Community pharmacists as vaccine providers

Purpose - The purpose of this paper is to describe the history of pharmacist involvement as vaccine providers in the USA and discuss examples of growing interests in other parts of the world. Design/methodology/approach - Literature searches were performed in PubMed as well as pharmacy-related journals. Findings - Pharmacists have been involved with the storage and management of vaccines for more than a century. Based on the unmet needs in meeting national goals for vaccination rates among adults in the USA, efforts led to training and recognizing pharmacists as vaccine providers which is now within the scope of practice for a pharmacist in all US states and territories. Pharmacists complete a comprehensive training program in vaccine sciences, regulatory considerations, as well as demonstration of skills in administering vaccines. Over 300,000 pharmacists have been trained in vaccine delivery and this represents the majority of the pharmacist workforce in the USA. There are examples of the beneficial impact of pharmacist involvement as vaccine providers in community pharmacy settings. Research limitations/implications - This review is based on a thorough review of the literature but was not conducted in a systematic fashion. Originality/value - This review provides a historical perspective and evidence of the benefit of pharmacists as vaccine providers

Patterns of ‘balancing between hope and despair’ in the diagnostic phase: a grounded theory study of patients on a gastroenterology ward

Aim: The aim of the study was to learn how patients going through the diagnostic phase experienced and handled their situation. Background: Many studies report about the stressful diagnostic phase; however, none has presented a conceptual theory where the concepts are sufficiently related to each other. The Theory of Preparative Waiting has previously been published as a descriptive grounded theory and describes the experience of a group of gastroenterology patients going through the diagnostic phase. Method: A classical grounded theory design was used, with data derived from 18 in-depth interviews with 15 patients in a gastroenterology ward at a Norwegian University Hospital. Interviews were conducted during 2002–2003. Findings: Participants’ main concern was found to be how they could prepare themselves for the concluding interview and life after diagnosis. The theoretical code of ‘balancing’ had four patterns; controlling pain, rational awaiting, denial, and accepting. These patterns of ‘balancing’ guided how participants used the categories of ‘Preparative Waiting Theory’ ‘seeking and giving information’, ‘interpreting clues’, ‘handling existential threats’ and ‘seeking respite’. Patterns were strategies, so one person could use more than one pattern. Conclusion: The diagnostic phase was a difficult time for the participants and the ‘Preparative Waiting Theory’ can assist nurses in assessing how patients prepare themselves differently for getting a diagnosis. All patients would find it helpful to be followed up by a designated contact person at the ward; however, patients using mostly the patterns of controlling pain and denial would benefit most from such support

Detector for imaging and dosimetry of laser-driven epithermal neutrons by alpha conversion

An epithermal neutron imager based on detecting alpha particles created by boron neutron capture mechanism is discussed. The diagnostic mainly consists of a mm thick Boron Nitride (BN) sheet (as an alpha converter) in contact with a non-borated cellulose nitride film (LR115 type-II) detector. While the BN absorbs the neutrons below 0.1 eV, the fast neutrons register insignificantly in the detector due to their low neutron capture and recoil cross-sections. The use of solid-state nuclear track detectors (SSNTD), unlike image plates, micro-channel plates and scintillators, provide safeguard from the x-rays, gamma-rays and electrons. The diagnostic was tested on a proof-of-principle basis, in front of a laser driven source of moderated neutrons, which suggests the potential of using this diagnostic (BN+SSNTD) for dosimetry and imaging applications

Large trans-ethnic meta-analysis identifies AKR1C4 as a novel gene associated with age at menarche

STUDY QUESTION: Does the expansion of genome-wide association studies (GWAS) to a broader range of ancestries improve the ability to identify and generalise variants associated with age at menarche (AAM) in European populations to a wider range of world populations? SUMMARY ANSWER: By including women with diverse and predominantly non-European ancestry in a large-scale meta-analysis of AAM with half of the women being of African ancestry, we identified a new locus associated with AAM in African-ancestry participants, and generalised loci from GWAS of European ancestry individuals. WHAT IS KNOWN ALREADY: AAM is a highly polygenic puberty trait associated with various diseases later in life. Both AAM and diseases associated with puberty timing vary by race or ethnicity. The majority of GWAS of AAM have been performed in European ancestry women. STUDY DESIGN, SIZE, DURATION: We analysed a total of 38 546 women who did not have predominantly European ancestry backgrounds: 25 149 women from seven studies from the ReproGen Consortium and 13 397 women from the UK Biobank. In addition, we used an independent sample of 5148 African-ancestry women from the Southern Community Cohort Study (SCCS) for replication. PARTICIPANTS/MATERIALS, SETTING, METHODS: Each AAM GWAS was performed by study and ancestry or ethnic group using linear regression models adjusted for birth year and study-specific covariates. ReproGen and UK Biobank results were meta-analysed using an inverse variance-weighted average method. A trans-ethnic meta-analysis was also carried out to assess heterogeneity due to different ancestry. MAIN RESULTS AND THE ROLE OF CHANCE: We observed consistent direction and effect sizes between our meta-analysis and the largest GWAS conducted in European or Asian ancestry women. We validated four AAM loci (1p31, 6q16, 6q22 and 9q31) with common genetic variants at P 18 years) were excluded from analysis. Women may not fully recall their AAM as most of the studies were conducted many years later. Further studies in women with diverse and predominantly non-European ancestry are needed to confirm and extend these findings, but the availability of such replication samples is limited. WIDER IMPLICATIONS OF THE FINDINGS: Expanding association studies to a broader range of ancestries or ethnicities may improve the identification of new genetic variants associated with complex diseases or traits and the generalisation of variants from European-ancestry studies to a wider range of world populations. STUDY FUNDING/COMPETING INTEREST(S): Funding was provided by CHARGE Consortium grant R01HL105756-07: Gene Discovery For CVD and Aging Phenotypes and by the NIH grant U24AG051129 awarded by the National Institute on Aging (NIA). The authors have no conflict of interest to declare

