Nevin Manimala

Am J Pharm Educ. 2021 Mar;85(3):848116. doi: 10.5688/ajpe848116. Epub 2020 Dec 4.

ABSTRACT

Objective. To teach interprofessional communication and teamwork skills to health professions students through a standardized patient simulation on acute patient stabilization and measure the impact on learners’ perceptions of interprofessional collaboration.Methods. Medical and pharmacy students in their final year and post-licensure nurses in their initial six-month probationary period worked together to stabilize a simulated acutely ill standardized patient. Perceptions of IPE were assessed pre- and post-simulation using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument, version 2 (SPICE-R2). Medical student participants’ scores were compared to those of a concurrently enrolled cohort of medical students who did not participate in the simulation.Results. Eighty learners participated in the simulation and all completed pre and post SPICE-R2 assessments. Learners’ perceptions increased significantly in all domains, including understanding of roles in collaborative practice, interprofessional teamwork and team-based practice, and patient outcomes from collaborative practice. Compared to the control cohort, participants’ perceptions of team-based practice and the impact on patient outcomes improved significantly, while a statistically similar improvement in scores for understanding of roles and responsibilities was seen. The SPICE-R2 scores increased similarly among students in each profession. Repeat exposure to the simulation continued to improve perceptions but not as robustly as the initial simulation.Conclusion. This simulation changed learners’ perceptions of how interprofessional collaboration affects patient care, which supports the incorporation of standardized patient-based interprofessional education even in the late-stage education of health professionals.

PMID:34283775 | DOI:10.5688/ajpe848116

Am J Pharm Educ. 2021 Mar;85(3):8045. doi: 10.5688/ajpe8045. Epub 2020 Nov 24.

ABSTRACT

Objective. To evaluate how pharmacy programs administer and evaluate American Association of Colleges of Pharmacy (AACP) curriculum quality perception surveys for continuous quality improvement, and to compare usage across the academy to the Principles of Good Use: AACP Quality Perception Surveys document.Methods. A 27-item survey instrument examining how schools used the curriculum quality survey was created and administered between March and June 2019 to assessment contacts of accredited schools and colleges of pharmacy. Descriptive statistics were performed for each survey item.Results. Of the 140 programs invited to participate, 88 (62.8%) responded. Curriculum quality survey data were triangulated with additional existing data (39.8%) or additional data sources were collected for triangulation with the survey data (54.5%). Programs reported on modifications made in the following areas: curriculum (85.2%), communication (75.0%), student services (68.2%), policy and process (61.4%), and professional development (53.4%). Most programs reported the assessment lead was responsible for oversight of the curriculum quality survey.Conclusion. Of respondents, 66% were familiar with the AACP Principles of Good Use document, and results indicate that institutions are generally following the recommendations. Survey analysis revealed that a significant number of programs are utilizing curriculum quality survey data for making meaningful programmatic improvements. Future work should center on further development of best practices for schools and colleges of pharmacy to effectively use the CQS data for continuous quality improvement.

PMID:34283765 | DOI:10.5688/ajpe8045

Am J Pharm Educ. 2020 Nov;84(11):7825. doi: 10.5688/ajpe7825. Epub 2020 Jul 31.

ABSTRACT

Objective. To assess pharmacy student learning from co-curricular activities and map this to Accreditation Council of Pharmacy Education (ACPE) standards and the institution’s curricular outcomes.Methods. Student representatives of professional organizations at one college of pharmacy were asked to complete a 16-item questionnaire on behalf of their members about each cocurricular activity their organization completed. Descriptive statistics were used to characterize the results. Content analysis was conducted on open-ended questions, and resulting codes were mapped to ACPE Standards 2016 and curricular outcomes.Results. The majority (74%) of the 152 unique cocurricular activities reported were designated as community outreach events and an average of 15 (SD=43) student members participated in each activity. The most frequently selected domain by student representatives was “promoted professionalism” for 86% of activities. Upon distilling student representatives’ open-ended responses regarding their members’ learning, each response was assigned to one or more of 34 codes. The most frequently assigned codes to learning descriptions (36%) were for patient education and counseling.Conclusion. Representatives of student organizations characterized their members’ participation in cocurricular activities as opportunities for learning. The results from the content analysis aligned with the quantitative data collected. Cocurricular activities provide opportunities for Doctor of Pharmacy students to enhance their skills, knowledge, and attitudes in both pharmacy practice and personal areas that map to ACPE Standards 2016 and the college’s own curricular outcomes.

