A theoretically based cross-sectional survey on the behaviors and experiences of clinical pharmacists caring for patients with chronic kidney disease.

The literature shows a lack of evidence on pharmacists contributing to chronic kidney disease services. The aim was to determine pharmacists’ behaviors and experiences and perceptions of barriers and facilitators to implementation of models of care. A theoretically informed survey was developed and sent to pharmacist members of the United Kingdom renal pharmacy group. Sections included: demographics, clinical practice and prescribing practice. Questions were of various types; closed type and some open for comments. Attitudinal items on clinical/prescribing used 5-point Likert scale. Development/implementation items were derived from the Consolidated Framework for Implementation Research (CFIR). Analysis used descriptive statistics and open comments were analysed thematically. Ethical approval was granted by an academic institution. Response rate; 50% (n = 71), seven were incomplete and excluded. Respondents provided; inpatient general pharmaceutical care (n = 56, 87.5%), to those receiving dialysis (n = 54, 84.4%) and transplantation. Non-clinical roles; audits (n = 46, 71.9%), patient education (n = 31, 48.4%), only 7.8% (n = 5) doing academic research. For barrier/facilitators most strongly agreed/agreed with most CFIR items relating to clinical practice. A majority (n = 44, 68.7%) disagreed that they had sufficient time to practice clinically and 44 (68.7%) disagreed there was sufficient cover for services. For prescribing roles, 90.5% (n = 48) were currently actively prescribing. Although prescribing related CFIR items were largely positive, 39.6% (n = 19) disagreed about sufficient time to practice and 18.7% (n = 9) were neutral. Two thirds (n = 33, 68.7%) disagreed that there was sufficient cover for the prescribing. The majority of respondents provided general pharmaceutical care to dialysis and transplant patients, were confident in their abilities and tried new ways of working including independent prescribing. Many expressed that lack of resources was the main barrier to providing more advanced care. Further work is needed to explore these matters in more depth

Culture Shock: Representation and Presentation

Panel Chair: Whitney Pisani Papers presented: A Grounded Theory analysis of \u27The Karate Kid\u27 by Joshua Newman Grounded Theory by Hannah Chirwa The Effects of Police Killings on African American Adolescents\u27 Internalized behaviors by Ashley Cunningham Abstract: News and social media tycoons including YouTube and Facebook give the world access to social injustices on a day to day basis. A particular injustice that riddles the African American community is the unjust killing of men and women at the hands of police. Often times, these men and women leave behind children that require assistance in which is not offered. There has been minimal research on the effects of how this experience affects youth in a school environment. This review explores the effects on African American adolescents’ ages 13 through 17 internalized behavior after a parent is shot and killed by police. The Socioeconomic Effects on the use of prepositions in titles by Julian P. Quinn Abstract: To delve into the linguistic appeal and popularity of certain titles of texts, specifically newspaper, journal/magazine, and fictional texts that either begin with these prepositions: on, after, concerning, towards, with, or contain one of them. My research will include data analyses of the most common of these five prepositions in titles during three distinct years, 1929, 1969, 2001 – the stock market crash, the landing on the moon, and the Al-Qaeda terrorist attacks. I will make analyses of the potential socioeconomic/linguistic reasons for the leading preposition’s popularity in these distinct cultural moments. I will use GlobalCat, the world\u27s largest network of library content and services to conduct my research. Deaf Culture: An Analysis of Cultural Legitimacy by Sarah Neely Ocana

Long-Term Behavioral Effects of Post-weaning Social Isolation in Males and Females

Adolescence is a developmental period associated with vast neural and behavioral changes which are accompanied by altered sensitivity to stimuli, both stressful and rewarding. Perturbations, especially stressful stimuli, during this period have been shown to alter behavior in adulthood. Social isolation rearing is one such perturbation. This review highlights the long-term behavioral consequences of adolescent social isolation rearing in rodents with a specific focus on anxiety- and addiction-related behaviors. Sex-specific effects are discussed where data are available. We then consider changes in monoaminergic neurotransmission as one possible mechanism for the behavioral effects described. This research on both normative and perturbed adolescent development is crucial to understanding and treating the increased vulnerability to psychiatric disorders seen in humans during this life stage

A theoretically based cross-sectional survey on the behaviours and experiences of clinical pharmacists caring for chronic kidney disease patients.

Chronic kidney disease (CKD) is a comorbid condition with high economic burden. Patients need multiple medications and pharmacists provide care that improves outcomes. Al Raiisi et al. recently completed a systematic review showing a paucity of information on the structures and processes of clinical pharmacy services (CPS) and a need to define core outcomes. More work is needed to describe renal CPS which reflects developments such as non-medical prescribing (NMP)

A theoretically based cross-sectional survey on the behaviors and experiences of clinical pharmacists caring for patients with chronic kidney disease

The literature shows a lack of evidence on pharmacists contributing to chronic kidney disease services. The aim was to determine pharmacists’ behaviors and experiences and perceptions of barriers and facilitators to implementation of models of care.A theoretically informed survey was developed and sent to pharmacist members of the United Kingdom renal pharmacy group. Sections included: demographics, clinical practice and prescribing practice. Questions were of various types; closed type and some open for comments. Attitudinal items on clinical/prescribing used 5-point Likert scale. Development/implementation items were derived from the Consolidated Framework for Implementation Research (CFIR). Analysis used descriptive statistics and open comments were analysed thematically. Ethical approval was granted by an academic institution.Response rate; 50% (n = 71), seven were incomplete and excluded. Respondents provided; inpatient general pharmaceutical care (n = 56, 87.5%), to those receiving dialysis (n = 54, 84.4%) and transplantation. Non-clinical roles; audits (n = 46, 71.9%), patient education (n = 31, 48.4%), only 7.8% (n = 5) doing academic research. For barrier/facilitators most strongly agreed/agreed with most CFIR items relating to clinical practice. A majority (n = 44, 68.7%) disagreed that they had sufficient time to practice clinically and 44 (68.7%) disagreed there was sufficient cover for services. For prescribing roles, 90.5% (n = 48) were currently actively prescribing. Although prescribing related CFIR items were largely positive, 39.6% (n = 19) disagreed about sufficient time to practice and 18.7% (n = 9) were neutral. Two thirds (n = 33, 68.7%) disagreed that there was sufficient cover for the prescribing.The majority of respondents provided general pharmaceutical care to dialysis and transplant patients, were confident in their abilities and tried new ways of working including independent prescribing. Many expressed that lack of resources was the main barrier to providing more advanced care. Further work is needed to explore these matters in more depth

Polytraumatized patient lower extremity nonunion development: Raw data

In this article we report data collected to evaluate the pathomechanistic effect of acute anaerobic metabolism in the polytraumatized patient and its subsequent effect on fracture nonunion; see "Base Deficit ≥6 within 24 Hours of Injury is a Risk Factor for Fracture Nonunion in the Polytraumatized Patient" (Sardesai et al., 2021) [1]. Data was collected on patients age ≥16 with an Injury Severity Score (ISS) >16 that presented between 2013-2018 who sustained a fracture of the tibia or femur distal to the femoral neck. Patients presenting to our institution greater than 24 hours post-injury and those with less than three months follow-up were excluded. Medical charts were reviewed to collect patient demographic information and known nonunion risk-factors, including smoking, alcohol use, and diabetes. In addition, detailed injury characteristics to quantify injury magnitude including ISS, Glasgow Coma Scale (GCS) at admission, and ICU length of stay were recorded. ISS values were obtained from our institutional trauma database where they are entered by individuals trained in ISS calculations. Associated fracture-related features including fracture location, soft-tissue injury (open vs. closed fracture), vascular injury, and compartment syndrome were recorded. Finally, vital signs, base deficit (BD), and blood transfusions over 24 hours from admission were recorded. We routinely measure BD and less consistently measure serum lactate in trauma patients at the time of presentation or during resuscitation. BD values are automatically produced by our laboratory with any arterial blood gas order, and we recorded BD values from the medical record. Clinical notes and radiographs were reviewed to confirm fracture union versus nonunion and assess for deep infection at the fracture site. Patients were categorized as having a deep infection if they were treated operatively for the infection prior to fracture healing or classification as a nonunion. Nonunion was defined by failure of progressive healing on sequential radiographs and/or surgical treatment for nonunion repair at least six months post-injury

