Complex Issues Affecting Student Pharmacist Debt

It is time for colleges and schools of pharmacy to examine and confront the rising costs of pharmacy education and the increasing student loan debt borne by graduates. These phenomena likely result from a variety of complex factors. The academy should begin addressing these issues before pharmacy education becomes cost-prohibitive for future generations. This paper discusses some of the more salient drivers of cost and student debt load and offers suggestions that may help alleviate some of the financial pressures.     

Moral Fiber: Breakfast as a Symbol of ‘a Good Start’ in an Australian Obesity Intervention

What are the symbolic meanings of breakfast in the context of one of Australia’s largest childhood obesity intervention programs? Utilizing a range of theoretical insights into the morality of food and eating and the anthropology of food, we trace how breakfast is packaged and promoted to families in an Australian community as a ‘healthy start’ to the day. Through ethnographic and historic investigation, we argue that eating breakfast and certain types of breakfast foods are symbolic of a classed, healthy lifestyle pattern, embodying parental knowledge and bodily regulation to routinely structure daily life. In communities where poverty and unemployment are harsh realities, well-intentioned programs that encourage people to eat a healthy breakfast are encoded with an assemblage of moral values—of knowledge, foods, families, and times and spaces—that are often difficult to reconcile with the wider sociocultural context in which many people live.     

Outcome of patients with systemic light chain amyloidosis with concurrent renal and cardiac involvement

Cardiac involvement in systemic light chain amyloidosis (AL) is generally associated with a worse outcome, especially if other organs are also involved. We sought to determine whether concurrent cardiac and renal involvement were associated with a worse outcome than either organ alone. We identified 129 patients with AL, who received high‐dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto‐HCT) at our institution between 1997 and 2014. Ninety‐nine patients had either renal (group 1: n = 62, 62%), cardiac (group 2: n = 20, 20%), or both cardiac and renal (group 3: n = 17, 17%) involvement. The overall hematological response rate (CR+VGPR+PR) post‐auto‐HCT in groups 1, 2, and 3 was 69%, 74% and 82%, respectively (P = 0.62). Overall, organ response in groups 1, 2, and 3 was 39%, 42%, and 70%, respectively. The median PFS from auto‐HCT in groups 1, 2, and 3 was not reached (NR), 13.3 and 21 months, respectively (P = 0.02). The median OS in groups 1, 2, and 3 was 120, 46, and 60 months, respectively (P = 0.1). In conclusion, median PFS and OS in patients with concurrent cardiac and renal AL were comparable to patients with cardiac AL only, but worse than patients with renal AL.     

Leave the levofloxacin? A case report of levofloxacin-induced psychosis

Fluoroquinolones, including levofloxacin, exhibit desirable antimicrobial characteristics, including broad spectrum of activity and excellent bioavailability. This widely prescribed class of antibiotics has come under scrutiny due to a new black box warning of adverse reactions. Central nervous system effects have been sparsely described in previous literature. We present a case of levofloxacin-induced psychosis in a patient without underlying psychological history.     

Peer norms regarding drug use and drug selling among household youth in a low-income 'drug supermarket' urban neighborhood

Aims : To describe, illustrate, and assess the reliability and construct validity of a method for assessing peer norms regarding drug use and selling. Design and participants : Face-to-face interviews of young adults (age 18-24) selected through multi-stage probability sampling in a low-income, high drug use, urban environment. Measurements : Subjects reported what proportion of their close friends actually encouraged them to use specific drugs, or would have objected to such use, currently and at age 15. Findings : Self-reports of peer norms are highly reliable, and have considerable construct validity in predicting drug behaviors. There is little encouragement of drug use, and substantial objection to use of drugs other than marijuana. While few subjects had many friends who encouraged them to sell drugs, about a third of the subjects said few if any of their friends would object to their selling drugs. Objection to drug use is more common, and encouragement of drug use less common, among women's peers than among men's peers. Conclusions : These items can be used to reliably and validly assess young adults' peer norms regarding drug use. Men and women report different peer norms.