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Student evaluation surveys provide educational institutions with important feedback regarding the student experience of teaching and courses; however, qualitative comments can contain offensive, insulting or threatening content. Large educational institutions generate thousands of comments per academic term; therefore, manual screening processes to find potentially harmful comments are not generally feasible. We developed a methodology for semi-automated screening of student comments that incorporates a machine learning decision support system and a detailed psychological assessment protocol. In a case study at a large public Australian university, our system identified 4,258 out of 62,049 (6.9%) comments as potentially harmful and requiring further review. Feedback from stakeholders demonstrates that this methodology is useful in reducing staff workload and could be broadly applied to different settings. Implications for practice or policy: Educational institutions can adopt this methodology to dramatically decrease the number of working hours required to screen harmful free-text comments. Researchers can use the proposed psychology-based assessment as an example of how to develop a protocol to categorise comments. Educators and researchers can use this case study to follow best practices to develop their own decision support system that implements free-text comment classifiers.

Background The success of clinical trials in Epidermolysis Bullosa (EB) is dependent upon the availability of a valid and reliable scoring tool that can accurately assess and monitor disease severity. The Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI) and Instrument for Scoring Clinical Outcomes of Research for Epidermolysis Bullosa (iscorEB) were independently developed and validated against the Birmingham Epidermolysis Bullosa Severity Score but have never been directly compared. Objective To compare the reliability, convergent validity, and discriminant validity of the EBDASI and iscorEB scoring tools. Methods An observational cohort study was conducted in 15 patients with EB. Each patient was evaluated using the EBDASI and iscorEB-clinician scoring tools by 6 dermatologists with expertise in EB. Quality of life was assessed using the iscorEB-patient and Quality of Life in EB measures. Results The intraclass correlation coefficients for interrater reliability were 0.942 for the EBDASI and 0.852 for the iscorEB-clinician. The intraclass correlation coefficients for intrarater reliability was 0.99 for both scores. The two tools demonstrated strong convergent validity with each other. Conclusion Both scoring tools demonstrate excellent reliability. The EBDASI appears to better discriminate between EB types and disease severities.

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous in the environment and often ingested with food. PFAS exposure in people can have detrimental health consequences. Therefore, reducing PFAS burdens in food items is of great importance to public health. Here, we investigated whether cooking reduces PFAS concentrations in animal-derived food products by synthesizing experimental studies. Further, we examined the moderating effects of the following five variables: cooking time, liquid / food item ratio, cooking temperature, carbon chain length of PFAS and the cooking category (oil-based, water-based & no-liquid cooking). In our systematic review searches (including the grey literature), we obtained 512 effect sizes from 10 relevant studies. These studies exclusively explored changes in PFAS concentrations in cooked seafood and freshwater fish. Our phylogenetically controlled multilevel-meta-analysis has revealed that, on average, cooking reduced PFAS concentrations by 28%, although heterogeneity among effect sizes was very high (I2 = 94.65%). Our five moderators cumulatively explained 36% of the observed heterogeneity. Specifically, an increase in cooking time and liquid / animal tissue ratio, as well as shorter carbon chain length of PFAS (when cooked with oil) were associated with significant reductions in PFAS concentrations. The effects of different ways of cooking depended on the other moderators, while the effect of cooking temperature itself was not significant. Overall, cooking can reduce PFAS concentrations in blue food (seafood and freshwater fish). However, it is important to note that complete PFAS elimination requires unrealistically long cooking times and large liquid / animal tissue ratios. Currently, literature on the impact of cooking of terrestrial animal produce on PFAS concentrations is lacking, which limits the inference and generalisation of our meta-analysis. However, our work represents the first step towards developing guidelines to reduce PFAS in food via cooking exclusively with common kitchen items and techniques.

Background: Opioid use is classified as an epidemic by many due to the impact of these medications on society. Federal and state laws for prescribing and dispensing opioids have changed rapidly in a short period of time to hopefully balance proper pain control with their use. Pharmacy directors must be informed of these rapid changes to effectively work as part of any opioid stewardship team. Objective: The objective of this study was to provide foundational leadership guidance to pharmacy directors on current opioid legislation, literature, and best practices to assist in improving opioid use. Methods: A review of the literature from 2003 to the present was conducted along with collating important up to date resources and other publications that provide foundational information to help support a comprehensive management of opioid use. A summary of these data has been collated into an easy to use table and summarized throughout this article. Conclusion: The information provided in this article helps to properly inform pharmacy leaders to the resources available to improve the prescribing, dispensing, and monitoring of opioids and alternatives.

Background Pathologists sometimes disagree over the histopathologic diagnosis of melanoma. "Over-calling" and "under-calling" of melanoma may harm individuals and healthcare systems. Objectives To estimate the extent of "over-calling" and "under-calling" of melanoma for a population undergoing one excision per person and to model the impact of potential solutions. Methods In this epidemiological modelling study, we undertook simulations using published data on the prevalence and diagnostic accuracy of melanocytic histopathology in the United States population. We simulated results for 10,000 patients each undergoing excision of one melanocytic lesion, interpreted by one community pathologist. We repeated the simulation using a hypothetical intervention that improves diagnostic agreement between community pathologist and a specialist dermatopathologist. We then evaluated four scenarios for how melanocytic lesions judged to be neither clearly benign (post-test probability of melanoma 90%) might be handled, before sending for expert dermatopathologist review to decide the final diagnosis. These were; 1) No intervention before expert review. 2) Formal second community pathologist review. 3) Intervention to increase diagnostic agreement. 4) Both the intervention and formal second community pathologist review. The main outcomes were the probability of "over-calling" and "under-calling" melanoma, and number of lesions requiring expert referral for each scenario. Results For 10,000 individuals undergoing excision of one melanocytic lesion, interpreted by a community pathologist, a hypothetical intervention to improve histopathology agreement reduced the number of benign lesions "over-called" as melanoma from 308 to 164 and the number of melanomas "under-called" from 289 to 240. If all uncertain diagnoses were sent for expert review, the number of referrals would decrease from 1,500 to 737 cases if formal second community pathologist review was used, and to 701 cases if the hypothetical intervention was additionally used. Conclusions Interventions to improve histopathology agreement may reduce melanoma "over-calling" and "under-calling".

Current remote sensing platforms generate a vast amount of imagery but the best current methods to index and retrieve that data require expensive and difficult to procure labels. In this paper, we aim to address this problem by presenting a performant content based image retrieval (CBIR) system that is capable of indexing and retrieval using only unlabelled data. We investigate the use of self-supervised learning, a method for end-to-end learning of visual features from large datasets. In particular, we investigate the performance of four state-of-the-art self-supervised learning methods: variational autoencoders, bidirectional GANs, colourisation networks and DeepCluster, and evaluate the quality of the representations learned on remote sensing CBIR problems. Experiments on two very high resolution datasets show that the best of these methods, DeepCluster, is able to achieve near parity with supervised transfer learning despite not using any label information.

Urban climate monitoring is an important problem which is examined in the JURSE 2019 contest. The contest requires dense, spatio-temporal predictions from little data. A sparse variational Gaussian process is a natural tool to model some of the complexities in the contest data. We fit such models using a variety of spatial features and evaluate their predictions.

Objectives: The primary objective of the study is to identify the barriers to providing Introductory Pharmacy Practice Experiences (IPPEs) in the hospital setting. Methods: Potential barriers to IPPEs were identified via literature review and interviews with current IPPE preceptors from various institutions. Based on this information, an electronic survey was developed and distributed to IPPE preceptors in order to assess student, preceptor, logistical and college or school of pharmacy related barriers that potentially exist for providing IPPE in the hospital setting. Results: Sixty-eight of the 287 eligible survey respondents (24%) completed the electronic survey. Seventy-six percent of respondents agreed or strongly agreed that available time was a barrier to precepting IPPE students even though a majority of respondents reported spending a third or more of their day with an IPPE student when on rotation. Seventy-three percent of respondents disagreed or strongly disagreed that all preceptors have consistent performance expectations for students, while just 46% agreed or strongly agreed that they had adequate training to precept IPPEs. Sixty-five percent of respondents agreed that IPPE students have the ability to be a participant in patient care and 70% of preceptors believe that IPPE students should be involved in patient care. Conclusions: Conducting IPPEs in the institutional setting comes with challenges. Based on the results of this study, experiential directors and colleges/schools of pharmacy could make a positive impact on the quality and consistency of IPPEs by setting student expectations and training preceptors on appropriate and consistent expectations for students. Type: Original Research

Objective: Social phobia can be treated by brief Internet-based cognitive behaviour therapy (CBT). Most people with social phobia, however, meet criteria for another mental disorder; this comorbidity is associated with significant disability, and cases of comorbidity may be more difficult to treat. The present study examined the impact of the Shyness programme, an Internet-based treatment programme for social phobia, on comorbid symptoms of depression and generalized anxiety disorder. Method: Data from three randomized controlled trials using the Shyness programme to treat social phobia were reanalysed. The 211 subjects, all of whom met DSM-IV criteria for social phobia, were divided into four groups: (i) social phobia only; (ii) social phobia with elevated symptoms of depression; (iii) social phobia with elevated symptoms of generalized anxiety; and (iv) social phobia with elevated symptoms of both generalized anxiety and depression. The improvement in social phobia, depression and anxiety following Internet-based treatment for social phobia was measured. Results: Improvement in social phobia was seen in all groups, whether comorbid or not. Significant improvements in comorbid symptoms of depression and generalized anxiety occurred even though the treatment was focused on the social phobia. Conclusions: Brief Internet-based CBT can reduce both the target disorder as well as comorbid symptoms. These findings are consistent with evidence that unified or transdiagnostic programmes may reduce the severity of comorbid disorders and symptoms, indicating an important direction for future research.

Objective. To provide an update to the 2007 ASHP-AACP survey by examining the current capacity of hospitals/health systems’ ability to conduct experiential education for doctor of pharmacy students.Methods. Pharmacists identified as pharmacy directors were sent an invitation to participate in an online survey tool. The survey tool asked IPPE- and APPE-specific questions, the nature of support provided by colleges/schools of pharmacy, the types of experiences available for students, and the factors influencing the quality, value, and challenges of experiential education.Results. Four hundred sixty five of the 2,911 surveys sent were completed yielding a response rate of 16%. Respectively, 45.1% and 28.5% of respondents believe that the capacity for APPE and IPPE will increase in the next five years. Overall, respondents believe that students receive a high-quality experiential education (91.4%).Conclusion. The results of this survey provide insight to the capacity, benefits and challenges of experiential e...