Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

In Islamic Sharia law, prescription has been more commonly referred to as murūr al-zamān [the lapse of time]. It has been claimed that the abstract principle of the lapse of time only has the effect of barring a claim and that is not capable of creating and extinguishing the right itself. In the context of Islamic law, this concept of prescription is often ascribed only to the Hanafi and Maliki schools of Sharia law, and it has been claimed that such principle has not been recognized by the Hanbali School. Based on that, my reading shows that, under Saudi jurisdiction (which is principally based on uncodified Hanbali Sharia law), this hypothesis is a key problem as in practice there are many secondary Saudi laws in place applying prescription rules to bar civil actions. Thus, by arguing that such principle has not been recognized by Sharia law as applied in Saudi Arabia, the legality of such provisions would be in question, given the fact that all Saudi enacted laws must conform with Islamic law. Moreover, my analysis argues that in studies of Saudi Hanbali law, prescription has neither been discussed widely nor given serious independent consideration. In the context of Saudi and Hanbali law, issues of prescription have not only been marginalized and minimized, but also inaccuracies and mis-readings are often found in related academic literature. Drawing on findings across various disciplines, including studies of classical and modern Islamic law, as well as legal studies on Saudi and Arab laws, this study presents new readings of the issues of the existence and origins of the legal concept of civil prescription from the perspectives of the Saudi-Hanbali School of law. Moreover, it presents the first comprehensive survey of the extent of implementation of the rules of prescription in the Saudi civil regulations over the last eight decades. Finally, from both theory and practice aspects, the thesis attempts to conclude with a critical analysis of the single ‘negative’ perspective of prescription in both Islamic and Saudi law.

Le législateur français a intégré le critère d’efficience dans la détermination du prix du médicament remboursable en 2012. L’efficience des médicaments doit être documentée pour les produits susceptibles d’apporter un bénéfice thérapeutique important et d’avoir un impact significatif sur les dépenses d’assurance maladie. Elle vise à mesurer le coût du gain marginal en santé produit par une intervention, par rapport au coût et à l’efficacité d’une autre intervention substituable. La thèse se situe dans une perspective d’analyse empirique des relations de délégation à l’œuvre dans la régulation du médicament, en vue de son accès au remboursement et de la fixation de son prix en France. Elle se fonde sur une analyse de trois applications de l’évaluation de l’efficience reflétant un approfondissement progressif de l’évaluation économique de l’intervention de santé dans trois contextes institutionnels distincts. Leur comparaison permet d’identifier les enjeux soulevés par la mise en œuvre de la régulation, les facteurs de son efficacité et les risques associés au regard du cadre théorique de la théorie des incitations en se posant successivement les questions suivantes : 1) L’information produite par le calcul économique expose-t-elle le décideur à un risque de manipulation de l’outil ? 2) L’apport du calcul économique est-il amélioré dans un processus d’évaluation contraint? 3) Des approches complémentaires peuvent-elles enrichir l’évaluation économique et en améliorer l’usage en révélant d’autres déterminants de la décision en santé? Les travaux de la thèse mettent en évidence l’apport du critère d’efficience pour améliorer l’information du décideur. Le risque, réel, de capture de régulation peut être limité par un processus d’évaluation plus transparent et par une explicitation des enjeux de la décision et des objectifs de la régulation. / In 2012, cost-effectiveness has been formally introduced in the French legislation as a criterion to determine the price of prescription drugs. Cost-effectiveness is requested to claim for reimbursement of drugs expected to provide a therapeutic benefit and to have a significant impact on Social Insurance budget. Cost-effectiveness estimates the incremental cost and effectiveness produced by an intervention in comparison to other interventions that could have been used. The thesis is an empirical analysis of delegation relationships in the regulation of reimbursed drugs in France. The thesis analyses three different applications of cost-effectiveness evaluation to highlight the issues surrounding the use of economic calculation and the risks that are associated with it through three questions: 1) does the cost-effectiveness evaluation expose the regulator to regulation capture? 2) Is the contribution of the cost-effectiveness evaluation enhanced in a regulatory framed process? 3) Could complementary evaluations enrich cost-effectiveness evaluation and favour its usage via the clarification of the issues surrounding the decision? The thesis documents the benefit provided by the introduction of the cost-effectiveness criteria. The actual risk of regulation capture could be limited through a more transparent process of evaluation and through a clarification of the objectives of the regulation.

