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Experiences regarding discrimination amid young adults encountering homelessness: Relationship in order to psychological well being outcomes.
In addition, we found lower success rates for 'knows how' questions compared to 'knows' questions in the combined PK/PD domain. Our data show that we overall succeeded in aligning our course objectives with both our teaching strategy and assessment, but that outcomes on the PK domain might benefit from additional attention. OBJECTIVES Despite progress in addressing health disparities among vulnerable populations, minority populations are at risk for chronic health conditions associated with multiple determinants of health, which affects their health status and access to care. We offer a potential solution, which creates an unconventional medical team between a pharmacist and a community health worker (CHW). We explore weaknesses and challenges in our medication use system in the context of adherence as a drug therapy problem, the role of culture in shaping medication use, and finally offer a unique paradigm for a collaborative interprofessional team consisting of CHWs and pharmacists. SUMMARY Medication adherence is far from optimal, especially in minority ethnic populations. Members of an ethnic group may acquire beliefs about illness consistent with their culture's shared customs. These findings intimate that ethnocultural minority groups may have their own remedies for illness that shape their decision to use medications as prescribed. An interprofessional team in which CHWs and pharmacists collaborate offers an opportunity to improve the effectiveness of pharmacists to address adherence-related problems, especially among minority populations in which culturally determined beliefs can shape medication use decisions. This approach holds promise because CHWs are usually embedded within the community in which their patients live, having experienced the same life experiences. These shared experiences may lead CHWs to uncover medication use practices that pharmacists are not able to discover on their own because the relationship with their patients is often not authentic, which, for many minority patients, can only be established through shared experiences. CONCLUSION This paper argues that creating teams of CHWs and pharmacists will help address challenges in achieving health equity and health disparities among vulnerable populations in the medication use system. OBJECTIVE This study aimed to identify pharmacist professional liability patterns and trends associated with 2 of the most common allegations in legal claims wrong drug dispensing errors and wrong dose dispensing errors. Cisplatinum mouse METHODS This study used pharmacist professional liability claim data from the Healthcare Providers Service Organization professional liability insurance program, underwritten by CNA. The final 2018 claims dataset consisted of pharmacist professional liability (i.e., malpractice) claims that closed between 2012 and 2016 and incurred a payment of at least $1 from the Healthcare Providers Service Organization program. Using malpractice claim data, the claims were classified by clinical license (pharmacist or pharmacy technician), primary allegation type, and total payment amount. These claims were then analyzed to determine the risk factors that most often led to wrong drug and wrong dose dispensing errors and the factors that led to claims with higher-than-average total payments. Then, the results were compared with the 2013 claims dataset to identify patterns and trends. RESULTS Inclusion criteria, applied to 1264 reported adverse incidents and claims, created the 2018 claim dataset consisting of 184 closed claims over the 5 years available for review. The average total payment was $124,407 for closed claims with a payment of at least $1. Wrong drug dispensing errors represented 36.8% of claims in the 2018 dataset, and wrong dose dispensing errors represented 15.3% of claims. Comparisons with the 2013 dataset revealed that the percentage of claims associated with wrong drug dispensing errors decreased from 43.8% in the 2013 dataset to 36.8% in the 2018 dataset. The percentage of wrong dose claims also decreased since the 2013 dataset from 31.5% to 15.3%. CONCLUSION Although technology and automation have contributed to improvements in the area of medication error prevention, wrong drug and wrong dose dispensing errors continue to occur because of system and human factor errors. OBJECTIVES Assess the impact of pharmacy technician-supported point-of-care testing (POCT), including sample collection, on the number of cholesterol screenings performed in a community pharmacy setting. Secondary objectives include assessment of provider perceptions and patient satisfaction of POCT when executed by a technician. PRACTICE DESCRIPTION Thirty-two community pharmacies in 1 regional division of a large community pharmacy chain in Tennessee; 16 participated in a certified pharmacy technician (CPhT) training program, and 16 did not. PRACTICE INNOVATION CPhTs supported POCT service delivery limited to the nonprofessional, technical tasks (e.g., sample collection, quality assurance). EVALUATION The primary objective was evaluated by comparing the total number of screenings for control and intervention sites. Descriptive and inferential statistics were used. Both secondary measures were assessed via anonymous, Likert-type scale questionnaires. RESULTS Intervention pharmacies performed 358 screenings, . OBJECTIVE To explore how pharmacists can best support young people using medication for any mental health condition. The experiences of obtaining or supplying psychotropic medication and recommendations for service improvement were explored from the perspectives of young people, community pharmacists, and key stakeholders. DESIGN A qualitative study using semistructured interviews with young people and pharmacists and the nominal group technique as a consensus method for stakeholders. SETTING AND PARTICIPANTS Face-to-face interviews were conducted with 18 young people and a nominal group with 6 stakeholders