Evaluation of a pharmacist-led medication assessment used to identify prevalence of and associations with polypharmacy and potentially inappropriate medication use among ambulatory senior adults with cancer.

PURPOSE: The use of multiple and/or inappropriate medications in seniors is a significant public health problem, and cancer treatment escalates its prevalence and complexity. Existing studies are limited by patient self-report and medical record extraction compared with a pharmacist-led comprehensive medication assessment. PATIENTS AND METHODS: We retrospectively examined medication use in ambulatory senior adults with cancer to determine the prevalence of polypharmacy (PP) and potentially inappropriate medication (PIM) use and associated factors. PP was defined as concurrent use of five or more and less than 10 medications, and excessive polypharmacy (EPP) was defined as 10 or more medications. PIMs were categorized by 2012 Beers Criteria, Screening Tool of Older Person\u27s Prescriptions (STOPP), and the Healthcare Effectiveness Data and Information Set (HEDIS). RESULTS: A total of 248 patients received a geriatric oncology assessment between January 2011 and June 2013 (mean age was 79.9 years, 64% were women, 74% were white, and 87% had solid tumors). Only 234 patients (evaluated by pharmacists) were included in the final analysis. Mean number of medications used was 9.23. The prevalence of PP, EPP, and PIM use was 41% (n = 96), 43% (n = 101), and 51% (n = 119), respectively. 2012 Beers, STOPP, and HEDIS criteria classified 173 occurrences of PIMs, which were present in 40%, 38%, and 21% of patients, respectively. Associations with PIM use were PP (P \u3c .001) and increased comorbidities (P = .005). CONCLUSION: A pharmacist-led comprehensive medication assessment demonstrated a high prevalence of PP, EPP, and PIM use. Medication assessments that integrate both 2012 Beers and STOPP criteria and consider cancer diagnosis, prognosis, and cancer-related therapy are needed to optimize medication use in this population

Cybersecurity in Industrial Automation Lab Design for EE 435

This project involves the creation of an instructional laboratory aimed at teaching cybersecurity for industrial automation applications. Specifically tailored for Electrical Engineering students at Cal Poly, the experiment focuses on configuring the Modicon M580, a PLC from Schneider Electric, and serves to introduce students to relevant cybersecurity protocols and techniques. This project will be implemented into the EE435 (Industrial Power Control and Automation) course curriculum upon Cal Poly’s transition to the semester system

Wellspring Waste to Energy Feasibility Study

This study was conducted by the University of Massachusetts Amherst public policy masters students for Springfield based Wellspring Cooperative, a nonprofit focused on cooperative job creation and training. The project assesses three potential scale options for Wellspring in order to use organic material to heat and/or generate electricity to power its hydroponic greenhouse. Though the greenhouse is not constructed as of yet, its source of energy is an important element for Wellspring. Motivations for utilizing organic waste to power the greenhouse are due in part to the influx of food waste sources being diverted due to the new Massachusetts Food Waste Ban. Indeed, new Massachusetts Department of Environmental Protection (DEP) restrictions on commercial food waste entering into landfills (CMR 310 19.017(3)) has created a conducive environment for composting and associated organic waste processing technology growth. Moreover, the commercial organic waste ban was a catalyst for Wellspring to contact the Center for Public Policy and Administration to determine what types of waste to energy technology could be incorporated to power their greenhouse and subsequent associated job growth. In assessing potential energy generation sources, we researched the technological aspects for a compost-to-heat system, a small scale anaerobic digester, and a large scale anaerobic digester. We then evaluated the relevant financial and implementation factors involved. we determined Wellspring\u27s goals of waste to energy generation should be framed through the context of a short term and long term lens. The recommended short term strategy is to utilize composting systems to heat the greenhouse and connect the greenhouse to the electrical grid. The recommended long term strategy includes partnering with the City of Springfield to develop an organic waste processing facility that would generate electricity from food, animal, and human waste and/or contract with the city as a food waste hauler. With these recommendations we believe that Wellspring will achieve its goals and lead the way in sustainable energy generation

Clinical consequences of polypharmacy in elderly.

