UHSP Collections (University of Health Sciences and Pharmacy)
Not a member yet
1490 research outputs found
Sort by
β-Lactam Therapeutic Drug Monitoring in Critically Ill Patients: Weighing the Challenges and Opportunities to Assess Clinical Value
No full textOBJECTIVE: β-lactams are the cornerstone of empiric and targeted antibiotic therapy for critically ill patients. Recently, there have been calls to use β-lactam therapeutic drug monitoring (TDM) within 24-48 hours after the initiation of therapy in critically ill patients. In this article, we review the dynamic physiology of critically ill patients, β-lactam dose response in critically ill patients, the impact of pathogen minimum inhibitory concentration (MIC) on β-lactam TDM, and pharmacokinetics in critically ill patients. Additionally, we highlight available clinical data to better inform β-lactam TDM for critically ill patients. DATA SOURCES: We retrospectively analyzed patients admitted for sepsis or septic shock at a single academic medical center who were treated with β-lactam antibiotics. STUDY SELECTION: Indexed studies in PubMed in English language were selected for review on topics relative to critical care physiology, β-lactams, pharmacokinetics/pharmacodynamics, TDM, and antibiotic susceptibility. DATA EXTRACTION: We reviewed potentially related studies on β-lactams and TDM and summarized their design, patients, and results. This is a synthetic, nonsystematic, review. DATA SYNTHESIS: In the retrospective analysis of patients treated with β-lactam antibiotics, approximately one-third of patients received less than 48 hours of β-lactam therapy. Of those who continued beyond 48 hours, only 13.7% had patient-specific factors (augmented renal clearance, fluid overload, morbid obesity, and/or surgical drain), suggesting a potential benefit of β-lactam TDM. CONCLUSIONS: These data indicate that a strategy of comprehensive β-lactam TDM for critically ill patients is unwarranted as it has not been shown yet to improve patient-oriented outcomes. This review demonstrates that β-lactam TDM in the ICU, while laudable, layers ambiguous β-lactam exposure thresholds upon uncertain/unknown MIC data within a dynamic, unpredictable patient population for whom TDM results will not be available fast enough to significantly affect care. Judicious, targeted TDM for those with risk factors for β-lactam over- or underexposure is a better approach but requires further study. Clinically, choosing the correct antibiotic and dosing β-lactams aggressively, which have a wide therapeutic index, to overcome critical illness factors appears to give critically ill patients the best likelihood of survival
Distance Education Policy
No full textThe purpose of this policy is to provide institution-level standards and definitions for distance education and to provide a consistent approach to course design and delivery to ensure quality of education delivered distantly. This policy aims to facilitate academic excellence; support student achievement of course and program learning outcomes; support student retention and persistence; and ensure regulatory compliance with the U.S. Department of Education requirements for distance (online) education
A Call to Action for a Programmatic Approach to Addressing Health Disparities and Cultural Competency in Pharmacy Education
No full textPharmacy has recognized the importance of education in health disparities and cultural competency (HDCC) for two decades. More recently, there has been emphasis on incorporating equity, diversity, and inclusion (EDI) in pharmacy programs. While many institutions identify a need to incorporate a programmatic approach to HDCC education to meet the growing needs of a diverse population, pharmacy curricula continue to lack a holistic, programmatic approach. More than ever, Doctor of Pharmacy (PharmD) students should graduate with the knowledge, values, and skills to provide culturally appropriate care for a diverse patient population. This commentary advocates for a holistic, programmatic approach to integrating HDCC education and serves as a call to action for curricular development. It is hoped that this commentary will also set the foundation for additional scholarly work and recommendations regarding a programmatic approach
New antimicrobial treatment options for severe Gram-negative infections
No full textPurpose of reviewThis review will provide rationale for the development of new antibiotics to treat severe or multidrug-resistant (MDR) Gram-negative infections. It will also provide an overview of recently approved and pipeline antibiotics for severe/MDR Gram-negative infections.Recent findingsMDR Gram-negative infections are recognized as critical threats by global and national organizations and carry a significant morbidity and mortality risk. Increasing antibiotic resistance amongst Gram-negative bacteria, including carbapenem-resistant Acinetobacter baumannii, extended-spectrum β-lactamase-producing Enterobacterales, carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa, with difficult-to-treat-resistance has made both empiric and definitive treatment of these infections increasingly problematic. In recent years, several antibiotics have been approved for treatment of MDR Gram-negative infections and ongoing clinical trials are poised to provide additional options to clinicians\u27 armamentarium. These agents include various β-lactam/β-lactamase inhibitor combinations, eravacycline, plazomicin and cefiderocol.SummarySevere/MDR Gram-negative infections continue to be important infections due to their impact on patient outcomes, especially in critically ill and immunocompromised hosts. The availability of new antibiotics offers an opportunity to improve empiric and definitive treatment of these infections
The relationship between trait emotional intelligence and problematic alcohol use among college students
No full textBackground: Problematic alcohol use among college students is a significant public health concern. Emotional intelligence (EI), or the ability to detect one’s own and others’ emotions and to use this information to direct behavior, is suggested to mitigate problematic alcohol use. The purpose of this study was to examine the relationship between EI and problematic alcohol use among college students while controlling for drug use covariates. Methods: This cross-sectional study utilized an online survey comprised of previously validated measures to determine EI, problematic alcohol use, and drug use among college students from a large, public university in the south-central United States. Regression modeling and independent samples t-test were used to determine the relationship between EI and problematic alcohol use. Results: Problematic alcohol consumption was reported among 27.3% of participants (n=587). In regression modeling, EI demonstrated a significant, protective effect on problematic alcohol use (b=-0.050, P\u3c0.001, 95% CI: -0.076 – -0.023), when adjusting for important covariates. Independent samples t-test showed that students who screened positive for harmful alcohol use reported significantly lower EI values than those who did not (Mean difference=4.53, t=2.98, P=0.003, 95% CI: 1.54–7.51). Conclusion: The findings from this study show that problematic alcohol use is prevalent among college students and EI may provide a protective effect against this deleterious behavior. Given the findings observed in this study, university officials should incorporate EI training into the university curriculum, such as in onboarding courses for freshman and transfer students, to target prevention of potentially harmful alcohol consumption and associated negative health impacts
Love is in the air: additional evidence for a volatile sex-attractant pheromone in snakes
No full textMany taxa utilise chemosensation as their primary sensory modality and communicate with one another using pheromones. Sex-attractant pheromones facilitate mate location and provide information regarding the reproductive status of the potential mate. Snakes have adaptively radiated to many different habitats, some of which preclude the possibility of depositing a continuous terrestrial pheromone trail (e.g., arboreal, semi-aquatic). We suggest that volatile signals are present in species inhabiting such environments. The majority of investigations into snake sex-attractant pheromones have examined terrestrial species, largely ignoring non-terrestrial species and their signal modality. We examined the potential existence of terrestrial and volatile signals in the northern watersnake (Nerodia sipedon) with a modified Y-maze. During the mating period, males of this semi-aquatic species successfully trailed both the terrestrial and volatile signals from estrous females but did not successfully trail the terrestrial or volatile signals from non-estrous females and other males. Whether a single multimodal sex-attractant pheromone (or multiple sex-attractant pheromones) produced this result remains unknown. However, we feel future investigations into the volatile nature of sex-attractant pheromones in the Ophidia would prove fruitful; particularly for arboreal, aquatic, and semi-aquatic taxa providing a greater understanding of communication and mating system dynamics
Evaluating the relationship between moral values and vaccine hesitancy in Great Britain during the COVID-19 pandemic: A cross-sectional survey
No full textRational/Objective: Mandating vaccinations can harm public trust, and informational interventions can backfire. An alternative approach could align pro-vaccination messages with the automatic moral values and intuitions that vaccine-hesitant people endorse. The current study evaluates the relationships between six automatic moral intuitions and vaccine hesitancy. Methods: A cross-sectional survey was designed using Qualtrics (2020) software and conducted online from April 6th to April 13, 2021. A representative sample of 1201 people living in Great Britain took part, of which 954 (514 female) passed the attention check items. Participants responded to items about their automatic moral intuitions, vaccination behaviours or intentions related to COVID-19 vaccines, and general vaccine hesitancy. Regressions (with and without adjustments for age, gender, and ethnicity) were performed assessing the association between endorsement of each automatic intuition and self-reported uptake of COVID-19 vaccines, and between each automatic intuition and general vaccine hesitancy. Results: People who endorsed the authority foundation and those who more strongly endorsed the liberty foundation tended to be more vaccine hesitant. This pattern generalises across people\u27s self-reported uptake of COVID-19 vaccines and people\u27s hesitancy towards vaccines in general. To a lesser extent people who expressed less need for care and a greater need for sanctity also displayed greater hesitancy towards vaccines in general. The results were consistent across the adjusted and non-adjusted analyses. Age and ethnicity significantly contributed to some models but gender did not. Conclusion: Four automatic moral intuitions (authority, liberty, care, and sanctity) were significantly associated with vaccine hesitancy. Foundation-aligned messages could be developed to motivate those people who may otherwise refuse vaccines, e.g., messages that strongly promote liberty or that de-emphasize authority voices. This suggestion moves away from mandates and promotes the inclusion of a more diverse range of voices in pro-vaccination campaigns