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Pharmacists are uniquely placed in the community to be of assistance to disaster-affected patients. However, the roles undertaken by pharmacists in disasters are identified based on their own experiences and networks. There is currently no definition or acknowledgment of pharmacists' roles in disasters. To acquire consensus from an expert panel of key opinion leaders within the field of disaster health on pharmacists' roles in disasters throughout the four disaster phases-prevention, preparedness, response, and recovery. A Delphi study consisting of three rounds of online surveys was utilised. Twenty-four key opinion leaders were contacted, with 15 completing all three rounds. The 15 expert panellists were presented with 46 roles identified in the literature and asked to rank their opinions on a 5-point Likert scale. This study used an international, all-hazard, and multijurisdictional approach. Consensus was benchmarked at 80% and any role which did not reach consensus was re-queried in the subsequent round. The third round provided the results of the Delphi study and sought commentary on the acceptance or rejection of the roles. Of the 46 roles provided to the expert panel, 43 roles were accepted as roles pharmacists are capable of undertaking in a disaster. There were five roles for the prevention phase, nine for the preparedness phase, 21 for the response phase, and eight for the recovery phase. The experts were asked to prioritise the top five roles for each of the disaster phases. The three roles which did not make consensus were deemed to be specialised roles for disaster pharmacists and not generalisable to the broader pharmacy profession. This study identifies pharmacists' roles in disasters which have been accepted by the international disaster health community. The international key opinion leaders recommended that pharmacists could be undertaking 43 roles in a disaster, however, this is dependent on individual jurisdiction considerations. Pharmacy professional associations need to advocate to policymakers for legislative support and to ensure pharmacists are equipped with the training and education required to undertake these roles within specific jurisdictions.

The number of jurisdictions allowing access to medicinal cannabis has been steadily increasing since the state of California introduced legislation in 1996. Although there is a high degree of legislative heterogeneity across jurisdictions, the involvement of a health professional is common among all. This places health professionals at the forefront of therapy, yet no systematic review of literature has offered insight into the beliefs, knowledge, and concerns of health professionals regarding medicinal cannabis. Using a predetermined study protocol, PubMed, EMBASE, PsycINFO, CINAHL, and Scopus databases were searched for studies indexed up to the 1st August 2018. Pre-defined inclusion and exclusion criteria were applied uniformly. Screening for relevancy, full-text review, data extraction, and risk of bias were completed by two independent investigators. Risk of bias was assessed using CASP criteria (qualitative) and a modified domain-based risk assessment tool (quantitative). Of the 15,775 studies retrieved, 106 underwent full-text review and of these, 26 were included. The overall risk of bias was considered low across all included studies. The general impression was that health professionals supported the use of medicinal cannabis in practice; however, there was a unanimous lack of self-perceived knowledge surrounding all aspects of medicinal cannabis. Health professionals also voiced concern regarding direct patient harms and indirect societal harms. This systematic review has offered a lens through which to view the existing literature surrounding the beliefs, knowledge, and concerns of health professionals regarding medicinal cannabis. These results are limited, however, by the implicit common-sense models of behaviour utilised by the included studies. Before strategies can be developed and implemented to change health professional behaviour, a more thorough understanding of the factors that underpin the delivery of medicinal cannabis is necessary.

Pharmaceuticals and their packaging have a significant negative impact on the environment providing a very strong argument for action on the part of pharmacists and pharmacy technicians to engage with pro-environmental behaviours (PEBs) in their workplaces. The aims of this research were therefore to investigate in hospital pharmacists and pharmacy technicians, 1) factors affecting engagement with workplace PEBs, and 2) determine if legislated carbon reduction targets in the UK influenced workplace PEBs in the UK compared with Australia which does not have legislated carbon reduction targets. The environmentally responsible disposal of pharmaceutical waste was the PEB of interest in this study. A mixed methods research design was utilised and a conceptual model (key variables: environmental attitude, concern, and knowledge, and organisational factors) was developed to identify factors influencing workplace PEBs. Participants were from five hospitals in Queensland, Australia and five NHS hospitals in England, UK. There was no statistically significant difference in environmental attitude or concern between the two groups—most had a mid-environmental attitude score and low levels of environmental concern. Participants lacked knowledge of the issue and the link between the environment and public health. Both Australian and UK participants reported recycling packaging waste was not a priority in the hospital pharmacy workplace (even in hospitals with recycling capability) as hospitals focused on compliance with clinical (contaminated) and confidential waste streams. Environmental attitude, knowledge, and concern therefore appeared to be weak influences on intention to perform workplace PEBs with workplace social norms (compliance due to audits) appearing to be a significant mediator of action. The key difference between the cohorts was that UK pharmacists felt waste was not in the scope of their role, and therefore not their responsibility. This study identified that legislated carbon reduction targets did not influence hospital pharmacy workplace PEBs–neither cohort reported engaging significantly in workplace PEBs. UK Government and NHS sustainability policy did not appear to have disseminated to pharmacy department level of UK public hospitals to any great extent.

