28 research outputs found

    Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice

    Get PDF
    BACKGROUND: Complementary medicines (CMs) are popular amongst Australians and community pharmacy is a major supplier of these products. This study explores pharmacy customer use, attitudes and perceptions of complementary medicines, and their expectations of pharmacists as they relate to these products. METHODS: Pharmacy customers randomly selected from sixty large and small, metropolitan and rural pharmacies in three Australian states completed an anonymous, self administered questionnaire that had been pre-tested and validated. RESULTS: 1,121 customers participated (response rate 62%). 72% had used CMs within the previous 12 months, 61% used prescription medicines daily and 43% had used both concomitantly. Multivitamins, fish oils, vitamin C, glucosamine and probiotics were the five most popular CMs. 72% of people using CMs rated their products as 'very effective' or 'effective enough'. CMs were as frequently used by customers aged 60 years or older as younger customers (69% vs. 72%) although the pattern of use shifted with older age. Most customers (92%) thought pharmacists should provide safety information about CMs, 90% thought they should routinely check for interactions, 87% thought they should recommend effective CMs, 78% thought CMs should be recorded in customer's medication profile and 58% thought pharmacies stocking CMs should also employ a complementary medicine practitioner. Of those using CMs, 93% thought it important for pharmacists to be knowledgeable about CMs and 48% felt their pharmacist provides useful information about CMs. CONCLUSIONS: CMs are widely used by pharmacy customers of all ages who want pharmacists to be more involved in providing advice about these products

    The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe

    Get PDF
    The preponderance of matter over antimatter in the early Universe, the dynamics of the supernova bursts that produced the heavy elements necessary for life and whether protons eventually decay --- these mysteries at the forefront of particle physics and astrophysics are key to understanding the early evolution of our Universe, its current state and its eventual fate. The Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed plan for a world-class experiment dedicated to addressing these questions. LBNE is conceived around three central components: (1) a new, high-intensity neutrino source generated from a megawatt-class proton accelerator at Fermi National Accelerator Laboratory, (2) a near neutrino detector just downstream of the source, and (3) a massive liquid argon time-projection chamber deployed as a far detector deep underground at the Sanford Underground Research Facility. This facility, located at the site of the former Homestake Mine in Lead, South Dakota, is approximately 1,300 km from the neutrino source at Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino charge-parity symmetry violation and mass ordering effects. This ambitious yet cost-effective design incorporates scalability and flexibility and can accommodate a variety of upgrades and contributions. With its exceptional combination of experimental configuration, technical capabilities, and potential for transformative discoveries, LBNE promises to be a vital facility for the field of particle physics worldwide, providing physicists from around the globe with opportunities to collaborate in a twenty to thirty year program of exciting science. In this document we provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess.Comment: Major update of previous version. This is the reference document for LBNE science program and current status. Chapters 1, 3, and 9 provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess. 288 pages, 116 figure

    Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

    Get PDF
    Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

    Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

    Get PDF
    Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

    Cultivating a Science, Technology, Engineering and Mathematics (STEM) community for two-year college student success and persistence.

    No full text
    Undergraduate students studying Science, Technology, Engineering and Mathematics (STEM) often fail to persist in critical "gateway" courses, resulting in students leaving the STEM pathway. Community college students leave STEM pathways at higher rates than students at universities. Implementation of a program designed to engage community college STEM students and faculty in a community of support was associated with increased persistence in STEM gateway courses and associate degree completion. Program elements included support staff, a STEM study room with peer tutors, faculty advisors, and transfer assistance. Over seven years, 415 students joined this opt-in support program. The majority of students in this program were economically disadvantaged and many were nontraditional college students. Using institutional data we tested the hypothesis that participation in this program was associated with increased student success and persistence in STEM courses and at the college. The mean GPA for students in the program in the ten courses with the highest STEM enrollments was higher (2.89) than that for other students (2.76). Quarter-to-quarter persistence was 87% for program students compared to 67% for non-program students in a matched student population. In STEM gateway courses, program students had between 1.2x to 3.5x greater likelihood than non-program students of progressing to precalculus-2 controlling for first-attempt GPA in precalculus-1. Similar persistence patterns were observed for other gateway STEM courses. Observed persistence for students in the program was higher than comparable groups of students, including persistence for those who experienced early failure in STEM courses. These data suggest students should be supported through early failure to enable persistence in critical STEM sequences, especially in gateway Math and Chemistry courses