Introdução: Medicamentos potencialmente inapropriados (MPI) representam um importante problema de saúde para os idosos, e estão associados com morbidade, mortalidade e custos hospitalares elevados. Abordagens quanto ao uso de MPI e preditores são amplamente explorados na literatura. No entanto, no âmbito das unidades de terapia intensiva, os estudos ainda são incipientes. Objetivo: Analisar o uso de MPI em idosos internados em Unidades de Terapia Intensiva (UTI). Método: Coorte retrospectiva de idosos internados em UTI (Clínicas, Cirúrgicas e Especialidades) de um Hospital Público de São Paulo. A amostra foi composta por idosos que haviam recebido pelo menos um medicamento. Utilizou-se um instrumento para coletar os dados referentes às variáveis demográficas clinicas e de regime terapêutico. Os MPI foram identificados pelo Critério de Beers Versão 2015. Na análise estatística utilizaram-se os testes Mann Whitney, Kruskal-Wallis e correlações Pearson/Fisher/Spearman e regressão logística múltipla. Resultados: Participaram do estudo 283 idosos. A maioria dos pacientes era do sexo masculino (55,1%), com comorbidades (67,8%) e sobreviveu à internação na UTI (77%). A idade média foi 71,15 anos. A quase totalidade dos pacientes usou pelo menos um MPI (99,6%). Quanto ao regime terapêutico foram identificados 219 medicamentos, destes, 14,2% eram MPI. Os MPI mais usados foram omeprazol (80,9%), insulina (70,4%) e metoclopramida (51,6%). O número de medicamentos foi preditor independente para maior consumo de MPI (OR: 1,248; IC95%: 1,167 1,344; p < 0,001). A condição de saída da UTI de óbito foi fator de proteção (OR: 0,404; IC95%: 0,182 0,861; p=0,022). Conclusões: Prescrições de MPI foram comuns entre os idosos internados. Os MPI mais frequentes neste estudo foram prescritos baseando-se na condição de gravidade dos pacientes e considerando-se as circunstancias e/ou contexto clinico da abordagem terapêutica na UTI, procurando reduzir as complicações associadas à internação e, assim, reduzir a morbimortalidade dos idosos internados. / Introduction: Potentially inappropriate medications (PIM) represents an important health problem for the elderly, and are associated with morbidity, mortality and high hospital costs. Approaches related to the use of PIM and predictors are widely investigated in the literature. However, in the field of intensive care units, studies are still incipient. Objective: To analyze the use of PIM in elderly patients admitted to intensive care units (ICU). Method: Retrospective cohort of elderly patients in ICU (Clinical, Surgical and Specialties) of a public hospital in São Paulo. The sample consisted of elderly people who had received at least one medication. Data were collected using an instrument consisting of demographic, clinical and therapeutic regimen variables. The MPI were identified by Beers criteria (2015 version). In the statistical analysis Mann Whitney, Kruskal-Wallis test and Pearson/Fisher/Spearman\'s correlations and multiple logistic regressions were used. Results: The study included 283 elderly. Most patients were male (55.1%), with comorbidity (67.8%) and survived internment in the ICU (77%). The average age was 71.15 years; probability of death SAPS II was 18.7%; average ICU length of stay was 6.81 days; average prescription medication was 15.23; and average use of PIM was 3.52. Almost all patients used, at least, one PIM (99.6%). Concerning to the treatment regimen they were identified 219 drugs, 14.2% of these were PIM. The most commonly used PIM were omeprazole (80.9%), insulin (70.4%) and metoclopramide (51.6%). The number of drugs was an independent predictor for increased MPI consumption (OR: 1.248, 95% CI: 1.167 - 1.344, p <0.001). The ICU death condition was a protective factor (OR: 0.404, 95% CI: 0.182-0.861, p = 0.022). Conclusion: The PIM prescriptions were common between hospitalized elderly. The most common PIM in this study were prescribed based on the condition of patient severity and considering the circumstances and/or clinical context of therapeutic approach in the ICU, seeking to reduce the complications associated with hospitalization and, in this way, reduce morbidity and mortality of hospitalized elderly.

