Pharmacist Services

The overall goal of this book is to give the reader a state-of-the-art synopsis of the pharmacist services domain. To accomplish this goal, the authors have addressed the social, psychosocial, political, legal, historic, clinical, and economic factors that are associated with pharmacist services. In this book, you will gain cutting-edge insights from learning about the research of experts throughout the world. The findings have relevance for enhancing pharmacist professionalism, pharmacist practice, and the progression of pharmacist services in the future

Promising Practice: Book Studies as Professional Development for Rural Teachers

This promising practice article describes conducting book studies as professional development in rural communities. In this article, we share our understanding of the importance of this type of professional development in rural schools, as well as considerations for those who wish to start something similar in their districts

Resolution dependence of rough surface scattering using a power law roughness spectrum

Contemporary high-resolution sonar systems use broadband pulses and long arrays to achieve high resolution. It is important to understand effects that high-resolution sonar systems might have on quantitative measures of the scattered field due to the seafloor. A quantity called the broadband scattering cross section is defined, appropriate for high-resolution measurements. The dependence of the broadband scattering cross section, $\sigma_{bb}$ and the scintillation index, $SI$ on resolution was investigated for one-dimensional rough surfaces with power-law spectra and backscattering geometries. Using integral equations and Fourier synthesis, no resolution dependence of $\sigma_{bb}$ was found. The incoherently-averaged frequency-domain scattering cross section has negligible bandwidth dependence. $SI$ increases as resolution increases, grazing angle decreases, and spectral strength increases. This trend is confirmed for center frequencies of 100 kHz and 10 kHz, as well as for power-law spectral exponents of 1.5, 2, and 2.5. The hypothesis that local tilting at the scale of the acoustic resolution is responsible for intensity fluctuations was examined using a representative model for the effect of slopes (inspired by the composite roughness approximation). It was found that slopes are responsible in part for the fluctuations, but other effects, such as multiple scattering and shadowing may also play a role.Comment: 22 pages, 10 figures, preprint version of paper published in the Journal of the Acoustical Society of America, at \url{https://doi.org/10.1121/10.0002974

Virtually passing monitor detection pulse over software due to hardware constraints

During normal DisplayPortTM operation, a cable connects from the Sink (monitor) to the Source directly via physical DisplayPort pins. But, what happens when Sink is connected to an Intermediary Device (ID) that connects to the Source? The straightforward approach is to transfer DisplayPort signals from Intermediary Device (ID) to the Source by hard-wiring all DisplayPort signals between them. This approach could be challenging if enough hardware pins are not available to send all the DisplayPort signals across from Intermediary Device to Source. Thus, the idea disclosed in this disclosure demonstrates a way to successfully transfer all DisplayPort signals using the Controller Area Network (CAN) bus across from the Intermediary Device to the Midplane connector and then to the Source. This approach eliminates the need for expensive hardware pins on the connectors and extends the DisplayPort functionality from back of the Chassis to the front of the Chassis. M4 microcontroller on the ID is utilized to calculate pulse duration. This Pulse Duration generates unique high priority CAN packets and these packets are delivered to the Source device over the CAN bus. This approach provides better user experience without spending extra money on bigger expensive hardware connectors. Also, it utilizes one Source in the back of the enclosure thus removing the need of a more expensive processor on the front of the enclosure that could run Graphical User Interface. Additionally, ordinary DisplayPort use cases have all pins hard-wired between the Sink and the Source thus they don’t have this problem. But, if there is a need to carry DisplayPort signals over multiple layers of hardware/software then this is one of the solution to be used. Thus, carrying relevant Hot Plug Detect (HPD) signal via high priority CAN messages instead of an actual pin is very useful. This is a more complex problem due to the time sensitivity of pulses generated by HPD signal. This solution utilizes the processing power of another microcontroller to calculate the Pulse Duration and based on the length of the duration sends a unique message to DisplayPort Source to act on

