Social Determinants of Health in People Living with Psychiatric Disorders: The Role of Pharmacists.

INTRODUCTION: Social determinants of health (SDOH) affect outcomes of people living with psychiatric disorders, including substance use disorders. As experts in medication optimization, pharmacists play a vital role in identifying and addressing medication-related problems associated with SDOH. However, there is a paucity of literature on how pharmacists can be part of the solution. OBJECTIVE: The purpose of this article is to provide a narrative review and commentary on the intersection between SDOH, medication-related outcomes in people living with psychiatric disorders, and the role of pharmacists in addressing them. METHOD: The American Association of Psychiatric Pharmacists appointed an expert panel to research the issue, identify barriers, and develop a framework for including pharmacists in addressing medication therapy problems associated with SDOH in people with psychiatric disorders. The panel used Healthy People 2030 as the framework and sought input from public health officials to propose solutions for their commentary. RESULTS: We identified potential connections between SDOH and their impact on medication use in people with psychiatric disorders. We provide examples of how comprehensive medication management can afford opportunities for pharmacists to mitigate medication-related problems associated with SDOH. CONCLUSION: Public health officials should be aware of the vital role that pharmacists play in addressing medication therapy problems associated with SDOH to improve health outcomes and to incorporate them in health promotion programs

Describing the Evidence Linking Interprofessional Education Interventions to Improving the Delivery of Safe and Effective Patient Care: A Scoping Review

Empirical evidence indicates that collaborative interprofessional practice leads to positive health outcomes. Further, there is an abundance of evidence examining student and/or faculty perceptions of learning or satisfaction about the interprofessional education (IPE) learning experience. However, there is a dearth of research linking IPE interventions to patient outcomes. The objective of this scoping review was to describe and summarize the evidence linking IPE interventions to the delivery of effective patient care. A three-step search strategy was utilized for this review with articles that met the following criteria: publications dated 2015–2020 using qualitative, quantitative or mixed methods; the inclusion of healthcare professionals, students, or practitioners who had experienced IPE or training that included at least two collaborators within coursework or other professional education; and at least one of ten Centers for Medicare & Medicaid Services quality measures (length of stay, medication errors, medical errors, patient satisfaction scores, medication adherence, patient and caregiver education, hospice usage, mortality, infection rates, and readmission rates). Overall, n=94 articles were identified, providing overwhelming evidence supporting a positive relationship between IPE interventions and several key quality health measures including length of stay, medical errors, patient satisfaction, patient or caregiver education, and mortality. Findings from this scoping review suggest a critical need for the development, implementation, and evaluation of IPE interventions to improve patient outcomes

Crummer SunTrust Portfolio Recommendations: Crummer Investment Management [2018]

The Crummer SunTrust Portfolio’s Investment Policy Statement requires that the management team determine portfolio allocations based on a consensus estimate of the market’s behavior throughout the coming year. This team has conducted thorough economic research using a variety of respected sources, developed a comprehensive market analysis, and heard from a well-rounded selection of industry experts (including economists, portfolio managers, and financial advisors) to inform this year’s investment decision. The team analyzed and discussed a range of likely economic possibilities for the upcoming year to shape a consensus that would serve to inform portfolio decisions. The team also evaluated the potential upsides and downsides relative to each economic factor to guide appropriate responses regarding individual stock selections and portfolio design. Finally, the team’s investment strategy has been to select securities trading at a significant discount to market value. We believe this strategy will mitigate any market volatility while providing a larger total return

Inhibition of iNOS as a Novel Effective Targeted Therapy Against Triple-Negative Breast Cancer

INTRODUCTION: Triple-negative breast cancer (TNBC) is an aggressive form of breast cancer with no effective targeted therapy. Inducible nitric oxide synthase (iNOS) is associated with poor survival in patients with breast cancer by increasing tumor aggressiveness. This work aimed to investigate the potential of iNOS inhibitors as a targeted therapy for TNBC. We hypothesized that inhibition of endogenous iNOS would decrease TNBC aggressiveness by reducing tumor initiation and metastasis through modulation of epithelial-mesenchymal transition (EMT)-inducing factors. METHODS: iNOS protein levels were determined in 83 human TNBC tissues and correlated with clinical outcome. Proliferation, mammosphere-forming efficiency, migration, and EMT transcription factors were assessed in vitro after iNOS inhibition. Endogenous iNOS targeting was evaluated as a potential therapy in TNBC mouse models. RESULTS: High endogenous iNOS expression was associated with worse prognosis in patients with TNBC by gene expression as well as immunohistochemical analysis. Selective iNOS (1400 W) and pan-NOS (L-NMMA and L-NAME) inhibitors diminished cell proliferation, cancer stem cell self-renewal, and cell migration in vitro, together with inhibition of EMT transcription factors (Snail, Slug, Twist1, and Zeb1). Impairment of hypoxia-inducible factor 1α, endoplasmic reticulum stress (IRE1α/XBP1), and the crosstalk between activating transcription factor 3/activating transcription factor 4 and transforming growth factor β was observed. iNOS inhibition significantly reduced tumor growth, the number of lung metastases, tumor initiation, and self-renewal. CONCLUSIONS: Considering the effectiveness of L-NMMA in decreasing tumor growth and enhancing survival rate in TNBC, we propose a targeted therapeutic clinical trial by re-purposing the pan-NOS inhibitor L-NMMA, which has been extensively investigated for cardiogenic shock as an anti-cancer therapeutic

Nutritional Value of Crops affected by Elevated Carbon Dioxide Concentrations in Atmospheric Conditions

This research was conducted to evaluate the effects of rising atmospheric carbon dioxide concentrations, and the nutritional quality of crops. Using Free Air CO2 Enrichment (FACE) and Decision Support System for Agrotechnology Transfer (DSSAT) to simulate elevated carbon dioxide levels, more review of previous literature was studied. Studies found that although there is a negative loss of nutrient availability, there are major signs that nutrient deficiencies. Nitrogen(protein), Iron, and Zinc are the most impacted with elevated atmospheric CO2 conditions. Further research and experiments regarding long term plant growth should be considered moving forward. With only limted situations and different CO2 levels, more reserach should be conducted

NextGen Voices: Quality mentoring

In her Working Life, “Paying it forward as a mentor” (3 August, p. 522),B. Abderrahman describes how a mentor’s encouragement can help shapea career. She then explains how her positive mentorship experienceinspired her to mentor others. We asked young scientists to describe onequality of a mentor you’ve had that you will try to emulate when youbecome a mentor yourself. Respondents from around the world wrotein appreciation of their patient, honest, humble, and supportive