Abstract Background Extreme heat (EH) events are increasing in frequency and duration and cause more deaths in Australia than any other extreme weather event. Consequently, EH events lead to an increase in the number of patient presentations to hospitals. Methods Climatic observations for Hobart’s region and Royal Hobart Hospital (RHH) emergency department admissions data were collected retrospectively for the study period of 2003–2010. A distributed lag non-linear model (DLNM) was fitted using a generalized linear model with quasi-Poisson family to obtain adjusted estimates for the relationship between temperature and the relative risk of being admitted to the RHH. Results The model demonstrated that relative to the annual mean temperature of 14°C, the relative risk of being admitted to the RHH for the years 2003–2010 was significantly higher for all temperatures above 27°C (P < 0.05 in all cases). The peak effect upon admission was noted on the same day as the EH event, however, the model suggests that a lag effect exists, increasing the likelihood of admission to the RHH for a further 14 days. Conclusions To relieve the added burden on emergency departments during these events, adaptation strategies adopted by public health organizations could include preventative health initiatives.

Introduction Work Integrated Learning (WIL) experiences are a key component in medical imaging (MI) studies. However, these unpaid placements often result in significant financial stress, otherwise known as ‘placement poverty’, due to reduced income during placement and associated costs. Despite significant research in other allied health disciplines, the impact on MI students remains under‐researched. Methods A structured survey based upon the WIDE survey originally developed in New Zealand was administered by the University's Qualtrics platform. Ethics approval was granted (Ethics # 6894). The survey targeted students in their final 2 years of the four‐year Honours degree, along with students within 2 years post‐graduation. The survey collected both quantitative and qualitative data on financial stress during WIL placements. Of 250 eligible participants, 56 responded, with 28 complete responses included in the analysis. Results Findings have demonstrated MI students experience substantial financial hardship during WIL placements. Key stressors included travel, accommodation, uniforms, and increased daily living costs. Full‐time placement schedules limited students' ability to maintain part‐time employment, with rural placements further increasing their financial burden. Students reported impacts on mental health, academic performance, and overall wellbeing. Financial stress led some students to reduce their study load, take leave from the course or consider course withdrawal. Conclusion This study highlights the significant financial challenges facing MI students during WIL placements, with implications for students' retention and workforce sustainability. Targeted financial support, flexible placement models, and policy reform are urgently needed to ensure equitable training and to address the ongoing workforce shortage. Medical imaging students face major financial stress during unpaid clinical placements, with costs for travel, accommodation, and lost income impacting mental health and study success. This stress can affect their mental health, studies, and even lead some to consider leaving their course. Urgent action is needed to provide support and ensure workforce sustainability.

In a disaster aftermath, pharmacists have the potential to provide essential health services and contribute to the maintenance of the health and well-being of their community. Despite their importance in the health care system, little is known about the factors that affect pharmacists' disaster preparedness and associated behaviors. The goal of this study was to determine the factors that influence disaster preparedness behaviors and disaster preparedness of Australian pharmacists. A 70-question survey was developed from previous research findings. This survey was released online and registered Australian pharmacists were invited to participate. Multiple linear regression was used to determine the factors that influenced preparedness and preparedness behaviors among pharmacists. The final model of disaster preparedness indicated that 86.0% of variation in preparedness was explained by disaster experience, perceived knowledge and skills, colleague preparedness, perceived self-efficacy, previous preparedness behaviors, perceived potential disaster severity, and trust of external information sources. The final model of preparedness behaviors indicated that 71.1% of variation in previous preparedness behaviors can be explained by disaster experience, perceived institution responsibility, colleague preparedness, perceived likelihood of disaster, perceived professional responsibility, and years of practice as a pharmacist. This research is the first to explore the significant factors affecting preparedness behaviors and preparedness of Australian pharmacists for disasters. It begins to provide insight into potential critical gaps in current disaster preparedness behaviors and preparedness among pharmacists.

In addition to the traditional logistics role, pharmacists are undertaking important new roles in disasters. Despite this, little is known about the level of acceptance of these activities by other providers.ProblemThe aim of this study was to determine the international opinion of disaster and health professionals regarding the emerging roles of pharmacists in disasters. Delegates at the World Association for Disaster and Emergency Medicine's (WADEM; Madison, Wisconsin USA) 20th Congress in Toronto, Canada (April 2017) were invited to complete an anonymous survey posing eight questions regarding attitudes towards pharmacists' roles in disasters. Quantitative data were analyzed using IBM (IBM Corp.; Armonk, New York USA) SPSS statistical software version 23, and qualitative data were manually coded. Of the 222 surveys handed out, 126 surveys were completed yielding a 56.8% response rate. Of the respondents, 96.8% (122/126) believed pharmacists had a role in disasters additional to logistics. Out of 11 potential roles pharmacists could perform in a disaster, provided on a 5-point Likert scale, eight roles were given a rating of \"Agree\" or \"Strongly Agree\" by 72.4% or more of the participants. Lack of understanding of a pharmacist's roles and capabilities was the highest described barrier to pharmacists' roles in disaster management. This multi-disciplinary disaster health \"community\" agreed pharmacists have roles in disasters in addition to the established role in supply chain logistics. Participants accepted that pharmacists could possibly undertake numerous clinical roles in a disaster. Several barriers were identified that may be preventing pharmacists from being further included in disaster health management planning and response.Watson KE, Tippett V, Singleton JA, Nissen LM. Disaster health management: do pharmacists fit in the team?

