Design, implementation and evaluation of a model for Service-learning in Pharmacy (SLIP) at a tertiary hospital

Magister Pharmaceuticae - MPharmIn recent years the focus of pharmacy practice has changed from being primarily 'drug-centred to' one which is 'patient-centred' (El-Awady et al., 2006, p. l ). Developments in pharmacy curricula worldwide are reflecting this change. Pharmacy courses no longer concentrate primarily on theoretical content, but increasingly on the ability of students to apply their theoretical knowledge in practice. The South African Pharmacy Council (SAPC) requires that pharmacy education and training in South Africa equips pharmacists for the roles they will take on in practice. In order to accomplish this, the SAPC has prescribed competency unit standards for entry level pharmacists which may serve as a guide for pharmacy educators. A significant challenge in pharmacy education is the application of theory in practice settings (Bucciarelli et al., 2007), which possibly affects the ability of entry-level pharmacists to meet the SAPC unit standard competencies. The dire shortage of pharmacists in public sector health settings further emphasizes the need for a level of competency of entry level pharmacists so that they may enter the workplace ready to serve the medicine related needs of society. Service-learning is defined as experiential learning in which students engage in structured activities that address community needs and promote learning. The purpose of this study was to design, implement and evaluate a Service-learning in Pharmacy (SLIP) intervention which is intended to serve as a generic model which can be used in tertiary hospital pharmacies. The SLIP intervention aimed to promote student learning by providing opportunities for students to engage in structured activities, while simultaneously alleviating pharmacy workload

Les frustrés e a vanguarda parisiense dos anos 70 : o modo de expressao de um sujeito em crise

Orientadora: Sandra Lopes MonteiroDissertaçao (mestrado) - Universidade Federal do Paraná, Setor de Ciencias Humanas, Letras e Artes, Programa de Pós-Graduaçao em Letras. Defesa: Curitiba, 2005Inclui bibliografia e anexoÁrea de concentraçao: Estudos lingüístico

Optimisation of the post-harvest conditions to produce chocolate aroma from jackfruit seeds

Jackfruit seeds are an under-utilized waste in many tropical countries. In this work, we demonstrate the potential of roasted jackfruit seeds to develop chocolate aroma. Twenty-seven different roasted jackfruit seed flours were produced from local jackfruit by acidifying or fermenting the seeds prior to drying, and roasting under different time/temperature combinations. The chocolate aroma of groups of four flours were ranked by a sensory panel (n=162) and response surface methodology was used to identify optimum conditions. The results indicated a significant and positive influence of fermentation and acidification on the production of chocolate aroma. SPME/GC-MS of the flours showed that important aroma compounds such as 2,3-diethyl-5-methylpyrazine and 2-phenylethyl acetate were substantially higher in the fermented product, and that the more severe roasting conditions produced 2-3 times more 2,3-diethyl-5-methylpyrazine, but less 3-methylbutanal. Moisture, aw, pH, luminosity and color were also monitored to ensure that these properties were similar to cocoa powder or cocoa substitutes

PLAUR polymorphisms and lung function in UK smokers

<p>Abstract</p> <p>Background</p> <p>We have previously identified Urokinase Plasminogen Activator Receptor (<it>PLAUR</it>) as an asthma susceptibility gene. In the current study we tested the hypothesis that <it>PLAUR </it>single nucleotide polymorphisms (SNPs) determine baseline lung function and contribute to the development of Chronic Obstructive Pulmonary Disease (COPD) in smokers.</p> <p>Methods</p> <p>25 <it>PLAUR </it>SNPs were genotyped in COPD subjects and individuals with smoking history (n = 992). Linear regression was used to determine the effects of polymorphism on baseline lung function (FEV₁, FEV₁/FVC) in all smokers. Genotype frequencies were compared in spirometry defined smoking controls (n = 176) versus COPD cases (n = 599) and COPD severity (GOLD stratification) using logistic regression.</p> <p>Results</p> <p>Five SNPs showed a significant association (p < 0.01) with baseline lung function; rs2302524(Lys220Arg) and rs2283628(intron 3) were associated with lower and higher FEV₁respectively. rs740587(-22346), rs11668247(-20040) and rs344779(-3666) in the 5'region were associated with increased FEV₁/FVC ratio. rs740587 was also protective for COPD susceptibility and rs11668247 was protective for COPD severity although no allele dose relationship was apparent. Interestingly, several of these associations were driven by male smokers not females.</p> <p>Conclusion</p> <p>This study provides tentative evidence that the asthma associated gene <it>PLAUR </it>also influences baseline lung function in smokers. However the case-control analyses do not support the conclusion that <it>PLAUR </it>is a major COPD susceptibility gene in smokers. PLAUR is a key serine protease receptor involved in the generation of plasmin and has been implicated in airway remodelling.</p

