Redesigning kinase inhibitors to enhance specificity

Kinases are important targets in molecular cancer therapy. However, the evolutionary relatedness and structural conservation of these proteins often lead to unforeseen cross reactivity, yielding unexpected side effects. Thus, the use of promiscuous drugs is likely to introduce dangerous clinical uncertainties. Here, we show how to rationally redesign two promiscuous kinase inhibitors, staurosporine (7) and EKB-569 (8), with the goal of turning them into more selective ligands. This problem is addressed by exploiting a structure-based selectivity filter for specificity: the pattern of packing defects in the target. These singularities, called dehydrons, are solvent-exposed intramolecular hydrogen bonds that may be protected by drugs upon association and are not conserved across protein families. Our redesigned compounds possess a significantly focused activity, as experimentally corroborated in high-throughput screening assays. Thus, our design strategy proves to be operative to reduce the inhibitory impact of promiscuous kinase ligands, enhancing their safety as therapeutic agents.     

Development and implementation of a pharmacy technician training program.

A nine-month on-the-job training program for hospital pharmacy technicians is described. The first three months of the program are devoted to didactic training and the remaining six months to acquiring practical experience. Candidates for the program are provided through state-sponsored public assistance or manpower training programs. A minimum of six individuals are needed to begin a program to ensure that during at least three complete it. Forth technicians have completed the program during the past six years, and eight are currently employed by the hospital. Thirteen others are known to be employed at other institutions or in health-related occupations.     

石杉碱甲胶囊提高34对青春期学习记忆和学习成绩

研究石杉碱甲胶囊对初中学生记和学习成绩的效能。方法：采用双盲法,按照心理健康正常,记忆商接近,同班,同性别的要求。将６８例初中学生配对成两组,随机各给石杉碱甲胶囊２粒或空白胶囊２片,一日两次口服,４周为一疗程,以记商及语文英语和数学以及上述三课均分为观测指标评定疗效。结果;石杉碱甲胶囊组疗末的记商明显高于空白组,语文成绩也明显提高。     

石杉碱甲胶囊提高34对青春期学生记忆和学习成绩

目的:研究石杉碱甲胶囊对初中学生记忆和学习成绩的效能。方法:采用双盲法,按照心理健康正常、记忆商接近、同班、同性别的要求,将68例初中学生配对成两组,随机各给石杉碱甲胶囊2粒(每粒含50μg)或空白胶囊2片(含淀粉和乳糖),一日两次口服,4周为一疗程。以记忆商及语文、英语和数学以及上述三课均分为观测指标评定疗效。结果:石杉碱甲胶囊组疗末的记忆商明显高于空白组(P<0.01),语文成绩也明显提高。结论:石杉碱甲胶囊提高青春期学生的记忆和学习成绩。     

The Optimizing Care Model: A novel community pharmacy approach to enhance patient care delivery by leveraging the technician workforce through technician product verification

ObjectivesTo explore initial outcomes of the Optimizing Care Model’s impact on patient care through technician product verification after the first 3 months of implementation, including the model’s impact on pharmacist workday composition, rates of patient care services delivered, and rates of product selection errors not identified during final product verification.SettingFourteen chain and independent community pharmacies licensed and located in Tennessee.InnovationThe Optimizing Care Model is an innovative approach to community pharmacy practice aiming to foster a new patient-centered care delivery model that expands clinical service delivery through task delegation to pharmacist extenders.EvaluationA quasiexperimental 1-group pretest–posttest design was used. Study sites self-reported data from 3 months before and 3 months after implementation of the intervention.ResultsOverall pharmacist time spent delivering patient care services increased significantly on implementation of the Optimizing Care Model (25% vs. 43%; P < 0.001), and time spent performing dispensing-related activities decreased significantly (63% vs. 37%; P = 0.02). There was a total increase in quantity of clinical services delivered to patients from baseline, but data from initial study outcomes did not reach statistical significance. At least 1 new clinical service provided under a collaborative practice agreement had been implemented by all 14 sites (100%) as of Spring 2018. Total undetected error rates were significantly less in the Optimizing Care Model phase compared to the traditional model (0.063% vs. 0.085%; P < 0.001).ConclusionInitial results of the Optimizing Care Model demonstrate improved patient care through increased clinical service delivery versus the traditional model. Undetected error detection rates were low in both models, but lower in the Optimizing Care Model. The Optimizing Care Model may represent a novel approach to improving care for patients while creating efficiencies through a staff delegation model, providing pharmacists the opportunity to further evolve their practice and advance clinical care for patients.     

