Palliative medication kits are a simple and effective way of anticipating and addressing comfort and symptom control for dying patients being cared for in the community. These kits can avert institutional crisis admissions, extend the period of time patients can be cared for in their homes and may increase the likelihood of a home death.

This paper summarises pilot work by Irise International to develop an acceptable and replicable solution to menstrual hygiene management (MHM) in East Africa based around the manufacture of a reusable pad. The paper presents a theoretical justification for the approach and the results of pilot work used to develop it, including baseline menstrual hygiene practices and their relationship to school absenteeism in schoolgirls in western Kenya, the short-term impact of training girls to make a reusable product on school absenteeism using a partial preference, parallel group randomised control trial, and an assessment of the acceptability of the approach.Cet article résume des activités pilotes entreprises par Irise International pour mettre au point une solution acceptable et reproductible en matière de gestion de l'hygiène menstruelle (GHM) en Afrique de l'Est, basée sur la fabrication d'une serviette hygiénique réutilisable. Cet article présente une justification théorique pour cette approche et les résultats des activités pilotes mises en oeuvre pour la mettre au point, y compris des pratiques d'hygiène menstruelle de référence et leur rapport avec l'absentéisme des écolières de l'ouest du Kenya, l'impact sur l'absentéisme que peut avoir à court terme la formation des filles à la fabrication d'un produit réutilisable en utilisant une préférence partielle, un essai contrôlé randomisé effectué sur un groupe parallèle et une évaluation de l'acceptabilité de l'approche.El presente artículo realiza una síntesis del trabajo pionero de Irise International en África Oriental, el cual se orienta a desarrollar una solución aceptable y replicable del manejo de la higiene menstrual (MHM) centrada en la producción de una toalla sanitaria reutilizable. Se presenta la justificación teórica de este enfoque, explicando luego los resultados del trabajo pionero que lo produjo. Se establece una línea de base en torno a las prácticas de higiene menstrual, su relación con el ausentismo escolar de las jóvenes educandas en Kenia occidental y con el impacto que la capacitación de las jóvenes en la elaboración de un producto reutilizable tendrá a corto plazo sobre dicho ausentismo. Para efectos del estudio, se usó un ensayo controlado aleatorio de preferencia parcial y de grupo paralelo. Asimismo, el artículo evalúa el grado de aceptación de dicho enfoque.

Benzodiazepines are commonly prescribed psycho-pharmaceuticals (e.g., for anxiety, tension, and insomnia); they are generally considered safe but have potential adverse effects. Benzodiazepine use in Canada versus internationally is comparably high, yet no recent comprehensive review of use, misuse, or related (e.g., morbidity, mortality) harm at the population level exists; the present review aimed to fill this gap. We searched four key scientific literature databases (Medline, CINAHL, EBM Reviews, and Web of Science) with relevant search terms, and collected relevant "gray literature" (e.g., survey, monitoring, government reports) data published in 1995-2015. Two reviewers conducted data screening and extraction; results were categorized and narratively summarized by key sub-topics. Levels of benzodiazepine use in the general population have been relatively stable in recent years; medical use is generally highest among older adults. Rates of non-medical use are fairly low in general but higher in marginalized (e.g., street drug use) populations; high and/or inappropriate prescribing appears common in older adults. Benzodiazepines are associated with various morbidity outcomes (e.g., accidents/injuries, cognitive decline, sleep disturbances, or psychiatric issues), again commonly observed in older adults; moreover, benzodiazepines are identified as a contributing factor in suicides and poisoning deaths. Overall there is a substantial benzodiazepine-related health problem burden-although lower than that for other psycho-medications (e.g., opioids)-in Canada, mainly as a result of overuse and/or morbidity. National benzodiazepine prescription guidelines are lacking, and few evaluated interventions to reduce benzodiazepine-related problems exist. There is a clear need for reducing inappropriate benzodiazepine use and related harm in Canada through improved evidence-based practice as well as monitoring and control.

Background. The common practice of switching between branded (reference) medications and their corresponding generic products, between generic products, or even from a generic product to a branded medication during the treatment of central nervous system (CNS) disorders may compromise efficacy and/or tolerability. Methods. We assessed the published literature from March 1, 2010 through June 30, 2017 via PubMed using the MeSH term 'generics, drugs' alone and in combination with class-specific terms (e.g., 'anticonvulsants', 'mood stabilisers'), for studies detailing outcomes following product switches. Results. Although some studies comparing the initiation of reference versus generic drugs suggest equivalence between products, several studies detailing a switch between reference and generic products describe reductions in efficacy, reduced medication adherence and persistence, and increased overall health care resource utilization and costs associated with generic substitution. Conclusion. When product switches are considered, they should only proceed with the full knowledge of both patient and provider.