UHSP Collections (University of Health Sciences and Pharmacy)
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Evaluation of focused teaching compared to usual teaching on Advanced Pharmacy Practice Experiences
No full textObjective To determine the impact of focused teaching (FT) methods during an Advanced Pharmacy Practice Experience (APPE) on student pharmacist knowledge compared to usual teaching (UT). Methods Student pharmacists completing a five-week Ambulatory Care or Acute Care/General Medicine APPE from January 2011 to December 2012 were randomized to receive either UT or FT. Each student pharmacist completed a pre-rotation and post-rotation assessment. The absolute change in assessment scores between the groups was evaluated. Results A total of 34 and 44 student pharmacists were included in the UT and FT arms, respectively. Overall, the mean pre-rotation assessment score was 42/75 (56%) and mean post-rotation assessment score of 46/75 (61%) (p ≤ 0.001). The absolute change in assessment score was 4.03 ± 6.30 and 4.84 ± 6.65 (p = 0.586) for the UT and FT groups, respectively. Conclusion During a five-week APPE, FT had a similar influence on student pharmacist knowledge as UT when evaluating pre- and post-rotations assessments
Comparison of clevidipine versus sodium nitroprusside for the treatment of postoperative hypertension in cardiac surgery patients
No full textObjective: To evaluate the efficacy and safety of clevidipine (CLV) versus sodium nitroprusside (SNP) for the treatment of hypertension (HTN) in postoperative cardiac surgery patients at a community hospital. Methods: This single-center, retrospective, cohort study included cardiac surgery patients treated with CLV or SNP for postoperative systolic blood pressure (SBP) control. The primary efficacy outcome was defined as the mean number of times the SBP rose above 140 mm Hg. Secondary outcomes included a comparative cost analysis and a safety analysis. Results: Forty patients were included in each arm. Patients who received CLV had a higher incidence of SBP readings greater than 140 mm Hg (p \u3c .05). There were no differences in safety outcomes, number of patients who received as-needed (PRN) antihypertensives, or mean number of PRN antihypertensives required. There were differences in infusion duration (22.4 hours CLV vs 15.6 hours SNP; p = .035), number of infusions dispensed (2.8 CLV vs 1.3 SNP; p = .001), and length of hospital stay (12.33 days CLV vs 7.65 days SNP; p = .013). However, CLV was less expensive based on the AWP cost at the time of review. Conclusions: Although a difference in blood pressure control was seen between CLV and SNP, the safety profiles were similar between the 2 drugs. In addition, CLV remained less expensive than SNP for postoperative BP control
Identification of factors impacting recurrent Clostridium difficile infection and development of a risk evaluation tool
No full textPurpose. Recurrent Clostridium difficile infection (RCDI) is a growing concern, yet limited data exists to clarify which patients are at highest risk. Identification of these patients may better inform decisions of those who may benefit from prophylactic intervention. The purpose of this study was to determine which factors are associated with the recurrence of Clostridium difficile infection (CDI) and to develop a risk stratification tool. Methods. Patients readmitted within 10 weeks of positive C. difficile polymerase chain reaction (PCR) with symptoms were included in this retrospective case control study. The primary outcome was analyzed via univariate regression analyses of the independent factors including age, gender, number of CDI episodes, administration of acid blocking agents, antibiotics or chemotherapy, Charlson Comorbidity Index, gastrointestinal conditions, and exposure to healthcare facilities. Results. Recurrent CDI was identified in 44 of 220 included patients. In the univariate analysis, factors associated with development of RCDI included antibiotic exposure (OR 2.51, 95% CI 1.14-5.54; p 0.02) and inflammatory bowel disease (OR 5.77, 95% CI 1.24-26.79; p 0.03). An evaluation tool was created from a well-fit model. Additional factors included in the tool were chosen based on evaluation of findings from existing literature. Conclusions. Antibiotic therapy and inflammatory bowel disease were found to be associated with RCDI. Although a statistically significant association with RCDI was not found for other factors, this is likely related to small sample size. The creation of an evaluation tool using specific patient factors can help determine the risk of RCDI, while future studies may validate this tool
Relationship between patients\u27 perceptions of care quality and health care errors in 11 countries: A secondary data analysis
No full textPatients may be the most reliable reporters of some aspects of the health care process; their perspectives should be considered when pursuing changes to improve patient safety. The authors evaluated the association between patients\u27 perceived health care quality and self-reported medical, medication, and laboratory errors in a multinational sample. The analysis was conducted using the 2010 Commonwealth Fund International Health Policy Survey, a multinational consumer survey conducted in 11 countries. Quality of care was measured by a multifaceted construct developed using Rasch techniques. After adjusting for potentially important confounding variables, an increase in respondents\u27 perceptions of care coordination decreased the odds of self-reporting medical errors, medication errors, and laboratory errors (P\u3c.001). As health care stakeholders continue to search for initiatives that improve care experiences and outcomes, this study\u27s results emphasize the importance of guaranteeing integrated care
Distribution and factors associated with salivary secretory leukocyte protease inhibitor concentrations
No full textObjectives: This cross-sectional study examined the distribution and correlates of salivary secretory leukocyte protease inhibitor (SLPI) concentrations within a multinational cohort of men. Methods: Extracellular SLPI was measured in oral gargle cell supernatants of 378 men from three countries using an ELISA-based assay. Risk factor data were collected by a questionnaire. Factors associated with SLPI were assessed using linear and logistic regression for continuous and categorical SLPI, respectively. Results: Among men aged 18–73 years, the median SLPI concentration was 492.0 ng ml−1 (range: 2.3–1919.9). In multivariable modeling, men in Brazil and younger men (18–30 years) were more likely to have higher levels of SLPI [adjusted odds ratio (aOR) 3.84; 95% confidence interval (CI): 1.94–7.59, and aOR 3.84; 95% CI: 1.98–7.43, respectively]. Men with a self-reported sexually transmitted diseases diagnosis in the past 6 months were more likely to have higher SLPI levels (aOR 2.98; 95% CI: 1.1–7.83) and men reporting bleeding/swollen gums were less likely to have higher SLPI (aOR 0.34; 95% CI: 0.15–0.79). Similar results were observed for linear regression models. Conclusions: Secretory leukocyte protease inhibitor concentrations varied significantly by country and decreased with increasing age. The interaction between SLPI, modifiable factors, and oral infections that influence cancer risk warrants further investigation
