PaCE Yourself: Impact of COVID-19 on Patient-Centered Care Experience

(1) Background: The outbreak of the novel coronavirus, COVID-19, forced colleges of pharmacy to implement new online learning methodologies to ensure that students could complete required courses. This transition was especially acute for laboratory simulation courses that require students to practice professional skills. This study aims to compare student assessment performance within a simulation-based laboratory course for students who completed the module prior to and after the online transition. (2) Methods: This study was a retrospective cohort comparison of student outcome performance with two distinct content delivery methods. Students were organized into two tracks at the beginning of the semester to determine the order of the simulation module. The online learning transition occurred in-between the delivery of the same module, which allowed comparison of online versus in-person content delivery with consistent assessment. Remediation rates on each assessment were compared using chi-squared tests. (3) Results: Student pharmacists across the first and second professional year performed similarly despite in-person or online course formats, with no significant differences in remediation rates. (4) Conclusions: Pharmacy course content, including laboratory-based simulation activity, may produce similar assessment performance when using online content delivery. Further research into hybrid or mixed-delivery models may enhance learning without affecting assessment performance

Indigenous University Student Persistence: : Supports, Obstacles, and Recommendations

The tumultuous history of Indigenous education in Canada has negatively affected the persistence of Indigenous peoples at university. The research goals of this study were to identify the key supports and obstacles related to Indigenous university student persistence and to make recommendations as to how to improve levels of persistence. Combining interview, survey, and database information with 527 Indigenous students revealed that the strongest factors related to persistence were (a) social engagement, including good relationships with faculty and students, and support services provided by the Indigenous gathering place for Indigenous students on campus; (b) cognitive, such as academic support at university, learning effectively on their own, and hands-on teaching; (c) physical, including insufficient financial support and availability of affordable housing and child care; and (d) cultural, including connections with Indigenous faculty and culture. Age, home location, and parental education were not found to be related to persistence. Keywords: Indigenous, Aboriginal, persistence, university, graduation, Indigenous student experience, CanadaL’histoire tumultueuse de l’éducation des Autochtones au Canada a eu un impact négatif sur la persistance des populations autochtones à l’université. Cette recherche avait pour but d’identifier les principaux soutiens et obstacles liés à la persévérance des étudiants autochtones à l’université et de formuler des recommandations. Des entretiens, des enquêtes et des bases de données convergentes de 527 étudiants autochtones révèlent que les facteurs les plus importants liés à la persévérance sont : a) sociaux – notamment les bonnes relations avec le corps enseignant et les étudiants ainsi que les services fournis par le lieu de rassemblement des Autochtones sur le campus ; b) cognitifs – comme le soutien scolaire à l’université, l’apprentissage efficace personnel et l’enseignement pratique ; c) physiques – dont l’insuffisance de soutien financier, de logement abordable et de services de garde d’enfants ; et d) culturels – principalement en lien avec le nombre d’enseignants autochtones et la culture. L’âge, le lieu de résidence et le niveau d’éducation des parents ne semblent pas associés à la persistance. Mots-clés : autochtones, premières nations, persistance, université, diplomation, expérience des étudiants autochtones, Canad

Author Correction: Longitudinal assessment of tumor development using cancer avatars derived from genetically engineered pluripotent stem cells.

An amendment to this paper has been published and can be accessed via a link at the top of the paper

Healthcare Mistreatment, State-Level Policy Protections, and Healthcare Avoidance Among Gender Minority People

Introduction: This study examined whether past experiences of mistreatment in healthcare were associated with greater healthcare avoidance due to anticipated mistreatment among gender minority (GM) people. We evaluated whether state-level healthcare policy protections moderated this relationship. Methods: Data from the 2018 Annual Questionnaire of The PRIDE Study, a national longitudinal study on sexual and gender minority people’s health, were used in these analyses. Logistic regression modeling tested relationships between lifetime healthcare mistreatment due to gender identity or expression and past-year healthcare avoidance due to anticipated mistreatment among GM participants. Interactions between lifetime healthcare mistreatment and state-level healthcare policy protections and their relationship with past-year healthcare avoidance were tested. Results: Participants reporting any lifetime healthcare mistreatment had greater odds of past-year healthcare avoidance due to anticipated mistreatment among gender expansive people (n = 1290, OR = 4.71 [CI]: 3.57–6.20), transfeminine people (n = 263, OR = 10.32 [CI]: 4.72–22.59), and transmasculine people (n = 471, OR = 3.90 [CI]: 2.50–6.13). Presence of state-level healthcare policy protections did not moderate this relationship in any study groups. Conclusions: For GM people, reporting lifetime healthcare mistreatment was associated with healthcare avoidance due to anticipated mistreatment. State-level healthcare policy protections were not a moderating factor in this relationship. Efforts to evaluate the implementation and enforcement of state-level policies are needed. Continued efforts to understand instances of and to diminish healthcare mistreatment of GM people are recommended

Minority Stress, Structural Stigma, and Physical Health among Sexual and Gender Minority Individuals: Examining the Relative Strength of the Relationships

