UHSP Collections (University of Health Sciences and Pharmacy)
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The co-existence of diabetes and subclinical atherosclerosis in rural central Appalachia: Do residential characteristics matter?
No full textAim Disparities exist in cardiovascular diseases (CVD) and diabetes in the United States (U.S.) with Central Appalachia having disproportionate burden. This study examined prevalence and correlates of CVD risk-factors among patients with diabetes/subclinical atherosclerosis in Central Appalachia. Methods: During 2012–2016, 3000 patients from Central Appalachia were screened for subclinical atherosclerosis, using coronary artery calcium (CAC) scores; 419 participants had diabetes. Patients were categorized into four groups, with emphasis on those having subclinical atherosclerosis, CAC score ≥ 1. Descriptive statistics and multilevel multinomial logistic regression were conducted to identify CVD risk and spatial factors associated with co-existence of diabetes and subclinical atherosclerosis. Results: Among participants, prevalence of CVD risk-factors ranged from 11.7% for current smokers to 69.2% for those with CVD family history. Average BMI was 29.8. Compared to patients with diabetes only, age [RR = 1.07; p ≤ 0.0001], being male [RR = 5.33; p ≤ 0.0001], having hypertension [RR = 2.37; p ≤ 0.05] and being a former smoker were associated with increased likelihood of having diabetes/subclinical atherosclerosis. At the zip-code level, unemployment rate [RR = 1.37; p ≤ 0.05] was significantly associated with having diabetes/subclinical atherosclerosis. Conclusion: Consistent with clinical guidelines, study results suggest the need to integrate CAC screening into primary care diabetes programs while addressing spatial issues that predispose patients to have diabetes/subclinical atherosclerosis
A Case Control Study of the Seroprevalence of Proteins and Their Association with Pancreatic Cancer Risk
No full textThe association between () infection and pancreatic cancer (PC) risk remains inconclusive. We examined the association between antibodies and PC risk in a case-control study at a comprehensive cancer center. Multiplex serology using a glutathione S-transferase capture immunosorbent assay in conjunction with fluorescent bead technology was used to measure antibodies to 15 proteins in serum or plasma from 131 incident cases with PC or a PC precursor and 131 healthy controls. Reactivity to ≥4 proteins was defined as the overall seroprevalence. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustment for age at diagnosis/interview, gender, and race. The majority of the sample was 50 years or older, and from the white race group. Half of the sample were women. Seroprevalence ≥4 of proteins was 11.1%. Overall, seroprevalence was not associated with PC risk (OR: 0.59; 95% CI: 0.25-1.40). The prevalence of several -specific proteins HP537 (OR: 1.78; 95% CI: 0.30-10.51), HP305 (OR: 1.38; 95% CI: 0.61-3.16), and HP410 (OR: 1.31; 95% CI: 0.44-3.96) increased the odds of PC. Similarly, -specific proteins HP522 (OR: 0.25; 95% CI: 0.04-1.66), HyuA (OR: 0.49; 95% CI: 0.21-1.14), and HP1564 (OR: 0.63; 95% CI: 0.27-1.51) decreased the odds of PC. However, these findings were not statistically significant at = 0.05. Our findings do not support an association between and PC risk. Further evaluation of this lack of association is recommended
Exploring career development through a student-directed practicum to provide individualized learning experiences
No full textIntroduction: The primary objective was to assess the impact of an optional student-directed career development program on career and professional development between the second and third year of a doctor of pharmacy curriculum. Methods: Students who completed the student-directed practicum (SDP) completed a nine item pre−/post-survey assessing its impact on their career development within the learning constructs of discovery, application, and reflection. Additional open-ended questions assessed why students participated in the SDP and their perceived benefits of doing so. An additional questionnaire regarding the impact of the practicum was conducted at graduation. Quantitative data were analyzed with Wilcoxon signed-rank test for the pre−/post-survey and descriptive statistics for the graduation survey while qualitative data used a two-cycle open coding process. Results: Statistically significant increases were noted with those responding with “agree” or “strongly agree” to each of the nine statements in the pre−/post-survey. Students participated to further explore career options, and believed doing so resulted in enhanced career direction and future employability. The graduation survey showed those participating in the SDP had a higher rate of: postgraduate placement (86% vs. 77%), receiving ≥ five residency interview offers (81% vs. 69%), and first or second choice residency match (92% vs. 85%) compared to those who completed an internship outside of the SDP. Students commented that the SDP was a valuable part of their education and helped them take the next steps for their career. Conclusions: A student-directed career development experience can positively impact student\u27s career direction and professional development
A multi-site qualitative study examining pharmacy student perspectives on the opioid crisis
No full textObjective. To determine pharmacy students’ perspectives regarding opioid use, the opioid crisis, and pharmacy education related to both topics. Methods. Students from each professional year at eight participating schools and colleges of pharmacy were invited to participate in focus groups and answer questions about their experiences with the opioid crisis. Faculty and/or staff moderated the focus groups and audio-recorded responses. Recordings were deidentified, transcribed, and analyzed. Results. One hundred fifty students participated in one of 29 focus groups conducted. Responses were cate-gorized according to themes using consensual qualitative research (CQR) methodology. Sources impacting student views on the crisis included school, personal and work experience, and media. Perspective changes since starting school included increased knowledge and awareness and decreased bias/stigma. Conclusion. Conducting focus groups on the opioid crisis provided pharmacy schools with information on what student pharmacists are learning about the crisis, practices they see, and their recommendations to address the crisis. Pharmacy schools can better prepare students to combat the opioid crisis by providing them with training in opioid counseling, use of naloxone, and how to have difficult conversations with patients
Assessment of early COVID-19 compliance to and challenges with public health and social prevention measures in the Kingdom of Eswatini, using an online survey