A comparative state-level analysis of carbon capture and storage (CCS) discourse among U.S. energy stakeholders and the public

AbstractPerceptions of the potential of emerging technologies like carbon capture and storage (CCS) are constructed not just through technical and economic processes but also through discourse, i.e. through compelling narratives about what a technology is, what a technology might become and why it is needed and preferable to competing technologies. The influence of discourse is particularly important in the innovation phases prior to commercialization when innovation activities are focused on research, development and demonstration, and when feasibility and costs of alternatives systems cannot yet be tested by market dynamics. This paper provides a state-level comparative analysis of CCS discourse in the U.S. to provide insights about the socio-political context in which CCS technology is advancing and being considered in four different states: Massachusetts, Minnesota, Montana, and Texas. This research combines analysis of interviews of state-level energy stakeholders and media analysis of state-level newspapers. In semi-structured interviews, state-level energy policy stakeholders were asked to explain their perceptions of the potential opportunities and risks of CCS technology within their unique state context. Interview texts were coded to assess the frequency and extent of various different frames of CCS opportunities and risks including technical, political, economic, environmental, aesthetic, and health/safety. A similar coding scheme was applied to analysis of state-level newspaper coverage of CCS technology. Here, the frequency of these different framings of CCS opportunities and risks in state-level print media was assessed. This analysis demonstrates wide variation in state-level CCS discourse and perceptions of the potential opportunities and risks associated with CCS technology. This mixed-methods approach to characterizing the socio-political context for CCS advancement in these four states contributes to improved understanding of state-level variation in energy technology innovation, provides valuable information about energy technology development in these specific states, and also offers insight into the very different sub-national discourses associated with emerging low-carbon energy technologies in the U.S

Comparison of different approaches to manage multi-site magnetic resonance spectroscopy clinical data analysis

IntroductionThe effects caused by differences in data acquisition can be substantial and may impact data interpretation in multi-site/scanner studies using magnetic resonance spectroscopy (MRS). Given the increasing use of multi-site studies, a better understanding of how to account for different scanners is needed. Using data from a concussion population, we compare ComBat harmonization with different statistical methods in controlling for site, vendor, and scanner as covariates to determine how to best control for multi-site data.MethodsThe data for the current study included 545 MRS datasets to measure tNAA, tCr, tCho, Glx, and mI to study the pediatric concussion acquired across five sites, six scanners, and two different MRI vendors. For each metabolite, the site and vendor were accounted for in seven different models of general linear models (GLM) or mixed-effects models while testing for group differences between the concussion and orthopedic injury. Models 1 and 2 controlled for vendor and site. Models 3 and 4 controlled for scanner. Models 5 and 6 controlled for site applied to data harmonized by vendor using ComBat. Model 7 controlled for scanner applied to data harmonized by scanner using ComBat. All the models controlled for age and sex as covariates.ResultsModels 1 and 2, controlling for site and vendor, showed no significant group effect in any metabolites, but the vendor and site were significant factors in the GLM. Model 3, which included a scanner, showed a significant group effect for tNAA and tCho, and the scanner was a significant factor. Model 4, controlling for the scanner, did not show a group effect in the mixed model. The data harmonized by the vendor using ComBat (Models 5 and 6) had no significant group effect in both the GLM and mixed models. Lastly, the data harmonized by the scanner using ComBat (Model 7) showed no significant group effect. The individual site data suggest there were no group differences.ConclusionUsing data from a large clinical concussion population, different analysis techniques to control for site, vendor, and scanner in MRS data yielded different results. The findings support the use of ComBat harmonization for clinical MRS data, as it removes the site and vendor effects

Perceived impacts of COVID-19 responses on routine health service delivery in Liberia and UK: cross-country lessons for resilient health systems for equitable service delivery during pandemics

Background COVID-19 has caused significant public health problems globally, with catastrophic impacts on health systems. This study explored the adaptations to health services in Liberia and Merseyside UK at the beginning of the COVID-19 pandemic (January–May 2020) and their perceived impact on routine service delivery. During this period, transmission routes and treatment pathways were as yet unknown, public fear and health care worker fear was high and death rates among vulnerable hospitalised patients were high. We aimed to identify cross-context lessons for building more resilient health systems during a pandemic response. Methods he study employed a cross-sectional qualitative design with a collective case study approach involving simultaneous comparison of COVID-19 response experiences in Liberia and Merseyside. Between June and September 2020, we conducted semi-structured interviews with 66 health system actors purposively selected across different levels of the health system. Participants included national and county decision-makers in Liberia, frontline health workers and regional and hospital decision-makers in Merseyside UK. Data were analysed thematically in NVivo 12 software. Results There were mixed impacts on routine services in both settings. Major adverse impacts included diminished availability and utilisation of critical health services for socially vulnerable populations, linked with reallocation of health service resources for COVID-19 care, and use of virtual medical consultation in Merseyside. Routine service delivery during the pandemic was hampered by a lack of clear communication, centralised planning, and limited local autonomy. Across both settings, cross-sectoral collaboration, community-based service delivery, virtual consultations, community engagement, culturally sensitive messaging, and local autonomy in response planning facilitated delivery of essential services. Conclusion Our findings can inform response planning to assure optimal delivery of essential routine health services during the early phases of public health emergencies. Pandemic responses should prioritise early preparedness, with investment in the health systems building blocks including staff training and PPE stocks, address both pre-existing and pandemic-related structural barriers to care, inclusive and participatory decision-making, strong community engagement, and effective and sensitive communication. Multisectoral collaboration and inclusive leadership are essential

Oceanic forcing of interannual and multidecadal climate variability in the southwestern Indian Ocean: evidence from a 160 year coral isotopic record (La Réunion, 55°E, 21°S)

We have developed a new 163-year bimonthly coral δ18O record from La Réunion (55°E, 21°S). Interannual variations in coral δ18O are coherent with the Southern Oscillation Index but not with regional sea surface temperature (SST). Correlations with the global SST field suggest more negative seawater δ18O (δ18Osw) during La Niña years. We propose that the signal results from changes in the strength of the South Equatorial Current and the Indonesian throughflow, which carry low salinity water. Multidecadal variations in coral δ18O are coherent with regional SST, but the sign is of opposite sense as expected from the coral δ18O-temperature relationship. This requires multidecadal changes in salinity large enough to overprint the SST contribution in the coral δ18O record. Our results suggest that multidecadal salinity variations result from modulations in the transport of the South Equatorial Current, which varies in response to the surface wind field and/or the Indonesian throughflow

De novo UBE2A mutations are recurrently acquired during chronic myeloid leukemia progression and interfere with myeloid differentiation pathways

Despite the advent of tyrosine kinase inhibitors, a proportion of chronic myeloid leukemia patients in chronic phase fails to respond to Imatinib or to second generation inhibitors and progress to blast crisis. Limited improvements in the understanding of the molecular mechanisms responsible for chronic myeloid leukemia transformation from chronic phase to the aggressive blast crisis were achieved until now. We present here a massive parallel sequencing analysis of 10 blast crisis samples and of the corresponding autologous chronic phase controls which reveals, for the first time, recurrent mutations affecting the ubiquitin-conjugating enzyme E2A gene (UBE2A, formerly RAD6A). Additional analyses on a cohort of 24 blast crisis, 41 chronic phase as well as 40 acute myeloid leukemia and 38 atypical chronic myeloid leukemia patients at onset confirmed that UBE2A mutations are specifically acquired during chronic myeloid leukemia progression with a frequency of 16.7% in advanced phases. In vitro studies show that the mutations here described cause a decrease in UBE2A activity, leading to an impairment of myeloid differentiation in chronic myeloid leukemia cells

Genome-wide protein QTL mapping identifies human plasma kallikrein as a post-translational regulator of serum uPAR levels

The soluble cleaved urokinase plasminogen activator receptor (scuPAR) is a circulating protein detected in multiple diseases, including various cancers, cardiovascular disease, and kidney disease, where elevated levels of scuPAR have been associated with worsening prognosis and increased disease aggressiveness. We aimed to identify novel genetic and biomolecular mechanisms regulating scuPAR levels. Elevated serum scuPAR levels were identified in asthma (n=514) and chronic obstructive pulmonary disease (COPD; n=219) cohorts when compared to controls (n=96). In these cohorts, a genome-wide association study of serum scuPAR levels identified a human plasma kallikrein gene (KLKB1) promoter polymorphism (rs4253238) associated with serum scuPAR levels in a control/asthma population (P=1.17×10−7), which was also observed in a COPD population (combined P=5.04×10−12). Using a fluorescent assay, we demonstrated that serum KLKB1 enzymatic activity was driven by rs4253238 and is inverse to scuPAR levels. Biochemical analysis identified that KLKB1 cleaves scuPAR and negates scuPAR's effects on primary human bronchial epithelial cells (HBECs) in vitro. Chymotrypsin was used as a proproteolytic control, while basal HBECs were used as a control to define scuPAR-driven effects. In summary, we reveal a novel post-translational regulatory mechanism for scuPAR using a hypothesis-free approach with implications for multiple human diseases