Pacientes que procuram atendimento odontológico frequentemente relatam dor de variada intensidade, principalmente aqueles que buscam atendimento em caráter de urgência. Não é incomum que os pacientes busquem alívio de seus sintomas, previamente à consulta odontológica, por meio de medidas locais e/ou automedicação. Paralelamente, a prescrição de medicamentos é comum por parte dos cirurgiões-dentistas, em especial após o atendimento em caráter de urgência. Este estudo visou avaliar a intensidade da dor dentária relatada pelos pacientes, no momento da consulta, uso de medidas locais e os principais medicamentos utilizados pelos pacientes, por meio de automedicação, previamente à consulta odontológica, o relato de efeitos adversos e a influência que diferentes mídias (televisão, jornais e revistas) exercem no momento da aquisição de medicamentos. Também foram analisados os medicamentos prescritos e os diagnósticos realizados por profissionais que atuam em serviços de urgência odontológica, além de avaliação do nível de ansiedade dos pacientes atendidos, por meio da Escala de Ansiedade Dental de Corah e questionário do Inventário de Ansiedade Traço-Estado. Para tal, foi realizado estudo observacional transversal, de caráter prospectivo, por meio de entrevista com 179 pacientes adultos, atendidos em Serviço de Urgência Odontológica da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (UFRGS) e Unidade de Pronto Atendimento (UPA) Moacyr Scliar. A frequência de automedicação observada foi de 60,9%. Os principais medicamentos utilizados previamente à consulta foram analgésicos não opioides (54,2%). Pacientes que utilizaram antimicrobianos representaram 16,8% da amostra, sendo que 6,7% dos entrevistados utilizaram antimicrobianos por meio de automedicação. Efeitos adversos foram descritos por 21,5% dos pacientes que utilizaram medicamentos. Uso de medidas locais previamente à consulta foi descrito em 59 (33%) atendimentos. Aproximadamente um quarto dos entrevistados (25,7%) relatou se sentir influenciado por propagandas de medicamentos e já ter adquirido medicamentos por influência direta de propagandas. Houve associação estatisticamente significativa entre automedicação e relato de dores moderadas e intensas, assim como entre automedicação e o fato ser paciente muito ansioso, em avaliação realizada por meio do questionário de Inventário de Ansiedade Traço-Estado (IDATE) (Testes Exatos de Fisher P< 0,05). Quanto ao padrão de prescrição, anti-inflamatórios não esteroides foram os medicamentos indicados com maior frequência (36,9%). Antimicrobianos foram prescritos em 65 (36,3%) atendimentos. Diagnósticos envolvendo patologias pulpares e periapicais foram os mais prevalentes (59,2%), sendo abertura coronária, medicação local e selamento o tratamento realizado na maioria dos casos (48%). Concluiu-se que automedicação é prática comum entre os pacientes que buscam serviço público odontológico de urgência. Presença de dores moderadas e intensas e alto nível de ansiedade podem contribuir para esta prática. Antiinflamatórios não esteroides e antimicrobianos são os medicamentos mais frequentemente prescritos pelos cirurgiões-dentistas após o atendimento. / Patients seeking dental care often report pain of varying intensity, especially those seeking urgent care. It is not uncommon for patients to seek relief from their symptoms, prior to dental consultation, through local measures and/or self-medication. Prescription of medications is common by dental surgeons, especially after urgent care. This study aimed to evaluate the intensity of dental pain reported by the patients at the time of consultation, use of local measures and the main medications used by the patients, through self-medication, prior to dental consultation, adverse effects and influences by social media (television, newspapers, magazines) at the moment of purchase of medicines. The drugs prescribed and the diagnoses performed by professionals working in dental emergency services were also analyzed, as well as an evaluation of the level of anxiety of the patients attended, through the Corah Dental Anxiety Scale and the Trait-State Anxiety Inventory questionnaire. A prospective, crosssectional observational study was conducted through an interview with 179 adult patients, attended at the Dental Emergency Service of the Federal University of Rio Grande do Sul (UFRGS) and the Emergency Care Unit (UPA) Moacyr Scliar. The frequency of selfmedication observed was 60.9%. The main drugs used prior to the consultation were nonopioid analgesics (54.2%). Patients who used antimicrobials accounted for 16.8% of the sample, with 6.7% of those interviewed using antimicrobials by self-medication. Adverse effects were reported by 21.5% of patients using medication. Use of local measures prior to the dental appointment was described in 59 (33%) consultations. Approximately one quarter of respondents (25.7%) reported feeling influenced by drug advertisements and have already purchased drugs by direct influence of advertisements. There was a statistically significant association between self-medication prior to the consultation and reporting of moderate and severe pain, as well as between self-medication and the fact that the patient was very anxious, using the Trait-State Anxiety Inventory (STAI) questionnaire (Fisher's Exact Tests P <0.05). Regarding to the prescription pattern, non-steroidal anti-inflammatory drugs were the most frequently indicated medications (36.9%). Antimicrobials were prescribed in 65 (36.3%) dental appointments. Diagnoses involving pulp and periapical pathologies were the most prevalent (59.2%), being coronary opening, local medication and sealing the treatment performed in most cases (48%). It was concluded that self-medication is common practice among patients seeking urgent dental public service. Presence of moderate and intense pain and high level of anxiety can contribute to this practice. Non-steroidal anti-inflammatory drugs and antimicrobials are medications most frequently prescribed by dentists after care.

Esforços para assegurar a melhoria da qualidade da assistência de enfermagem tem sido um desafio para os serviços de enfermagem. O controle de qualidade da assistência de enfermagem vinculado à auditoria dos cuidados de enfermagem representa uma estratégia fundamental na busca de uma enfermagem segura e com qualidade. O objetivo desse estudo é analisar os indicadores de qualidade da elaboração da prescrição de enfermagem da Unidade de Terapia Intensiva Neonatal do Hospital Universitário Regional do Norte do Paraná, no período de 2001 a 2003. Trata-se de um estudo descritivo, que utilizou o método quantitativo e o referencial teórico da auditoria retrospectiva. Os dados analisados provem dos 10 relatórios trimestrais da avaliação da qualidade de assistência de enfermagem, que se constitui na auditoria retrospectiva das prescrições de enfermagem efetuada nos prontuários dos pacientes. Conclui-se que embora os enfermeiros tenham conhecimento do manual de preenchimento da prescrição de enfermagem e acreditem na sistematização da assistência, os padrões estabelecidos para uma boa elaboração da prescrição não foram atingidos em nenhum dos relatórios. O indicador que atingiu maior escore, das prescrições avaliadas foi o Não Preenchido, com 47,7%, seguido do Completo com 34,2%, o Incompleto apresentando 14,6% e finalmente o Incorreto com um percentual de 1,7%. A maior concentração de itens Não Preenchidos estão naqueles que avaliam, de certa forma, os conhecimentos científicos bem como a capacidade de raciocínio clínico e crítico. Os itens que avaliam se a prescrição de enfermagem foi elaborada pelo enfermeiro que admitiu o paciente e se os horários foram prescritos de forma adequada apresentaram valores de 4,7% e 7,4% respectivamente, o que preocupa já que o valor aceitável para este indicador é 0%. O controle da qualidade da elaboração da prescrição de enfermagem demonstrou ser um valioso instrumento da prática assistencial possibilitando a visualização das situações favoráveis e desfavoráveis que irão redirecionar planejamento e as ações de enfermagem. / Efforts to assure improvements at nursing quality assistance have been a challenge to nursing services. Management of nursing quality assistance added to nursing care auditorship represents a fundamental strategy to conquer safe nursing with quality. The aim of this study is to analyse quality indicators over nursing