PMID:34283747 | DOI:10.5688/ajpe7825

Am J Pharm Educ. 2021 Feb;85(2):8290. doi: 10.5688/ajpe8290. Epub 2020 Nov 13.

ABSTRACT

Objective. To further refine and examine the validity of an instrument for assessing pharmacy students’ self-efficacy in implementing the Pharmacists’ Patient Care Process (PPCP) components.Methods. An instrument was developed and pilot tested in spring 2018 at one college of pharmacy. In spring 2019, a modified version of the instrument, the PPCP Self-Efficacy Scale (PPCP-SES), was administered to third professional year (P3) pharmacy students at seven institutions. Self-efficacy items were based on Bandura’s theory of self-efficacy, and students were asked to rate each item on a continuous scale (0-100). Data analyses included descriptive statistics, reliability analysis, and confirmatory factor analysis (CFA).Results. Three hundred P3 students completed the PPCP-SES. The domain-specific Cronbach alpha coefficients were: collect, α=.89; assess, α=.92; plan, α=.95; implement, α=.96; and follow-up, α=.95. Based on the factor analysis results, three items were removed. Model fit statistics indicated the overall instrument had moderate goodness of fit.Conclusion. Results indicate the PPCP-SES demonstrated initial evidence of validity for use by pharmacy faculty members to identify students’ self-efficacy related to implementing components of the PPCP. Future research is needed to examine validity evidence in other student populations and among practicing pharmacists.

PMID:34283742 | DOI:10.5688/ajpe8290

Am J Pharm Educ. 2021 May;85(5):8269. doi: 10.5688/ajpe8269. Epub 2021 Feb 11.

ABSTRACT

Objective. To determine the impact of a workshop on the growth mindset and team communication of first year Doctor of Pharmacy (PharmD) students.Methods. A multi-week workshop was developed for first year pharmacy students. The workshop included completion of the StrengthsFinder 2.0, a session on identifying individual and team member strengths, a session on situational communication and conflict resolution models, and a work-up of two pharmacy scenarios requiring conflict resolution. The workshop was delivered to two intervention groups (fall 2019 and fall 2018) and compared to a control group (fall 2017). A pre-post survey was administered to measure change in students’ growth mindset and team communication using the validated Growth Mindset and Team Communication (GMTC) tool. Data were analyzed using descriptive statistics, independent sample t tests, and chi-square tests to compare difference and association. Focus groups were conducted in fall 2017 and fall 2018 to assess students’ views regarding teamwork.Results. Team communication subscale scores increased significantly among students in the intervention group while there was no significant change in these scores among students in the control group. The focus groups reflected that students had overall positive views about team communication and collaboration, which were also supported by discussions of advantages and challenges during teamwork.Conclusion. A teamwork workshop affected pharmacy students’ communication skills. Future work should focus on longitudinal measurement of students’ self-views to determine the long-term impact of teamwork training interventions.

PMID:34283727 | DOI:10.5688/ajpe8269

IEEE/ACM Trans Comput Biol Bioinform. 2021 Jul 20;PP. doi: 10.1109/TCBB.2021.3098278. Online ahead of print.