Replication of genetic loci for ages at menarche and menopause in the multi-ethnic Population Architecture using Genomics and Epidemiology (PAGE) study

Do genetic associations identified in genome-wide association studies (GWAS) of age at menarche (AM) and age at natural menopause (ANM) replicate in women of diverse race/ancestry from the Population Architecture using Genomics and Epidemiology (PAGE) Study

Learning from multimedia and hypermedia

Computer-based multimedia and hypermedia resources (e.g., the world wide web) have become one of the primary sources of academic information for a majority of pupils and students. In line with this expansion in the field of education, the scientific study of learning from multimedia and hypermedia has become a very active field of research. In this chapter we provide a short overview with regard to research on learning with multimedia and hypermedia. In two review sections, we describe the educational benefits of multiple representations and of learner control, as these are the two defining characteristics of hypermedia. In a third review section we describe recent scientific trends in the field of multimedia/hypermedia learning. In all three review sections we will point to relevant European work on multimedia/hypermedia carried out within the last 5 years, and often carried out within the Kaleidoscope Network of Excellence. According to the interdisciplinary nature of the field this work might come not only from psychology, but also from technology or pedagogy. Comparing the different research activities on multimedia and hypermedia that have dominated the international scientific discourse in the last decade reveals some important differences. Most important, a gap seems to exist between researchers mainly interested in a “serious” educational use of multimedia/ hypermedia and researchers mainly interested in “serious” experimental research on learning with multimedia/hypermedia. Recent discussions about the pros and cons of “design-based research” or “use-inspired basic research” can be seen as a direct consequence of an increasing awareness of the tensions within these two different cultures of research on education

Methylome-wide association study of central adiposity implicates genes involved in immune and endocrine systems

Aim: We conducted a methylome-wide association study to examine associations between DNA methylation in whole blood and central adiposity and body fat distribution, measured as waist circumference, waist-to-hip ratio and waist-to-height ratio adjusted for body mass index, in 2684 African-American adults in the Atherosclerosis Risk in Communities study. Materials & methods: We validated significantly associated cytosine-phosphate-guanine methylation sites (CpGs) among adults using the Women's Health Initiative and Framingham Heart Study participants (combined n = 5743) and generalized associations in adolescents from The Raine Study (n = 820). Results & conclusion: We identified 11 CpGs that were robustly associated with one or more central adiposity trait in adults and two in adolescents, including CpG site associations near TXNIP, ADCY7, SREBF1 and RAP1GAP2 that had not previously been associated with obesity-related traits

The Dynamics of Brane-World Cosmological Models

Brane-world cosmology is motivated by recent developments in string/M-theory and offers a new perspective on the hierarchy problem. In the brane-world scenario, our Universe is a four-dimensional subspace or {\em brane} embedded in a higher-dimensional {\em bulk} spacetime. Ordinary matter fields are confined to the brane while the gravitational field can also propagate in the bulk, leading to modifications of Einstein's theory of general relativity at high energies. In particular, the Randall-Sundrum-type models are self-consistent and simple and allow for an investigation of the essential non-linear gravitational dynamics. The governing field equations induced on the brane differ from the general relativistic equations in that there are nonlocal effects from the free gravitational field in the bulk, transmitted via the projection of the bulk Weyl tensor, and the local quadratic energy-momentum corrections, which are significant in the high-energy regime close to the initial singularity. In this review we discuss the asymptotic dynamical evolution of spatially homogeneous brane-world cosmological models containing both a perfect fluid and a scalar field close to the initial singularity. Using dynamical systems techniques it is found that, for models with a physically relevant equation of state, an isotropic singularity is a past-attractor in all orthogonal spatially homogeneous models (including Bianchi type IX models). In addition, we describe the dynamics in a class of inhomogeneous brane-world models, and show that these models also have an isotropic initial singularity. These results provide support for the conjecture that typically the initial cosmological singularity is isotropic in brane-world cosmology.Comment: Einstein Centennial Review Article: to appear in CJ