prescription making from the neonatal intensive care of the Northern Paraná University Hospital, from 2001 to 2003. It is a descriptive study that made use of the quantitative method and theoric referencial of retrospective auditorship. The analysed data come from 10 trimester reports of nursing quality assistance avaliation, which constitutes retrospective auditorship of nursing prescriptions on patients’ records. Finally, although the nurses know how to fill in the nursing prescription and believe in the assistance systematization, the established patterns to provide good quality to the prescription were not reached in any of the reports. The highest indicator was Not Filled with 47.7%, followed by Full adding up 34.2%, Incomplete summed up 14.6% and finally Incorrect accounted for 1.7%. The highest amounts of Not Filled items were about cientific knowledge as well as critical and clinical thinking capacity. The items grading whether the prescription was made by the nurse that admitted the patient and if the time was correctly displayed presented 4.7% and 7.4% respectively, which is a concern considering that the acceptable rate should be 0%. Quality control proved to be a precious instrument of assistance practice providing the visualization of favorable and unfavorable situations that will redirect planning and nursing auditorship.

Made available in DSpace on 2016-04-28T18:22:32Z (GMT). No. of bitstreams: 1 Ermelinda Barricelli.pdf: 2406283 bytes, checksum: d88b59ce0444a6bf7ecc3ea473048757 (MD5) Previous issue date: 2012-06-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This thesis is aimed at investigating how the interviews of a prescriber, a trainer and a teacher represent in the processes of creating, spreading and using the official document called Orientações Curriculares Expectativas de Aprendizagens e Orientações Didáticas OCs (2007), developed by the City of São Paulo with focus at Pre-school Education. Studying the Pre-school Education history has shown us how fragile this segment is, particularly in Brazil, due to the fact that a) the child is perceived as physically as well as intellectually fragile; and b) thus the transposition of such beliefs to the educational contexts culminates in a split service: taking care and educating. Such contradictions have taken us to consider the hypothesis that historical conflicts would appear somehow in the processes of creating, spreading and using the official document. In order to check this hypothesis the following interviews were analyzed: a) one conducted with the coordinator of the group responsible for elaborating the official document, the prescriber; b) another with a trainer from Diretoria de Orientações Técnicas da Secretaria de Educação de São Paulo; c) and the other interview was performed with a teacher from the public school system run by the City of São Paulo. The interviews were carried out in December, 2008, June 2010 and August 2010, respectively. In this way, we were able to monitor the process since its conception up to the implementation at the Pre-school facilities. It was taken into consideration as our theoretical framework the studies conducted by researchers from CNAM (Conservatoire National des Arts et Métiers), ERGAPE (Ergonomie de l Activité des Professionnels de l Éducation), LAF (Langage, Action, Formation) and ALTER CNPq (Analysis of Language, Educational Work and their Connections) based at LAEL, PUC-SP. The data was analyzed according to the procedures proposed by the Socio-discursive Interactionism (BRONCKART, 1997/2003) in relation to the analysis of some elements of the feuilleté textuel: 1) the general infrastructure of the text (general text plan, thematic content, sequences and types of discourses); 2) mechanisms of textualization (nominal connection) and 3) the enunciative mechanisms (voices). It was also was employed as a category for analysis the action figures from the same theoretical framework (BULEA, 2007, 2010). Therefore, this thesis shows that, on one hand, the processes of creating, spreading and using of a new prescription are made by conflicts related to the dimensions of the job (CLOT, 2008) and, on the other, such conflicts can be linguistically and discursively