Using normalisation process theory to understand implementation of integrated multi-sector pre-registration trainee pharmacy technician training

BackgroundThe pre-registration trainee pharmacy technician (PTPT) integrated training programme is a workforce intervention designed to train PTPTs in multiple sectors. The programme recruited 35 PTPTs to 2-year training posts which involved employment in one sector, and a minimum of 12 weeks' work-based training in ≥2 further settings each year.AimTo identify facilitating and inhibiting factors to implementation of the PTPT integrated training programme and make recommendations on ways to embed and maintain PTPT integrated training in routine practice.MethodsNormalisation Process Theory (NPT) constructs were used as a framework for analysis. Semi-structured interviews (14 PTPTs, 15 supervisors) explored PTPTs' learning and practice experiences over their 2-year training. A survey explored training outcomes (confidence and preparedness to practise) of integrated (n = 31) and single sector PTPTs (n = 39).ResultsWhilst some understood the intervention well, others had differing understandings of its purpose and potential benefits (coherence). Educational and practice supervisors acknowledged the importance of regular communication but reported difficulties implementing this due to time constraints (cognitive participation). PTPTs benefitted from having an educational supervisor oversee learning and progress over 2-years, and a practice supervisor for their day-to-day learning. PTPTs' experiences of supervision were inconsistent due to variation in supervisors' availability, knowledge, experience, and level of support (collective action). Participants perceived the PTPT integrated training as supporting development of a flexible pharmacy technician workforce able to work across sectors. The survey found that integrated PTPTs felt significantly more prepared than single-sector PTPTs to work in different settings (reflective monitoring).ConclusionsPTPTs on the programme had better ability to work in different sectors. Improving implementation requires clear understanding of the intervention's purpose by all stakeholders; clarity on supervisors' roles/contributions; and effective communication between supervisors to create effective learning opportunities. Findings can inform implementation of future multi-sector education and training globally.     

Cannabis use to enhance sportive and non-sportive performances among French sport students

PURPOSE: Despite a large public health interest in substance use among athletes, only a few works have addressed illicit drug use in relation with sport practice. We have studied cannabis use to enhance both sportive and non-sportive performance among French sport university students. METHODS: An anonymous self-reported questionnaire was administered to a sample of students from six Sport Science Universities from Southern France. Information on sport practice and cannabis use (frequency, quantity, motives) was collected. RESULTS: Males were more prone to have already used cannabis to enhance non-sportive performance as well as sportive performance. The simultaneous equation model indicated that both kinds of enhancing-substance use were endogenous: cannabis use to enhance sportive performance leads to cannabis use to enhance non-sportive performance and reciprocally. Moreover, the relaxing properties of cannabis may be frequently used to enhance performance. Cannabis use to enhance sportive performance was positively related to the competitive level and to sliding sports. CONCLUSIONS: The present study helps to improve understanding on an empirical paradox about the relationship between doping agents use and so-called 'recreational' drug use among athletes. Indeed, people who use doping agents may also use 'recreational' drugs for a 'non-recreational' purpose.     

在健康教育实践中提高护生的职业能力

目的打破传统的以带教老师为主体的垂直单向教学模式,将健康教育实践作为护生实习的核心内容,建立新型的以护生为主体的横纵联合模式。方法以小组为单位由护生独立完成健康教育,带教老师从旁指导,为护生提供独立思考与操作的平台。从深入病区收集、评估病人资料,到制订健康教育计划和内容、开展多形式健康教育活动,将健康教育始终贯穿于护理工作的全过程。结果通过设制护士核心职业能力考核表,对两组护生进行综合考核,在健康教育实践中,护生学习的积极性主动性高,职业能力得到充分培养。结论将健康教育实践作为护生实习的核心内容的教学模式可大大提高护生的职业能力,为社会、医疗机构培养高素质的护理人才。     

A case-based toxicology elective course to enhance student learning in pharmacotherapy

Objective. To assess the impact of a case-based toxicology elective course on student learning in related required courses and student performance on the Pharmacy Curriculum Outcomes Assessment (PCOA) examination.Design. A case-based clinical toxicology elective course that contained topics from 2 required courses, Pharmacology III and Pharmacotherapy II, was offered in the spring 2009 to second- and third-year pharmacy students.Assessment. Scores on the Toxicology subsection of the PCOA of students enrolled in the elective were higher than those of students not enrolled (91.3% ± 4.1 vs. 67.2% ± 5.7). Enrollment in the elective was related to increased examination scores among Pharmacotherapy II students (89.5% ± 2.0 vs. 83.9% ± 1.8). Students indicated on course survey instruments that they were satisfied with the new elective offering.Conclusions. A toxicology elective provided a clinically relevant, active-learning experience for pharmacy students that addressed a curricular need within the college and increased examination scores.     

Crossword puzzles as a tool to enhance learning about anti-ulcer agents

Objective

To design, implement, and evaluate the use of crossword puzzles as a low-stakes educational tool for enhancing learning about anti-ulcer agents.

Design

Crossword puzzles were created using a free Internet resource and administered to students during 3 consecutive lectures covering the pharmacology and medicinal chemistry of anti-ulcer agents. Student perceptions of the crossword puzzle were examined using an 8-item survey instrument.

Assessment

Over 90% of students indicated that crossword puzzles enhanced their learning, oriented them to the important topics, and served as good reviews of the lecture material.

Conclusion

Students perceived that crossword puzzles enhanced their learning of anti-ulcer agents. