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Objectives In Australia, pharmacists may become authorised immunisers by obtaining additional credentialling from certified providers. Some Australian Universities are providing externally accredited immunisation training to final year pharmacy students. Student satisfaction has been demonstrated, but graduate views on benefits and outcomes are yet to be determined. The aim of this study was to evaluate graduates’ perceptions of providing an accredited immunisation certification during their University pharmacy programme. Methods A survey was sent to Griffith University pharmacy graduates of 2016–2020 inclusive. Respondents who completed the accredited immunisation training at University were asked to rank their agreement with five statements on a five-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree). Further information, including free-text responses, was collected on current area of practice and involvement in vaccinations. Key findings Of the 46 graduates who completed the survey, 42 (91.3%) completed the accredited immunisation training at University. Statements that the accredited immunisation training was considered a valuable additional offering to the pharmacy programme and the time commitment was worthwhile resulted in a mean agreement of 4.74 ± 0.73 and 4.64 ± 0.76, respectively. The majority of respondents (n = 27, 58.7%) were providing immunisations on a daily, weekly or monthly basis with over half reporting becoming more actively involved in immunisation due to COVID-19. Conclusions Pharmacy graduates valued completing an externally accredited immunisation training within their University programme and reported benefits to their employability and current roles. Incorporating externally accredited training into the curriculum can ensure graduates are prepared and skilled in continually expanding roles for pharmacists.

Ensuring NCLEX-RN success for graduates of Historically Black Colleges and Universities (HBCUs) is integral to increasing Blacks and other racial/ethnic minorities underrepresented as registered nurses (RNs).To examine the association between program type (traditional (TBSN) and accelerated Bachelor of Science [ABSN]) and first-time NCLEX-RN exam outcome.A retrospective descriptive design was used. TBSN and ABSN students (n = 465) who graduated between 2015-2018 at an HBCU were examined.First-time pass rates for the total sample was 91.58%. Differences were observed between program type in 10 nursing courses for both programs, with Child Health being the only course predicting NCLEX-RN in both programs. In a multivariate logistic regression model, male students were 69% less likely to pass NCLEX-RN exam on first attempt compared to females, AOR = 0.31, p = 0.005.HBCUs can successfully prepare a diverse population of BSN graduates who pass NCLEX-RN on first attempt. Increased understanding of factors that decrease NCLEX-RN success of males is a prerequisite to development of strategies to ensure that all students have positive outcomes. There is also a need to understand differential relationships between nursing course grades and NCLEX-RN success among students enrolled in TBSN versus ABSN paths.

Background Infectious mononucleosis (IM) is a contagious illness most frequently caused by Epstein-Barr virus (EBV). There are no recent published studies characterizing the burden of IM in the general US population over time. Methods Nationally representative samples of US ambulatory medical care data were utilized to estimate the N and proportion of visits with an IM diagnosis (based on ICD-9/10 codes) by time period. The National Ambulatory Medical Care Survey (NAMCS: 2006–2015) and National Hospital Ambulatory Care Survey (NHAMCS: 2006–2019) allow estimation of annual visits in free-standing and hospital-based ambulatory care, including emergency departments (EDs). Restricted cubic spline models were implemented to assess temporal trends. NHAMCS data were divided based on availability: combined outpatient and ED (2006–2011) and ED-only (2012–2019). Analyses were conducted using SAS 9.4 & SUDAAN 11.0.3. Results There were 3,182,082 IM-related visits in NAMCS, 599,837 in combined outpatient and ED NHAMCS, and 449,000 in ED-only NHAMCS across study years. For overlapping study years, 2006–2011, across all databases the average annual number of IM-related visits was 419,927. Persons aged 10–30 years comprised the majority of IM-related visits: 61% in NAMCS, 88% in combined NHAMCS, and 85% in ED-only NHAMCS. While 66% of IM visits were made by females in NAMCS, this proportion was lower in combined NHAMCS (58%) and ED-only NHAMCS (51%). Most IM-related visits were among non-Hispanic white patients: 92% in NAMCS, 87% in combined NHAMCS, and 67% in ED-only NHAMCS. Across databases and years, there were no consistent linear trends in IM-related visits (Figure 1). Rates of IM-related visits in NAMCS decreased from 4.18 (95% confidence interval [CI]: 3.02–5.78) in 2006–2009 to 2.89 (95% CI: 1.40–5.96) per 10,000 visits in 2013–2015; decreased from 4.94 (95% CI: 3.41, 7.16) in 2006–2007 to 3.56 (95% CI: 2.33–5.45) per 10,000 visits in 2010–2011 in combined NHAMCS data; and increased from 3.61 (95% CI: 2.30–5.67) in 2012–2014 to 5.98 (95% CI: 3.20–11.17) per 10,000 visits in 2018–2019 in ED-only data. Conclusion This study contributes epidemiologic information concerning IM and EBV by estimating US ambulatory medical care burden of IM over time and describing the demographics of those affected. Disclosures Christina Chandra, MPH, Moderna, Inc.: Contractor Jianheng Li, MBBS, MPH, Moderna, Inc.: Contractor W. Dana Flanders, MD, DSc, MPH, MA, Moderna, Inc.: Contractor Roderick McPhee, MD, PhD, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Robert Paris, MD, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Philip Buck, PhD, MPH, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Sumana Chandramouli, PhD, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Susan Hall, PhD, MS, Moderna, Inc.: Salary|Moderna, Inc.: Stocks/Bonds Cathy Lally, MSPH, Moderna, Inc.: Contractor.