identified. The relevance of this research lies on to the fact that it was possible to identify linguistic features, which point to conflicts. These linguistic features have enabled us to check how these conflicts have an effect on the above-mentioned processes which is the aim of this research. Consequently, it was possible to acknowledge the outcome when implementing an Educational Public Policy, as well as to conduct a research that also contributes for the Pre-school segment, as there are few studies aimed at the teachers work in this area / O objetivo desta tese é investigar de que forma os textos-entrevistas de uma Prescritora, de uma Formadora e de uma Professora representam os processos de elaboração, de difusão e de utilização de um documento oficial do Município de São Paulo voltado para Educação Infantil - Orientações Curriculares Expectativas de Aprendizagens e Orientações Didáticas OCs (2007). O levantamento de parte da história da Educação Infantil nos mostrou a fragilidade desse segmento, especialmente no Brasil, já que nele se considera a) uma visão de criança marcada pela crença da sua fragilidade física e intelectual; e b) a consequente transposição dessas crenças para os contextos educacionais que culminam em um atendimento dicotomizado entre o cuidar e o educar. Essas contradições, por sua vez, nos levaram à hipótese de que esses conflitos históricos se manifestariam, de alguma forma, nos processos de elaboração, de difusão e de utilização do documento municipal. Para a verificação dessa hipótese propomo-nos a analisar três entrevistas: a) com a coordenadora do grupo de elaboradores do documento oficial do Município de São Paulo, a Prescritora; b) com uma Formadora da Diretoria de Orientações Técnicas da Secretaria de Educação de São Paulo; c) com uma Professora da Rede Municipal de São Paulo. As entrevistas foram realizadas, respectivamente, em dezembro de 2008, em junho de 2010 e em agosto de 2010. Desse modo, pudemos verificar o andamento do processo, desde a sua idealização até a sua chegada à escola de Educação Infantil. Tomamos como base teórica central os estudos realizados por pesquisadores da Clínica da Atividade do CNAM (Conservatoire National des Arts et Métiers), do grupo ERGAPE (Ergonomie de l Activité des Professionnels de l Éducation), do grupo LAF (Langage, Action, Formation) e do grupo ALTER CNPq (Análise de Linguagem, Trabalho Educacional e suas Relações) sediado no LAEL da PUC-SP. Os dados foram analisados de acordo com os procedimentos propostos pelo Interacionismo Sociodiscursivo (BRONCKART, 1997/2003) no tocante à análise de alguns elementos do folhado textual: 1) a infraestrutura geral do texto (plano global, conteúdos temáticos, sequências e tipos de discurso); 2) os mecanismos de textualização (conexão nominal) e 3) os mecanismos enunciativos (vozes). Utilizamos, ainda, como categoria de análise as figuras de ação, desse mesmo aporte teórico (BULEA, 2007, 2010). Assim, esta tese demonstra que os processos de elaboração, de difusão e de utilização de uma nova prescrição se constituem por conflitos relacionados com as dimensões do trabalho (CLOT, 2008) e que esses conflitos, por sua vez, podem ser identificados linguístico e discursivamente. A relevância desta pesquisa deve-se, principalmente, ao fato de termos levantado as marcas linguísticas que nos indicam conflitos verificando de que forma esses conflitos incidem sobre os processos mencionados anteriormente, foco desta pesquisa. Assim, pudemos conhecer os desdobramentos da implantação de uma Política Pública Educacional e, finalmente, a pesquisa contribui também para o segmento de Educação Infantil, já que ainda são escassas as pesquisas voltadas para o trabalho docente nessa área