Background: Sexual and gender minority (SGM; i.e., non-heterosexual and transgender or gender-expansive, respectively) people experience physical health disparities attributed to greater exposure to minority stress (experiences of discrimination or victimization, anticipation of discrimination or victimization, concealment of SGM status, and internalization of stigma) and structural stigma. Purpose: To examine which components of minority stress and structural stigma have the strongest relationships with physical health among SGM people. Methods: Participants (5,299 SGM people, 1,902 gender minority individuals) were from The Population Research in Identity and Disparities for Equality (PRIDE) Study. Dominance analyses estimated effect sizes showing how important each component of minority stress and structural stigma was to physical health outcomes. Results: Among cisgender sexual minority women, transmasculine individuals, American Indian or Alaskan Native SGM individuals, Asian SGM individuals, and White SGM individuals a safe current environment for SGM people had the strongest relationship with physical health. For gender-expansive individuals and Black, African American, or African SGM individuals, the safety of the environment for SGM people in which they were raised had the strongest relationship with physical health. Among transfeminine individuals, victimization experiences had the strongest relationship with physical health. Among Hispanic, Latino, or Spanish individuals, accepting current environments had the strongest relationship with physical health. Among cisgender sexual minority men prejudice/discrimination experiences had the strongest relationship with physical health. Conclusion: Safe community environments had the strongest relationships with physical health among most groups of SGM people. Increasing safety and buffering the effects of unsafe communities are important for SGM health

State-Level Policy Environments, Discrimination, and Victimization among Sexual and Gender Minority People

Legislation has been passed in some states to reduce discrimination and victimization toward sexual and gender minority people (SGM; people who are not solely heterosexual and/or whose gender identity is not equal to what is socially associated with sex assigned at birth). The purpose of these analyses is to test whether state-level policy environments are associated with past-year discrimination and victimization among SGM people. Cross-sectional data from The Population Research in Identity and Disparities for Equality (PRIDE) Study annual questionnaire (collected 2018–2019), a national study of the health of SGM adults in the USA, were used for these analyses. Measures included related to discrimination, victimization, and demographic characteristics. State-level policy environments were measured using data from the Movement Advancement Project. Logistic regression analyses evaluated state-level policy environment scores and past-year discrimination and victimization among gender identity categories. In this sample, 7044 people (gender minority n = 2530) were included. Cisgender sexual minority (odds ratio [OR] = 1.007, p = 0.041) and the gender expansive subgroup of gender minority people (OR = 1.010, p = 0.047) in states with more protective policy environments had greater odds of discrimination. The gender expansive subgroup was found to have greater odds of victimization in states with more protective policy environments (OR = 1.003, p \u3c 0.05). There was no relationship between state-level policy environments and victimization among any other study groups. SGM people may experience increased risk for discrimination and victimization despite legislative protections, posing continued risks for poor health outcomes and marginalization. Evaluation of factors (e.g., implementation strategies, systems of accountability) that influence the effectiveness of state-level polices on the reported experiences of discrimination and victimization among SGM people is needed

Harnessing person-generated health data to accelerate patient-centered outcomes research: the Crohn’s and Colitis Foundation of America PCORnet Patient Powered Research Network (CCFA Partners)

The Crohn’s and Colitis Foundation of America Partners Patient-Powered Research Network (PPRN) seeks to advance and accelerate comparative effectiveness and translational research in inflammatory bowel diseases (IBDs). Our IBD-focused PCORnet PPRN has been designed to overcome the major obstacles that have limited patient-centered outcomes research in IBD by providing the technical infrastructure, patient governance, and patient-driven functionality needed to: 1) identify, prioritize, and undertake a patient-centered research agenda through sharing person-generated health data; 2) develop and test patient and provider-focused tools that utilize individual patient data to improve health behaviors and inform health care decisions and, ultimately, outcomes; and 3) rapidly disseminate new knowledge to patients, enabling them to improve their health. The Crohn’s and Colitis Foundation of America Partners PPRN has fostered the development of a community of citizen scientists in IBD; created a portal that will recruit, retain, and engage members and encourage partnerships with external scientists; and produced an efficient infrastructure for identifying, screening, and contacting network members for participation in research

United States Midwest Soil and Weather Conditions Influence Anaerobic Potentially Mineralizable Nitrogen

Nitrogen provided to crops through mineralization is an important factor in N management guidelines. Understanding of the interactive effects of soil and weather conditions on N mineralization needs to be improved. Relationships between anaerobic potentially mineralizable N (PMNan) and soil and weather conditions were evaluated under the contrasting climates of eight US Midwestern states. Soil was sampled (0–30 cm) for PMNan analysis before pre-plant N application (PP0N) and at the V5 development stage from the pre-plant 0 (V50N) and 180 kg N ha−1 (V5180N) rates and incubated for 7, 14, and 28 d. Even distribution of precipitation and warmer temperatures before soil sampling and greater soil organic matter (SOM) increased PMNan. Soil properties, including total C, SOM, and total N, had the strongest relationships with PMNan (R2 ≤ 0.40), followed by temperature (R2 ≤ 0.20) and precipitation (R2 ≤ 0.18) variables. The strength of the relationships between soil properties and PMNan from PP0N, V50N, and V5180N varied by ≤10%. Including soil and weather in the model greatly increased PMNan predictability (R2 ≤ 0.69), demonstrating the interactive effect of soil and weather on N mineralization at different times during the growing season regardless of N fertilization. Delayed soil sampling (V50N) and sampling after fertilization (V5180N) reduced PMNan predictability. However, longer PMNan incubations improved PMNan predictability from both V5 soil samplings closer to the PMNan predictability from PP0N, indicating the potential of PMNan from longer incubations to provide improved estimates of N mineralization when N fertilizer is applied