The value of a Surgical Care Practitioner to an orthopaedic team is demonstrated in this case study of a patient who presented with a re-ruptured Achilles tendon. It highlights the role the practitioner plays in the patient journey and illustrates it’s value throughout the clinical course from consultation through to discharge. The Surgical Care Practitioner, as a member of the extended surgical team can help to explain the diagnosis and associated treatment options, facilitate informed consent and provide expert procedural assistance to the surgeon. A Surgical Care Practitioner is ideally placed to answer patient queries and aid in rehabilitation.

Objective: Caffeine (CAF) is one of the most commonly consumed nutritional stimulant in beverages. Interestingly, CAF produces varied effects in a dose-dependent manner, and that makes it one of th...

AIM: This study is a systematic review that aims to assess how healthcare professionals manage ethical challenges regarding information within the clinical context. METHOD AND MATERIALS: We carried out searches in PubMed, Google Scholar and Embase, using two search strings; searches generated 665 hits. After screening, 47 articles relevant to the study aim were selected for review. Seven articles were identified through snowballing, and 18 others were included following a system update in PubMed, bringing the total number of articles reviewed to 72. We used a Q-sort technique for the analysis of identified articles. FINDINGS: This study reveals that healthcare professionals around the world generally employ (to varying degrees) four broad strategies to manage different types of challenges regarding information, which can be categorized as challenges related to confidentiality, communication, professional duty, and decision-making. The strategies employed for managing these challenges include resolution, consultation, stalling, and disclosure/concealment. CONCLUSION: There are a variety of strategies which health professionals can adopt to address challenges regarding information management within the clinical context. This insight complements current efforts aimed at enhancing health professional-patient communication. Very few studies have researched the results of employing these various strategies. Future empirical studies are required to address this. ABBREVIATIONS: CIOMS: Council of International Organization of Medical Sciences; WHO: World Health Organization; AMA: American Medical Association; WMA: World Medical Association; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ISCO: International Standard Classification of Occupations; ILO: International Labour Office; SPSS: The Statistical Package for the Social Sciences. ispartof: Glob Bioeth vol:32 issue:1 pages:67-84 ispartof: location:England status: Published online

To investigate how social context and social network activation influence appraisal and help-seeking for symptoms potentially indicative of cancer.Semi-structured telephone interview study. Community dwelling adults who had experienced at least one symptom potentially indicative of cancer within the last month were sampled from a national symptom survey.Thirty-four interviews were conducted. Participants looked to peers and wider society to judge whether symptoms might be normal for their age. Involvement of others in symptom appraisal promoted an active management strategy, such as contacting a healthcare professional or trying a medication. There were practical, emotional, attitudinal, normative and moral barriers to involving others. Cancer narratives from significant others, public health campaigns and the media influenced symptom appraisal. Participants held mental representations of types of people who get cancer, for example, smokers and unfit people. This had two consequences. First, participants did not identify themselves as a candidate for cancer; impeding help-seeking. Second, social judgements about lifestyle introduced stigma.Involving friends/family in symptom appraisal facilitates help-seeking but barriers exist to involving others. Campaigns to promote earlier cancer diagnosis should incorporate age-appropriate narratives, address misconceptions about 'types' of people who get cancer and tackle stigma about lifestyle factors.