The rates of non-medical prescription drug use in the United States (U.S.) have increased dramatically in the last two decades, leading to a more than 300% increase in deaths from overdose, surpassing motor vehicle accidents as the leading cause of injury deaths. In rural areas, deaths from unintentional overdose have increased by more than 250% since 1999 while urban deaths have increased at a fraction of this rate. The objective of this research was to test the hypothesis that cultural, economic, and environmental factors prevalent in rural America affect the rate of substance use disorder (SUD) in that population, and that diagnosis of these disorders across rural and urban populations may not be generalizable due to these same effects. This study applies measurement invariance analysis and factor analysis techniques: item response theory (IRT), multiple indicators, multiple causes (MIMIC), and latent class analysis (LCA), to the DSM-IV abuse and dependency diagnosis instrument. The sample used for the study was a population of adult past-year illicit drug users living in a rural or urban area drawn from the 2011-2012 National Survey on Drug Use and Health data files (N = 3,369| analyses 1 and 2; N = 12,140| analysis 3). Results of the IRT and MIMIC analyses indicated no significant variance in DSM item function across rural and urban sub-groups; however, several socio-demographic variables including age, race, income, and gender were associated with bias in the instrument. Latent class structures differed across the sub-groups in quality and number, with the rural sample fitting a 3-class structure and the urban fitting 6-class model. Overall the rural class structure exhibited less diversity and lower prevalence of SUD in multiple drug categories (e.g. cocaine, hallucinogens, and stimulants). This result suggests underlying elements affecting SUD patterns in the two populations. These findings inform the development of surveillance instruments, clinical services, and public health programming tailored to specific communities.

In my senior year at ETSU I produced a documentary about opioid abuse in East Tennessee. In 2016, two local health care providers and a university collaborated on a project that would bring an opioid treatment center to Gray, Tennessee. The center includes a methadone clinic, an addition that piqued the concern of many citizens living in Gray. The film evaluates the concerns citizens had about the clinic and explores the issue of opioid abuse in East Tennessee.

Objectives: 1) To determine 2010 pharmacy-related ambulatory care sensitive condition (ACSC) hospital discharges by Tennessee (TN) county; 2) To explore pharmacy-related ACSC hospital discharges across county characteristics for Tennessee counties, including community pharmacies per county, age, and county rurality; 3) To explore pharmacy-related ACSC hospital discharges across age for northeastern Tennessee counties. Methods: Data were obtained from the TN Department of Health Statistics (hospital discharge data), TN Board of Pharmacy (licensed community pharmacies), the United States (US) Census Bureau (county-level populations), the Office of Rural Health Policy (rural designations), and the US Health Resources and Services Administration (health professional shortage area designations). ACSC discharges were determined using the Agency for Healthcare Research & Quality's (AHRQ's) Prevention Quality Indictors (PQIs) for asthma, bacterial pneumonia, congestive heart failure, chronic obstructive pulmonary disease, hypertension, uncontrolled diabetes, and short-term and long-term diabetes complications. County-level analyses were population adjusted and analyzed across age. Analyses were conducted using SPSS and ArcGIS software. Results: In 2010, 79,683 hospital discharges were noted for pharmacy-related ACSCs, 55% of which were for residents 65 and over. For northeast Tennessee counties, 8,538 were documented accounting for 11% of Tennessee pharmacy-related ACSCs discharges. Bacterial pneumonia, heart failure, and COPD accounted for nearly 65% of discharges in northeastern Tennessee counties. The number of community pharmacies per Tennessee county was statistically significantly negatively correlated with county-level bacterial pneumonia (r=-0.339; p=0.001), CHF (r=-0.215; p=0.036), and COPD (r=-0.403; p<0.001) hospital discharges. Implications/Conclusions: Community pharmacies have the potential to positively impact the health needs of Tennesseans by targeting services (e.g., MTM, immunizations, adherence assistance) based on ambulatory care sensitive conditions. Future research is warranted to quantify current services and determine the capacity to provide such services.