UHSP Collections (University of Health Sciences and Pharmacy)
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Global Leaders in Development: a global leadership module across three international pharmacy schools
No full textObjectives: The objective of this study was to assess the impact of the Global Leaders in Development (GLIDE) module to determine whether the concepts of global mindset, citizenship and leadership can be effectively taught within a short-term didactic module. Methods: Faculty members of PharmAlliance, a partnership between three schools of pharmacy, created a three-week optional, non-credit-bearing distance-based global leadership development module. Material and assignments focused on the concepts of global mindset, global citizenship and global leadership as applied to the global health issues of non-communicable diseases, universal health coverage and primary care. Student self-rated growth was measured with an adapted fifteen question pre–post-survey that also included open-ended questions. Key Findings: Most statements showed growth on the pre–post-survey with seven being statistically significant (P \u3c 0.05). The largest growth involved students’ perceived potential to be a global leader in pharmacy (global leadership category), the students’ connectedness to the pharmacy profession worldwide (global citizenship category) and the students’ awareness of global challenges faced in the pharmacy profession (global mindset category). Qualitative analysis identified several themes for each of the open-ended questions. Student expectations focused on the desire to expand their global mindset, better understand global pharmacy practice, develop teamwork skills and understand global pharmacy challenges and strategies for engagement. Conclusions: The concepts of global mindset, global citizenship and global leadership may help promote awareness of global health challenges, opportunities to make a global difference in a local context and connectivity to the profession on a global scale
A Load off Whose Heart? Psychiatry and the Politics of Respectability and Race Representation in Harlem, 1943-45
No full textIn wartime Harlem, liberal mental health professionals, eager to serve the black freedom struggle, sought to depict the minds of troubled black children as human without reinforcing pernicious racial stereotypes. This paper examines how psychiatrist Viola W. Bernard and the Community Service Society struggled to portray the black community as both psychologically damaged and morally beyond reproach when publicly presenting the cases of her male and female clients. As a consequence, liberals helped champion the mental health needs of delinquent black males as a matter of racial justice while rendering young unmarried mothers effectively invisible
Flattening the curve of emotional distress during COVID-19
No full textAims: The aim of this article is to examine how the facilitation of narrative sessions aids in \u27flattening the curve\u27 of distress and anxiety experienced by healthcare professionals during the COVID-19 pandemic. Methods and Material: Sixty-eight participants were surveyed. Quantitative and qualitative data were collected through postsession surveys, copies of stories submitted by participants, and de-identified statements captured by facilitators during the sessions. Two primary themes were used (i.e., difficult/challenging and uplifting/inspiring) to structure the writing prompt and to analyze participant stories. Using a layered account, the authors narrate their experiences as session facilitators and the anonymous experiences of session participants. Results: Results show that 90% of participants reported the ability to listen more closely, 92.5% reported improved resilience, and 92.5% reported the ability to immediately apply what they practiced or witnessed in the narrative sessions. Conclusion: Engaging in narrative writing and sharing stories verbatim in online sessions has the potential to address moral distress, increase active listening, and build resilience for health-care professionals. This article highlights the critical role of engaging health-care professionals in reflective practices to process, reflect, and share their personal and professional experiences related to the impact of COVID-19. The following core competencies are addressed in this article: Interpersonal and communication skills
Extending advice response theory to the advisor: Similarities, differences, and partner-effects in advisor and recipient advice evaluations
No full textWe extended advice response theory by drawing from construal-level theory to understand advisors’ evaluation processes and how advisors’ and recipients’ evaluations impact each other. An actor-partner interdependence model (N = 130 dyads) indicated, for both advisors and recipients, advisor expertise assessments were positively associated with advice facework and efficacy evaluations, which were positively associated with advice quality ratings. Advisors rated certain aspects of their advice more favorably than recipients, viewed absence of limitations as more important when rating advice quality, and were less influenced by their relational satisfaction when evaluating message features. We examined how recipient-to-advisor and advisor-to-recipient significant effects manifested in conversations using post-hoc qualitative analyses and found that behaviors are role-dependent and may reflect role-specific construal levels
