RESUMEN
BACKGROUND:: Over the last decade, the pharmacists' role in health-care services has evolved and expanded to include more direct patient care and disease management services. OBJECTIVE:: To evaluate medical students' perceptions on pharmacists, their role in health care, and demographic or experiential factors that influenced the medical students' opinions. METHODS:: Medical students, at a Midwest, academic medical center, were solicited to complete a cross-sectional, web-based survey consisting of 3 domains: basic demographics, knowledge of the pharmacy profession, and opinions of pharmacists. RESULTS:: Participants supported pharmacists' role in recommending and monitoring drug therapy. However, participants did not support pharmacists' role in performing physical examinations, health screenings, or managing patients with chronic diseases. The main factors that influenced perceptions of pharmacists were female gender and frequent (weekly or more) interaction with a pharmacist or pharmacy student. Neither year in medical school nor participation in intercollaborative practice significantly influenced perceptions of pharmacists. CONCLUSION:: This survey highlights the need to improve the education medical students receive about pharmacists' contribution to the health-care team and the importance of increasing the interaction between medical students and pharmacists or pharmacy students to enhance interprofessional collaboration.
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Actitud del Personal de Salud , Percepción , Farmacéuticos , Rol Profesional/psicología , Estudiantes de Medicina/psicología , Adulto , Estudios Transversales , Educación en Farmacia , Femenino , Humanos , Masculino , Atención al Paciente , Servicios Farmacéuticos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Activity-dependent changes in hippocampal energy consumption have largely been determined using microdialysis. However, real-time recordings of brain energy consumption can be more accurately achieved using amperometric sensors, allowing for sensitive real-time monitoring of concentration changes. Here, we test the theory that systemic pre-treatment with glucose in rats prevents activity-dependent decreases in hippocampal glucose levels and thus enhances their performance in a spontaneous alternation task. Male Sprague Dawley rats were implanted into the hippocampus with either: 1) microdialysis probe; or 2) an oxygen sensor and glucose biosensor co-implanted together. Animals were pre-treated with either saline or glucose (250mg/kg) 30min prior to performing a single 20-min spontaneous alternation task in a +-maze. There were no significant differences found between either treatment group in terms of spontaneous alternation performance. Additionally, there was a significant difference found between treatment groups on hippocampal glucose levels measured using microdialysis (a decrease associated with glucose pre-treatment in control animals) but not amperometry. There were significant increases in hippocampal oxygen during +-maze exploration. Combining the findings from both methods, it appears that hippocampal activity in the spontaneous alternation task does not cause an increase in glucose consumption, despite an increase in regional cerebral blood flow (using oxygen supply as an index of blood flow) and, as such, pre-treatment with glucose does not enhance spontaneous alternation performance.
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Conducta Animal/fisiología , Glucosa/metabolismo , Glucosa/farmacología , Hipocampo/metabolismo , Memoria a Corto Plazo/fisiología , Oxígeno/metabolismo , Memoria Espacial/fisiología , Animales , Técnicas Biosensibles , Glucosa/administración & dosificación , Masculino , Microdiálisis , Ratas , Ratas Sprague-DawleyRESUMEN
OBJECTIVE: To determine pharmacy students' knowledge of and attitudes toward medical marijuana and to determine if pharmacy students need additional education on the topic. METHODS: Pharmacy students were asked to complete a survey on medical marijuana that assessed their knowledge of, medical uses of, adverse effects with, and attitudes toward medical marijuana through 23 Likert-scale questions. RESULTS: Three hundred eleven students completed the survey. Fifty-eight percent of the students felt that medical marijuana should be legalized in all states. However, the majority of students did not feel comfortable answering consumers' questions regarding efficacy, safety, or drug interactions related to the substance. Accurate responses for diseases or conditions for permitted medical marijuana use was low, with only cancer (91%) and glaucoma (57%) identified by more than half the students. CONCLUSION: With an increasing number of states adopting medical marijuana use, pharmacy schools need to evaluate the adequacy of medical marijuana education in their curriculum.
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Actitud del Personal de Salud , Competencia Clínica , Educación en Farmacia/métodos , Marihuana Medicinal/uso terapéutico , Estudiantes de Farmacia , Competencia Clínica/normas , Humanos , Marihuana Medicinal/efectos adversos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: The aim of this paper was to describe the Adolescent Intensive Management (AIM) team at the Austin Child and Adolescent Mental Health Service (CAMHS), a unique model of intensive outreach service with high-risk and difficult-to-engage adolescents, and describe the profile of clients referred to it. METHOD: This study used a retrospective review of clients' data, collected through file audit, over a 12-month period. RESULTS: The result of the study showed that a 100% retention rate of adolescents with complex social, emotional and mental health needs is possible in a flexible and multi-system approach to service provision. CONCLUSION: Clients referred to the CAMHS' AIM team displayed a pattern of multiple risk factors and comorbidities. Low caseload of 8-10 clients per clinician allowed flexibility and a level of intensity to make any necessary changes in service provision to better suit the client's needs. The majority of clients showed improvement in functioning following intervention by the team.