BACKGROUND Melanoma is a relatively common cancer type with a high survival rate, but survivors risk recurrences or second primaries. Consequently, patients receive regular hospital follow-up, but this can be burdensome to attend and not optimally timed to detect arising problems. Total skin self-examination (TSSE) supports improved clinical outcomes from melanoma via earlier detection of recurrences and second primaries, and digital technology has the potential to support TSSE. Recent research with app-based interventions aimed at improving the well-being of older adults has found that they can use the technology and benefit from it, supporting the use of digital health care in diverse demographic groups. Thus, the Achieving Self-directed Integrated Cancer Aftercare (ASICA) digital health care intervention was developed. The intervention provided melanoma survivors with a monthly prompt to perform a TSSE as well as access to a dermatology nurse who provided them with feedback on photographs and descriptions of their skin. OBJECTIVE We aimed to explore participants’ attitudes, beliefs, and experiences regarding TSSE practices. Furthermore, we explored how participants experienced technology and how it influenced their practice of TSSE. Finally, we explored the practical and technical experiences of ASICA users. METHODS This was a nested qualitative evaluation within a dual-center randomized controlled trial of the ASICA intervention. We conducted semistructured telephone interviews with the participants during a randomized controlled trial. The participants were purposively sampled to achieve a representative sample with representative proportions by age, sex, and residential geography. Interviews were transcribed verbatim and analyzed using a framework analysis approach applied within NVivo 12. RESULTS A total of 22 interviews were conducted with participants from both groups. In total, 40% (9/22) of the interviewed participants were from rural areas, and 60% (13/22) were from urban areas; 60% (13/22) were from the intervention group, and 40% (9/22) were from the control group. Themes evolved around skin-checking behavior, other people’s input into skin checking, contribution of health care professionals outside ASICA and its value, ideas around technology, practical experiences, and potential improvements. ASICA appeared to change participants’ perceptions of skin checking. Users were more likely to report routinely performing TSSE thoroughly. There was some variation in beliefs about skin checking and using technology for health care. Overall, ASICA was experienced positively by participants. Several practical suggestions were made for the improvement of ASICA. CONCLUSIONS The ASICA intervention appeared to have positively influenced the attitudes and TSSE practices of melanoma survivors. This study provides important qualitative information about how a digital health care intervention is an effective means of prompting, recording, and responding to structured TSSE by melanoma survivors. Technical improvements are required, but the app offers promise for technologically enhanced melanoma follow-up in future. CLINICALTRIAL ClinicalTrials.gov NCT03328247; https://clinicaltrials.gov/ct2/show/NCT03328247?term=ASICA&rank=1 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s13063-019-3453-x