INTRODUCTION: Polypharmacy, defined as the use of multiple drugs or more than are medically necessary, is a growing concern for older adults. MEDLINE and EMBASE databases were searched from January 1, 1986 to June 30, 2013) to identify relevant articles in people aged \u3e 65 years. AREAS COVERED: We present information about: i) prevalence of polypharmacy and unnecessary medication use; ii) negative consequences of polypharmacy; and iii) interventions to improve polypharmacy. EXPERT OPINION: International research shows that polypharmacy is common in older adults with the highest number of drugs taken by those residing in nursing homes. Nearly 50% of older adults take one or more medications that are not medically necessary. Research has clearly established a strong relationship between polypharmacy and negative clinical consequences. Moreover, well-designed interprofessional (often including clinical pharmacist) intervention studies that focus on enrolling high-risk older patients with polypharmacy have shown that they can be effective in reducing aspects of unnecessary prescribing with mixed results on distal health outcomes

An Evidence-Based Approach to Identify Student Success Strategies: Focus on Individualized Reassessment

Objectives Describe a process for engaging faculty in evaluating the feasibility of and designing and implementing evidence-based strategies to improve student success. Highlight one successful outcome of this process: IR.https://jdc.jefferson.edu/pharmacyposters/1026/thumbnail.jp

Relief in Gastrointestinal Symptoms with Medical Marijuana Over 1 Year.

INTRODUCTION: Subjective improvement in gastrointestinal (GI) symptoms was assessed among patients using medical marijuana (MMJ). METHODS: Participants completed surveys at 0 days, 30 days, 6 months, and 12 months with questions about the severity of their GI symptoms on a scale from 1 (mild) to 3 (severe). RESULTS: In each survey, participants reported a significant decrease in GI symptom severity when using MMJ versus when not using MMJ (p < 0.05). The most common self-reported side effects from using MMJ were increased appetite (12-21.4%), fatigue (6-16.7%), anxiety (4-11.9%), cough (4-11.9%), headache (6-7.9%), and dry mouth (4-7.1%). CONCLUSION: In patients with chronic GI symptoms, MMJ may provide persistent symptom severity improvement. Limited product availability and mild to moderate side effects are factors to consider before trialing MMJ

A Longitudinal Observational Study of Medical Cannabis Use and Polypharmacy among Patients Presenting to Dispensaries in Pennsylvania

Background: Cannabis use is increasing among adults to treat a variety of health conditions. Given the potential for interactions and adverse events, it is important to assess the use of medical cannabis along with other concomitant medications when assessing for polypharmacy. Methods: The objective of this observational, longitudinal study was to examine medical cannabis (MC) use along with concomitant medications over 12 months in patients with serious medical conditions enrolled in the Pennsylvania (PA) Department of Health’s (DOH) Medical Marijuana Program and to collect and catalog which forms of MC patients are taking along with their concomitant medications. Results: There were 213 participants who completed the baseline surveys in full, and 201, 187, and 175 who completed the 1, 6, and 12-month follow-up surveys. The mean age of the participants was 41.3 years, and 54.5% were female. The mean number of MC products taken at baseline was 3.41 and 3.47 at the 12-month survey. Participants took an average of 3.76 (SD 3.15) medications at baseline and 3.65 (SD 3.4) at 12 months. Most commonly used concomitant medications at baseline included vitamins (42.3%), antidepressants (29.1%), analgesics (22.1%), herbal products (19.7%), and anxiolytics (17.8%). Conclusion: Participants used multiple medical cannabis products to treat a number of medication conditions in conjunction with multiple medications

Leading an Interprofessional Geriatric Clinical Skills Fair: A Train the Trainer Seminar

Objectives • Practice teaching skills related to interprofessional education (IPE) and geriatric competencies • Formulate an Action Plan and prepare to introduce an Interprofessional Geriatric Clinical Skills Fair at their own institutions • Recognize essential elements of a measurement tool that evaluates the effectiveness of an Interprofessional Geriatric Clinical Skills Fai

Evaluation of an Interprofessional Geriatric Clinical Skills Fair

Objectives •Describe the utilization of an interprofessional geriatric clinical skills fair to impart knowledge and skills pertaining to both core geriatric and IPE competencies. •Prepare to introduce an Interprofessional Geriatric Clinical Skills Fair at one’s own institution •Recognize essential elements of a measurement tool that evaluates the effectiveness of an Interprofessional Geriatric Clinical Skills Fai

Characterization of greater middle eastern genetic variation for enhanced disease gene discovery

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia1-3, has resulted in an elevated burden of recessive disease4. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized ‘genetic purging’. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics