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)

A Study of the Relationship Between Coping Effectiveness in Stepmothers and the Length of Their Marriage

The relationship between coping effectiveness of step-parenting and length of marriage was examined for 30 stepmothers. Participants included stepmothers in St. Louis and St. Louis County who volunteered to complete the Coping Response Inventory and a cover/survey letter that contained demographic questions. Where it was predicted that there would be no relationship between coping effectiveness and length of marriage, it was found that length of time remarried does affect coping effectiveness in stepmothers in that the type of coping style used changes with length of time remarried

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

Another step closer to measuring the ghosts in the nursery: preliminary validation of the Trauma Reflective Functioning Scale

The aim of this study was to examine preliminary evidence of the validity of the Trauma Reflective Functioning Scale and to investigate reflective functioning (RF) and attachment in pregnant women with histories of trauma, with a particular focus on the capacity to mentalize regarding trauma and its implications for adaptation to pregnancy and couple functioning. The Adult Attachment Interview was used to assess attachment, unresolved trauma and mentalization (measured as RF) regarding relationships with attachment figures (RF-G) and trauma (RF-T) in 100 pregnant women with histories of abuse and neglect. The majority (63%) of women had insecure attachment states of mind and approximately half were unresolved regarding trauma. Furthermore, the majority of women manifested deficits specific to RF-T. Their RF-T was significantly lower than their RF-G; the findings indicate that women with histories of childhood abuse and neglect do not manifest a generic inhibition of reflectiveness, but a collapse of mentalization specific to trauma. Low RF-T, indicative of difficulty in considering traumatic experiences in mental state terms, was associated with difficulty in investment in the pregnancy and lack of positive feelings about the baby and motherhood. In addition, low RF-T was also associated with difficulties in intimate relationships. Results of a regression analysis with RF indicated that RF-T was the best predictor of investment in pregnancy and couple functioning. In sum, the study provides preliminary evidence that RF-T can be reliably measured and is a valid construct that has potential usefulness for research and clinical practice. It highlights the importance of mentalization specifically about trauma and suggests that it is not the experience of trauma per se, but the absence of mentalization regarding trauma that is associated with difficulties in close relationships and in making the transition to parenthood