ABSTRACT

Uncovering genotype-phenotype relationships is a fundamental challenge in genomics. Gene prioritization is an important step for this endeavor to make a short manageable list from a list of thousands of genes coming from high-throughput studies. Network propagation methods are promising and state of the art methods for gene prioritization based on the premise that functionally related genes tend to be close to each other in the biological networks. Recently, we introduced PhenoGeneRanker, a network-propagation algorithm for multiplex heterogeneous networks. PhenoGeneRanker allows multi-layer gene and phenotype networks. It also calculates empirical p values of gene and phenotype ranks using random stratified sampling of seeds of genes and phenotypes based on their connectivity degree in the network. In this study, we introduce the PhenoGeneRanker Bioconductor package and its application to multi-omics rat genome datasets to rank hypertension disease-related genes and strains. We showed that PhenoGeneRanker performed better to rank hypertension disease-related genes using multiplex gene networks than aggregated gene networks. We also showed that PhenoGeneRanker performed better to rank hypertension disease-related strains using multiplex phenotype network than single or aggregated phenotype networks. We performed a rigorous hyperparameter analysis and, finally showed that Gene Ontology (GO) enrichment of statistically significant top-ranked genes resulted in hypertension disease-related GO terms.

PMID:34283720 | DOI:10.1109/TCBB.2021.3098278

Subst Abus. 2021 Jul 20:1-7. doi: 10.1080/08897077.2021.1949666. Online ahead of print.

ABSTRACT

Background: Responses to problem substance use have largely focused on illicit drugs, but reports on rising prescription drug misuse worldwide raise questions about their combined use with alcohol and potential consequences. The current study assessed prevalence of alcohol in conjunction with nonmedical opioid and benzodiazepine use across a nationally representative sample of adults in Brazil. Methods: Cross-sectional data on prevalence were estimated from the 2015 Brazilian Household Survey on Substance Use. We estimated past month nonmedical use of benzodiazepines and alcohol and past month nonmedical use of opioids and alcohol among adults who reported any past-year alcohol use. Zero-inflated Poisson models assessed independent correlates of alcohol and nonmedical opioid use, and alcohol and nonmedical benzodiazepine use. Results: Among adults who reported past year alcohol use, 0.4% (N = 257,051) reported past month alcohol and non-medical benzodiazepine use, and 0.5% (N = 337,333) reported past month alcohol and non-medical opioid use. Factors independently associated with co-use of alcohol and benzodiazepines included having depression (adjusted prevalence ratio (aPR):4.61 (95%CI 1.76-12.08)), anxiety (aPR:4.21 (95%CI 1.59-11.16)) and tobacco use (aPR: 5.48 (95%CI 2.26-13.27)). Factors associated with past-month alcohol and opioid use included having experienced physical or a threat of violence (aPR: 4.59 (95%CI 1.89-11.14)), and tobacco use (aPR:2.81(95%CI:1.29-6.12)). Conclusions: Co-use of prescription drugs with alcohol remains relatively rare among Brazilians, but findings point to a unique profile of persons at risk. Results of this study are important in light of changing dynamics and international markets of prescription drugs and the need for more research on use of these substances on a global scale.

PMID:34283709 | DOI:10.1080/08897077.2021.1949666

Ital J Dermatol Venerol. 2021 Jul 20. doi: 10.23736/S2784-8671.21.07111-5. Online ahead of print.

ABSTRACT

BACKGROUND: Diclofenac 3% gel is a widely used topical treatment with proven efficacy in reducing the burden of Actinic Keratosis (AK), however clinical benefit might not fully translate in clinical practice as non-adherence is substantial for prolonged treatment regimens. We evaluated the efficacy of an integrated low-intensity intervention program versus standard-of-care on treatment adherence among patients with multiple AK receiving diclofenac in hyaluronic acid gel 3%.

METHODS: We designed an open label, randomized, parallel group, interventional, multicenter, longitudinal cohort study including patients with multiple, grade I/II AKs. Visits were scheduled for end of treatment (T4), follow-up 1 (T5) and follow-up 2 (T6) at 90, 180 and 365 days from baseline, respectively. Patients in the intervention group received additional visits at 30 and 60 days from baseline, a brief health education intervention, an enhanced patient-physician communication, a weekly SMS reminder to medication prescriptions.

