Rx for Addiction and Medication Safety (RAMS-PEER): Evaluation of an Education and Peer Program on Opioid Misuse

The Rx (prescription) for Addiction and Medication Safety (RAMS) program was developed during the 2017 through 2018 academic year to educate students from 6 selected Rhode Island public high schools about opioid misuse, overdose, and recovery. During 2016, 3 schools participated in the RAMS program and returned for RAMS-PEER in 2017; 3 schools were newly recruited in 2016. Tenth graders returned from schools that participated during RAMS in 2016, and all ninth graders were new. Our study’s aim was to evaluate the overall effect and spillover benefit of the RAMS-PEER intervention from tenth to ninth graders by surveying students both before and after the education program. Survey questions were modified from the 2015 Youth Risk Behavior Survey and the 2015 Ontario Study Survey. Student responses were matched for preintervention and postintervention analysis using a unique identifier. We observed an improvement in knowledge of opioid misuse; however, we found no evidence of a significant spillover benefit

Immunization of mice with YscF provides protection from Yersinia pestis infections

BACKGROUND: Yersinia pestis, the causative agent of plague, is a pathogen with a tremendous ability to cause harm and panic in populations. Due to the severity of plague and its potential for use as a bioweapon, better preventatives and therapeutics for plague are desirable. Subunit vaccines directed against the F1 capsular antigen and the V antigen (also known as LcrV) of Y. pestis are under development. However, these new vaccine formulations have some possible limitations. The F1 antigen is not required for full virulence of Y. pestis and LcrV has a demonstrated immunosuppressive effect. These limitations could damper the ability of F1/LcrV based vaccines to protect against F1-minus Y. pestis strains and could lead to a high rate of undesired side effects in vaccinated populations. For these reasons, the use of other antigens in a plague vaccine formulation may be advantageous. RESULTS: Desired features in vaccine candidates would be antigens that are conserved, essential for virulence and accessible to circulating antibody. Several of the proteins required for the construction or function of the type III secretion system (TTSS) complex could be ideal contenders to meet the desired features of a vaccine candidate. Accordingly, the TTSS needle complex protein, YscF, was selected to investigate its potential as a protective antigen. In this study we describe the overexpression, purification and use of YscF as a protective antigen. YscF immunization triggers a robust antibody response to YscF and that antibody response is able to afford significant protection to immunized mice following challenge with Y. pestis. Additionally, evidence is presented that suggests antibody to YscF is likely not protective by blocking the activity of the TTSS. CONCLUSION: In this study we investigated YscF, a surface-expressed protein of the Yersinia pestis type III secretion complex, as a protective antigen against experimental plague infection. Immunization of mice with YscF resulted in a high anti-YscF titer and provided protection against i.v. challenge with Y. pestis. This is the first report to our knowledge utilizing a conserved protein from the type III secretion complex of a gram-negative pathogen as a candidate for vaccine development

Rx for addiction and medication safety: An evaluation of teen education for opioid misuse prevention

Background: Rhode Island (RI) ninth graders report lifetime nonmedical use of prescription opioids (NMUPO) of 8.9%. NMUPO is associated with transition to heroin use, opioid overdose, and death. Objectives: Measure changes in 9th grade students\u27 knowledge, confidence, perceptions of opioid use disorder prevention, overdose response with naloxone, treatment, and recovery, following the delivery of an interactive substance use disorder curriculum. Methods: Eight RI public high schools were recruited to participate. Freshman in each school were administered identical surveys that collected demographic data, substance use and misuse knowledge, students\u27 perceptions of substance misuse harm, reported drug use, and risk and protective behaviors before and after the curriculum. Results: Among 969 pre-intervention survey respondents, 19% reported use of marijuana, 3% heroin use, and 21% nonmedical use of prescription opioids. Between the pre-intervention to the post-intervention survey, significantly more students identified that addiction is a chronic brain disease (79%–83%, p = 0.05), drug users are not responsible for their addiction (81%–88%, p = 0.001), and that non-medical use of a prescription medication is use without a prescription (81%–88%, p = 0.001). Improved confidence was also reported in identifying opioid withdrawal symptoms (26%–45%, p \u3c 0.0001), identifying signs of an opioid overdose from 29% to 46% (p \u3c 0.0001), and knowing when to administer naloxone (17%–45%, p \u3c 0.0001). Confidence to refer someone to treatment improved from 31% to 45% (p \u3c 0.0001). Logistic regression showed associations between mental health, peer use, parental affection, and academic performance factors as related to NMUPO. Conclusions: Students reported significant NMUPO prevalence. Ninth grade students\u27 knowledge and confidence of opioid misuse, overdose response, and recovery resources increased following the delivery of a multi-modal interactive substance use disorder curriculum. Community, school, and student-level interventions are needed to reduce NMUPO

Luminescent Ruthenium(II) Polypyridyl Functionalized Gold Nanoparticles; Their DNA Binding Abilities and Application As Cellular Imaging Agents

The synthesis and photophysical and biological investigation of Ru(II)-polypyridyl stabilized watersoluble, luminescent gold nanoparticles (AuNPs) are described. These structures bind to DNA and undergo rapid cellular uptake, being localized within the cell cytoplasm and nucleus within 4 h

