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4%), as assessed by a clinical SLEDAI score. Nonadherence rates were 32% and 25.3% by VAS and the MTB-Thai scale, respectively. Patients aged 55 years or older, who used the universal coverage of health care system, who used multiple medications (>10 pills/day), and who had a good attitude towards the disease were associated with a low risk of nonadherence.
Up to 25% SLE patients poorly adhered to their prescriptions. Age, reimbursement scheme, pill number, and attitude towards SLE were associated with nonadherence in our patients with SLE.
Up to 25% SLE patients poorly adhered to their prescriptions. Age, reimbursement scheme, pill number, and attitude towards SLE were associated with nonadherence in our patients with SLE.The US Centers for Disease Control and Prevention define community engagement as "the process of working collaboratively with and through groups of people" in order to improve their health and well-being. Central to the field of public health, community engagement should also be at the core of the work of schools and programs of public health. This article reviews best practices and emerging innovations in community engagement for education, for research, and for practice, including critical service-learning, community-based participatory research, and collective impact. Leadership, infrastructure, and culture are key institutional facilitators of successful academic efforts. check details Major challenges to overcome include mistrust by community members, imbalance of power, and unequal sharing of credit. Success in this work will advance equity and improve health in communities all around the world.Aldosterone excess is a pathogenic factor in many hypertensive disorders. The discovery of numerous somatic and germline mutations in ion channels in primary hyperaldosteronism underscores the importance of plasma membrane conductances in determining the activation state of zona glomerulosa (zG) cells. Electrophysiological recordings describe an electrically quiescent behavior for dispersed zG cells. Yet, emerging data indicate that in native rosette structures in situ, zG cells are electrically excitable, generating slow periodic voltage spikes and coordinated bursts of Ca2+ oscillations. We revisit data to understand how a multitude of conductances may underlie voltage/Ca2+ oscillations, recognizing that zG layer self-renewal and cell heterogeneity may complicate this task. We review recent data to understand rosette architecture and apply maxims derived from computational network modeling to understand rosette function. The challenge going forward is to uncover how the rosette orchestrates the behavior of a functional network of conditional oscillators to control zG layer performance and aldosterone secretion.I raise concerns about Doerig et al.'s general project, about three of their criteria, and about their treatment of higher-order-thought theory.In their paper Doerig et al. argue that we should put the hard problem aside and focus on empirical data to solve the 'easy' problems of consciousness - finding the neural and functional correlates of consciousness. In other words 'shut up and measure'. This has worked well with other thorny issues, such as explaining life, so why not adopt this approach here? We argue that despite the popularity of this view it is not feasible. In order to collect any consciousness data one needs to take an implicit or explicit stance on the hard problem.Postpartum pelvic floor dysfunction (PFD) has been identified as a significant public health issue. The study aimed to (a) identify the impact of PFD on parous women's occupations, (b) explore how PFD impacts daily life, and (c) determine the level of awareness regarding availability of PFD treatment. The preliminary study utilized a mixed-methods descriptive design. In total, 255 participants completed the Mothers and Children (MAC) survey, distributed electronically throughout the United States. Results indicated that PFD symptoms limit parous women's occupational performance, specifically sexual activity and exercise. Despite results indicating PFD significantly detracted from participants' daily life, 66.8% of participants reported having no awareness of pelvic floor rehabilitation to address PFD. Findings suggest that further research and increased advocacy within the field of occupational therapy are necessary to increase the awareness of PFD rehabilitation and mitigate the impact on women's lives after childbirth.
Immune checkpoint inhibitors (ICI) are novel oncolytic therapies associated with various immune related adverse events (irAEs) affecting multiple organ systems, which may have a delayed presentation. Identification of irAEs and prompt initiation of appropriate treatment represents a challenge to clinicians. The purpose of this study was to evaluate the effectiveness of a pharmacy consult service in identification and management of irAEs.
This was a single center, retrospective study. Patients included were ≥18 years old, admitted as inpatients, and reported a history of cancer treatment within the last year. A pharmacy consult was developed and implemented for patients who reported a history of ICI therapy within the last year. Education regarding the consult service was provided to select physicians, nurses, and all pharmacists. Primary outcome percent of admitted patients reporting ICI therapy within the last year, who required pharmacist intervention for an irAE. Secondary outcomes types of interventions performed, percentage of recommendation acceptance, pharmacist time spent.
Fifty-one patients received a pharmacy immunotherapy consult. Seventeen patients (33%) met the primary outcome. Thirty-three separate recommendations were made by pharmacists for these 17 patients. The secondary outcomes of interventions made and percentage accepted (n; % accepted) Initiation/adjustment of steroid therapy (20; 40%), placement of a consult for oncology or other specialist (10; 70%), other therapeutic interventions (3; 67%). Average time spent by pharmacist on initial consultations (SD) 29 minutes (15).
A pharmacy consult service may help to increase identification of patients receiving immune checkpoint inhibitors and initiate timely interventions.
A pharmacy consult service may help to increase identification of patients receiving immune checkpoint inhibitors and initiate timely interventions.