Group assessment is an important collaborative learning structure for development of graduate teamwork competencies. However, group assessments are often associated with poorer learning outcomes due to highly negative student experiences involving tension and conflict. In this study, an online tool incorporating four strategic ‘GATES’ ( Team structure, Communication, Leadership, and Situation monitoring/Mutual support) was designed to support the social processes required for team cohesion. The ‘GATES’ tool was evaluated using mixed methods in an observational, correlational (cross-sectional) study of 693 undergraduate and post-graduate university students and five academics in five Allied Health university courses with a group assessment task. Participants completed two anonymous questionnaires (previous experiences and current experiences) that generated both quantitative and qualitative data. In the first, 95.19% (178/187) of respondents reported a previous group assessment experience, and the experience was negative for 19.1% (34/178) of these students, with 85.3% (29/34) attributing this to group member behaviour. All academics reported issues with previous group assessments they had delivered. Of the students who used the tool ( n  = 52), there was no statistically significant association between gender, CALD status, or age with group assessment experience. However, 56.9% (29/52) of students and all five academics found the tool useful for getting the group started early, and for managing team issues. The tool appeared most helpful with organisation and planning than in managing team issues, potentially due to the tool negating issues before they arose. Overall, our study’s findings indicate that ‘GATES’ keeps students on track and provides timely support during the team management process.

Introduction:Human-induced climate change is increasing the likelihood and severity of wildfires across the globe. This has negative consequences for the health of affected communities through the loss of health systems’ infrastructure and disrupted health services. Community pharmacies are a central hub between patients and the health care system and can provide continuity of care during wildfires. However, there is little in peer-reviewed literature about the impacts of wildfires on community pharmacy operations.Study Objective:The aim of this study was therefore to explore the impacts of the 2018/2019 summer bushfires in Tasmania, Australia on community pharmacy operations in affected areas.Methods:Semi-structured telephone interviews were conducted with four community pharmacists who were working in the affected region during the bushfires. Interviews were audio recorded and transcribed verbatim. Qualitative data were analyzed using two methods– manual coding utilizing NVivo software and Leximancer analysis. Inter-rater reliability was ensured by two researchers analyzing the data independently. Differences in coding were discussed and agreement reached through negotiation amongst the research team.Results:From the manual coding analysis, five key themes emerged – communication and collaboration; support; patient health challenges; pharmacist experiences in delivering health care; and future planning. These aligned with the five themes that emerged from the Leximancer analysis – community; local; town; patients; and work. Participants described working during the wildfires as difficult, with multiple challenges reported including communication difficulties, operational barriers such as power cuts, legislative barriers, logistical issues with obtaining and storing medication supplies, and lack of preparation, support, and funding. They highlighted a lack of operational and financial support from the government and received most assistance from local council bodies and local branches of professional pharmacy organizations.Conclusion:During disasters, community pharmacies help reduce the burden on public hospitals by maintaining medication supplies and treating patients with minor ailments. However, increased support and inclusion in disaster management planning is needed to continue this role.

Objective. The aim of this study was to explore whether a relationship exists between the number of disasters a jurisdiction has experienced and the presence of disaster-specific pharmacy legislation. Methods. Pharmacy legislation specific to disasters was reviewed for five countries: Australia, Canada, UK, US and New Zealand. A binary logistic regression test using a generalised estimating equation was used to examine the association between the number of disasters experienced by a state, province, territory or country and whether they had disaster-specific pharmacy legislation. Results. Three of six models were statistically significant, suggesting that the odds of a jurisdiction having disaster-specific pharmacy legislation increased as the number of disasters increased for the period 2007-17 and 2013-17. There was an association between the everyday emergency supply legislation and the presence of the extended disaster-specific emergency supply legislation (χ21 = 7.16, P = 0.007). Conclusions. It is evident from this review that there are inconsistencies as to the level of assistance pharmacists can provide during times of crisis depending on their jurisdiction and location of practice. It is not a question of whether pharmacists have the skills and capabilities to assist, but rather what legislative barriers are preventing them from being able to contribute further to the disaster healthcare team.