Tag: pubmed

PLoS Negl Trop Dis. 2021 Jul 20;15(7):e0009581. doi: 10.1371/journal.pntd.0009581. Online ahead of print.

ABSTRACT

A number of mathematical models have been developed for canine rabies to explore dynamics and inform control strategies. A common assumption of these models is that naturally acquired immunity plays no role in rabies dynamics. However, empirical studies have detected rabies-specific antibodies in healthy, unvaccinated domestic dogs, potentially due to immunizing, non-lethal exposure. We developed a stochastic model for canine rabies, parameterised for Laikipia County, Kenya, to explore the implications of different scenarios for naturally acquired immunity to rabies in domestic dogs. Simulating these scenarios using a non-spatial model indicated that low levels of immunity can act to limit rabies incidence and prevent depletion of the domestic dog population, increasing the probability of disease persistence. However, incorporating spatial structure and human response to high rabies incidence allowed the virus to persist in the absence of immunity. While low levels of immunity therefore had limited influence under a more realistic approximation of rabies dynamics, high rates of exposure leading to immunizing non-lethal exposure were required to produce population-level seroprevalences comparable with those reported in empirical studies. False positives and/or spatial variation may contribute to high empirical seroprevalences. However, if high seroprevalences are related to high exposure rates, these findings support the need for high vaccination coverage to effectively control this disease.

PMID:34283827 | DOI:10.1371/journal.pntd.0009581

PLoS One. 2021 Jul 20;16(7):e0254728. doi: 10.1371/journal.pone.0254728. eCollection 2021.

ABSTRACT

INTRODUCTION: Suicide is a global public health issue. Several environmental, psychosocial, behavioral factors along with physical, sexual, and emotional abuse have been associated with suicidal ideation and attempts. Childhood physical, sexual abuse, and health risk behaviors are also associated with suicidal attempts. The suicidal ideation prevalence varied from 1 to 20% and it varied with study population, geography, age group, gender, and other factors. The Beck suicidal ideation scale is an effective tool for assessing the major suicidal ideation with a six cut-off score.

MATERIALS AND METHOD: 160 patients who met the inclusion criteria were enrolled into this cross-sectional study after random sampling among the patients visiting the Psychiatric OPD of Shree Birendra Hospital, Kathmandu, Nepal. The Semi-Structured Interview Schedule (SSIS), Beck Scale for Suicide Ideation (BSS), and Kuppuswamy’s Scale were used to collect the data from the patients enrolled in the study. The Chi-square test and binary logistic regression analyses were used to identify and differentiate the factors associated with high suicidal risk.

RESULTS: Out of total 160 patients, 65% (n = 104) were female, 92.5% (n = 148) were married, 61.9% (n = 99) were residing in urban area, 93.1% (n = 148) were Hindus, 74.4% (n = 119) patients were living in the nuclear family, 5% (n = 8) patients had family history of psychiatric illness and 10.6% (n = 17) patients were using the substance of abuse. In the Beck scale for suicidal ideation questionnaire, 87.5% (n = 140) patients had moderate to strong wish to live, 89.4% (n = 143) patients responded as they would take precautions to save a life, 88.8% (n = 142) patients had such ideation/wish for brief, 96.3% (n = 154) had not considered for specificity/planning of contemplated suicidal attempt, 91.9% (n = 147) patients stated that they would not attempt active suicide because of a deterrent example from family, religion, irreversibility of the act and 98.1% (n = 157) patients had revealed ideas of deception/concealment of contemplated suicide openly. 16.9% (n = 27) of participants were categorized as high risk for suicide while 83.1% (n = 133) patients were as a low-risk category for suicide based on the Beck scale for suicidal ideation scoring.

CONCLUSION: In conclusion, this study found that most of the suicidal attempts were done as an act of impulse and it is higher among female and married individuals residing in the urban areas. This study did not establish any statistically significant association or differences among independent variables with the higher risk scoring in the Beck suicidal ideation scale.

PMID:34283849 | DOI:10.1371/journal.pone.0254728

Am J Pharm Educ. 2021 Apr;85(4):8365. doi: 10.5688/ajpe8365. Epub 2020 Dec 23.

ABSTRACT

Objective. To examine pharmacy career engagement, interest, and confidence in Doctor of Pharmacy (PharmD) students identifying as underrepresented racial minorities (URMs).Methods. A 15-item survey about career engagement, confidence, and goals was administered at a business session of a national conference. The survey included demographic items and items about career exposure prior to and during school, career aspirations after graduation, frequency of engagement in various settings, career factors, and career confidence. Cronbach alpha was used to examine survey reliability. Descriptive statistics and nonparametric statistical tests were used to analyze survey responses.Results. Sixty-nine URM students completed the survey. Most indicated frequent engagement with community pharmacy prior to and during school; no engagement with hospital pharmacy prior to school, yet occasional or frequent engagement during school; and no engagement with the pharmaceutical industry prior to and during school. Most selected hospital pharmacy as their career aspiration, followed by community pharmacy and industry. Approximately half indicated an interest in completing a postgraduate fellowship. Items selected as important to career choice included patient care, job security, and level of stress. Group differences were found by gender and year in school.Conclusion. Despite calls for diversity in pharmacy, there is a paucity of research in this area. This study provides a first glimpse into the career engagement, confidence, and goals of students identifying as URMs, raising a number of critical issues for pharmacy education. Moving forward, schools, employers, and researchers must work to better understand the career development of URM students, including barriers and facilitators to access and success.

PMID:34283794 | DOI:10.5688/ajpe8365

Wound Manag Prev. 2021 Apr;67(4):16-22.

ABSTRACT

BACKGROUND: Chronic wounds require frequent assessment, minor procedures, and dressing changes. Discomfort, anxiety, and stress are commonly reported during treatment procedures.