Associations between Modifiable Health-Risk Behaviors and Personality Types

Objectives: The first objective for this study was to explore if characteristics of personality type (using the Preferred Communication Style Questionnaire) are associated with the following modifiable health-risk behaviors: smoking, exercise, alcohol consumption, nutrition, sleep, depression-related stress, anxiety-related stress, healthcare professional usage, and self-discipline. The second objective for this study was to explore if characteristics of personality type are associated with (1) the quality of patient-physician relationships, (2) patient-physician communication, and (3) preferred method for receiving information. Methods: Data were collected from 10,500 adult individuals residing in the United States via an on-line, self-administered survey coordinated by Qualtrics Panels from March 14-30, 2016. Chi-square analysis was used for making comparisons between categories of personality types and items related to health-risk behaviors. Statistical significance was set at p \u3c 0.05. However, chi-square analysis with large sample sizes (e.g. 10,500 in this study) readily yields statistical significance. Practical significance was set at four or more percentage points above or below the overall mean. Results: Regarding objective 1, personality type was associated with all nine health-risk behaviors studied. Personality types within the Experiencer temperament (17% of the U.S. population) accounted for 46% of the undesirable scores we computed for health-risk behaviors. The Idealist temperament (17% of population) accounted for 32% of the undesirable scores. Conceptualizers (10% of population) accounted for 17% of the undesirable scores and Traditionalists (46% of population) accounted for 5% of the undesirable scores. Regarding objective 2, the findings showed that personality type was associated with (1) the importance people place on the patient-physician relationship, (2) which characteristics of that relationship are most desirable, (3) desire for more communication with their physician, and (4) the preferred method for receiving information. Discussion and Conclusions: Precision medicine has been proposed as a way to create a new taxonomy of disease that uses individual specific data to develop accurate diagnosis, targeted treatment, and improved health outcomes. Based on the findings of this study, we propose that inclusion of personality type is an important component of these efforts so that the health care system can conform more to the individual patient in order to increase engagement and adherence, reduce errors, minimize ineffective treatment and waste, and can be cost effective

One Health proof of concept: Bringing a transdisciplinary approach to surveillance for zoonotic viruses at the human-wild animal interface.

As the world continues to react and respond inefficiently to emerging infectious diseases, such as Middle Eastern Respiratory Syndrome and the Ebola and Zika viruses, a growing transdisciplinary community has called for a more proactive and holistic approach to prevention and preparedness - One Health. Such an approach presents important opportunities to reduce the impact of disease emergence events and also to mitigate future emergence through improved cross-sectoral coordination. In an attempt to provide proof of concept of the utility of the One Health approach, the US Agency for International Development's PREDICT project consortium designed and implemented a targeted, risk-based surveillance strategy based not on humans as sentinels of disease but on detecting viruses early, at their source, where intervention strategies can be implemented before there is opportunity for spillover and spread in people or food animals. Here, we share One Health approaches used by consortium members to illustrate the potential for successful One Health outcomes that can be achieved through collaborative, transdisciplinary partnerships. PREDICT's collaboration with partners around the world on strengthening local capacity to detect hundreds of viruses in wild animals, coupled with a series of cutting-edge virological and analytical activities, have significantly improved our baseline knowledge on the zoonotic pool of viruses and the risk of exposure to people. Further testament to the success of the project's One Health approach and the work of its team of dedicated One Health professionals are the resulting 90 peer-reviewed, scientific publications in under 5 years that improve our understanding of zoonoses and the factors influencing their emergence. The findings are assisting in global health improvements, including surveillance science, diagnostic technologies, understanding of viral evolution, and ecological driver identification. Through its One Health leadership and multi-disciplinary partnerships, PREDICT has forged new networks of professionals from the human, animal, and environmental health sectors to promote global health, improving our understanding of viral disease spillover from wildlife and implementing strategies for preventing and controlling emerging disease threats

