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Introduction: This short report describes the piloting of a resilience building workshop for pharmacy interns to aid with the transition from university to the workforce. Methods: A 2-hour workshop was designed focussing on responding to change and exploration of real-life examples that interns had encountered in the workplace. The workshop involved a combination of whole and small group discussions, problem-solving and self-reflection. A total of 108 interns participated in the workshop as part of The University of Sydney Pharmacy Intern Training Program. Conclusion: Pharmacy educators must continue to embed resilience training in curricula to promote graduates’ readiness to transition and deal with adversity in the contemporary workforce.

Background In healthcare, preceptors act as a role model and supervisor, thereby facilitating the socialisation and development of the preceptee into a professional fit to practice. To ensure a consistent approach to every preceptorship experience, preceptor competencies should be measured or assessed to ensure that the desired outcomes are achieved. Defining these would ensure quality management and could inform development of an preceptor competency framework. This review aimed to evaluate the evidence for preceptor competencies and assessment in health professions. Methods This study followed the PRISMA ScR scoping review guidelines. A database search was conducted in Embase, Medline, CINAHL and IPA in 2019. Articles were included if they defined criteria for competency, measured or assessed competency, or described performance indicators of preceptors. A modified GRADE CERQual approach and CASP quality assessment were used to appraise identified competencies, performance indicators and confidence in evidence. Results Forty one studies identified 17 evidence-based competencies, of which 11 had an associated performance indicator. The competency of preceptors was most commonly measured using a preceptee completed survey (moderate to high confidence as per CERQual), followed by preceptor self-assessment, and peer-assessment. Preceptee outcomes as a measure of preceptor performance had good but limited evidence. Conclusions Competencies with defined performance indicators allow for effective measurement and may be modifiable with training. To measure preceptor competency, the preceptor perspective, as well as peer and preceptee assessment is recommended. These findings can provide the basis for a common preceptor competency framework in health professions.

Brain kappa-opioid receptors (KORs) are implicated in the pathophysiology of depressive and anxiety disorders, stimulating interest in the therapeutic potential of KOR antagonists. Research on KOR function has tended to focus on KOR-expressing neurons and pathways such as the mesocorticolimbic dopamine system. However, KORs are also expressed on non-neuronal cells including microglia, the resident immune cells in the brain. The effects of KOR antagonists on microglia are not understood despite the potential contributions of these cells to overall responsiveness to this class of drugs. Previous work in vitro suggests that KOR activation suppresses proinflammatory signaling mediated by immune cells including microglia. Here, we examined how KOR antagonism affects microglia function in vivo, together with its effects on physiological and behavioral responses to an immune challenge. Pretreatment with the prototypical KOR antagonist JDTic potentiates levels of proinflammatory cytokines (IL-1ß, IL-6) in blood following administration of lipopolysaccharide (LPS), an immune-activating agent, without triggering effects on its own. Using magnetic-activated cell sorting (MACs), we found that KOR antagonism potentiates LPS-induced cytokine expression within microglia. This effect is accompanied by potentiation of LPS-induced hyperthermia, although reductions in body weight and locomotion were not affected. Histological analyses confirm that LPS produces visible changes in microglia morphology consistent with activation, but this effect is not altered by KOR antagonism. Considering that inflammation is increasingly implicated in depressive and anxiety disorders, these findings raise the possibility that KOR antagonist actions on microglia may detract from actions on neurons that contribute to their therapeutic potential.

Heart failure (HF) is the most common reason for admission to the hospital in people over the age of 65 and has been found to be a possible complication following a joint replacement. Self-management education has been shown to reduce hospital readmissions rates among patients with HF and to cause significant improvements. The purpose of this case report was to describe physical therapy (PT) self-management education in the care of a patient with both a recent hip replacement (THR) surgery and HF. Case description 85-year-old female with a THR and HF. Objective measurements included Timed Up and Go Test (TUG); 10-meter walk test (10MWT) and the 6-minute walk test (6MWT). Standard PT care for THR and self-management education strategies was provided. The patient was seen two times per week for nine weeks. Improvements were noted in all outcome measures: (TUG, 10MWT, 6MWT). The patient was able to meet all ambulation goals and become independent in transfers. In this case, self-management education was shown to provide positive benefits by increasing functional mobility and helping prevent further complications from HF. Self- management education in the home health setting is important for older adult patients who had a THR.

Teaching large cohorts of pharmacy students with a team of multiple tutors in a feedback intensive course poses challenges in relation the amount of data generated, data integrity, interpretation of the data and importantly application of the insights gained from the data. The dispensing and counselling course in the third year BPharm at the University of Sydney has implemented the USyd Pharmacy Dashboard, developed to address these challenges following the Technological Pedagogical Content Knowledge Framework (TPACK) to integrate technology into teaching. The dashboard was designed to improve the student experience through more consistent feedback, gain insights to improve teaching delivery and provide efficiencies in maintaining data integrity. The tool has been developed using an action-based research approach whereby ideas are put into practice as the means to further develop the idea and improve practice. Refinement of the USyd Pharmacy Dashboard over three years has shown improvements in teaching delivery as teachers can respond to emerging trends. Student performance and satisfaction scores have increased, mainly due to improved consistency between tutors and improved delivery of feedback. Time involved with administrative tasks such as data maintenance is reduced. Opportunities for further refinements such as real time benchmarking and developing an open learner model have become apparent.

Anxiety disorders are highly prevalent psychiatric disorders often comorbid with depression and substance abuse. Twin studies have shown that anxiety disorders are moderately heritable. Yet, genome-wide association studies (GWASs) have failed to identify gene(s) significantly associated with diagnosis suggesting a strong role for environmental factors and the epigenome. A number of anxiety disorder subtypes are considered “stress related.” A large focus of research has been on the epigenetic and anxiety-like behavioral consequences of stress. Animal models of anxiety-related disorders have provided strong evidence for the role of stress on the epigenetic control of the hypothalamic-pituitary-adrenal (HPA) axis and of stress-responsive brain regions. Neuroepigenetics may continue to explain individual variation in susceptibility to environmental perturbations and consequently anxious behavior. Behavioral and pharmacological interventions aimed at targeting epigenetic marks associated with anxiety may prove fruitful in developing treatments.

Large stores of seismic information currently exist on paper, film, and other media, containing unique records of earthquakes, geological exploration, and nuclear testing events. In order to become useful, the seismic data from the traces on these seismograms need to be extracted and outputted as computer‐readable digital data, a process referred to in this paper as digitization. Individual paper or microfilm seismograms can be digitized by hand and this tedious process has been ongoing since the 1950s. A few software packages were developed for semi‐automatic digitization, for example, the Teseo software for digitizing scanned seismogram images by Pintore et al. (2005). However, there is a pressing need to automate this process as much as possible, in order to realize the possibility of extracting the vast stores of information that reside in large archives worldwide. Although seismograms created since the 1980s are now readily available online in digital format, the need to digitize old seismograms is still necessary in order to apply modern techniques in studying pre‐1980 earthquakes (e.g., see Kanamori et al. , 2010; 2012) and nuclear explosions. We have made significant progress on this problem, working under a DOE SBIR Phase I grant, No. DE‐SC002717. The objective of our Phase I work was to create computer code that automatically extracts x – y digital data files of the seismic traces in seismogram image files, while addressing some of the problems associated with noise, distortions, and image discontinuities. In accomplishing this goal, we have developed a preliminary start‐to‐finish digitization process that begins with the inputted raster image, and ends with a digital data file representing trace center‐line coordinates. This process applies corrections to the images via our filters, and outputs, if desired, image overlays to allow for direct visual checking of the accuracy of the work. In this work, we used …

Fabricating large single crystals with colloidal spheres as building blocks is challenging and of competitive interest. Spin-coating of colloids offers a robust technique, which is highly reproducible in obtaining colloidal crystals even at fast dynamical regimes; however, these crystals are intrinsically polycrystalline due to the axial symmetry of spin-coating. We report a new method that applies a nonuniform electric field during the spin-coating process. By arranging the field direction to be stationary in the rotating frame, we are able to break the axial symmetry and to orient the colloids along one predefined direction. By regulating the applied field strength, we demonstrate local control over the orientation of the crystallites, and thus, the orientation is determined by the applied field strength.

Estimates of canine and feline euthanasia at U.S. animal shelters--largely based on voluntary surveys with low response rates--make it difficult to estimate the population from which the euthanized animals derive. Estimates of euthanasia rates (animals euthanized per unit of population) have varied widely and been available only sporadically. This study used requirements of Michigan state law (Pet Shops, Dog Pounds, and Animal Shelters Act, 1969) for animal shelters to collect admission and discharge data for all 176 Michigan-licensed animal shelters. In 2003, Michigan shelters discharged 140,653 dogs: Of these, 56,972 (40%) were euthanized; 40,005 (28%) were adopted. This annual euthanasia rate is 2.6% of the estimated 2003 Michigan dog population. Michigan shelters discharged 134,405 cats in 2003: 76,321 (57%) by euthanasia and (24%) by adoption. The estimated ratio of euthanized cats to cats who had owners was 3.1%. Small shelters and privately owned shelters were associated with higher adoption rates. Comparison with historical information from the past 10 to 20 years suggests the number of companion animals being euthanized in shelters has decreased and that progress has been made in reducing the companion animal overpopulation problem.

An age-matched case-control study was initiated to determine the major risk factors associated with CKD in cats and dogs and to determine what clinical signs cat and dog owners observed before their veterinarian diagnosed their pet with CKD. When compared to controls, the feline cases were more likely to have had polydipsia and polyuria in the year before the owners' cats were diagnosed with CKD. In the dogs, increased water intake, increased urination, small size and a recent history of weight loss and bad breath were noticed by the dog owners before veterinary CKD diagnosis. Dog owners recognized abnormal drinking and urination behavior over half a year before their pet's veterinary diagnosis with CKD, and they recognized weight loss almost 4 months before CKD diagnosis. Bad breath was noticed 1.2 years before recognition of CKD by a veterinarian. Given that earlier CKD diagnosis should have been possible in most cases, clinical trials should proceed to measure the efficacy of early interventions.

Determination of the steady state response of a system to an input composed of steps, ramps, and various other signals is considered. If the system and/or the input depend on uncertain parameters then a worst-case philosophy dictates that the analysis goal should be to determine the maximum and minimum possible equilibrium values of the output. It is shown that the system is robustly stable and if the dependence on the uncertain parameters is to an extent multiaffine, then the extreme values of the steady state response over the entire set of parameters is equal to the extreme values over just the vertices of the parameter set. This vertex result is doubly useful because it is valid in both continuous-time and discrete-time. For the transient response of stable systems, the vertices do not provide sufficient information for a complete analysis. Examples are presented which show that the maximum overshoot to the step response of a robustly stable uncertain system does not necessarily occur at a vertex. The systems in these examples have an affine dependence on a single uncertain parameter. >

In this paper we present our positive experience with use of Aquaplast thermoplastic as a tie-down dressing for securing and maintaining skin grafts in good position against their nutrient recipient beds. This unique polymer is safe to use, simple to apply, and maintains uniform pressure across the entire surface of the skin graft, no matter how contoured the shape of the anatomical region.