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Assessment of pharmacists\u27 self-reported preparedness to provide pharmacotherapy services to individuals with psychiatric disorders
No full textIntroduction: The purpose of this study was to compare pharmacists\u27 level of training and/or experience in psychiatric pharmacy to (1) their self-perceived preparedness to provide pharmacotherapy services to individuals with psychiatric disorders and (2) barriers to providing pharmacotherapy services to individuals with psychiatric disorders. Methods: This study used data from an Internet-based questionnaire. Respondents were divided into 2 groups: group A completed the Arizona Pharmacy Association\u27s Psychiatric Certificate Program, and/or was board certified in psychiatric pharmacy, and/or was a member of the College of Psychiatric and Neurologic Pharmacists, and/or had completed a psychiatric pharmacy residency; group B had no specialized training and/or experience in psychiatric pharmacy. A Mann-Whitney U test was used to compare the scaled responses for each group. Results: Compared with pharmacists without training and/or experience in psychiatry (N=235), respondents with specialized training and/or experience in psychiatric pharmacy (N=38) reported more frequent interactions with patients with psychiatric disorders and provided more counseling and drug information, monitoring for adverse drug reactions, screening for treatment issues, and both pharmacologic and nonpharmacologic treatment recommendations (P \u3c.05). Pharmacists trained in psychiatry reported being more prepared to provide all pharmacotherapy services (P \u3c.003), except in addressing nonadherence, utilizing online resources, and providing pharmacotherapy services to patients with attention deficit hyperactivity disorder. They reported fewer barriers to providing pharmacotherapy services (P \u3c.005), except for time to provide services, having a private consultation area, and reimbursement for patient care activities. Discussion: This study found that responding pharmacists without psychiatric training/experience may need additional education and training after graduation and that they perceive more barriers in providing services to the population with psychiatric disorders
Using Small Step Service Design Thinking to Create and Implement Services that Improve Patient Care
No full textService design and service thinking in many industries concentrate on providing a competitive advantage. In healthcare, better service design focused on the patient and provider experience can also improve patient outcomes, for example, by ensuring healthcare regimens are followed. Improving patient care while concurrently minimizing costs requires both big leap and small step design thinking. Healthcare organizations that use service design and service thinking innovations are often touted for big leap, system-wide design innovations. While these types of big leap design change are important, small step design thinking can also help healthcare organizations make service changes with significant results. This chapter will present two case studies illustrating small step design thinking in healthcare. Small step service design focuses on processes that may seem routine or mundane but are integral to improving patient service experience and patient health outcomes. Examples include a patient appointment process that was designed to address research showing a patient is more likely to attend a clinical appointment if that appointment is set before the patient leaves the office of the current clinician visit and a design change at a city fire department that improved access and saved taxpayer dollars. These case studies will show how small step service design thinking can be used to achieve improved patient care and can be used by other healthcare organizations to guide their service thinking
Guide for Drug Selection During Pregnancy and Lactation: What Pharmacists Need to Know for Current Practice
No full textObjective: To provide guidance for clinicians on risk assessment of medication use during pregnancy and lactation. Data Sources: Authors completed PubMed searches to identify articles focused on the use of medications in pregnancy, including fetal development, drug transfer across the placenta, trimester exposure, chronic conditions in pregnancy, medications in lactation, and lactation and chronic disease. Study Selection and Data Extraction: Articles were reviewed to provide overall guidance to medication selection during pregnancy. The following information was reviewed: medication use in pregnancy, including fetal development, drug transfer across the placenta, trimester exposure, chronic conditions in pregnancy, medications in lactation, and lactation and chronic disease. Data Synthesis: This article will provide an overview of medication safety considerations during pregnancy and lactation. Information was interpreted to help clinicians predict the potential risk and benefit in each patient to make an evidence-based decision. The article concludes with guidance on risk assessment and how pharmacists may support fellow health care providers and their patients when considering medication use. Conclusions: Information about the effects of medication use during reproductive periods is limited. With the removal of the Food and Drug Administration pregnancy categories, clinicians will be relying on pharmacists to aid in the appropriate selection of therapies for patients. It is critical that pharmacists keep abreast of resources available and be able to assess data to help prescribers and their patients
Direct oral anticoagulants for stroke prevention in atrial fibrillation: treatment outcomes and dosing in special populations
No full textBackground: To review data from the pivotal phase III trials evaluating the efficacy and safety of direct oral anticoagulants (DOACs) versus warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), and to summarize the major findings with regards to patient subgroups that are at an increased risk for stroke or bleeding. Methods: A PubMed literature search (January 2009 to January 2017) was performed using the terms ‘dabigatran’, ‘rivaroxaban’, ‘apixaban’, ‘edoxaban’, ‘atrial fibrillation’, ‘RE-LY’, ‘ROCKET AF’, ‘ARISTOTLE’, and ‘ENGAGE AF-TIMI 48’. All primary publications and secondary analyses in special populations at increased risk of stroke or bleeding from the pivotal phase III clinical trials were evaluated. Results: Available secondary analyses indicate no treatment interactions with regards to stroke or systemic embolic event (SEE) prevention for any of the DOACs in the patient subgroups, including patients with advanced age, impaired renal function, diabetes, prior stroke, concomitant antiplatelet therapy, heart failure, prior stroke, history of hypertension, myocardial infarction (MI), coronary artery disease, and peripheral artery disease (PAD). Although higher bleeding incidence was reported with dabigatran and rivaroxaban in patients aged 75 years and over with apixaban in patients with diabetes, and with rivaroxaban in patients with previous MI or PAD, no changes in dosing are recommended. Conclusions: Overall, results of secondary analyses indicate that the recommended dosing strategy for each of the DOACs produces a consistent anticoagulant effect across a diverse patient population, including those at increased risk of stroke or bleeding
Research Integrity Policy
No full textFederal regulations require that institutions applying for or receiving federal research funding have an established administrative process for reporting, reviewing, investigating, and taking appropriate actions to address allegations of research misconduct. The goal of this policy is to provide a framework to resolve allegations of research misconduct as rapidly and fairly as possible and to protect the rights and integrity of all individuals involved
Hazardous Waste Minimization Plan
No full textUniversity of Health Sciences and Pharmacy in St. Louis (UHSP) is classified as a “small quantity generator” of hazardous waste by the Missouri Department of Natural Resources (MoDNR) and the U.S. Environmental Protection Agency. These agencies enforce the Resource Conservation and Recovery Act of 1984, which requires a “large quantity generator” to certify that it has a program in place to reduce the volume and toxicity of waste generated to the degree it has determined to be economically practicable (RCRA Sections 3002(b) and 3005(h)).