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Servicios Comunitarios de Salud Mental/organización & administración , Relaciones Comunidad-Institución , Trastornos Mentales/terapia , Grupo de Atención al Paciente/organización & administración , Adolescente , Factores de Edad , Manejo de Caso/organización & administración , Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricos , Terapia Cognitivo-Conductual , Terapia Combinada , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Terapia Psicoanalítica , Psicotrópicos/uso terapéutico , Derivación y Consulta/organización & administración , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Intento de Suicidio/prevención & control , Intento de Suicidio/psicología , VictoriaRESUMEN
BACKGROUND: beta-Adrenergic receptor stimulation appears to have contrasting effects on inflammatory processes. METHODS: In 25 healthy volunteers we examined the effects of a 20-min isoproterenol infusion (20 ng/kg/min) on systemic and peripheral blood mononuclear cell (PBMC) production of LPS-stimulated inflammatory mediators. RESULTS: Plasma soluble CD40 ligand and stimulated MIP-1alpha production were both reduced (p < or = 0.05) by systemic beta-adrenergic stimulation. Stimulated TNF-alpha production was reduced (p < 0.03) but plasma TNF-alpha was unchanged. In contrast, plasma IL-6 was elevated (p < 0.05) while stimulated IL-6 was unchanged, indicating the main source may not be PBMCs. CONCLUSIONS: beta-Adrenergic receptor activation leads to a reduction in markers of the early inflammation cascade. Our findings also suggest that adipose tissue is a contributing source of beta-adrenergically stimulated increases in circulating IL-6. Since beta-adrenergic agonists and antagonists are commonly used in the treatment of disease, it is important that we clearly elucidate and contrast their systemic versus cell-specific effects.
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Agonistas Adrenérgicos beta/farmacología , Ligando de CD40/efectos de los fármacos , Quimiocina CCL3/efectos de los fármacos , Inflamación/tratamiento farmacológico , Leucocitos Mononucleares/efectos de los fármacos , Receptores Adrenérgicos beta/efectos de los fármacos , Tejido Adiposo/efectos de los fármacos , Tejido Adiposo/inmunología , Tejido Adiposo/metabolismo , Adulto , Biomarcadores/análisis , Biomarcadores/sangre , Ligando de CD40/sangre , Ligando de CD40/inmunología , Quimiocina CCL3/inmunología , Quimiocina CCL3/metabolismo , Regulación hacia Abajo/efectos de los fármacos , Regulación hacia Abajo/fisiología , Femenino , Humanos , Inflamación/sangre , Inflamación/inmunología , Interleucina-6/sangre , Isoproterenol/farmacología , Leucocitos Mononucleares/inmunología , Leucocitos Mononucleares/metabolismo , Lipopolisacáridos , Masculino , Persona de Mediana Edad , Neuroinmunomodulación/efectos de los fármacos , Neuroinmunomodulación/inmunología , Receptores Adrenérgicos beta/metabolismo , Factor de Necrosis Tumoral alfa/sangre , Factor de Necrosis Tumoral alfa/efectos de los fármacosRESUMEN
Hypoxia is defined as a deficiency of oxygen reaching the tissues of the body, and it plays a critical role in development and pathological conditions, such as cancer. Once tumors outgrow their blood supply, their central portion becomes hypoxic and the tumor stimulates angiogenesis through the activation of the hypoxia-inducible factors (HIFs). HIFs are transcription factors that are regulated in an oxygen-dependent manner by a group of prolyl hydroxylases (known as PHDs or HPHs). Our understanding of hypoxia signaling is limited by our incomplete knowledge of HIF target genes. cDNA microarrays and a cell line lacking a principal HIF protein, HIF1alpha, were used to identify a more complete set of hypoxia-regulated genes. The microarrays identified a group of 286 clones that were significantly influenced by hypoxia and 54 of these were coordinately regulated by cobalt chloride. The expression profile of HIF1alpha -/- cells also identified a group of downregulated genes encoding enzymes involved in protecting cells from oxidative stress, offering an explanation for the increased sensitivity of HIF1alpha -/- cells to agents that promote this type of response. The microarray studies confirmed the hypoxia-induced expression of the HIF regulating prolyl hydroxylase, PHD2. An analysis of the members of the PHD family revealed that they are differentially regulated by cobalt chloride and hypoxia. These results suggest that HIF1alpha is the predominant isoform in fibroblasts and that it regulates a wide battery of genes critical for normal cellular function and survival under various stresses.