BACKGROUND Melanoma is common and incidence increasing. Guidelines recommend monthly Total-Skin-Self-Examination (TSSE) performed by melanoma survivors to detect recurrent and new primary melanoma. TSSE is underperformed despite evidence of benefit. OBJECTIVE To compare a self-directed digital intervention (intervention group) with treatment as usual (control group) in patients treated for a first stage 0-IIC primary cutaneous melanoma within the preceding 60 months. METHODS This randomized clinical trial was conducted at two UK NHS hospitals (Aberdeen Royal Infirmary, Grampian and Addenbrookes, Cambridge). Adults (aged ≥18) diagnosed with a first 0-IIC primary cutaneous melanoma were randomised to receive ASICA (Achieving Self-directed Integrated Cancer Aftercare) a tablet-based digital intervention to prompt and support TSSE in melanoma survivors, or to usual care. The hypothesis tested was that ASICA would increase TSSE practice in those affected by melanoma using it, and compared to controls, without affecting psychological well-being. The main outcomes melanoma worry (Melanoma Worry Scale, MWS), anxiety and depression (Hospital Anxiety and Depression Scale; HADs), and quality of life (EuroQoL EQ-5D-5L) were collected by postal questionnaire 3, 6 and 12-months following randomisation. RESULTS 241 recruits randomised (1:1) to ASICA (n=141) or control, n=140). There were no significant differences between groups for melanoma worry at 12 months (mean difference 0⸱12 95% confidence interval (-0⸱6, 0⸱84), p=0⸱743), at 3 months (0⸱23 (-0⸱31, 0⸱78) p=0.402) or 6 months (-0⸱1 (-0⸱7, 0⸱51) p=0⸱757). The ASICA group had lower anxiety scores at 12 months (-0.54 (-1.31, 0.230 p=0.168), at 3 months (-0⸱13; -0⸱.79, 0⸱54; p=0⸱711) and significantly at 6 months (-1⸱00 (-1⸱74, -0⸱26) p=0⸱009). Depression scores were similar being lower at 12 months (-0⸱44 (-1⸱11, 0⸱23), p=0.195) and 3 months (-0⸱24 (-0⸱84, 0⸱35)p=0⸱421) but only significantly lower at 6 months (-0⸱77 (-1⸱41, -0⸱12) p=0⸱020). The ASICA group had significantly higher quality of life scores at 12 months (0⸱044; (0⸱003, 0⸱085); p=0⸱036) and 6 months (0⸱070 (0⸱032, 0⸱107) p CONCLUSIONS Using ASICA for 12 months does not increase melanoma worry, and can reduce anxiety and depression and improves quality of life. ASICA has the potential to improve well-being of melanoma survivors and enable the benefits of regular TSSE. CLINICALTRIAL Clinical Trials.gov:Trial registration number NCT03328247. Registered 01 November 2017, https://clinicaltrials.gov/ct2/show/NCT03328247?term=ASICA&rank=1. First participant randomised on 25 January 2018. INTERNATIONAL REGISTERED REPORT RR2-10.1186/s13063-019-3453-x

Background and ObjectivesReduced mobility in patients with amyotrophic lateral sclerosis (ALS) is hypothesized to increase the risk of venous thromboembolism (VTE). A few small, single-center studies have investigated the risk of VTE in patients with ALS. Given the high morbidity and mortality associated with VTE, further understanding of the risk in patients with ALS may inform clinical care. The objective of this study was to investigate the incidence of VTE in patients with ALS compared with controls without ALS.MethodsPatients were identified from a US health insurance claims database, Optum's deidentified Clinformatics Data Mart Database, between 2004 and 2019. ALS cases were defined as patients aged 18 years or older with (1) 2 or more ALS claims at least 27 days apart including at least 1 claim from a neurologist visit or (2) 1 or more ALS claims and a prescription for riluzole or edaravone. Each ALS case was matched on age and sex to 5 controls without ALS. VTE was defined as at least 1 claim for VTE and at least 1 anticoagulant prescription or VTE-related procedure within 7 days before and 30 days after a VTE claim date. Incidence rates were reported per 1,000 person-years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model.ResultsAmong 4,205 ALS cases and 21,025 controls, incident VTE occurred in 132 ALS cases (3.1%) and 244 controls (1.2%). Incidence rates of VTE were 19.9 per 1,000 person-years (95% CI 16.7–23.6) in ALS cases compared with 6.0 per 1,000 person-years (95% CI 5.0–7.1) in controls. ALS cases were about 3 times more likely to develop VTE (HR 3.3, 95% CI 2.6–4.0), with similar results among men and women. The median time to first VTE was 10 months from the initial ALS claim in ALS cases.DiscussionConsistent with previous smaller studies, a higher incidence rate of VTE was observed in a large sample of patients with ALS from across the United States, as compared to matched controls. The markedly increased risk underscores the importance of preventive efforts and careful monitoring for VTE in patients with ALS and may have implications for the management of ALS.

BackgroundMelanoma is a common cancer with a high survival rate, as well as a high chance of recurrence. Combined, this leads to a high burden of follow-up. Total-Skin-Self-Examination (TSSE) improves clinical outcomes of melanoma via early detection of new primaries and recurrences, and technology is an increasingly popular means of facilitating TSSE. Thus, the Achieving Self-directed Integrated Cancer Aftercare (ASICA) digital healthcare intervention was developed. Embedded within a randomised control trial (RCT), this nested study used qualitative interviews to explore in depth participants’ experiences of TSSE, their orientation toward technology and both participant and professionals’ practical and technical experiences of the ASICA intervention.MethodsSemi-structured telephone interviews were undertaken during the RCT with participants and the coordinating Dermatology Nurse Practitioner (DNP). Participants were purposively sampled to achieve a representative sample. Interviews were transcribed verbatim and analysed using a Framework Analysis approach applied within NVivo12.ResultsTwenty-two interviews were completed with participants and one with the coordinating DNP. ASICA appeared to change participants’ perceptions of skin checking: users were more likely to report routinely performing TSSE thoroughly. There was some variation in beliefs about skin-checking and using technology for healthcare generally. Overall, ASICA was experienced positively by participants and the DNP. Several clear practical suggestions were made for how ASICA can be improved.ConclusionThe ASICA app appears to have positively influenced the attitudes and TSSE practices of melanoma survivors. Technical improvements are required, but the app offers promise for technologically enhanced melanoma follow-up in future.Trial RegistrationClinical Trials.gov, NCT03328247. Registered on 1 November 2017 - https://clinicaltrials.gov/ct2/show/NCT03328247?term=ASICA&rank=1

Students often approach biochemistry with a degree of trepidation with many considering it one of the more difficult subjects. This is, in part, due to the necessity of making visual images of submicroscopic concepts. Molecular interactions underpin most biological processes; therefore, mastering these concepts is essential. Understanding the forces and mechanisms that underpin protein–ligand interactions is a key learning goal for mastering the protein structure–function relationship. We intended to overcome such learning barriers by implementing assignment-based activities across three successive biochemistry cohorts. The activities involved 3D printed proteins and cheminformatics/molecular modeling software activities which had the advantage of targeting students’ visual–spatial ability. Learning activities, conducted in small groups, were specifically designed to enhance understanding of the protein structure–function relationship through a detailed analysis of molecular-level interactions between proteins and ligands. Here we describe the methodology for preparation of the learning tools and how they were incorporated in the learning exercises in the form of both formative and summative assessments. We compared their perceived effectiveness via student feedback surveys conducted over three consecutive cohorts. Survey results showed students were positively engaged with these technologies with a slight preference for cheminformatics. From an instructor’s perspective, we found significantly improved overall grade averages for the subjects following implementation of the assignments which may suggest these tools contributed to enhanced understanding. While print resolution could not match that of cheminformatics software, we present evidence to support their continued incorporation in the course. Feedback obtained will inform future curriculum development.

Metformin (MET), a biguanide oral hypoglycaemic agent, recently has been shown to be effective in various conditions other than type-2 diabetes including cancer, stroke, weight reduction, and polycystic ovarian syndrome, to name a few. MET has also possessed antioxidant and antiinflammatory properties by activation of AMPK . This study was aimed at evaluating the effects of MET on lipopolysaccharide (LPS)-induced systemic and neuroinflammation, oxidative stress, and behavioural changes. The study consisted of six groups, where three selected doses of MET (100, 200, and 300 mg/kg) were employed in male Swiss albino mice, with one group of imipramine (IMI), saline, and LPS each. Systemic inflammation was induced by injecting LPS (1.5 mg/kg) by intraperitoneal route. A battery of behavioural tests including open field, forced swim, and tail suspension tests were employed to assess the impact of systemic inflammation on exploratory behaviour and learned helplessness. LPS induced significant immobility with profound symptoms of sickness behaviour. Furthermore, LPS led to significant increase in serum and brain proinflammatory cytokines TNF-α and IL-6; and also increased lipid peroxidation with reduced glutathione levels. Pretreatment of the animals with 100 and 200 mg/kg of MET significantly reduced both systemic and central inflammatory markers along with protecting against LPS-induced oxidative stress. The higher dose, 300 mg/kg of MET was not effective against most of LPS-induced biochemical changes. Our preliminary results from this study suggest the antiinflammatory and neuroprotective effects of MET in LPS-induced model of sickness behaviour and neuroinflammation.

