524 research outputs found

    A national survey of antimicrobial stewardship content in Canadian entry-to-practice pharmacy programs

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    Abstract Objective: To describe the current landscape of antimicrobial stewardship (AMS) instruction in Canadian entry-to-practice pharmacy programs and the perceived barriers and facilitators to optimizing teaching and learning. Design: Electronic survey. Participants: Faculty representatives from the 10 Canadian entry-to-practice pharmacy programs, including content experts and faculty leadership. Methods: A review of international literature pertaining to AMS in pharmacy curricula informed a 24-item survey, which was open for completion from March to May of 2021. Curriculum content questions were developed using AMS topics recommended by pharmacy educators in the United States, and professional roles described by the Association of Faculties of Pharmacy of Canada. Results: All 10 Canadian faculties returned a completed survey. All programs reported teaching AMS principles in their core curricula. Content coverage varied, with programs teaching, on average, 68% of the recommended AMS topics from the United States. Potential gaps were identified within the professional roles of ā€œcommunicatorā€ and ā€œcollaborator.ā€ Didactic methods of content delivery and student assessment, such as lectures and multiple-choice questions, were most frequently used. Three programs offered additional AMS content in their elective curricula. Experiential rotations in AMS were commonly offered, thoughĀ teaching AMS in formalized interprofessional settings was rare. Curricular time constraints were identified by all programs as a barrier to enhancing AMS instruction. A course to teach AMS, a curriculum framework, and prioritization by the facultyā€™s curriculum committee were perceived as facilitators. Conclusions: Our findings highlight potential gaps and areas of opportunity within Canadian pharmacy AMS instruction

    OX40/OX40 Ligand Interactions in T-Cell Regulation and Asthma

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    The OX40 receptor is preferentially expressed by T cells, and its cognate ligand OX40L is primarily expressed by antigen-presenting cells such as dendritic cells following activation by thymic stromal lymphopoietin (TSLP). TSLP is released by the bronchial epithelium, airway smooth muscle, and some inflammatory cells in response to numerous insults such as allergens, viruses, and physical damage. OX40L is a costimulatory molecule that plays a sentinel role in the adaptive immune response by promoting T helper (Th) 2 polarization of naive T cells within the lymph node. These polarized T cells produce Th2 cytokines such as IL-4, IL-5, and IL-13, which have been implicated particularly in allergic eosinophilic asthma. Animal models have positioned both TSLP and OX40/OX40L as critical in the development of airway inflammation and hyperreactivity. In human disease, there is good evidence that TSLP is upregulated in asthma, but there are limited data to demonstrate overexpression of OX40 or OX40L in disease. Targeting the OX40/OX40L axis or TSLP presents a novel therapeutic strategy that has the potential of modifying the disease process and, therefore, impacting on its natural history. Whether this approach can demonstrate efficacy in established disease rather than at disease onset is unknown. Biologic therapies directed toward OX40/OX40L are in early phases of development, and results from these studies are eagerly awaited

    Optical Propagation and Communication

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    Contains research summary and reports on four research projects.National Science Foundation (Grant ECS81-20637)National Science Foundation (Grant ECS85-09143)Maryland Procurement Office (Contract MDA904-84-C-6037)National Science Foundation (Grant ECS84-15580)U.S. Army Research Office - Durham (Contract DAAG29-84-K-0095)U.S. Navy - Office of Naval Research (Contract NO0014-80-C-0941

    Established Risk Factors Account for Most of the Racial Differences in Cardiovascular Disease Mortality

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    BACKGROUND: Cardiovascular disease (CVD) mortality varies across racial and ethnic groups in the U.S., and the extent that known risk factors can explain the differences has not been extensively explored. METHODS: We examined the risk of dying from acute myocardial infarction (AMI) and other heart disease (OHD) among 139,406 African-American (AA), Native Hawaiian (NH), Japanese-American (JA), Latino and White men and women initially free from cardiovascular disease followed prospectively between 1993ā€“1996 and 2003 in the Multiethnic Cohort Study (MEC). During this period, 946 deaths from AMI and 2,323 deaths from OHD were observed. Relative risks of AMI and OHD mortality were calculated accounting for established CVD risk factors: body mass index (BMI), hypertension, diabetes, smoking, alcohol consumption, amount of vigorous physical activity, educational level, diet and, for women, type and age at menopause and hormone replacement therapy (HRT) use. RESULTS: Established CVD risk factors explained much of the observed racial and ethnic differences in risk of AMI and OHD mortality. After adjustment, NH men and women had greater risks of OHD than Whites (69% excess, P<0.001 and 62% excess, Pā€Š=ā€Š0.003, respectively), and AA women had greater risks of AMI (48% excess, Pā€Š=ā€Š0.01) and OHD (35% excess, Pā€Š=ā€Š0.007). JA men had lower risks of AMI (51% deficit, P<0.001) and OHD (27% deficit, Pā€Š=ā€Š0.001), as did JA women (AMI, 37% deficit, Pā€Š=ā€Š0.03; OHD, 40% deficit, Pā€Š=ā€Š0.001). Latinos had underlying lower risk of AMI death (26% deficit in men and 35% in women, Pā€Š=ā€Š0.03). CONCLUSION: Known risk factors explain the majority of racial and ethnic differences in mortality due to AMI and OHD. The unexplained excess in NH and AA and the deficits in JA suggest the presence of unmeasured determinants for cardiovascular mortality that are distributed unequally across these populations
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