Impact of academic detailing on clinical pharmacy specialist involvement in medication assisted

Title: Impact of academic detailing on clinical pharmacy specialist involvement in medication assisted treatment for opioid use disorder in a primary care setting Lindsey Bartos, PharmD; Kristin Tallman, PharmD, BCPS, BCACP; Dara Johnson, PharmD, BCPP, BCACP Introduction: Opioid prescribing and opioid overdose deaths have increased steadily since the 1990s, reaching a 6-fold increase between 1999 and 2017. The opioid crisis, as it became known, was declared a public health emergency in 2017. In 2018 alone, an estimated two million people had a diagnosed opioid use disorder (OUD). The use of medication-assisted treatment (MAT) for OUD reduces the use and cravings of opiates, and risk of all-cause and opioid-related mortality. The inclusion of clinical pharmacy specialists (CPSs) on multidisciplinary healthcare teams has been shown to improve health outcomes, increase cost-effectiveness, and improve the quality of healthcare. Nevertheless, CPS involvement in MAT for OUD in a primary care setting remains limited. This study will provide information regarding barriers to CPS involvement in MAT, and the effectiveness of academic detailing provided to CPSs in increasing CPS involvement. Objectives: The objectives of this project are to identify and describe the most common barriers to CPS involvement in MAT for OUD, then assess the impact of academic detailing on CPS comfort level with being involved in the care of patients undergoing MAT for OUD in the primary care setting. Additionally, this project will assess the hypothesis that academic detailing will increase the number of patients with a CPS involved in the treatment of OUD. Methods: Study participants are CPSs recruited from a large medical group in Oregon and SW Washington who completed a survey before and after participating in academic detailing. The pre-survey was used to assess demographics, current involvement with MAT, perceived barriers to involvement in MAT, and asked participants to anonymously assess their comfort level, knowledge, and beliefs regarding MAT for OUD using a 0-5 point scale. Academic detailing was developed based on reported barriers, and consisted of handouts, two 45 minute interactive presentations, and small group work with case-based application. Participants then filled out a post-survey to re-assess their comfort level, knowledge, and beliefs regarding MAT for OUD following academic detailing. Survey results were compared and summarized by using either % of respondents in each category or mean (standard deviation) for each question across all respondents, then compared using a Wilcoxon-rank-sum test. CPS involvement in MAT will be reassessed using a survey or electronic intervention tracking in June. Results: 19 CPSs responded to the pre-survey and 20 CPSs responded to the post-survey. 4 respondents (21.05%) were currently active in MAT, and of these respondents, 3 indicated they are involved with MAT for 1-5 patients annually, and 1 indicated they are involved with MAT for 20+ patients annually. The most common barriers to involvement in MAT were lack of time (23.08%), lack of X-waivered providers (23.08%), and lack of knowledge regarding MAT (21.15%). There was no change in the number of CPSs involved in MAT between the pre-survey and the post-survey. Median responses to 6 of the 8 survey questions differed significantly between the pre and post surveys (p Conclusions: Most CPSs within PMG are not involved in the use of buprenorphine in MAT for OUD, likely due to a combination of time constraints, a lack of providers with the ability to prescribe buprenorphine, and unfamiliarity with buprenorphine in MAT. Following academic detailing to address these barriers, CPS comfort with buprenorphine in MAT had significantly improved in most areas. CPS involvement in MAT for OUT will be reassessed in June, 3 months following the academic detailing intervention.https://digitalcommons.psjhealth.org/pharmacy_PGY2/1001/thumbnail.jp

Mycobacterial contamination of environment in pig farms in the Czech Republic between 1996 and 2002

The purpose of this study was to find source of mycobacterial infections in pig farms. A total of 2 411 environmental samples (bedding materials, water, biofilm from pipelines, peat, etc.) were examined by microscopy and culture. Isolates were identified by serotyping and PCR. Mycobacteria were isolated from 579 (24.0%) samples. 47.0% isolates were Mycobacterium avium subsp. hominissuis isolates (IS901-, IS1245+, serotypes 4, 6, 8, 9), 2.2% isolates were M. a. avium (IS901+, IS1245+, serotype 2) and 50.8% belong to atypical mycobacteria comprising of fifteen species. The frequent isolates were found in peat samples (213/65.1%) in which 81.2% isolates comprised M. a. hominissuis. High amount of mycobacteria were isolated from biofilm (36.4%) and water (29.6%). Alike peat, non-pathogenic species were predominant. The third sources of mycobacteria were bedding materials, mostly sawdust (43.6%). Presence of mycobacteria in the animals’ environment leads to economic losses due to meat condemnation in abattoirs