The aim of this paper is to enhance nurse educator’s knowledge of innovative strategies to improved students’ learning. When providing education on Intimate Partner Violence (IPV), it is projected that more learners will be moved to organize and act against IPV within the framework of social justice.

There is little information about survival of spinal muscular atrophy (SMA) patients into adulthood, in particular from population-based samples. We estimated and compared age-specific, all-cause mortality rates in patients with SMA and matched controls in a large, retrospective cohort study using electronic health records (EHRs) from the pre-treatment era.The US OptumFive thousand one hundred seventy-nine SMA cases and 51,152 controls were analyzed. The overall hazard ratio comparing cases with controls was 1.76 (95% CI 1.63-1.90). In patients with SMA type III diagnostic codes only, the all-age mortality rate was 1059/100,000 PYs in cases and 603/100,000 PYs in controls. In older age groups (13-20, 21-30, 31-40, 41-50, 51-60, and 60 years), age-specific mortality rates for cases consistently exceeded those of controls. Limitations of this study included the inability to confirm the SMA diagnosis or SMA type by genetic or clinical confirmation.Patients with SMA of all ages, including adults and type III patients, had a higher all-cause mortality rate as compared to age-matched controls during the pre-treatment era.

This paper is an interdisciplinary narrative review of efficacious non-invasive therapies that are increasingly used to restore function in people with chronic spinal cord injuries (SCI). First presented are the secondary injury cascade set in motion by the primary lesion and highlights in therapeutic development for mitigating the acute pathophysiologic process. Then summarized are current pharmacological strategies for modulation of noradrenergic, serotonergic, and dopaminergic neurotransmission to enhance recovery in bench and clinical studies of subacute and chronic SCI. Last examined is how neuromechanical devices (i.e., electrical stimulation, robotic assistance, brain-computer interface, and augmented sensory feedback) could be comprehensively engineered to engage efferent and afferent motosensory pathways to induce neuroplasticity-based neural pattern generation. Emerging evidence shows that computational models of the human neuromusculoskeletal system (i.e., human digital twins) can serve as functionalized anchors to integrate different neuromechanical and pharmacological interventions into a single multimodal prothesis. The system, if appropriately built, may cybernetically optimize treatment outcomes via coordination of heterogeneous biosensory, system output, and control signals. Overall, these rehabilitation protocols involved neuromodulation to evoke beneficial adaptive changes within spared supraspinal, intracord, and peripheral neuromuscular circuits to elicit neurological improvement. Therefore, qualitatively advancing the theoretical understanding of spinal cord neurobiology and neuromechanics is pivotal to designing new ways to reinstate locomotion after SCI. Future research efforts should concentrate on personalizing combination therapies consisting of pharmacological adjuncts, targeted neurobiological and neuromuscular repairs, and brain-computer interfaces, which follow multimodal neuromechanical principles.

Background: Melanoma is common and incidence is increasing. UK guidelines recommend monthly Total-Skin-Self-Examination (TSSE) performed by melanoma survivors to detect recurrent and new primary melanoma. TSSE is underperformed despite evidence of benefit. ASICA (Achieving Self-directed Integrated Cancer Aftercare) is a tablet-based digital intervention to prompt and support TSSE in melanoma survivors. Methods: Adults diagnosed with 0-IIC primary cutaneous melanoma from two UK NHS hospitals (Grampian and Cambridge) were recruited and randomised (1:1) to ASICA or control. Data on co-primary outcomes: melanoma worry (Melanoma Worry Scale, MWS), anxiety and depression (Hospital Anxiety and Depression Scale; HADs), and quality of life (EuroQoL EQ-5D-5L) were collected by postal questionnaire 3, 6 and 12-months following randomisation. Findings: Recruits were randomised (1:1) to ASICA (n=141) or control, n=140). There were no significant differences between groups for melanoma worry at 12 months (mean difference 0⸱12 95% confidence interval (-0⸱6, 0⸱84), p=0⸱743), at 3 months (0⸱23 (-0⸱31, 0⸱78) p=0.402) or 6 months (-0⸱1 (-0⸱7, 0⸱51) p=0⸱757). The ASICA group had lower anxiety scores at 12 months (-0.54 (-1.31, 0.230 p=0.168), at 3 months (-0⸱13; -0⸱.79, 0⸱54; p=0⸱711) and significantly at 6 months (-1⸱00 (-1⸱74, -0⸱26) p=0⸱009). Depression scores were similar being lower at 12 months (-0⸱44 (-1⸱11, 0⸱23), p=0.195) and 3 months (-0⸱24 (-0⸱84, 0⸱35)p=0⸱421) but only significantly lower at 6 months (-0⸱77 (-1⸱41, -0⸱12) p=0⸱020). The ASICA group had significantly higher quality of life scores at 12 months (0⸱044; (0⸱003, 0⸱085); p=0⸱036) and 6 months (0⸱070 (0⸱032, 0⸱107) p

