Summary Biosynthesis of the alkaloid nicotine in Nicotiana species is induced by insect damage and jasmonate application. To probe the transcriptional regulation of the nicotine pathway, we constructed two subtracted cDNA libraries from methyl jasmonate (MeJA)‐treated Nicotiana benthamiana roots directly in a viral vector suitable for virus‐induced gene silencing (VIGS). Sequencing of cDNA inserts produced a data set of 3271 expressed sequence tags (ESTs; 1898 unigenes), which were enriched in jasmonate‐responsive genes, and included 69 putative transcription factors (TFs). After a VIGS screen to determine their effect on nicotine metabolism, six TFs from three different TF families altered constitutive and MeJA‐induced leaf nicotine levels. VIGS of a basic helix‐loop‐helix (bHLH) TF, NbbHLH3, and an auxin response factor TF, NbARF1, increased nicotine content compared with control plants; silencing the bHLH family members, NbbHLH1 and NbbHLH2, an ethylene response factor TF, NbERF1, and a homeobox domain‐like TF, NbHB1, reduced nicotine levels. Transgenic N. benthamiana plants overexpressing NbbHLH1 or NbbHLH2 showed increased leaf nicotine levels compared with vector controls. RNAi silencing led to both reduced nicotine and decreased levels of transcript encoding of enzymes of the nicotine pathway. Electrophoretic mobility shift assays showed that recombinant NbbHLH1 and NbbHLH2 directly bind G‐box elements identified from the putrescine N‐methyltransferase promoter. We conclude that NbbHLH1 and NbbHLH2 function as positive regulators in the jasmonate activation of nicotine biosynthesis.

Canada’s universal public health care system provides physician, diagnostic, and hospital services at no cost to all Canadians, accounting for approximately 70% of the 264 billion CAD spent in health expenditure yearly. Pharmacy-related services, including prescription drugs, however, are not universally publicly insured. Although this system underpins the Canadian identity, primary health care reform has long been desired by Canadians wanting better access to high quality, effective, patient-centred, and safe primary care services. A nationally coordinated approach to remodel the primary health care system was incited at the turn of the 21st century yet, twenty years later, evidence of widespread meaningful improvement remains underwhelming. As a provincial/territorial responsibility, the organization and provision of primary care remains discordant across the country. Canadian pharmacists are, now more than ever, poised and primed to provide care integrated with the rest of the primary health care system. However, the self-regulation of the profession of pharmacy is also a provincial/territorial mandate, making progress toward integration of pharmacists into the primary care system incongruent across jurisdictions. Among 11,000 pharmacies, Canada’s 28,000 community pharmacists possess varying authority to prescribe, administer, and monitor drug therapies as an extension to their traditional dispensing role. Expanded professional services offered at most community pharmacies include medication reviews, minor/common ailment management, pharmacist prescribing for existing prescriptions, smoking cessation counselling, and administration of injectable drugs and vaccinations. Barriers to widely offering these services include uncertainties around remuneration, perceived skepticism from other providers about pharmacists’ skills, and slow digital modernization including limited access by pharmacists to patient health records held by other professionals. Each province/territory enables pharmacists to offer these services under specific legislation, practice standards, and remuneration models unique to their jurisdiction. There is also a small, but growing, number of pharmacists across the country working within interdisciplinary primary care teams. To achieve meaningful, consistent, and seamless integration into the interdisciplinary model of Canadian primary health care reform, pharmacy advocacy groups across the country must coordinate and collaborate on a harmonized vision for innovation in primary care integration, and move toward implementing that vision with ongoing collaboration on primary health care initiatives, strategic plans, and policies. Canadians deserve to receive timely, equitable, and safe interdisciplinary care within a coordinated primary health care system, including from their pharmacy team.

POLICY BrIef Peer-reviewed 2 0 C P J / R P C • J a n u a r y / F e b r u a r y 2 0 1 4 • V O L 1 4 7 , N O 1

The screening questionnaire was a reliable method for identifying patients in community pharmacies who have a large number of DTPs.

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Background: In 2013, Jorgenson et al. published guidelines for pharmacists integrating into primary care teams. these guidelines outlined 10 evidencebased recommendations designed to support pharmacists in successfully establishing practices in primary care environments. the aim of this review is to provide a detailed, practical approach to implementing these recommendations in real life, thereby aiding to validate their effectiveness.

No abstract

rimary health care reforms in many countries include paying attention to increasing access to health care. One approach to improving access in Canada is integration of nurse practitioners (NPs) into primary care, particularly in rural settings, where NPs are more likely to work in the community rather than in a hospital. 1 This study focuses on the practices of NPs working in northern British Columbia, where factors influencing integration of NP roles can include the combination of changing patterns in the family physician workforce, 2 increasing patient medical and social complexity 3,4 and uptake of the message by decisionmakers that "NPs increase access to care." 5 Nurse practitioners have been regulated primary care providers in British Columbia since 2005.Access to health care is dependent on interrelated dimensions of the health system and abilities of patients, 6 and although evidence supports that NPs do increase access to care, 7,8 few studies have evaluated how this is accomplished. [6][7][8][9][10] As advanced practice nurses, NPs have competencies that extend beyond direct patient care to encompass proficiencies related to research, education and leadership. 11 Therefore, NPs are poised to contribute to a shift toward delivery of comprehensive, interprofessional, community-based primary health care, 12,13 and away from selective or niche models of primary care that may not address patient or community needs in a thorough manner. 7,14 The message that NPs increase access is consistently offered as a rationale for NP role creation, [15][16][17] but there may be more nuanced aspects of NP practice that can be explicated to support further successful integration of NP roles and strengthen the primary health care system.The aim of this study was to evaluate how NPs are engaged in primary health care practices in the context of their work settings as salaried health authority employees who are part of interprofessional primary care teams in northern BC primary care clinics. Methods DesignThe study was a qualitative-dominant mixed-methods study, 18 using a survey and interviews. The study team included 3 members whose roles encompass research and clinical work