained the motivation behind their work, stating, “Residents of the affected areas are anxious and seek reassurance in their daily lives. We aimed to dispel any misinformation surrounding the biological repercussions of the nuclear plant disaster.”

For the Japanese cedar sampling, the team initially gauged the levels of radioactive cesium (137Cs) in the cone-bearing branches. Subsequently, these cones were utilised for seed collection, germination, and DNA extraction from the remaining megagametophytes. Conversely, an artificial crossing experiment preceded seed collection and DNA extraction for the Japanese flowering cherry. Employing restriction site-associated DNA sequencing, the researchers juxtaposed the DNA sequences of the offspring with those of the parent. The DNMs were discerned utilising a bioinformatic pipeline devised by the researchers.

Significantly, the researchers discovered no DNMs in the Japanese flowering cherry samples. However, an average of 0.67 DNMs per megagametophyte sample emerged for the Japanese cedar within the “difficult-to-return” zone. Surprisingly, neither the concentration of 137Cs nor the ambient dose rate showed any discernible impact on the presence or absence of DNMs in Japanese cedar and flowering cherry. These findings suggest that the mutation rate in trees thriving in contaminated regions did not significantly increase due to ambient radiation. Dr Ueno emphasised, “Our findings also suggest that mutation rates vary among lineages and are primarily influenced by environmental factors.”

This study marks the inaugural use of DNM frequency to evaluate the aftermath of a nuclear catastrophe. As the proliferation of nuclear power plants heightens globally, so does the peril of nuclear accidents. Regarding the future implications of their research, Dr. Ueno commented, “The methodology advanced in our study can not only enhance our comprehension of the interplay between genetics and radiation but also expedite hereditary risk assessments following nuclear mishaps.”

More information: Saneyoshi Ueno et al, Rapid survey of de novo mutations in naturally growing tree species following the March 2011 disaster in Fukushima: The effect of low-dose-rate radiation, Environment International. DOI: 10.1016/j.envint.2023.107893

Journal information: Environment International Provided by Forestry and Forest Products Research Institute