at 1 of 2 mental health support organizations in Brisbane, Queensland, Australia. Phone conversations were held with 11 pharmacists who were located across Australia. The young people were aged between 14 and 25 years, had used a mental health medication for the previous 2 months, and lived in the community. Pharmacists recognized as mental health advocates or providing a mental health service and stakeholafe health space and address young people's medication concerns beyond initial supply. The prevalence of depression in later life is higher in women than in men. However, the sex difference in the pathophysiology of depression in elderly patients is not fully understood. link2 Here, we performed gene expression profiling in leukocytes of middle-aged and elderly patients with major depressive disorder, termed later-life depression (LLD) in this context, and we characterized the sex-dependent pathophysiology of LLD. A microarray dataset obtained from leukocytes of patients (aged ≥50 years) with LLD (32 males and 39 females) and age-matched healthy individuals (20 males and 24 females) was used. Differentially expressed probes were determined by comparing the expression levels between patients and healthy individuals, and then functional annotation analyses (Ingenuity Pathway Analysis, Reactome pathway analysis, and cell-type enrichment analysis) were performed. A total of 1656 probes were differentially expressed in LLD females, but only 3 genes were differentially expressed in LLD males. The differentially expressed genes in LLD females were relevant to leukocyte extravasation signaling, Tec kinase signaling and the innate immune response. The upregulated genes were relevant to myeloid lineage cells such as CD14+ monocytes. In contrast, the downregulated genes were relevant to CD4+ and CD8+ T cells. Remarkable innate immune signatures are present in the leukocytes of LLD females but not males. Because inflammation is involved in the pathophysiology of depression, the altered inflammatory activity may be involved in the pathophysiology of LLD in women. In contrast, abnormal inflammation may be an uncommon feature in LLD males. Chronic low-grade inflammation contributes to the pathophysiology of major depressive disorder (MDD). This study aimed to examine the association between serum levels of FAM19A5, a novel chemokine-like peptide that reflects reactive astrogliosis and inflammatory activation in the brain, and the neurodegenerative changes of MDD by investigating the correlation between serum FAM19A5 levels and cortical thickness changes in patients with MDD. We included 52 drug-naïve patients with MDD and 60 healthy controls (HCs). Serum FAM19A5 levels were determined in peripheral venous blood samples using a sandwich enzyme-linked immunosorbent assay. All participants underwent T1-weighted structural magnetic resonance imaging. Serum FAM19A5 levels were greater in patients with MDD than in HCs. In the MDD group, there were significant inverse correlations between serum FAM19A5 levels and cortical thickness in the prefrontal regions (i.e., the left inferior and right medial superior frontal gyri), left posterior cingulate gyrus, right cuneus, and both precunei, which showed significantly reduced thickness in patients with MDD compared to HCs. However, no correlation between serum FAM19A5 level and cortical thickness was observed in the HC group. The results of our study indicate that serum FAM19A5 levels may reflect reactive astrogliosis and related neuroinflammation in MDD. Our findings also suggest that serum FAM19A5 may be a potential biomarker for the neurodegenerative changes of MDD. OBJECTIVE To compare estimated treatment effects of physical therapy (PT) between Patient-Reported Outcome Measures (PROMs) and outcomes measured in other ways. STUDY DESIGN AND SETTING We selected randomized trials of PT with both a PROM and a non-PROM included in Cochrane Systematic Reviews (CSRs). Two reviewers independently extracted data and risk-of-bias assessments. Our primary outcome was the ratio of odds ratios (ROR), used to quantify how effect vary between PROMs and non-PROMs; an ROR > 1 indicates larger effect when assessed by PROMs. We used REML-methods to estimate associations of trial characteristics with effects and between-trial heterogeneity. RESULTS From 90 relevant CSRs, 205 PT trials were included. The summary ROR across all the comparisons was not statistically significant (ROR, 0.88 [95% CI 0.70-1.12]; P=0.30); however, the heterogeneity was substantial (I2=88.1%). When stratifying non-PROMs further into clearly objective non-PROMs (e.g., biomarkers) and other non-PROMs (e.g., aerobic capacity), the PROMs appeared more favorable than did clearly objective non-PROMs (ROR, 1.92 [95% CI 0.99-3.72]; P=0.05). CONCLUSION Estimated treatment effects based on PROMs are generally comparable to treatment effects measured in other ways. However, in our study, PROMs indicate a more favorable treatment effect compared to treatment effects based on clearly objective outcomes. Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy and is characterized by asymmetric left ventricular hypertrophy and diastolic dysfunction, and a frequent cause of sudden cardiac death at young age. Pharmacological treatment to prevent or reverse HCM is lacking. This may be partly explained by the variety of underlying disease causes. Over 1500 mutations have been associated with HCM, of which the majority reside in genes encoding sarcomere proteins, the cardiac contractile building blocks. link3 Several mutation-mediated disease mechanisms have been identified, with proof for gene- and mutation-specific cellular perturbations. In line with mutation-specific changes in cellular pathology, the response to treatment may depend on the underlying sarcomere gene mutation. In this review, we will discuss evidence for mutation-specific pathology and treatment responses in HCM patients, mouse models and engineered heart tissue. The pros and cons of these experimental models for studying mutation-specific HCM pathology and therapies will be outlined.
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