Is present pharmacy education adapted to needs? Survey results from young practitioner views regarding pharmacy education outcome towards a national reform in Hungary

BackgroundThe pharmacist career is constantly adapting to societal and health care needs. The past decade has seen a growing demand for curricular development to align graduation outcome with workforce competencies.ObjectiveThis study aims to identify expectations for both didactic and experiential components of a new curriculum based on young pharmacist practitioner views.MethodsAn online survey questionnaire was used in 2019–2020 to evaluate the pharmacy curriculum to detect indicators or key areas which require comprehensive reform.ResultsThe predominant majority of the 205 study participants recommended reduction in credit hours for Natural Sciences (78.54%) and a similar increase in the Theoretical and Practical Expertise Module (77.9%). Pharmaceutical care, clinical therapeutics and clinical pharmacy competencies should also be more highlighted in the program. Findings indicate the current training does not prepare for problem-solving and daily workplace challenges (72.7%) or for extended pharmacist skills and competencies (71.71%). Results show inconsistency in practical training experience, as all respondents participated in practical training for drug manufacturing and analysis but 61.0% reported no hands-on skills training in a hospital-clinical simulation setting. Indications for practitioner involvement into the natural sciences and biomedical subjects (86.3%) confirm the obvious need for more practice-oriented education.ConclusionsEducational reforms seem to be inevitable to achieve measurable improvement in professional practice and skills competency. The country specific demand for a needs-based pharmacy education reflects global trends but may also provide useful insights for individual transitions to transform education through practice and improve practice through education.     

Knowledge and Attitudes About Pre-Exposure Prophylaxis Among Young Adults Experiencing Homelessness in Seven U.S. Cities

Purpose

Evidence suggests that young adults experiencing homelessness (YEH) are at elevated risk of HIV compared to housed youth. Given the limited research on pre-exposure prophylaxis (PrEP) awareness among YEH, this study examined their PrEP knowledge and attitudes.

Experiencias de vivir con cáncer para los adolescentes,adultos jóvenes y sus familias: revisión narrativa y síntesis

IntroductionAdolescence is a critical life stage marked by significant physical, psychological, and social change. Cancer diagnosis during adolescence profoundly affects this experience for adolescents and young adults (AYA) and their families with an impact that continues throughout life. It is important to understand these experiences to ensure delivery of appropriate and high-quality supportive care. This narrative review critically appraised and synthesised qualitative literature that explored the experiences of AYAs and their families living with cancer.MethodNarrative review and synthesis of qualitative research of AYAs’ and their families’ experiences of cancer. MEDLINE, CINAHL and PsycINFO were searched between February 2000 and September 2019 using search terms including «adolescent», «young people», «young adult», «cancer», «family», and «qualitative». Literature was appraised and synthesised using Popay et al.¹ framework.Results3016 articles were retrieved (Medline n = 1298, CINAHL n = 1632, PsycINFO n = 86). Of these, 151 duplicates were removed. 2865 papers were screened with 121 abstracts considered for eligibility for inclusion. Eighteen papers met the inclusion criteria. Three inter-related themes were identified: being diagnosed with cancer; uncertainty - holding on to life and gaps in care delivery.Discussion and recommendationsFew studies discuss the impact of cancer on the families of AYA living with cancer. Future research should explore this experience. By doing so the relational impact of cancer will be better understood as the basis of supportive family-centred care.PROSPERO Registration: CRD42017084148.     

Who are the women who enrolled in the POSITIVE trial: A global study to support young hormone receptor positive breast cancer survivors desiring pregnancy

BackgroundPremenopausal women with early hormone-receptor positive (HR+) breast cancer receive 5–10 years of adjuvant endocrine therapy (ET) during which pregnancy is contraindicated and fertility may wane. The POSITIVE study investigates the impact of temporary ET interruption to allow pregnancy.MethodsPOSITIVE enrolled women with stage I-III HR + early breast cancer, ≤42 years, who had received 18–30 months of adjuvant ET and wished to interrupt ET for pregnancy. Treatment interruption for up to 2 years was permitted to allow pregnancy, delivery and breastfeeding, followed by ET resumption to complete the planned duration.FindingsFrom 12/2014 to 12/2019, 518 women were enrolled at 116 institutions/20 countries/4 continents. At enrolment, the median age was 37 years and 74.9 % were nulliparous. Fertility preservation was used by 51.5 % of women. 93.2 % of patients had stage I/II disease, 66.0 % were node-negative, 54.7 % had breast conserving surgery, 61.9 % had received neo/adjuvant chemotherapy. Tamoxifen alone was the most prescribed ET (41.8 %), followed by tamoxifen + ovarian function suppression (OFS) (35.4 %). A greater proportion of North American women were <35 years at enrolment (42.7 %), had mastectomy (59.0 %) and received tamoxifen alone (59.8 %). More Asian women were nulliparous (81.0 %), had node-negative disease (76.2%) and received tamoxifen + OFS (56.0 %). More European women had received chemotherapy (69.3 %).InterpretationThe characteristics of participants in the POSITIVE study provide insights to which patients and doctors considered it acceptable to interrupt ET to pursue pregnancy. Similarities and variations from a regional, sociodemographic, disease and treatment standpoint suggest specific sociocultural attitudes across the world.     