PURPOSE: To examine the effect of music during treatment on post-wound care treatment anxiety levels and blood pressure measurements in patients with chronic wounds.

METHODS: This randomized controlled trial was conducted in a wound care center within a nonprofit academic medical center with a before-and-after intervention measurement. A total of 222 consecutive patients were randomly allocated to either an intervention group (n = 112; classical music was played during treatment) or a control group (n = 110; no music was played during treatment) at their scheduled routine outpatient visits. The State-Trait Anxiety Inventory (STAI) was administered and blood pressure measurements were obtained automatically by machine before and after the intervention. Pretreatment and posttreatment scores were compared using the paired t-test in SPSS 25.

RESULTS: Patient age and sex did not differ between the intervention and control groups and pretreatment and posttreatment STAI scores; blood pressure measurements were almost identitical in the control group. In the intervention group, statistically significant differences between the pretreatment and posttreatment STAI scores (M = 45.94 and 40.83), systolic blood pressure measurements (M = 141.94 and 135.72), and diastolic blood pressure measurements (M = 70.93 and 66.23) were observed (P < .001).

CONCLUSION: In this study, playing classical music in the treatment room during wound care interventions resulted in a significant decrease in patient anxiety scores and blood pressure measurements.

PMID:34283799

Wound Manag Prev. 2021 May;67(5):26-32.

ABSTRACT

BACKGROUND: Hospital-acquired pressure injuries (HAPIs) of the sacrum are among the most common iatrogenic events in health care. Multi-intervention programs have been shown to decrease the prevalence of pressure injuries.

PURPOSE: To assess changes in the yearly incidence of sacral HAPIs before and after implementation of a 3-pronged interdisciplinary intervention to reduce HAPI incidence.

METHODS: A retrospective study of all patients admitted between 2010 and 2017 was conducted to evaluate the effect of a 2012 initiative on the incidence of sacral HAPIs. In 2012, an interdisciplinary team was created, and enhanced education programs for nursing staff and quality data reporting measures were implemented for all patients admitted to North Shore University Hospital, Manhasset, NY. Pre- and post-intervention patient variables and sacral HAPI outcomes were compared.

RESULTS: Pre- intervention, the sacral HAPI incidence was 0.353% and 0.267% (mean 0.31%) in the years 2010 and 2011, respectively. Post-intervention the HAPI incidence was 0.033%, 0.043%, 0.008%, 0.007%, and 0.004% in the years 2013, 2014, 2015, 2016, and 2017, respectively (mean 0.019%) (2-sample unpaired t-statistic: 11.5937; P < .001). Significant variables and outcomes differences between pre-intervention (n = 245) and post-intervention (n = 49) patients with a sacral HAPI were seen for race (P < .0001), length of stay (P = .0096), and HAPI stage (P < .0001).

CONCLUSION: A hospital-wide, multi-part, interdisciplinary intervention resulted in a significant and sustained reduction in the incidence of sacral HAPIs.

PMID:34283802

Am J Pharm Educ. 2020 Dec;84(12):848016. doi: 10.5688/ajpe848016. Epub 2020 Oct 2.

ABSTRACT

Objective. To use an expert consensus-building process to develop a rubric used by multiple evaluator types to assess Doctor of Pharmacy students’ patient communication skills.Methods. Faculty and staff members from six schools and colleges of pharmacy collaborated on a multi-step expert consensus-building process to create the final version of a communication rubric. First, faculty and patient content experts evaluated each item in the rubric for its relevance, criticality, and global comprehensiveness using a five-point Likert scale (0=not at all, 4=to a high extent). Descriptive statistics were used to analyze the resulting data. Faculty members evaluated the results and came to a consensus on the second version of the rubric. A corresponding codebook was developed and refined through a two-phase process.Results. The initial communication rubric was evaluated by 13 expert reviewers. Mean global comprehensiveness on the rubric was 3.83 for faculty experts and 3.5 for patient experts. After evaluating results from the expert consensus-building process, 14 items on the rubric did not change, five items were revised, three items were removed, and two items were added. The second version of the instrument included 20 items in six topic areas. A codebook was finalized to increase scoring consistency for the 20 communication items.Conclusion. Overall, content experts concluded that the rubric had high global comprehensiveness. Collaboration involving faculty members from multiple schools of pharmacy resulted in a 20-item communication rubric and codebook that can be used to increase consistency in scoring student pharmacists’ patient communication skills.

PMID:34283782 | DOI:10.5688/ajpe848016

Am J Pharm Educ. 2021 Apr;85(4):8291. doi: 10.5688/ajpe8291. Epub 2020 Dec 23.

ABSTRACT

Objective. To characterize the impact of COVID-19 transitions on first professional year (P1) students’ domain-specific and overall well-being.Methods. All P1 students (N=74) enrolled at one college of pharmacy self-reported their career, community, financial, physical, social, and overall well-being on a weekly basis from January 6 through April 27, 2020. Parametric statistical tests and effect sizes were used to compare well-being scores pre-transition and post-transition and to compare well-being scores to a previous cohort of P1 students.Results. Mean well-being scores decreased when comparing pre-transition vs post-transition scores, with effect sizes ranging from d_av=.16 for financial well-being to d_av=.84 for social well-being. The average percent of students that reported struggling increased by 86.1% (16.8% vs 31.2%) post-transition, and the average percent of students that reported suffering post-transition was 351% higher (1.3% vs 6%) than pre-transition.Conclusion. Pharmacy students’ domain specific and overall well-being significantly decreased with COVID-19-related transitions. The percentage of students reporting struggling or suffering significantly increased post-transition.

PMID:34283792 | DOI:10.5688/ajpe8291

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. 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 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