    The 2019 P-MIG Student Survey Report and Capturing the Undergraduate Perspective of Physiology Programming

    No full text
    The aim of the 2019 Student Survey was to inform the Physiology Majors Interest Group (PMIG) of characteristics of undergraduates enrolled in physiology courses or degree programs from across the United States, to be used as one input source for development of program-level guidelines. 1389 participants from seven universities completed the 2019 P-MIG Student Survey. 37% reported enrollment in a physiology/human physiology major; allied health related programs were the second most common (24%). 61% of respondents reported attending a community college, the majority of whom enrolled in one or more courses at a community college while in high school (44%). Of participants who reported transferring coursework from one institution to another, 72% reported coursework transferred as expected. Homeostasis and Structure/Function were the two core concepts common to the top rankings for self-reported mastery, the expectation to be remembered in five years, and deemed to be career-relevant. Survey respondents indicated high engagement in co-curricular activities, with 72% participating or planning to participate in job shadowing opportunities followed by volunteering (57%) and internships (50%). Over half of all survey participants indicated they “strongly agree” that their coursework and undergraduate programming has prepared them for success in their field of study. While the majority of respondents were satisfied with the academic advising received, additional guidance with regard to career choices and non-coursework professional development opportunities may be beneficial. Taken together, the collective data provides information from current physiology students that may inform development of consensus guidelines regarding curriculum, professional skills, and advising for undergraduate physiology degree programs

    Checking equity: Why differential item functioning analysis should be a routine part of developing conceptual assessments

    No full text
    We provide a tutorial on differential item functioning (DIF) analysis, an analytic method useful for identifying potentially biased items in assessments. After explaining a number of methodological approaches, we test for gender bias in two scenarios that demonstrate why DIF analysis is crucial for developing assessments, particularly because simply comparing two groups’ total scores can lead to incorrect conclusions about test fairness. First, a significant difference between groups on total scores can exist even when items are not biased, as we illustrate with data collected during the validation of the Homeostasis Concept Inventory. Second, item bias can exist even when the two groups have exactly the same distribution of total scores, as we illustrate with a simulated data set. We also present a brief overview of how DIF analysis has been used in the biology education literature to illustrate the way DIF items need to be reevaluated by content experts to determine whether they should be revised or removed from the assessment. Finally, we conclude by arguing that DIF analysis should be used routinely to evaluate items in developing conceptual assessments. These steps will ensure more equitable—and therefore more valid—scores from conceptual assessments

    Where Do We Go from Here? A Forward-Thinking Vision for Physiology Undergraduate Education

    No full text
    This paper is a summary of the special collection of papers in Advances in Physiology Education dedicated to the Physiology Majors Interest Group (P-MIG). P-MIG is a new and vibrant community (1, 2) of educators and administrators who are united by the common goal of creating physiology courses, curricula and programs that will prepare our students for the future. It is an independent consortium that welcomes anyone interested in physiology education at the level of the undergraduate degree in physiology and physiology-related fields. As demonstrated by this special collection of papers of Advances in Physiology Education, P-MIG has already made substantial progress in three areas: 1) developing curricular guidelines based on core concepts in physiology (8, 10, 13, 17, 18, 22), 2) developing guidelines for professional skills for our students and surveying advising practices (7, 9, 19), and 3) using survey data to learn about physiology educators and physiology (3, 16, 21)
    corecore