Which young women are not being vaccinated against HPV? Cross-sectional analysis of a UK national cohort study

ObjectivesHPV vaccination is highly effective in preventing HPV-associated disease, including cervical cancer, which disproportionately affects women from disadvantaged and minority ethnic backgrounds. We examined inequalities in initiation of the HPV vaccination schedule among young women in the UK and reasons given by their parents for non-initiation.DesignCross sectional analyses of a prospective nationally representative cohort study.SettingFour UK countries.Participants5,695 young women (39.9% from households in lowest income quintiles, 5.1% ever excluded from school, 0.5% not attending school) whose parents (14.3% from minority ethnic backgrounds; 54.1% with no stated religious faith) took part in interviews conducted when their daughters were 14 years old.Main outcome measuresParent-reported initiation of HPV vaccination and reasons for non-initiation. The adjusted odds (aORs) and 95% Confidence Intervals (CI) of initiating HPV vaccination were estimated using logistic regression after mutual adjustment for household income, school exclusion, school attendance and parental ethnic background and religious faith.Results92.3% (5265) had initiated HPV vaccination at time of interview. Initiation was less likely among those living in the poorest households (aOR; 95% CI: 0.44; 0.30 to 0.64 for those in lowest household income quintile), who did not attend school (0.11; 0.04 to 0.33), had ever been excluded from school (0.47; 0.29 to 0.76), or whose parents were from Black African (0.49; 0.26 to 0.95) or Any Other (0.34; 0.17 to 0.66) ethnic backgrounds. A reason consistent with a conscious or practical decision was reported by 53.3% (219) and 24.1% (90) parents respectively.ConclusionsAlthough most young women are immunised, marked social inequalities in access to HPV vaccination initiation remain. Practical steps to address this are possible and should be implemented to reduce inequalities in primary prevention of cancers and to ensure equitable access to this important public health intervention.     

青年肺结核患者营养护理方案的构建及应用

目的 构建青年肺结核患者营养护理方案并评价其应用效果。 方法 通过文献分析、现况调查和专家会议法形成青年肺结核患者营养护理方案。选取某三级专科医院2019年8月1日—10月30日入院的青年肺结核患者为试验组,实施青年肺结核患者营养护理方案;选取2019年4月1日—6月30日入院的青年肺结核患者为对照组,实施常规营养护理;比较入院时、出院后1个月和出院后3个月两组营养指标、免疫指标和生活质量。 结果 入院时、出院后1个月和出院后3个月,试验组体重高于对照组（F_组间=12.955,F_时间=5.735,F_交互=36.713,均P<0.05）;出院后3个月,试验组CD3+、CD4+高于对照组（t=16.548,P=0.037;t=18.607,P=0.028）,生活质量总分高于对照组（t=5.351,P<0.001）,但生理功能维度、心理功能维度和社会功能维度的比较,差异无统计学差异（t=0.417,P=0.678;t=1.020,P=0.310;t=0.539,P=0.591）。 结论 青年肺结核患者营养护理方案可改善患者体重、免疫功能和生活质量,促进患者康复。     

Investigating attention in young adults with autism spectrum disorder (ASD) using change blindness and eye tracking

BackgroundSocial interaction at its core entails allocating attention to relevant stimuli. As such, the perception of change requires attention, but studies have suggested that the social impairment in people with autism spectrum disorder (ASD) occurs at the attentual level of "on-line" social cognition.MethodForty-four young adults—22 with autism spectrum disorder (ASD) and 22 with typical development (TD)—participated in two experiments. The first used a change blindness (CB) paradigm where attention was investigated through the detection of changed items with central and marginal levels of interest when viewing images of everyday scenarios. Eye-tracking was used to compare response times, first fixations and total fixation time on changes. The second used social films with eye tracking of gaze fixations.ResultsParticipants with ASD were slower in response time and first fixation than were participants with TD. Participants with TD showed longer fixation on items with marginal (compared to central) levels of interest. The social-film experiment showed that participants with ASD were slower to orient their gazes towards the characters’ faces and looked at speaking characters for less time than did the group with TD. This result correlates with less use of mental verbs in their narratives and less time spent looking at marginal items in the CB experiment.ConclusionsResults suggest reduced processing speed in young adults with ASD, which is associated with enhanced processing of local details. Clinically, these results imply that teaching strategies (e.g., cognitive cues) to process social context efficiently could benefit individuals with ASD.     

Needs of young adults with type 1 diabetes during life transitions – An Australian-Danish experience

ObjectiveTo explore the similarities and differences in the needs of young adults with T1D during life transitions.MethodsData obtained for this paper was based on three qualitative studies carried out in Denmark and Australia. In total, 33 Individual interviews and two focus groups (n = 46) were conducted. Data was analysed using thematic analysis.ResultsThe most pertinent themes related to the importance of support from peers with diabetes and healthcare professionals to help young adults adjust to independent living. The main difference experienced by Australian and Danish young adults related to the willingness and barriers in clinical attendance during this transitional period.ConclusionsClinical care for young adults with diabetes can be better adapted to support this population as they transition through significant milestones by engagement on the young adults' terms and encouraging young adults to seek out peer support. It is vital that clinical care is tailored to support them in order to ensure the best transition into adulthood with diabetes.Practice implicationsClinicians need to adopt a person-centred approach when engaging with young adults with diabetes. Considerations need to be made around external factors related to life events in young adulthood that may influence diabetes care.