Pharmacy Manager Strategies for Reducing Financial Losses From Adverse Drug Events by Polypharmacy Patients

Every year over 100,000 deaths occur in the U.S. from adverse drug events derived from medication errors. Medication errors account for an annual cost of $100 to$200 billion. Healthcare pharmacists lack strategies to reduce adverse drug events and medication errors from taking place. Grounded in complex adaptive system theory, the purpose of this qualitative multiple case study was to explore strategies to reduce advere drug events and medication errors. The participants were 5 pharmacist managers in a county in central Florida. These pharmacists were from different community pharmacies, and each had a minimum of 5 years’ experience in the field. The participants all responded to the same set of open-ended questions during semistructured interviews. Additional data sources for this study were field notes, business prescription literature, and analyzing observations of the participants. Data were analyzed using Yin’s 5 analytic techniques. Themes identified included: polypharmacy and the unknown, HIPAA and legal constraints, and CAS, the edge of chaos and clarity. The findings from this study may enable pharmacy managers to increase patient counseling time, encourage patient medication adherence; thereby, decreasing liability costs and additional medical expenses for polypharmacy patients. Social changes that may occur as a result of this study include a decrease in adverse events for polypharmacy patients and an increase in the quality of life for these patients

Sylvester\u27s Magic Pebble Is More Than Meets the Eye: Third-Graders Interpret the Meaning of Literature that is Extended Metaphor.

The importance of providing children with experience in using and understanding metaphor is inextricably tied to the process of constructing meaning from text. Metaphor may be embedded in the text by the author or used by the reader to actively create meaning. It is a means by which children make sense from stories using original formulations rather than repeated rules from the adult world (Miles, 1985; Lehr, 1988)

The Impact of Dynamics in Protein Assembly

Predicting the assembly of multiple proteins into specific complexes is critical to understanding their biological function in an organism, and thus the design of drugs to address their malfunction. Consequently, a significant body of research and development focuses on methods for elucidating protein quaternary structure. In silico techniques are used to propose models that decode experimental data, and independently as a structure prediction tool. These computational methods often consider proteins as rigid structures, yet proteins are inherently flexible molecules, with both local side-chain motion and larger conformational dynamics governing their behaviour. This treatment is particularly problematic for any protein docking engine, where even a simple rearrangement of the side-chain and backbone atoms at the interface of binding partners complicates the successful determination of the correct docked pose. Herein, we present a means of representing protein surface, electrostatics and local dynamics within a single volumetric descriptor, before applying it to a series of physical and biophysical problems to validate it as representative of a protein. We leverage this representation in a protein-protein docking context and demonstrate that its application bypasses the need to compensate for, and predict, specific side-chain packing at the interface of binding partners for both water-soluble and lipid-soluble protein complexes. We find little detriment in the quality of returned predictions with increased flexibility, placing our protein docking approach as highly competitive versus comparative methods. We then explore the role of larger, conformational dynamics in protein quaternary structure prediction, by exploiting large-scale Molecular Dynamics simulations of the SARS-CoV-2 spike glycoprotein to elucidate possible high-order spike-ACE2 oligomeric states. Our results indicate a possible novel path to therapeutics following the COVID-19 pandemic. Overall, we find that the structure of a protein alone is inadequate in understanding its function through its possible binding modes. Therefore, we must also consider the impact of dynamics in protein assembly

Transmembrane Protein Docking with JabberDock

Transmembrane proteins act as an intermediary for a broad range of biological process. Making up 20% to 30% of the proteome, their ubiquitous nature has resulted in them comprising 50% of all targets in drug design. Despite their importance, they make up only 4% of all structures in the PDB database, primarily owing to difficulties associated with isolating and characterizing them. Membrane protein docking algorithms could help to fill this knowledge gap, yet only few exist. Moreover, these existing methods achieve success rates lower than the current best soluble proteins docking software. We present and test a pipeline using our software, JabberDock, to dock membrane proteins. JabberDock docks shapes representative of membrane protein structure and dynamics in their biphasic environment. We verify JabberDock’s ability to yield accurate predictions by applying it to a benchmark of 20 transmembrane dimers, returning a success rate of 75.0%. This makes our software very competitive among available membrane protein–protein docking tools

ESL learners: Process writing and publishing good literature

The purpose of this article is to report on our examination of books written by children who are ESL learners, and compare the books with criteria for meritorious literature (Norton, 1995), and to discuss the implications of the results relevant to process writing instruction with second language learners. The books examined were written by students in grades K through 5 in a rural elementary school. They had been in the United States for a short period of time. Their familiarization with process writing was due to its being a part of their daily curriculum. The school\u27s writing program embraces those contexts purported to promote writing development, specifically, that feedback be focused primarily on content and secondarily on writing conventions and language form. The results of our inspection indicate an unexpected adherence to criteria for literary genres. Because each author\u27s book was written in English and translated into his native language, there was a validation of the primary language as fundamental to achievement, and the links between languages and cultures were maintained. Also noteworthy, in subsequent written and oral communications by the children, a growing facility with the English language was observed. Implications of these findings would serve teachers of ESL students looking for ways to better prepare themselves for in structing a population of diverse learners. Research on second language acquisition

Exploring the marketing of higher education: evidence from the Institutes of Technology sector

The purpose of this research dissertation is to explore the marketing of higher education \ud institutes, looking in detail at evidence from the Institutes of Technology (IoT) sector. The \ud aims of the research are to profile higher education in Ireland, to discover what the marketing \ud objectives of IoTs are and investigate possible future challenges, and to assess the marketing \ud techniques employed by IoTs. \ud The methodology approach which utilised for the purpose of this research dissertation is a \ud mixed methods approach, based on sequential explanatory strategy. This involves conducting \ud quantitative research in the first instance, followed by qualitative research. When both have \ud been completed the findings from both are combined to give an overview of the area being \ud researched. The quantitative research took the form of questionnaires distributed to students \ud in the Institute. The qualitative research took the form of interviews with those with \ud responsibility for marketing in the five IoTs in the BMW region, and an additional interview \ud with the Director of Academic Affairs in Institutes of Technology, Ireland. \ud The research found that there was a contrast between how students see the marketing \ud techniques employed by IoTs and how the staff within the IoTs perceive student’s \ud requirements are in relation to marketing. \ud It was evident from the interviews that there is not much emphasis placed on the marketing \ud function within the IoTs, despite the fact that this is one of the key determinants which \ud influence a prospective student when deciding whether or where to pursue third-level \ud education