The effectiveness and cost-effectiveness of the ‘Walk with Me’ peer-led walking intervention to increase physical activity in inactive older adults:Study protocol for a randomised controlled trial

Background: The proportion of the population aged 65 years or older is increasing. Typically, physical activity and health decline with age, which is why action to promote active ageing is a major public health priority, particularly due to health inequalities in older adults. The aim of this study is to assess the effectiveness and cost-effectiveness of the Walk with Me peer-led walking intervention for older adults. Methods: This study is a two-arm, assessor-blind, randomised controlled trial. The intervention is a 12-week peer-led walking intervention based on social cognitive theory. Participants in the control group will receive information on active ageing and healthy nutrition. The study will target 348 community-dwelling older adults, aged 60 years or over living in areas of socio-economic disadvantage communities. Trained peer mentors will deliver the intervention. The primary outcome will be a mean between-group change in moderate-to-vigorous physical activity at 12 months from baseline, measured using an Actigraph accelerometer. Secondary outcomes will include quality of life, mental wellbeing, blood pressure, BMI and waist circumference. An embedded process evaluation will involve focus groups and participant diaries. Discussion: Evidence-based, cost-effective interventions to promote physical activity in older adults living in socio-economically disadvantaged communities are needed to address health inequalities

Peer-led walking programme to increase physical activity in inactive 60- to 70-year-olds: Walk with Me pilot RCT

Background Levels of physical activity decline with age. Some of the most disadvantaged individuals in society, such as those with a lower rather than a higher socioeconomic position, are also the most inactive. Peer-led physical activity interventions may offer a model to increase physical activity in these older adults and thus help reduce associated health inequalities. This study aims to develop and test the feasibility of a peer-led, multicomponent physical activity intervention in socioeconomically disadvantaged community-dwelling older adults. Objectives The study aimed to develop a peer-led intervention through a rapid review of previous peer-led interventions and interviews with members of the target population. A proposed protocol to evaluate its effectiveness was tested in a pilot randomised controlled trial (RCT). Design A rapid review of the literature and the pilot study informed the intervention design; a pilot RCT included a process evaluation of intervention delivery. Setting Socioeconomically disadvantaged communities in the South Eastern Health and Social Care Trust and the Northern Health and Social Care Trust in Northern Ireland. Participants Fifty adults aged 60–70 years, with low levels of physical activity, living in socioeconomically disadvantaged communities, recruited though community organisations and general practices. Interventions ‘Walk with Me’ is a 12-week peer-led walking intervention based on social cognitive theory. Participants met weekly with peer mentors. During the initial period (weeks 1–4), each intervention group participant wore a pedometer and set weekly step goals with their mentor’s support. During weeks 5–8 participants and mentors met regularly to walk and discuss step goals and barriers to increasing physical activity. In the final phase (weeks 9–12), participants and mentors continued to set step goals and planned activities to maintain their activity levels beyond the intervention period. The control group received only an information booklet on active ageing. Main outcome measures Rates of recruitment, retention of participants and completeness of the primary outcome [moderate- and vigorous-intensity physical activity measured using an ActiGraph GT3X+ accelerometer (ActiGraph, LLC, Pensacola, FL, USA) at baseline, 12 weeks (post intervention) and 6 months]; acceptability assessed through interviews with participants and mentors. Results The study planned to recruit 60 participants. In fact, 50 eligible individuals participated, of whom 66% (33/50) were female and 80% (40/50) were recruited from general practices. At 6 months, 86% (43/50) attended for review, 93% (40/43) of whom returned valid accelerometer data. Intervention fidelity was assessed by using weekly step diaries, which were completed by both mentors and participants for all 12 weeks, and checklists for the level of delivery of intervention components, which was high for the first 3 weeks (range 49–83%). However, the rate of return of checklists by both mentors and participants diminished thereafter. Outcome data indicate that a sample size of 214 is required for a definitive trial. Limitations The sample was predominantly female and somewhat active. Conclusions The ‘Walk with Me’ intervention is acceptable to a socioeconomically disadvantaged community of older adults and a definitive RCT to evaluate its effectiveness is feasible. Some modifications are required to ensure fidelity of intervention delivery is optimised. Future research needs to identify methods to recruit males and less active older adults into physical activity interventions