No full textPublic health and social measures have been implemented around the world in a bid to prevent the spread of COVID-19. Public compliance with these measures is key in successfully controlling the pandemic. This online survey assessed the compliance and attitude of adults residing in the southern African Kingdom of Eswatini to government protection, activity and travel measures aimed at controlling the spread of COVID-19. A rapid online survey, comprising of 28 questions, was administered in May 2020. More than 90% of respondents knew the virus could kill anyone and most respondents (70%) reported to be compliant to public health and social measures. Females, those who did not use public transport and those aged 30 years and above were significantly (p\u3c0.01) more compliant, particularly to protective and travel measures. Social media, television and official government websites were the primary source of ongoing COVID-19 information for respondents of this online survey, and these methods should continue to be employed to reach the public who regularly use the internet. More than half of essential workers who responded to the online survey reported to have their own personal protective equipment; however, 32% either did not have any protective equipment or shared their equipment with other staff members. Due to the survey being online, these results should not be generalised to populations of low socioeconomic status
Post-Dialysis Parenteral Antimicrobial Therapy in Patients Receiving Intermittent High-Flux Hemodialysis
No full textPatients with end-stage renal disease (ESRD) requiring intermittent hemodialysis (IHD) are at increased risk of infection, which represents a leading cause of mortality in this population. The use of additional vascular access devices such as peripherally inserted central catheters to treat such infections should be minimized in patients with ESRD requiring IHD in order to mitigate complications such as infection and thrombosis and to maintain venous patency for hemodialysis access. Intravenous antimicrobial dosing following IHD has the advantages of avoiding additional access devices and providing convenience for patients and providers. Vancomycin, cefazolin, and aminoglycosides have historically been regarded as the primary intravenous antimicrobials administered with IHD given their relatively low cost, convenient dosing, and longevity of clinical use. Despite this, a growing body of literature is evaluating the use of an expanded list of antimicrobials that may be employed using post-dialysis dosing for patients requiring IHD; however, the available data are largely limited to pharmacokinetic studies and small cohorts of infected patients or uninfected subjects. Post-dialytic dosing of intravenous antimicrobials may be considered on a patient-by-patient basis after careful consideration of clinical, microbiological, and logistical factors that may influence the probability of treatment success. This document reviews and evaluates currently available information on the post-dialytic administration of an expanded list of intravenous antimicrobials in the setting of thrice-weekly, high-flux IHD
A pathway to professional identity formation: Report of the 2020-2021 AACP student affairs standing committee
No full textProfessional identity formation (PIF) involves internalizing and demonstrating the behavioral norms, standards, and values of a professional community, such that one comes to “think, act and feel” like a member of that community. Professional identity influences how a professional perceives, explains, presents and conducts themselves. This report of the 2020-2021 AACP Student Affairs Standing Committee (SAC) describes the benefits of a strong professional identity, including its importance in advancing practice transformation. Responding to a recommendation from the 2019-2020 SAC, this report presents an illustrative and interpretative schema as an initial step towards describing a pharmacist’s identity. However, the profession must further elucidate a universal and distinctive pharmacist identity, in order to better support pharmacists and learners in explaining and presenting the pharmacist’s scope of practice and opportunities for practice change. Additionally, the report outlines recommendations for integrating intentional professional identity formation within professional curricula at colleges and schools of pharmacy. Although there is no standardized, single way to facilitate PIF in students, the report explores possibilities for meeting the student support and faculty development needs of an emerging new emphasis on PIF within the Academy
Cumulative oral examinations in undergraduate human physiology: process, student perceptions, and outcomes
No full textAssessment methods vary widely across undergraduate physiology courses. Here, a cumulative oral examination was administered in two sections of a 300-level undergraduate physiology course. Student performance was quantified via instructor grading using a rubric, and self-perceptions (n = 55) were collected via survey. Overall, students affirmed that the oral examination assisted in their learning, specifically by leading them to begin preparation for their final written exam earlier than they otherwise would. The instructor considered the oral exam useful for student learning by providing a scaffold to the written final exam and a way to connect with students before a high-stakes final exam. Specific details of the examination format and suggestions and considerations for those considering this assessment approach are provided
Reflective Intuitions about the Causal Theory of Perception across Sensory Modalities
No full textMany philosophers believe that there is a causal condition on perception, and that this condition is a conceptual truth about perception. A highly influential argument for this claim is based on intuitive responses to Gricean-style thought experiments. Do the folk share the intuitions of philosophers? Roberts et al. (2016) presented participants with two kinds of cases: Blocker cases (similar to Grice’s case involving a mirror and a pillar) and Non-Blocker cases (similar to Grice’s case involving a clock and brain stimulation). They found that a substantial minority agreed that seeing occurs in the Non-Blocker cases, and that in the Blocker cases significantly less agreed that seeing occurs. They thus hypothesized that folk intuitions better align with a no blocker condition than with a causal condition. This paper continues this line of enquiry with two new experiments. The paper investigates the generality and robustness of Roberts et al.’s findings by expanding the sense modalities tested from only vision to audition and olfaction as well. The paper also uses Gricean-style thought experiments as a case study for investigating the “reflection defense” against the negative project in experimental philosophy. Our results replicate and extend Roberts et al.’s study and support their hypothesis that folk intuitions better align with a no blocker condition. They also provide an empirical reason to doubt the reflection defense
