Helping Patients Access Medications through a Partnership of Caring and Education

According to the Ohio Poverty Report – 2017, approximately 35 percent of people in Franklin County live at or below 200 percent of the federal poverty level. Many of these patients lack health insurance and cannot afford the medications prescribed to treat their chronic health conditions. The Charitable Pharmacy of Central Ohio (CPCO) functions to provide medications and pharmacy services to uninsured and underinsured individuals living in Franklin County. Since opening in February 2010, CPCO has provided 330,000 prescriptions for a medication value of more than $27 million. CPCO serves more than 700 unique patients per month, and provides both acute and chronic medications that patients otherwise could not afford. In addition to medications and counseling, pharmacists and pharmacy students at CPCO check patients' blood pressure and blood glucose, provide patient education about chronic disease management, administer immunizations, and counsel patients about healthy behaviors. The partnership between CPCO and the Ohio State College of Pharmacy uniquely positions pharmacy students, residents and faculty to help serve patients through direct patient care and practice-based research. Pharmacy students learn from practitioner preceptors to care for vulnerable patients in the community and discover ways to improve patients' access to their needed medications. Pharmacy residents fine-tune their practice management skills, precept students who are caring for patients, and conduct a research project that can inform best practices associated with providing medications and pharmacy care to vulnerable patients in the community. The shared faculty member and pharmacists guide the students' and residents' learning through modeling and precepting patient care encounters, providing feedback about patient case presentations, discussing timely therapeutic and medication-related topics, and mentoring research that leads to optimal care for the patients. Health care professionals, social workers and community-engaged volunteers would benefit from hearing about the services being provided at CPCO. Dr. Kristin Casper has been a pharmacist, faculty member and preceptor for the past 20 years, and she has served as shared faculty practitioner at CPCO for more than three years. She brings experience in pharmacy education, community pharmacy practice management, and pharmacy practice-based research. Jennifer Seifert, executive director and clinical pharmacist at CPCO, has been a community pharmacist for more than 20 years, and she has been at Charitable Pharmacy since its opening. She brings pharmacy education experience as both an instructor and preceptor, as well as practical experience working with underserved patients in their quest for consistent medication access. This program will provide information about the practice model at CPCO as well as highlight the education and research initiatives that have flourished from the partnership with the College of Pharmacy.AUTHOR AFFILIATION: Kristin Casper, Associate Professor and Shared Faculty Practitioner, College of Pharmacy, [email protected] (Corresponding Author); Jennifer Seifert, Executive Director, Charitable Pharmacy of Central Ohio.More than 30 percent of patients in Franklin County live at or below 200 percent of the federal poverty level. Many of these patients lack health and prescription medication insurance. The Charitable Pharmacy of Central Ohio (CPCO) functions to provide medications and pharmacy services to uninsured and underinsured individuals living in Franklin County. CPCO serves more than 700 unique patients per month, and provides medications that patients otherwise could not afford. Pharmacists and pharmacy students counsel about the medications, check patients' blood pressure and glucose, and provide education about chronic disease management. The partner-ship between CPCO and the Ohio State College of Pharmacy uniquely positions pharmacy students, residents, and faculty to serve patients through direct patient care and practice-based research. Learn about the practice model at CPCO and the education and research initiatives that have flourished from this unique partnership

Concise Review: Translating Regenerative Biology into Clinically Relevant Therapies: Are We on the Right Path?

Despite approaches in regenerative medicine using stem cells, bio-engineered scaffolds, and targeted drug delivery to enhance human tissue repair, clinicians remain unable to regenerate large-scale, multi-tissue defects in situ. The study of regenerative biology using mammalian models of complex tissue regeneration offers an opportunity to discover key factors that stimulate a regenerative rather than fibrotic response to injury. For example, although primates and rodents can regenerate their distal digit tips, they heal more proximal amputations with scar tissue. Rabbits and African spiny mice re-grow tissue to fill large musculoskeletal defects through their ear pinna, while other mammals fail to regenerate identical defects and instead heal ear holes through fibrotic repair. This Review explores the utility of these comparative healing models using the spiny mouse ear pinna and the mouse digit tip to consider how mechanistic insight into reparative regeneration might serve to advance regenerative medicine. Specifically, we consider how inflammation and immunity, extracellular matrix composition, and controlled cell proliferation intersect to establish a pro-regenerative microenvironment in response to injuries. Understanding how some mammals naturally regenerate complex tissue can provide a blueprint for how we might manipulate the injury microenvironment to enhance regenerative abilities in humans

Exploring the security narrative in the work context

It is a well-known fact that the language of IT security experts differs from that of non-security-related people, leading to a multitude of problems. However, very little work has examined the differences in perception between security experts within a single security department or company. The sociological theory of power relations and organizational uncertainties by Croizer and Friedberg suggests that uncertainties about the narratives used in a department can lead to potentially harmful power relations and dissatisfied employees. We conducted a qualitative interview study within two distinct IT security companies in order to research the impact of diverging security narratives within security departments. Our results show that there is indeed an uncertainty about the term IT security. However, one company we interviewed regarded this uncertainty as highly beneficial for team creativity, communication, and mutual education, while the other, more technical-focused company showed few diversions within the security staff, but a possibly uniting conflict with the company's IT department. Our results suggest that conscious shaping of a zone of uncertainty around the security narrative in the work context can be an important management skill for IT security practitioners. Furthermore, we show that the analysis of language uncertainties provides a powerful approach to studying the motivation of professional security groups

(De)Thematisierung von Geschlechtlichkeit in der beruflichen Sozialisation : eine kritische Diskursanalyse am Beispiel der Lehramtsstudierenden der Leibniz Universität Hannover