Tracking physical activity using smart phone apps: Assessing the ability of a current app and systematically collecting patient recommendations for future development
No full textBackground: Within the United Kingdom\u27s National Health System (NHS), patients suffering from obesity may be provided with bariatric surgery. After receiving surgery many of these patients require further support to continue to lose more weight or to maintain a healthy weight. Remotely monitoring such patients\u27 physical activity and other health-related variables could provide healthworkers with a more \u27ecologically valid\u27 picture of these patients\u27 behaviours to then provide more personalised support. The current study assesses the feasibility of two smartphone apps to do so. In addition, the study looks at the barriers and facilitators patients experience to using these apps effectively. Methods: Participants with a BMI \u3e 35 kg/m2 being considered for and who had previously undergone bariatric surgery were recruited. Participants were asked to install two mobile phone apps. The \u27Moves\u27 app automatically tracked participants\u27 physical activity and the \u27WLCompanion\u27 app prompted participants to set goals and input other health-related information. Then, to learn about participants\u27 facilitators and barriers to using the apps, some participants were asked to complete a survey informed by the Theoretical Domains Framework. The data were analysed using regressions and descriptive statistics. Results: Of the 494 participants originally enrolled, 274 participants data were included in the analyses about their activity pre- and/or post-bariatric surgery (ages 18-65, M = 44.02, SD ± 11.29). Further analyses were performed on those 36 participants whose activity was tracked both pre- and post-surgery. Participants\u27 activity levels pre- and post-surgery did not differ. In addition, 54 participants\u27 survey responses suggested that the main facilitator to their continued use of the Moves app was its automatic nature, and the main barrier was its battery drain. Conclusions: The current study tracked physical activity in patients considered for and who had previously undergone bariatric surgery. The results should be interpreted with caution because of the small number of participants whose data meet the inclusion criteria and the barriers participants encountered to using the apps. Future studies should take note of the barriers to develop more user-friendly apps. Trial registration: ClinicalTrials.gov- NCT01365416 on the 3rd of June 2011
Evaluation of the Safety and Effectiveness of Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation and Coexisting Valvular Heart Disease
No full textBackground: Current guidelines recommend direct-acting oral anticoagulants (DOACs) over warfarin in patients with atrial fibrillation (AF) and valvular heart disease (VHD) without a mechanical valve or moderate to severe mitral stenosis. However, real-world data to support the safety and efficacy of DOACs in this patient population are lacking. Objective: Our objective was to assess the safety and effectiveness of DOACs in patients with AF and VHD. Methods: This retrospective chart review evaluated patients aged ≥ 18 years with a diagnosis of AF and at least moderate VHD on echocardiogram. Patients were included if they received ≥ 1 month of DOAC therapy from December 2016 to December 2018. Patients were excluded if they received dual antiplatelet therapy or had additional indications for anticoagulation. The primary outcomes were incidence of stroke or systemic embolism (SSE) and major bleeding. Results: In total, 200 patients were included (disease type: aortic, n = 50; mitral, n = 50; tricuspid, n = 50; multivalve, n = 50). Most patients received apixaban (n = 133 [66.5%]) followed by rivaroxaban (n = 50 [25%]) and dabigatran (n = 17 [8.5%]). No patients received edoxaban. The mean CHA2DS2-VASc score was 4.25 and was similar among DOAC cohorts (p = 0.380). The overall SSE rate was 3.5% and was highest for dabigatran (n = 3 [17.6%]) compared with the other DOACs (apixaban, n = 1 [0.8%]; rivaroxaban, n = 3 [6%]; p = 0.001). Rates were similar among different valve types (aortic, n = 3 [6%]; mitral, n = 1 [2%]; tricuspid, n = 2 [4%]; multivalve, n = 1 [2%]; p = 0.653). The overall rate of major bleeding was 5.5% and did not differ among the DOACs (apixaban, n = 5 [3.8%]; rivaroxaban, n = 4 [8%]; dabigatran, n = 2 [11.8%]; p = 0.264) or valve type (aortic, n = 3 [6%]; mitral, n = 2 [4%]; tricuspid, n = 2 [4%]; multivalve, n = 4 [8%]; p = 0.787). Conclusions: In patients with AF and VHD, rates of major bleeding were similar among the DOACs and valve types; however, more patients receiving dabigatran experienced SSE. Further studies are needed to validate these findings