Establishing herd immunity against Ebola through vaccination

Objectives: In response to recent concern regarding Ebola outbreaks, this study aims to (1) determine the relationship between vaccination coverage and herd immunity, (2) determine the vaccination coverage necessary to establish herd immunity for previous Ebola viruses, and (3) recommend vaccination coverage thresholds for future Ebola viruses. Methods: Herd immunity thresholds needed to block transmission of Ebola virus were determined using vaccine efficacy and number of secondary cases per infected case during an entire infectious period. Results: In past Ebola outbreaks 42.2-63.0% of the population would need to be vaccinated in order to prevent transmission and outbreaks. Assuming 80% vaccine efficacy as reported by phase I clinical trials, 52.7-78.7% of the population would require vaccination coverage in order to establish herd immunity. In recent ring vaccination trials which considered the vaccine to be 100% effective after 10 days, 42.2-63.0% of the population would need to be vaccinated. Conclusion: For future Ebola outbreaks, the spread of the virus can be prevented by vaccinating certain percentages of the population depending on vaccine efficacy and number of secondary cases per infected case

Guidance for antibiotic selection: Tissue distribution and target site concentration

To be effective, antibacterials must be active against microorganism(s) and reach sufficient concentrations at the site of infection. Thus, antibacterial distribution and its subsequent tissue concentration are important determinants of antibiotic efficacy. Tissue distribution has many factors that contribute to an antibiotic reaching the target site of infection. This article reviews those factors (ie, basic biochemical and physiochemical properties of cell membranes, carrier-mediated transporters, plasma- and tissue-protein binding, blood flow, inflammation), and the role of impaired tissue distribution in therapeutic outcomes of patients with a variety of infections. Suboptimal target site concentrations may have important clinical implications in such infections, as they may help explain poor therapeutic outcomes. Therefore, we reviewed and summarized the literature for the concentrations of antibacterials as site to serum ratios, providing practical information as a guide for antibiotic selection. © 2009 Lippincott Williams & Wilkins, Inc

Novel conjugate vaccine for the prevention of Pseudomonas aeruginosa infection in cystic fibrosis patients

The published literature evaluating the safety and immunogenicity of the polyvalent O-polysaccharide-toxin A conjugate vaccine is reviewed. Primary immunization followed by annual booster significantly reduced the incidence of chronic Pseudomonas aeruginosa lung infections (particularly mucoid phenotype strains) and extended time to infection. The findings reflected lower frequency of P. aeruginosa in sputum/throat cultures and preservation of lung function. Additionally, studies indicated higher binding affinity of vaccine-induced anti-lipopolysaccharide (LPS) compared with infection-induced anti-LPS serum immunoglobulin C antibodies, suggesting protective capacity. P. aeruginosa prophylaxis with the conjugate vaccine in cystic fibrosis patients has proved safe and useful in preventing and delaying chronic lung infection. © 2008 Wiley-Liss, Inc

Tooth discoloration after treatment with linezolid

With the increasing frequency of methicillin-resistant Staphylococcus aureus in immunocompromised hosts, clinicians are increasingly prescribing the oral treatment option of linezolid. Linezolid is the first of a new class of antibiotics, the oxazolidinones. The drug is generally well tolerated. However, mild-to-moderate adverse effects have been reported, such as gastrointestinal effects (most frequent), myelosuppression, skin eruptions, elevated liver enzymes, and tongue discoloration. As with any new drug on the commercial market, not all adverse effects are elucidated during preclinical trials. An immunocompromised 11-year-old girl with cellulitis of the toe experienced tooth discoloration after receiving a 28-day course of linezolid. The discoloration was present on the enamel of her lower anterior teeth and was superficial and reversible with dental cleaning

Jamaican a difference: A grassroots approach by pharmacy students to develop an international service learning experience

Objective: To describe the implementation process of an international mission trip led by a pharmacy student and its acceptance as an introductory pharmacy practice experience (IPPE) at the University of Rhode Island. Methods: Mustard Seed Communities (MSC), a non-profit, Catholic organization, was selected as the mission sponsor by the student leader based on previous travel experience on non-medical missions. Educational needs of the specific communities were identified and included medication management, basic physical assessment, and treatment of human immunodeficiency-infected pediatric patients. A mission team established by the student leader a year prior to travel worked to develop educational resources and fundraise. Faculty created a post-mission, student survey based on Accreditation Council for Pharmacy Education (ACPE) criteria for an IPPE to assess the acceptability of the pharmacy mission as an approved international service learning experience. Results: Three workshops were delivered to the MSC caregivers by 11 pharmacy students and a pediatric faculty member. Educational sessions and interactions with children and caregivers gave students opportunities to provide medication counseling and expand their drug knowledge. Survey outcomes demonstrated ACPE service learning and pre-Advanced Pharmacy Practice Experience (APPE) skills guidelines, including communication, counseling, and medication information, and were satisfied. Conclusion: The implementation of an international service learning experience in the curriculum was successful. Through a student-led mission, pharmacy students were able to foster IPPE practice-based skills by working with the MSC children and caregivers