Das vorliegende Dissertationsvorhaben widmet sich nun diesen speziellen Diskurspraktiken und ihren Regelhaftigkeiten um Gender und Geschlecht. Es verbindet dazu einen intersektionellen Blickwinkel mit kritischer Diskursanalyse um Einblicke in die im Hinblick auf gender beruflich relevanten Diskursformationen in Universität, Bildungspolitik und Fachwissenschaft zu gewinnen und zu erheben wie sich Studierende als Diskursakteur*innen in ihrer beruflichen Sozialisation zum herrschenden Diskurs und seinen Strömungen verhalten und so ihre eigenen Positionen hinsichtlich Gender ausbilden

Tracking Valued and Avoidant Functions With Health Behaviors: A Randomized Controlled Trial of The Acceptance and Commitment Therapy Matrix Mobile App

This randomized controlled trial evaluated the acceptability and additive effects of self- monitoring avoidant and valued functions of behavior, in the context of self-monitoring physical activity and dietary behavior in a mobile app. The self-monitoring approach was based on the Acceptance and Commitment Therapy (ACT) Matrix. A sample of 102 adults interested in improving their diet and physical activity were randomized to a Health Behavior Tracking app (HBT), HBT plus ACT matrix app (HBT+ACT), or waitlist condition. Online self-report assessments were completed at baseline, mid (2 weeks), and post-intervention (4 weeks). Participants reported high usability, but mixed satisfaction with both apps. About half of the prompted app check-ins were completed on average, with 14% never using the ACT app. Participants in the HBT+ACT app condition reported greater self-reported physical activity over time relative to HBT and waitlist, potentially due to protecting against a decrease over time in physical activity observed in the other two conditions. HBT and HBT+ACT conditions both improved self-reported sedentary behavior relative to waitlist. HBT+ACT improved cognitive restraint with eating more than HBT. Neither the HBT or HBT+ACT app improved other health behavior outcome measures or values processes relative to the waitlist. Overall, findings suggest some benefits of the ACT Matrix app for addressing physical activity by tracking valued/avoidant functions, but mixed findings on acceptability, outcomes, and processes of change suggests impact may be relatively limited

Macrophages Are Necessary for Epimorphic Regeneration in African Spiny Mice

How the immune system affects tissue regeneration is not well understood. In this study, we used an emerging mammalian model of epimorphic regeneration, the African spiny mouse, to examine cell-based inflammation and tested the hypothesis that macrophages are necessary for regeneration. By directly comparing inflammatory cell activation in a 4 mm ear injury during regeneration (Acomys cahirinus) and scarring (Mus musculus), we found that both species exhibited an acute inflammatory response, with scarring characterized by stronger myeloperoxidase activity. In contrast, ROS production was stronger and more persistent during regeneration. By depleting macrophages during injury, we demonstrate a functional requirement for these cells to stimulate regeneration. Importantly, the spatial distribution of activated macrophage subtypes was unique during regeneration with pro-inflammatory macrophages failing to infiltrate the regeneration blastema. Together, our results demonstrate an essential role for inflammatory cells to regulate a regenerative response

Fungal Symbionts as Manipulators of Plant Reproductive Biology

Symbioses have shaped the evolution of life, most notably through the fixation of heritable symbionts into organelles. The inheritance of symbionts promotes mutualism and fixation by coupling partner fitness. However, conflicts arise if symbionts are transmitted through only one sex and can shift host resources toward the sex through which they propagate. Such reproductive manipulators have been documented in animals with separate sexes but not in other phyla or sexual systems. Here we investigated whether the investment in male relative to female reproduction differed between hermaphroditic host plants with versus without a maternally inherited fungal symbiont. Plants with the fungus produced more seeds and less pollen than plants lacking the fungus, resulting in an ∼40% shift in functional gender and a switch from male-biased to female-biased sex allocation. Given the ubiquity of endophytes in plants, reproductive manipulators of hermaphrodites may be widespread in nature

Sexual dysfunction in patients with schizophrenia treated with conventional antipsychotics or risperidone

Hong Liu-Seifert1, Bruce J Kinon1, Christopher J Tennant2, Jennifer Sniadecki1, Jan Volavka31Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA; 2CJT Biomedical Consulting, South Lake Tahoe, CA, USA; 3New York University, New York, NY, USAObjective: To better understand sexual dysfunction in patients with schizophrenia and its associations with prolactin and reproductive hormones.Methods: This was a secondary analysis of an open-label, one-day study (N = 402). The primary objective of the study was to assess the prevalence of hyperprolactinemia in patients with schizophrenia who had been treated with conventional antipsychotics or risperidone. Other atypical antipsychotics available at the time of the study were not included due to a more favorable prolactin profile.Results: The majority of patients (59% of females and 60% of males) reported impairment of sexual function. In postmenopausal females, risk of impaired sexual interest was increased by 31% for every 10 ng/ml increase in prolactin (p = 0.035). In males, lower testosterone was associated with higher prolactin (p < 0.001) and with orgasmic (p = 0.004) and ejaculatory dysfunction (p = 0.028).Conclusion: These findings suggest that hyperprolactinemia may be associated with sexual dysfunction. They also provide more information on the relationships between prolactin, reproductive hormones, and sexual dysfunction. Sexual dysfunction is an understudied yet important consideration in the treatment of schizophrenia. More attention is warranted in this area as it may provide opportunities for improved quality of life and adherence to treatment for patients.Keywords: sexual dysfunction, schizophrenia, hyperprolactinemia, antipsychotics, risperidon