Naming of Biological Products
No full textBiological products are rapidly expanding in the United States, and they are currently the fastest-growing class of therapeutic products. Biological products are being developed for rare, difficult-to-treat disease states and disease states with no treatment options, as well as creating new options for treatable conditions. The FDA has identified potential safety concerns for patients using biological products. These concerns include inappropriate or unintended biological-product substitution, along with pitfalls in pharmacovigilance monitoring for biological products. Recent FDA guidance discusses concerns, proposes solutions, and describes nomenclature for naming biological products
Evaluating provider acceptance of pharmacist interventions in the Discharge Companion Program and its association with readmission reduction
No full textObjective: To evaluate provider acceptance of pharmacist interventions within the Discharge Companion Program (DCP) and its association with hospital readmissions. Methods: This retrospective record review included patients referred to the DCP between January and October 2018. DCP pharmacists’ interventions were assessed for provider acceptance on follow-up consultation or readmission. A chi-square test assessed the association between provider acceptance, communication modality, and technology used. A logistic regression model assessed the association between readmission risk and variables of interest. An a priori alpha level of 0.05 was used. Results: Of the 197 patients referred to the DCP, 102 met inclusion criteria. DCP pharmacists made a total of 271 interventions; 185 (68.7%) required provider action. The most common intervention type was medication addition or discontinuation (n = 74, 40%); the communication mode was between DCP nurses and primary care provider offices or skilled nursing facilities (n = 56, 54.9%); and the preferred technology was the telephone (n = 58, 56.9%). Provider acceptance rate was 30.8% (n = 57) of actionable interventions, although it was not significantly associated with 30-day readmission reductions (P = 0.833) and did not differ significantly when interventions were communicated to other health care professionals (P = 0.53). The specific intervention communication mode (i.e., telephone, facsimile, or both) of pharmacist interventions did not significantly affect provider acceptance (P = 0.133). The overall readmission rate was 22.5% (n = 23), and the only significant predictor of 30-day readmission was the number of comorbidities (odds ratio 1.28 [95% CI 1.03–1.58], P = 0.024). Conclusion: Provider acceptance of pharmacists’ interventions did not significantly affect 30-day readmission rates, regardless of communication mode (telephone or facsimile) or technology used. However, the DCP successfully identified numerous medication-related problems. Further study is warranted regarding provider acceptance of pharmacist recommendations on 30-day readmission reduction
FERPA Confidentiality Guidelines Policy
No full textThe University has established guidelines covering access to information contained in student educational records to ensure compliance with the Family Educational Rights and Privacy Act (“FERPA”). This policy supplements existing FERPA policies and statements
Association between prescription opioid misuse and dimensions of suicidality among college students
No full textSuicide rates among young adults have increased in recent years. Prescription opioid misuse is not only associated with depression onset but misuse has also been reported as means to manage existing depressive symptoms. College students are at increased risk for psychological distress compared to other populations. The current cross-sectional study aimed to fill a literature gap by examining a relationship between prescription opioid misuse and 3 dimensions of suicidality among a large sample of college students (n = 889). Binomial logistic regression examined relationships between prescription opioid misuse and suicidality while adjusting for the effect of important demographic and substance use covariates. Among this sample 38.8% reported suicidal ideation, 11.6% reported making a plan to kill themselves, and 7.8% reported at least one suicide attempt in the past 12 months. Past year prescription opioid misuse was common (21.6% of participants) and significantly associated with each dimension of suicidality. Though the relationships were attenuated, past year prescription opioid misuse remained significantly associated with suicidal ideation, planning, and attempts following covariate adjustment. At a local level, University health promotion specialists should give particular consideration to individuals exhibiting prescription opioid misuse as this may serve as an indicator of underlying psychological distress and possible suicidality