An introduction to biological modeling using coin flips to predict the outcome of a diffusion activity
No full textIn order to increase students’ awareness for and comfort with mathematical modeling of biological processes, and increase their understanding of diffusion, the following lab was developed for use in 100-level, majors/non-majors biology and neuroscience courses. The activity begins with generation of a data set that uses coin-flips to replicate movement of dye molecules at an interface of a permeable gel. The class results are then collapsed into a single data set that is used to predict the movement of real dye molecules over time, which are then measured by students in a “wet-lab” activity
The outcome of interprofessional education: Integrating communication studies into a standardized patient experience for advanced practice nursing students
No full textThe purpose of this qualitative study was to examine the impact of standardized patient experiences (SPE) in the education of the Advanced Practice Nurse (APN). The education of the APN requires educators to make every attempt to promote competency in the areas of communication and clinical-decision making. SPE programs have been found to improve the interpersonal, problem solving, and critical thinking skills of nursing students. For this research twenty-nine APN students participated in SPEs over the course of two semesters. Fifteen student volunteers of those 29 participants were then interviewed three months after the experience. Results revealed that having an expert in the field of communication studies increased awareness of communication skills and how to improve nurse-patient encounters in the clinical setting.The interprofessional collaboration during the SPEs assisted in facilitating the application of learned communication skills into patient-centered care of the APN student
Salinity and hydrological barriers have little influence on genetic structure of the mosquitofish in a coastal landscape shaped by climate change
No full textGradients in salinity and vegetation have been dramatically altered along shoreline of the northern Gulf of Mexico by both natural (i.e., erosion, fluctuating sea levels) and anthropogenic (i.e., dredging, habitat restoration) drivers. We gauged the impacts of salinity gradients and open water barriers on the genetic structure of a common marsh resident, western mosquitofish (Gambusia affinis) by sampling 15 populations along 440 km of Texas/Louisiana coast. We characterized 602 individuals (~40/population) using seven microsatellite loci and our results reflected significant isolation by distance (IBD) among populations, but without the hypothesized genetic substructure from local adaptation. Large tracts of open water, thought to inhibit mosquitofish movement, were apparently not significant deterrents of dispersal. There was no evidence of a significant relationship between salinity gradients and genetic divergence. Although mosquitofish dispersal is sufficiently limited to result in a strong pattern of IBD, it is high enough to maintain the connectedness of populations. Our results suggest that limited gene flow, combined with large effective size, creates conditions suitable to adaptation to local environment, suggesting that mosquitofish and other marsh residents with similar life histories will be able to adapt to changes occurring in coastal environments
Health-promoting and disease-preventive potential of Trianthema portulacastrum Linn. (Gadabani) -An Indian medicinal and dietary plant
No full textIt is estimated that 80% of the world population depends on traditional medicine for primary healthcare need. Trianthema portulacastrum Linn. (family: Aizoaceae) is a small perennial weed found in the Americas, Africa, India, and other regions of the world. This plant is used extensively in Indian traditional medicines and is also consumed as a vegetable throughout Asia for its perceived health benefits. Phytochemical analysis of T. portulacastrum reveals the presence of alkaloids, flavonoids, terpenoids, saponins, and phenolic compounds. Emerging studies demonstrate that crude extracts as well as bioactive phytoconstituents of T. portulacastrum exhibit potent antioxidant, anti-infective, analgesic, and anti-inflammatory activities. A growing number of in vitro and in vivo studies demonstrate various biological and pharmacological activities, including prevention and amelioration of hepatotoxicity, nephrotoxicity, hyperglycemia, hyperlipidemia, infectious diseases and cancer. This review aims to present and analyze available literature to understand the full potential of T. portulacastrum in health promotion and disease prevention. Current limitations and future directions of research on this medicinal and dietary plant are also critically discussed
Higher Referrals for Diabetes Education in a Medical Home Model of Care
No full textBackground: The medical home model has been gaining attention from the health care community as a strategy for improved outcomes for management of chronic disease, including diabetes. The purpose of this study was to compare referrals for diabetes education among patients receiving care from a medical home model versus a traditional practice. Methods: Data were obtained from a large, university-affiliated primary care patient data registry. All patients (age 18-96 years) with a diagnosis of prediabetes or diabetes and seen by a physician at least twice during 2011 to 2013 were selected for inclusion. Multivariate regression models measuring the association between medical home status and referral to diabetes education were computed before and after adjusting for covariates. Results: A significantly (P ≤ .001) higher percentage of patients in a medical home than without a medical home (23.9% vs 13.5%) received a referral for diabetes education. After adjusting for covariates, medical home patients were 2.7 times more likely to receive a referral for diabetes education (odds ratio, 2.70; 95% confidence interval, 1.69-4.35). Conclusion: Patients in a medical home model were more likely to receive referrals for diabetes education than patients in a standard university-affiliated family medicine practice. Future longitudinal designs that match characteristics of patients with a medical home with those of patients without one will provide strong evidence to determine whether referral to diabetes education is a result of the medical home model of care independent of confounding factors