This chapter describes the process of supporting faculty as they moved their classes online during the pandemic. It describes how a range of professional development experiences fostered a sense of community among participants, as well as supporting their transitions to online teaching. These virtual communities enabled faculty members both to exchange information and to offer one another peer support. This experience of teaching online also prompted changes in pedagogical practices. Informed by social cognitive theory, these conclusions are supported by survey data as well as case studies.

AimThis article is a meta-analysis of studies examining the influence of doula support on birth outcomes among African American women with disabilities. While an estimated 11% of women in their childbearing years are impacted by some type of disability, mothers with disabilities are faced with risks during pregnancy. When risks in addition to maternal disability are present, mothers may encounter extra barriers that impede receipt of effective care.MethodA meta-analysis of studies revealed women with disabilities are at risk for poor birth outcomes. Specifically, women of color living in poverty-stricken areas are at a greater risk for adverse birth outcomes.ResultsAs a result of adverse experiences related to birth, mothers may experience levels of traumatic stress. To advocate for better pregnancy and birth outcomes, the intervention of doula support is emphasized.ConclusionThere is a widely recognized need to promote better pregnancy outcomes among African American women to address disproportionate birth outcomes. Strategies to enhance doula support among African American women with disabilities are offered. Implications include future research surrounding the development of a training program for doulas specific to disability, trauma-informed care, and maternal mental health.

Background: Little independent information on the caffeine content of the popular Nespresso® coffee pod range exists. Aim: To quantify the caffeine content of Nespresso® pod coffees. Methods: Initially, three serves (ristretto (S), espresso (M), lungo (L)) of two pod varieties (Livanto and Roma) were prepared on three different Nespresso® machines (2 × U-Delonghi (1 × 5 years since purchase (old), 1 × recently purchased (new)), 1 × new Lattissima Pro (alternate)) using two different batches (sleeves). Caffeine content was then determined via triplicate samples using high-performance liquid chromatography. Differences in content (i.e. serve size, machine or sleeve) were determined via an analysis of variance or paired sample t-tests. Results: Coffees prepared on different machines or pods from different sleeves did not influence the caffeine content (old = 63 ± 13, new = 60 ± 8, alternate = 60 ± 10 mg·serve–1; p = 0.537, sleeveA = 63 ± 11, sleeveB = 59 ± 9 mg·serve–1; p = 0.134). Less caffeine was delivered in S (51 ± 7 mg·serve–1) compared to larger sizes (M = 66 ± 7 and L = 66 ± 10 mg·serve–1). Subsequently, the caffeine content from two serve sizes (S and L) from 17 other varieties within the Nespresso® range was determined and compared to the manufacturer’s values. Caffeine content (all pods) ranged from 19 to 147 mg·serve–1, and represented 51–162% of manufacturer’s values. Conclusion: Nespresso® consumers are exposed to variable amounts of caffeine, which often differ from the manufacturer’s reports.