A Feasibility Study of a Program Integrating Mindfulness, Yoga, Positive Psychology, and Emotional Intelligence in Tertiary‑Level Student Musicians

Objectives Higher education student musicians face high physical, psychological, and emotional demands affecting their well-being and academic experience. This study examined the feasibility and preliminary effectiveness of the so-called CRAFT program, based on mindfulness, yoga, positive psychology, and emotional intelligence, to improve psychological well-being, psychological distress, emotional regulation, and physical flexibility amongst tertiary education student musicians. Methods Using a single-arm pre-post study design, student musicians (n = 25) at a royal conservatory of music in Spain followed a 25-week CRAFT program that was curricularly implemented during the academic year 2018/2019, once a week for 50 min. The outcome measures included were the Five Facet Mindfulness Questionnaire (FFMQ), the Subjective Psychological Well-Being Subscale (SPWS), the Emotional Regulation Questionnaire (ERQ), the Depression Anxiety and Stress Scale (DASS-21), and the Sit and Reach Test (SRT). Results Paired samples t-test and practical significance analyses revealed significant improvements for the total scale of the FFMQ (g = 0.28), the Observe (g = 0.44) and Describe (g = 0.38) subscales of the FFMQ, the SPWS (g = 0.32), the Reappraisal subscale of the ERQ (g = 0.43), and the SRT (g = 0.39). A similar pattern of results was observed in a filtered sample (n = 15) when excluding participants simultaneously engaged in yoga/meditation activities other than the CRAFT program. Conclusions These results indicated that the CRAFT program is a promising intervention for improving mindfulness skills and health and well-being states and abilities amongst higher education student musicians. Further research is needed to substantiate these findings and extend them to similar settings and populations with complex psychophysical concerns.Junta de Andalucia PIV-052/1

Electric-Field Gradient at Cd Impurities in In2o3. A FLAPW Study

We report an ab initio study of the electric-field gradient tensor (EFG) at Cd impurities located at both inequivalent cationic sites in the semiconductor In2O3. Calculations were performed with the FLAPW method, that allows us to treat the electronic structure of the doped system and the atomic relaxations introduced by the impurities in the host lattice in a fully self-consistent way. From our results for the EFG (in excellent agreement with the experiments), it is clear that the problem of the EFG at impurities in In2O3 cannot be described by the point-charge model and antishielding factors.Comment: 4 pages, 2 figures, and 2 table

Characterization of the seismic environment at the Sanford Underground Laboratory, South Dakota

An array of seismometers is being developed at the Sanford Underground Laboratory, the former Homestake mine, in South Dakota to study the properties of underground seismic fields and Newtonian noise, and to investigate the possible advantages of constructing a third-generation gravitational-wave detector underground. Seismic data were analyzed to characterize seismic noise and disturbances. External databases were used to identify sources of seismic waves: ocean-wave data to identify sources of oceanic microseisms, and surface wind-speed data to investigate correlations with seismic motion as a function of depth. In addition, sources of events contributing to the spectrum at higher frequencies are characterized by studying the variation of event rates over the course of a day. Long-term observations of spectral variations provide further insight into the nature of seismic sources. Seismic spectra at three different depths are compared, establishing the 4100-ft level as a world-class low seismic-noise environment.Comment: 29 pages, 16 figure

Effects of Vacuum Polarization in Strong Magnetic Fields with an Allowance Made for the Anomalous Magnetic Moments of Particles

Given the anomalous magnetic moments of electrons and positrons in the one-loop approximation, we calculate the exact Lagrangian of an intense constant magnetic field that replaces the Heisenberg-Euler Lagrangian in traditional quantum electrodynamics (QED). We have established that the derived generalization of the Lagrangian is real for arbitrary magnetic fields. In a weak field, the calculated Lagrangian matches the standard Heisenberg-Euler formula. In extremely strong fields, the field dependence of the Lagrangian completely disappears, and the Lagrangian tends to a constant determined by the anomalous magnetic moments of the particles.Comment: 19 pages, 3 figure