Could our patients be better served? A Health literacy assessment of rural community pharmacies

Pharmacy staff and patient health literacy practices were assessed for pharmacies in a rural MO county with many residents at risk for low health literacy. Using AHRQ’s Pharmacy Health Literacy Assessment Tool, overall weaknesses of county pharmacies determined as a result of the Assessment Tour section of the Tool included lack of interpretation services and poor print font size and clarity of leaflets. When a focus group was also conducted as part of the Tool, participants identified several barriers to service including reliance on their doctors, not their pharmacists, for medication information. The pharmacies in this sample were not as effective as they could be in meeting the needs of those with lower health literacy levels, and it is suggested that with some intentional changes, these pharmacies can better serve their patients with low health literacy

PATHWAYS TO MALADJUSTMENT AND RESILIENCE IN INNER-CITY MINORITY YOUTH: EXAMINING ACADEMIC FAILURE AND HOPELESSNESS AS MEDIATORS BETWEEN CONTEXTUAL RISK FACTORS AND CHILD MALADJUSTMENT FROM A DEVELOPMENTAL PSYCHOPATHOLOGY PERSPECTIVE

Literature has consistently documented links between contextual factors and developmental outcomes in inner city youth. Most of these associations, however, have been cross-sectional in nature. Furthermore, there is only a limited understanding of the pathways contributing to maladjustment and resilience in this population. While ethnographic studies have taken into account factors of academic failure and hopelessness, quantitative studies have lagged. The present study examines these issues by addressing the main question of how the experiences of low-income, African-American children contribute to later maladjustment or resilience, focusing on academic failure and hopelessness as significant mediators in the pathway to later outcomes.Specific aims of the proposed study are to determine whether 1) a hypothesized mediational model of the development of inner-city minority youth is supported as a better fit for the data from a multicohort, longitudinal study, than competing non-mediational models, 2) gender, religiosity, extracurricular involvement, and affiliation with prosocial peers moderate the associations specified within the model, and 3) there is a subgroup within this larger sample with higher levels of hopelessness who are significantly more likely to suffer from the risks and outcomes in the model as compared to their lower hopelessness counterparts. The following document begins with an introduction to outcomes in this population and links between contextual factors and outcomes. This is followed by a section devoted to academic failure and hopelessness as mediators, beginning with a description of why one would expect these to function as contributors to later maladjustment. As a conceptual framework, a model of the development of inner-city youth is presented, and each of its components included in the current study is described. Following this is a section that describes methodological improvements of the current study over existing research, including developmental considerations, multiple domains of risks, and mechanisms driving the associations. Primary questions are stated next. The methods section of the document then identifies the sample and describes the study procedures. Lastly, the results section outlines the findings from the completed analyses, followed by the conclusion which revisits the questions and the results from the current study and suggests directions for future researchers

Implications for Math and Science Professional Development within the Theory of Planned Behavior

This pilot study used the Theory of Planned Behavior (TpB) as a framework for developing a questionnaire that will help with planning professional development pertaining to the science and engineering practices, with the intention of repeating the same process for the mathematical practices. To ensure that all components of the new standards are implemented with fidelity, teachers should be provided with the appropriate tools, understanding, and administrative/peer support in order to foster their buy-in of the changes. Efforts to implement the new standards in all classrooms require a concerted effort in the planning of Professional Development (PD) for appropriately preparing teachers for the infusion of the science, engineering, and mathematical practices, which were new introductions to the standards’ format. The TpB, which has historically been used primarily in health and physical sciences, provides a sound framework and methodological approach for monitoring teachers’ attitudes and beliefs, thereby leading to predicting teachers’ behaviors in implementing the practices. This article provides an overview of the science, engineering, and mathematics practices; the constructs of the TpB; a description of how the TpB provides a solid framework for planning PD; and a discussion of the implications of applying the TpB in an educational setting, specifically for planning PD within the context of the practices

Association of MyPlate Diet and Exercise with Diabetes in African American Women

Lifestyle choices such as diet and physical activity have been described as significant predictors of preventable disease, such as Type 2 diabetes mellitus. African American women disproportionately develop Type 2 diabetes and are at greater risk, compared to Caucasian/European Americans. The purpose of this study was to examine the association of physical activity and adherence to the MyPlate diet plan with the occurrence of Type 2 diabetes among African American women. The health belief model was the theoretical foundation for this study. Research questions were designed to examine the extent to which diet and physical activity predict Type 2 diabetes. In this quantitative cross-sectional study, data from the 2015-2016 National Health and Nutrition Examination data sets were analyzed, including a representative sample of African American women, ages 18 and older in the United States. Using SPSS, a series of binary logistic regressions were conducted. After controlling for age, there was no statistically significant association between the MyPlate dietary pattern adherence and diabetes (OR = 0.706, 95% CI [0.292, 1.707], p \u3e 0.005). Similarly, no statistically significant association between exercise and diabetes status was observed among this population (OR = 1.032, 95%CI [0.721, 1.504], p \u3e 0.005). Implications for potential positive social change that could arise from this research include encouraging additional research into other dietary plans that may be better correlated with diabetes prevention. Likewise, researchers, health promotion advocates and public health professionals can build on these findings to expand research and examine lifestyle choices that may bring about improved health outcomes among African American diabetics

Hearing loss diagnosis provision of information and support: audiologist and parent perspectives