Use of the Jung/Myers Model of Personality Types to Identify and Engage with Individuals at Greatest Risk of Experiencing Depression and Anxiety

Depression is the leading cause of ill health and disability worldwide. Objectives were (1) to determine the strength of the association between personality type with depression and anxiety using the Preferred Communication Style Questionnaire (PCSQ©) and the Four-Item Patient Health Questionnaire for Depression and Anxiety (PHQ-4) and (2) evaluate the extent to which severity of depression and anxiety is associated with personality type. Data were collected via a self-administered online survey of 10,500. Chi-square analysis compared personality types and depression and anxiety. Practical significance was determined by calculating the percentage-from-expected score based on established statistics reflecting each personality type’s percentage in the US population. Personality type was strongly associated with both depression and anxiety with certain types at significantly greater risk than others. Findings can improve the research and clinical community’s understanding of the specific risk factors and triggers for depression and anxiety, and result in more efficacious, tailored treatment options

Financial Hardship from Purchasing Prescription Drugs Among Older Adults in the United States Before, During, and After the Medicare Part D “Donut Hole”: Findings from 1998, 2001, 2015, and 2021

BACKGROUND: Cost-related nonadherence compromises successful and effective management of chronic disease. The Medicare Modernization Act of 2003 (MMA) and Patient Protection and Affordable Care Act of 2010 (ACA) aimed to increase the affordability of outpatient prescription drugs for older adults (older than age 64 years). The Medicare Part D prescription drug insurance coverage gap (“donut hole”) created by the MMA was fully closed in 2020 by the ACA. OBJECTIVES: To (1) describe prescription drug coverage and financial hardship from purchasing prescription drugs among older American adults for 2021, (2) compare these results with findings from data collected before the MMA and during the progressive elimination of the Medicare Part D coverage gap, and (3) compute the likelihood for financial hardship from purchasing prescription drugs using variables for year, prescription drug insurance coverage, health-related information, and demographics. METHODS: Data were obtained from 4 nationally distributed, crosssectional surveys of older adults to track coverage for and financial hardship from purchasing prescription drugs. Surveys in 1998 and 2001 were mailed to national random samples of US seniors. Of 2,434 deliverable surveys, 700 (29%) provided useable data. Data were collected in 2015 and 2021 via online surveys sent to samples of US adults. Of 27,694 usable responses, 4,445 were from older adults. Descriptive statistics and logistic regression analyses described relationships among financial hardship and demographics, diagnoses, and daily prescription drug use. RESULTS: Five percent of older adults lacked prescription drug coverage in 2021, continuing a downward trend from 32% in 1998, 29% in 2001, and 9% in 2015. Contrastingly, 20% of older adults reported financial hardship from prescription drug purchases in 2021, bending an upward trend from 19% in 1998, 31% in 2001, and 36% in 2015. Financial hardship from purchasing prescription drugs was more likely to be reported by older adults lacking prescription drug insurance, taking multiple medications daily, and having a low annual household income across all survey years. The latter 2 of these 3 factors were still predictive of financial hardship from purchasing prescription drugs among older adults with prescription drug insurance. CONCLUSIONS: Financial hardship from purchasing prescription drugs is still experienced by many older adults after the full implementation of the MMA and ACA. Lacking prescription drug coverage, taking more than 5 prescription drugs daily, and a low annual household income may increase the likelihood of experiencing this financial hardship. Pharmacists can be a resource for older adults making choices about their prescription drug coverages and purchases. DISCLOSURES: Funding was provided by the American Association of Colleges of Pharmacy New Investigator Program, the University of Minnesota Grant-in-Aid of Research Program, the Peters Endowment for Pharmacy Practice Innovation, the Chapman University Research Program, and the University Minnesota Research Program. Plain language summary Almost all older adults in the United States have prescription drug insurance, but many still cannot afford them. This is most true for those who take many daily prescriptions, do not have prescription insurance, and have a low income