The viscosity-reducing effects of various alkaline additives to coal slurries were studied. It was found that especially in combination with leonardite, a naturally oxidized form of lignite, significant reductions could be achieved for a bituminous and a sub-bituminous coal. No reduction could be produced for lignite slurries, however. n this investigation, the effects of various additives

Background: Chronic insomnia is a common medical condition that negatively impacts quality of life and daytime function. Access to the first-line treatment for insomnia, cognitive behavioural therapy (CBT-i), is limited. Pharmacists are well positioned to provide this service, but evidence regarding pharmacist delivered CBT-i is sparse. The aim of this study was to evaluate the effectiveness of CBT-i delivered by pharmacists practicing in an outpatient clinic setting. Methods: This study was a retrospective chart audit of adult patients with chronic insomnia who received CBT-i from a pharmacist at one of two outpatient clinics in Canada. The primary endpoints were the differences between patient self-reported sleep diary parameters and utilization of hypnotic medications before and after CBT-i was delivered. The differences in patient reported sleep parameters were compared using Wilcoxon Signed Rank test and paired samples t-test and changes in hypnotic utilization was compared using McNemar Chi-square test. Results: 183 patients were referred for CBT-i and attended an initial appointment with a pharmacist. Of these, 105 did not receive the CBT-i. This resulted in 78 patients who met the inclusion criteria. Changes in sleep diary parameters were all statistically significantly improved after patients received CBT-i, except for total sleep time. Hypnotic medication use was also reduced. At baseline, 71.8% (n=56/78) of patients were taking one or more hypnotic medications compared to 52.6% (n=41/78) after CBT-i (p=0.0003). Discussion: The results of this study provide preliminary evidence that pharmacists working in an outpatient clinic setting may be able to effectively deliver CBT-i for patients with chronic insomnia. The external validity of these results is limited by the observational study design and the inclusion of pharmacists practicing in outpatient clinics, which is not the setting where most pharmacists currently practice. Conclusion: This observational study found improvements in sleep quality and efficiency, as well as, a reduction in hypnotic medication use, in patients who received CBT-i from pharmacists practicing in an outpatient clinic setting. Future randomized, controlled trials should evaluate the impact of CBT-i in a larger sample of patients, provided by pharmacists practicing in both outpatient clinics and community pharmacies.   Original Research

Background: The need for cultural competency education has been emphasized for health care professionals in Canada. According to the Canadian Pharmacy Residency Board accreditation standards, pharmacy residents must be able to provide culturally competent care for their patients, further building upon the education received during their undergraduate pharmacy programs. Although these standards exist, guidance for their implementation in pharmacy residency programsis lacking. Objectives: To review the available literature and develop recommendations for pharmacy residency coordinators and directors on cultural competency training for pharmacy residents. Data Sources: A literature search was conducted to explore the literature concerning cultural competency education for pharmacy residents. The search was expanded to encompass literature involving pharmacy students and medical residents for information that could be applied to pharmacy residents. Data Synthesis: The initial literature search did not yield any results for cultural competency education provided to pharmacy residents. The expanded search yielded information about methods used to educate pharmacy students and medical residents, including didactic lectures, online modules, experiential learning rotations, seminars, workshops, patient simulations and case discussions, and guest lectures by experts in the field or by patients. Conclusions: It is recommended that interactive education methods be used to train pharmacy residents in cultural competency, to match the experiential learning structure of residency training programs. Methods that could be implemented include offering online modules or readings, arranging for guest speakers, contacting local experts and community members for guidance on creation of a suitable curriculum, and providing immersive rotations focused on diverse populations. RÉSUMÉ Contexte : La nécessité d’une formation portant sur les compétences culturelles s’adressant aux professionnels de la santé a été soulignée au Canada. Selon les normes d’agrément du Conseil canadien de la résidence en pharmacie, les résidents en pharmacie sont tenus de prodiguer des soins culturellement adaptés à leurs patients, renforçant leur formation pendantles programmes de premier cycle en pharmacie. Malgré ces normes, les directives encadrant leur mise en oeuvre dans les programmes de résidence en pharmacie font défaut. Objectifs : Examiner la documentation disponible et préparer des recommandations à l’intention des coordonnateurs et des directeurs de résidence en pharmacie sur la formation en compétences culturelles pour les résidents en pharmacie. Sources des données : Une recherche documentaire a été menée pour étudier la littérature portant sur l’éducation en matière de compétences culturelles pour les résidents en pharmacie. La recherche a été élargie pour englober la littérature impliquant des étudiants en pharmacie et des résidents en médecine afin d’obtenir des informations pouvant êtreappliquées aux résidents en pharmacie. Synthèse des données : La recherche documentaire initiale n’a donné aucun résultat en ce qui concerne l’enseignement des compétences culturelles offert aux résidents en pharmacie. La recherche élargie a quant à elle fourni des informations sur les méthodes utilisées pour former les étudiants en pharmacie et les résidents en médecine, y compris des conférences didactiques, des modules en ligne, des stages d’apprentissage expérientiel, des séminaires, des ateliers, des simulations de patients et des discussions de cas ainsi que des conférences d’experts invités dans le domaine ou de patients. Conclusions : Il est recommandé d’utiliser des méthodes d’éducation interactives pour aider les résidents en pharmacie à acquérir des compétences culturelles pour que celles-ci correspondent à la structure d’apprentissage expérientiel de ces programmes. Les méthodes qui pourraient être mises en oeuvre comprennent l’offre de modules ou de lectures en ligne, l’organisation de conférenciers invités, la prise de contact avec des experts locaux et des membres de la communauté pour obtenir des conseils sur la création d’un programme approprié et l’offre de stages d’immersion axés sur les diverses populations.