Waste Minimization is necessary in order to minimize present and future threats to human health and the environment. Consistent with our sustainability efforts, UHSP has developed a Waste Minimization Plan although not required by our small quantity generator status. The RSC Waste Minimization Plan presents guidelines that can be used by Univeristy personnel to reduce the amount and toxicity of wastes generated at UHSP. While Plan procedures described below are voluntary, participation from UHSP personnel is expected to reduce our impact on our environment, generation of hazardous materials, and byproducts
Weapons on Campus Policy
No full textAt University of Health Sciences and Pharmacy in St. Louis, we are committed to the safety, security, and well-being of our students, faculty and staff. The Universitye continually works to improve security and foster a safe and secure climate for learning and living. The purpose of this policy is to establish restrictions regarding the possession of firearms and weapons on University Property, in vehicles parked on campus, University vehicles, or at University sponsored events and activities
Recombinant E. coli Cellulases, β-Glucosidase, and Polygalacturonase Convert a Citrus Processing Waste into Biofuel Precursors
No full textMolecular and biochemical characterization of lignocellulohydrolases cel12B, cel8C, β-glucosidase, and peh28 from Pectobacterium carotovorum subsp. carotovorum (Pcc) expressed in Escherichia coli (E. coli) was reported in a previous work. The current preliminary study investigates the enzymes\u27 catalytic performance on Rio-Red grapefruit processing waste (GPW) conversion which can lead to the development of low-cost and effective strategies with strain engineering and/or modified catalysts for production of biofuel precursors. The GPW utilized for the study is known for its low ash and lignin contents compared with corn stover, wheat straw, and sugar cane bagasse, while yielding soluble sugars and polysaccharide constituents proportionally comparable to wastes from other citrus sources. Pretreatment of GPW at 120 °C with 1% w/w NaOH for 15 min resulted in significant total solid losses due primarily to conversion of glucans and lignin. Subsequent enzymatic bioconversion using the recombinant E. coli lignocellulolytic system resulted in production of 24, 11, and 14 g/kg solid biomass for the respective glucose, cellobiose, and galacturonic acid products from GPW over 24 h at 45 °C and pH 5.4. Other sugar products (e.g., xylose, arabinose, galactose, mannose, and rhamnose) were also detectable throughout the catalysis but at lower concentrations compared with the main products
Behavioural insights into benefits claimants’ training
No full textPurpose: The purpose of this paper is to explore the behavioural determinants of work-related benefits claimants’ training behaviours and to suggest ways to improve claimants’ compliance with training referrals. Design/methodology/approach: Qualitative interviews were conducted with 20 Jobcentre Plus staff and training providers, and 60 claimants. Claimants were sampled based on whether or not they had been mandated to training and whether or not they subsequently participated. Along with general findings, differences between these groups are highlighted. Findings: Claimants’ behaviours are affected by their capabilities, opportunities, and motivations in interrelated ways. Training programmes should appreciate this to better ensure claimants’ completion of training programmes. Originality/value: Whilst past papers have largely examined a limited number of factors that affect claimants’ training behaviours, this report offers a synchronised evaluation of all the behavioural factors that affect claimants’ training behaviours
Correction: Correcting the effect of hematocrit in whole blood coagulation analysis on paper-based lateral flow device (Analytical Methods 2018 (2018) DOI: 10.1039/c8ay00192h)
No full textThe paragraph of text beneath eqn (3) in the published article should be changed as shown below. Eqn (3) serves calibration equation to generate a calibration value (Dy) at various Hct (x). The calibration value is positive for \u3e40% Hct, 0 for 40% Hct, and negative for \u3e40% Hct. Thenal calibrated RBC distance is the original RBC distanceminus the calibration value The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers