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Background Polyphenols have been implicated to have numerous health benefits, and much of these are attributed to the metabolism of phenolic compounds by gut microbiota. The aim of this systematic review was to examine the effects of polyphenol consumption in modulating gut microbiota and anthropometric variables/clinical markers in randomised controlled trials (RCTs). Scope and approach We systematically searched PubMed, Scopus, Embase, Cochrane library and Web of Science databases from inception to31st July 2019 following the PRIMSA guidelines.RCTs reporting on the effects of polyphenol consumption on gut microbes, and anthropometric variables (body weight, BMI, waist circumference, hip circumference)/clinical markers (CVD markers, and colon cancer markers) were included in this review. The methodological quality of the studies was assessed using the Cochrane Collaboration's risk of bias tool and Jadad scale. Key findings and conclusion Seventeen RCTs met the inclusion criteria. Ten studies highlighted significant changes in the microbial profile, while 15 reported significant changes in CVD and colon cancer markers. The univariate correlation data showed a significant correlation between certain genera with clinical markers, specifically TNFα, cholesterol, HDL, CRP, and LPS. In the multivariate analysis, negative correlations were reported between Lactobacillus and TAG, CRP, Bacteroides with TAG, HDL, DBP, and SBP, and Bifidobacterium with cholesterol and CRP. This review supports the notion of polyphenols as prebiotics as significant modulation of intestinal microbes affecting mainly CVD markers were found in most of the RCTs. Further well-structured trials with larger sample size, longer duration, and high-throughput molecular techniques, will provide more conclusive results. Protocol registration number PROSPERO; CRD42017077577

Background and purpose Pharmacists need to learn communication styles which adopt a more consultative model. The objectives of this paper are to describe the use of forum theatre facilitated by actors to teach communication skills to pharmacy students and to highlight perceptions of the workshops. Educational activity and setting During the actor-led forum theatre, students redirected scenes depicting pharmacist-patient consultations. Students also learned about their own communication styles and role-played consultations and interview situations with actors. Pharmacy undergraduate students enrolled in years 2, 3, and 4 answered open-ended questions online at the end of workshops. All responses were coded to identify themes. Findings Five themes emerged from 752 comments: (1) workshops were useful in facilitating communication skills development, (2) workshops encouraged reflection, (3) appreciation of feedback provided, (4) the live, interactive nature of the workshop enhanced learning, and (5) suggestions for improvement. There were requests for more varied scenarios involving different patient groups and more opportunities to participate in the role-plays. Students also requested smaller groups, which would encourage participation from those who were reticent and allow more personal feedback. Summary The use of forum theatre employing role-play, small group coaching on consultation and interview skills, and emphasizing feedback was perceived as an effective and engaging method to teach communication skills.

Background Medication non-adherence is one of the major challenges in treating patients with depression. This systematic review aims to determine the clinical and economic outcomes of non-adherence in depression. Methods A systematic search was performed across the following databases: PubMed, EMBASE, DARE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews; from database inception to March 31, 2015. Studies must report on the association between adherence and outcomes, and English full texts needed to be available. The quality of each study was assessed using the Newcastle-Ottawa scale. Results A total of 11 articles were included, with eight reporting on clinical outcomes, two reporting on economic outcomes, and one reporting on both. The majority of studies were retrospective cohort studies. The mean quality of all included studies was 7, with a range from 3 to 9. Results clearly indicate that patients who were non-adherent were more likely to experience increased risks of relapse and/or recurrence, emergency department visits, and hospitalization rates; increased severity of depression, and a decrease in response and remission rates. The worsening of clinical outcomes in patients who were non-adherent subsequently translated to an increase in healthcare utilization and charges. Limitations No standardized adherence measurement tools were used, and few studies looked at the economic impact of non-adherence in depression. Conclusion There is a strong association between non-adherence to antidepressants and a worsening of patients’ clinical and economic outcomes. Cost-effective interventions should be directed to this group of patients to improve medication adherence.

There is a paucity of studies assessing graduates’ perceptions of experiential learning and its effectiveness in preparing them for practice. This information would be important in informing changes to the experiential learning component of pharmacy education. We present Part 2 of a mixed-methods study involving graduates to obtain feedback on their experiential learning experience. Online survey responses and qualitative interviews provided suggestions on improving the experiential learning,which included adopting block placements which would allow for a better placement experience. Having a pre-registration trainee present was beneficial, highlighting the possible value of adopting a tiered-teaching model. Given the poor experience at certain placement sites, quality assurance measures should be adopted to ensure tutors and sites are suited and able to train students for the real-world. The majority wanted feedback from tutors, and indeed this should be formalised as it is a key component in the experiential learning cycle.