Antipsychotic drugs are the mainstay of psychotic disorders. The 'typical' antipsychotic agents are commonly employed for the positive symptoms of schizophrenia, though at an expense of extrapyramidal side effects (EPS). In the present study, we employed haloperidol (HP)-induced catalepsy model in mice to evaluate the role of adenosine receptor antagonist and cyclooxygenase (COX) enzyme inhibitor in the amelioration of EPS. HP produced a full blown catalepsy, akinesia and a significant impairment in locomotion and antioxidant status. Pre-treatment with COX inhibitor; naproxen (NPx) and adenosine receptor antagonist; caffeine (CAF), showed a significant impact on HP-induced cataleptic symptoms. Adenosine exerts pivotal control on dopaminergic receptors and is also involved in receptor internalization and recycling. On the other hand, prostaglandins (PGs) are implicated as neuro-inflammatory molecules released due to microglial activation in both Parkinson's disease (PD) and antipsychotics-induced EPS. The involvement of these neuroeffector molecules has led to the possibility of use of CAF and COX inhibitors as therapeutic approaches to reduce the EPS burden of antipsychotic drugs. Both these pathways seem to be interlinked to each other, where adenosine modulates the formation of PGs through transcriptional modulation of COXs. We observed an additive effect with combined treatment of NPx and CAF against HP-induced movement disorder. These effects lead us to propose that neuromodulatory pathways of dopaminergic circuitry need to be explored for further understanding and utilizing the full therapeutic potential of antipsychotic agents.

Objective Monotonous driving involves low levels of stimulation and high levels of repetition and is essentially an exercise in sustained attention and vigilance. The aim of this study was to determine the effects of consuming a high or low glycemic load meal on prolonged monotonous driving performance. The effect of consuming caffeine with a high glycemic load meal was also examined. Method Ten healthy, non-diabetic participants (7 males, age 51 ± 7 yrs, mean ± SD) completed a repeated measures investigation involving 3 experimental trials. On separate occasions, participants were provided one of three treatments prior to undertaking a 90 min computer-based simulated drive. The 3 treatment conditions involved consuming: (1) a low glycemic load meal + placebo capsules (LGL), (2) a high glycemic load meal + placebo capsules (HGL) and (3) a high glycemic load meal + caffeine capsules (3 mg kg− 1 body weight) (CAF). Measures of driving performance included lateral (standard deviation of lane position (SDLP), average lane position (AVLP), total number of lane crossings (LC)) and longitudinal (average speed (AVSP) and standard deviation of speed (SDSP)) vehicle control parameters. Blood glucose levels, plasma caffeine concentrations and subjective ratings of sleepiness, alertness, mood, hunger and simulator sickness were also collected throughout each trial. Result No difference in either lateral or longitudinal vehicle control parameters or subjective ratings were observed between HGL and LGL treatments. A significant reduction in SDLP (0.36 ± 0.20 m vs 0.41 ± 0.19 m, p = 0.004) and LC (34.4 ± 31.4 vs 56.7 ± 31.5, p = 0.018) was observed in the CAF trial compared to the HGL trial. However, no differences in AVLP, AVSP and SDSP or subjective ratings were detected between these two trials (p > 0.05). Conclusion Altering the glycemic load of a breakfast meal had no effect on measures of monotonous driving performance in non-diabetic adults. Individuals planning to undertake a prolonged monotonous drive following consumption of a morning meal may consider consuming caffeine as a means of improving vehicle control.

Background and purpose Medicinal chemistry and pharmacology are difficult topics to both teach and learn given the complex nature of drug mechanisms and drug-receptor interactions. This highlights the need for innovative teaching methods to deliver this information to students. One such method is through three-dimensional (3D) printing of enzymes and ligands in the teaching of molecular modelling concepts relating to drug-receptor and enzyme interactions be ligands. This type of printing has been shown to be beneficial in several educational settings; however, to our knowledge, its effectiveness in pharmacy, medicinal chemistry and pharmacology learning and teaching is largely unknown. Therefore, the aim of this study was to evaluate pharmacy student perceptions and the educational benefits of 3D printed molecules in molecular modelling with regards to engagement and learning outcomes when used in a drug-target interaction topic. Educational activity and setting This aim was achieved through administering students a short questionnaire designed to evaluate their engagement and learning outcomes with students also free to provide comments. Findings This study found that nearly all (>90%) students found the activity was useful in improving both student engagement and learning outcomes. Discussion and summary In conclusion, 3D printing may provide an alternative learning activity to help pharmacy students understand the drug-target interaction.