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While this is unlikely at standard
doses patients should be monitored
for changes in INR and symptoms of
excessive bruising or bleeding.3
Regular sexual intercourse, not urinating
after sex, cleaning genitals from back
to front, and not washing genitals
before or after sex, increases the risk
of developing a UTI. People at risk of
recurrent UTIs should be encouraged
to maintain good hydration and pay
careful attention to hygiene, especially
before and after sexual intercourse.3
Should a UTI set in, despite preventative
strategies, patients should be alert for
signs of non-menstrual blood in the
urine (smoky urine), or foaming which
may indicate the presence of protein.
These signs may indicate that the
infection has ascended to the kidneys
and will require prompt medical
1. Wang CH, Fang CC, Chen NC, Liu SS, Yu PH, Wu TY, et al.
Cranberry-containing products for prevention of urinary
tract infections in susceptible populations: a systematic
review and meta-analysis of randomized controlled trials.
Archives of internal medicine. 2012;172(13):988--96.
2. Aydin A, Ahmed K, Zaman I, Khan MS, Dasgupta P.
Recurrent urinary tract infections in women. International
urogynecology journal. 2015;26(6):795--804.
3. Oates L. Urinary tract infections and cranberries. Aust
4. Borchert D, Sheridan L, Papatsoris A, Faruquz Z, Barua JM,
Junaid I, et al. Prevention and treatment of urinary tract
infection with probiotics: Review and research perspective.
Indian J Urol. 2008;24(2):139--44.
5. Oates L. Complementary Medicines for Urinary Tract
Infections (UTIs). Australian Pharmacist. 2011;30(4):314--17.
6. Cadieux PA, Burton J, Devillard E, Reid G. Lactobacillus
by-products inhibit the growth and virulence of
uropathogenic Escherichia coli. J Physiol Pharmacol.
2009;60 Suppl 6:13--8.
7. Davidson E, Zimmermann BF, Jungfer E, Chrubasik-
Hausmann S. Prevention of urinary tract infections with
vaccinium products. Phytother Res. 2014;28(3):465--70.
8. Howell AB, Botto H, Combescure C, Blanc-Potard AB, Gausa
L, Matsumoto T, et al. Dosage effect on uropathogenic
Escherichia coli anti-adhesion activity in urine following
consumption of cranberry powder standardized for
proanthocyanidin content: a multicentric randomized
double blind study. BMC Infect Dis. 2010;10:94.
9. Ulrey RK, Barksdale SM, Zhou W, van Hoek ML. Cranberry
proanthocyanidins have anti-biofilm properties against
Pseudomonas aeruginosa. BMC complementary and
alternative medicine. 2014;14:499.
10. Jepson RG, Williams G, Craig JC. Cranberries for preventing
urinary tract infections. Cochrane Database Syst Rev.
11. Srinivas NR. Cranberry juice ingestion and clinical drug-
drug interaction potentials; review of case studies and
perspectives. Journal of pharmacy & pharmaceutical
This column is supported through an unrestricted
grant from Flordis.
clinically proven natural medicines
BY TORREN POWELL
As part of a widening participation program conducted at Queensland
University of Technology (QUT), Torren Powell participated in a homeless
connect event on 18 November 2015 where pharmacy services in a
multidisciplinary team were provided to people who are at risk of
homelessness. In this article he reflects on his experience.
Having no prior contact with homeless
people my expectations of the homeless
were of people with mental health
issues, violence, and substance and
alcohol abuse. By the day's end these
expectations were shattered.
The Homeless Connect Initiative is
organised by the Brisbane City Council
and Volunteering Queensland. It brings
hope, support and community to the
homeless through volunteers spanning
many professions and skills as well the
generosity of supporting companies
and members of the community. I was
a part of the Queensland University
of Technology's (QUT) health clinics
Pharmacy team, as a fourth year
During the initiative a middle-aged
woman approached the pharmacy
station, eyeing the various pamphlets.
'How are you feeling today?' I asked.
'Not good at all,' she replied.
I pushed further with open questions
and found myself listening, not only
with my ears and my knowledge but my
heart. She required complex care and
felt isolated and confused, stating that
nobody cared about her.
Through this exchange I knew that
simply addressing the medical issues
and treating the disease would not
help this patient. To have a real impact
I needed to enter her viewpoint and
give her an understanding of the advice
provided to find a path that would
achieve both our goals. Let us not get
lost in the overwhelming big picture
but look at a particular aspect, then step
by step break down the isolation
She left the booth feeling confident that
she could now seek help when needed
and that there are many avenues to find
support and medical advice. Using short
term achievable goals and motivating
the patient to move forward was a major
step towards convalesce. It's the human
to human contact that counts as well as
the professional to homeless contact.
Working in multidisciplinary
collaboration as part of an assembly
of health professionals and students
expanded and improved my own
practice as I was able to see the
viewpoints from many diverse
professions such as doctors, nurses,
podiatrists, audiologists, social workers
and see where I as a future pharmacist
can make a significant difference to the
health outcomes of these people.
Viewpoints and experiences are
important and need be collected.
Although I was providing help to the
homeless, from them I received the gift
of understanding and non-judgment.
I strongly encourage all students to
participate in similar events and expand
their experience and appreciation for
culture and circumstance, developing a
new and better outlook both personally
Lecturers, students and volunteers
of Health clinics from QUT through
Homeless Connect and other
community initiatives are breaking
through attitudinal, cultural and
community barriers; making our
practice work in the 'real world' so that
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