When a child is diagnosed with hearing loss, the parents are faced with many decisions that will impact their child’s future. This study aimed to obtain data to determine viewpoints on information being provided to parents of children with hearing loss from both audiologist and parent perspectives. Topics of information surveyed included information on modes of communication, Deaf culture, cochlear implants, emotional support, and state resources/laws. A survey was created and shared in Facebook groups for audiologists and parents of Deaf/hard of hearing children. The survey was completed by 91 audiologists and 111 parents. Audiologist and parent survey data was analyzed and compared to look for similarities, differences, and possible biases. The data obtained in the study showed that overall, information on the topics investigated is being provided to parents when their child is initially diagnosed with hearing loss. However, many parents felt that the information that was provided was insufficient; therefore, they did not feel confident in their decision-making process. Audiologists have the responsibility to provide parents with unbiased, extensive information for parents to successfully make informed decisions for their child. Provision of practical, comprehensive information and recommendations may lead to improved parent knowledge and confidence

Structure of IL-22 Bound to Its High-Affinity IL-22R1 Chain

SummaryIL-22 is an IL-10 family cytokine that initiates innate immune responses against bacterial pathogens and contributes to immune disease. IL-22 biological activity is initiated by binding to a cell-surface complex composed of IL-22R1 and IL-10R2 receptor chains and further regulated by interactions with a soluble binding protein, IL-22BP, which shares sequence similarity with an extracellular region of IL-22R1 (sIL-22R1). IL-22R1 also pairs with the IL-20R2 chain to induce IL-20 and IL-24 signaling. To define the molecular basis of these diverse interactions, we have determined the structure of the IL-22/sIL-22R1 complex. The structure, combined with homology modeling and surface plasmon resonance studies, defines the molecular basis for the distinct affinities and specificities of IL-22 and IL-10 receptor chains that regulate cellular targeting and signal transduction to elicit effective immune responses

Incorporating Nutrition Education Classes into Food Pantry Settings: Lessons Learned in Design and Implementation

The project reported here evaluated the effectiveness of nutrition education at food pantries. We offer best practices for future Extension-based nutrition programming with this clientele. Three classes were offered at food pantries through the Expanded Food and Nutrition Education Program (EFNEP). Entry and exit surveys were collected for each series, including 24-hour food recalls. Seventy-three percent of participants reported an increase in vegetable consumption, and 82% reported positive changes in consumption of at least one food group. Nutrition education in food pantries is promising, particularly for Extension-led programs like SNAP-Ed and EFNEP, to address nutrition behaviors among food insecure populations

Measuring the Impact of the Affordable Care Act Medicaid Expansion on Access to Primary Care Using an Interrupted Time Series Approach

BACKGROUND: The Patient Protection and Affordable Care Act of 2010, commonly referred to as the Affordable Care Act (ACA), was created to increase access to primary care, improve quality of care, and decrease healthcare costs. A key provision in the law that mandated expansion of state Medicaid programme changed when states were given the option to voluntarily expand Medicaid. Our study sought to measure the impact of ACA Medicaid expansion on preventable hospitalization (PH) rates, a measure of access to primary care. METHODS: We performed an interrupted time series analysis of quarterly hospitalization rates across eight states from 2012 to 2015. Segmented regression analysis was utilized to determine the impact of policy reform on PH rates. RESULTS: The Affordable Care Act\u27s Medicaid expansion led to decreased rates of PH (improved access to care); however, the finding was not significant (coefficient estimate: -0.0059, CI -0.0225, 0.0107, p = 0.4856). Healthcare system characteristics, such as Medicaid spending per enrollee and Medicaid income eligibility, were associated with a significant decrease in rates of PH (improved access to care). However, the Medicaid-to-Medicare fee index (physician reimbursement) and states with a Democratic state legislature had a significant increase in rates of PH (poor access to care). CONCLUSION: Health policy reform and healthcare delivery characteristics impact access to care. Researchers should continue evaluating such policy changes across more states over longer periods of time. Researchers should translate these findings into cost analysis for state policy-makers to make better-informed decisions for their constituents. CONTRIBUTION TO KNOWLEDGE: Ambulatory care-sensitive conditions are a feasible method for evaluating policy and measuring access to primary care. Policy alone cannot improve access to care. Other factors (trust, communication, policy-makers\u27 motivations and objectives, etc.) must be addressed to improve access

Residential Perceptions of Environmental Exposures and Associated Health Effects in the Fresno, Texas Community

Background: Environmental contaminants are often located in areas heavily populated by African Americans, Hispanics/Latinos, and the poor. In many communities, the discovery of environmental hazards occurs following concern and investigation by its constituents. The residents of Fresno, Texas, which is a predominantly minority community located near Houston, Texas, have long-standing undocumented concerns related to potential environmental exposures and associated health effects. To begin to document the concerns of the members of the Fresno community, we used focus group methodology to examine the resident’s perceptions of the environment in the Fresno community, potential routes and sources of environmental exposures, and how Fresno residents perceived that these environmental hazards could affect their health. Methods: Focus group methodology was used to assess the Fresno communities’ perceptions of environmental exposure, perceived routes of exposure, and perceived adverse health affects. Nineteen Fresno residents took part in four focus group discussions that were recorded, transcribed, and analyzed using content analysis. Results: The residential participants overwhelmingly described poor water quality in the Fresno community. While some residents perceived that the air quality was good or clear, others described the air as poor or potentially dangerous. Some residents identified the local chemical companies, a landfill, chlorination, and a lack of public water supply as potential sources of contamination in the Fresno community. The residents perceived that environmental exposures could potentially affect their health status, in particular the drinking water. Conclusions: The findings of our study convey the concerns of the members of the Fresno community. Potential environmental exposures were identified along with sources of environmental hazards. Although there were differing perceptions of air quality, the perceptions of water quality and sources of contamination were consistent. These findings should be used in developing a larger-scale environmental health assessment in the Fresno community to examine self-reported health status and measure contaminant levels in the residential drinking water