RESULTS: Patients were equally allocated between intervention (intervention group [IG], N=86) and control group (CG, N=86); at baseline, both groups had similar socio-demographic and clinical characteristics. Change scores from baseline showed a slight increment in quality of life related to AK in both groups (CG: ΔT4 – T1=-0.079; IG: ΔT4 – T1=-0.006; p=0.39) and in quality of physicianpatient interaction reported by IG (ΔT3 – T2=0.18; p<.0001). Adherence rate was not statistically different between IG and CG (28.4% vs 40.7%; p=0.11). Patients reported similar satisfaction for effectiveness, convenience and side effects of treatment. Clinical conditions improved over time and results did not differ between groups; complete clearance rate at 1 year was 18% and 29% for CG and IG, respectively.

CONCLUSIONS: Our findings showed no difference in adherence rate between the two groups, suggesting that enhanced follow-up interventions and health care education may not be sufficient drivers to promote adherence among this clinical population. Further studies are needed to explore barriers to adherence with treatments for AKs.

PMID:34282872 | DOI:10.23736/S2784-8671.21.07111-5

Ital J Dermatol Venerol. 2021 Jul 20. doi: 10.23736/S2784-8671.21.06953-X. Online ahead of print.

ABSTRACT

BACKGROUND: The etiopathogenesis of MF remains obscure. CD27 is a member of the tumor necrosis factor receptor superfamily (TNFRS) that regulates lymphocyte function4. Expression of CD27 protein and mRNA has been reported in B-cell lymphomas5 and adult T-cell leukemia/lymphoma6. In this study, we examined the expression of CD27 in the skin of MF patients by real time PCR. The amount of CD27 was measured in MF patients and healthy controls.

METHODS: A total of 98 skin biopsies were analyzed: 12 obtained from healthy donors and 86 obtained Cryostatic sections OCT-embedded affected by MF. Relative quantification of mRNA CD27 expression was achieved by means of TaqMan amplification and normalization to glyceraldehyde-3-phosphate dehydrogenase (GAPDH).

RESULTS: Housekeeping gene was detectable in all Skin samples and there isn’t difference between healthy control and MF p value 0.1564. CD27 mRNA sequences were found in 3 of 12 (25%) of skin obtained from healthy donors and in 59 of 86 (68%) of skin obtained from Cryostatic sections OCT-embedded affected by MF. The chi-square statistic with Yates correction is 6.8413 and the p-value is 0.0089. When we compared the CD27 expression in MF and controls the RQ analysis show a value of 9.12±14.13. A RQ of 9.12 means that this gene is 9.12 times more expressed in MF skin samples then in the healthy skin samples. No difference were observed in the MF clustered by stages.

CONCLUSIONS: Our findings indicates that CD27 can be used as diagnostic/prognostic markers, and whether anti-CD27 antibodies can be used in therapy.

PMID:34282858 | DOI:10.23736/S2784-8671.21.06953-X

Histol Histopathol. 2021 Jul 20:18359. doi: 10.14670/HH-18-359. Online ahead of print.

ABSTRACT

Undifferentiated pleomorphic sarcoma (UPS) in oral-maxillary area is rarely reported. Herein, we aimed to investigate the clinical characteristics, treatment strategies, prognosis, and molecular features of the oral-maxillary UPS. In total, 10 cases with primary oral-maxillary UPS were included. The rapidly progressive UPS can easily develop to an advanced and life-threatening stage, especially concerning the complex anatomical structures and spaces in the oral-maxillary area. The final diagnosis for UPS greatly depended on histological findings and immunohistochemistry staining after the exclusion of all possible differential diagnoses. Retrospectively, the treatment strategies for the included cases still referred to those of oral squamous cell carcinoma (OSCC). Statistically, the median overall survival (OS) for all the included cases was 7.75 months (range: 5-17 months). Comparatively, 3 cases had improved OS (median survival: 17 months, range: 17-18 months) and experienced PR/SD with neoadjuvant chemotherapy (anlotinib). The molecular features were demonstrated by using whole exonic sequencing for 1 included case. Cancer driver gene detection revealed GBP4 as a candidate driver gene for the primary oral-maxillary UPS. Additionally, a missense mutation in gene PIK3CA (p.E545K) was also identified. Our findings could greatly expand the knowledge about primary oral-maxillary UPS, and provide molecular evidences to improve the therapeutic options for primary oral-maxillary UPS.

PMID:34282850 | DOI:10.14670/HH-18-359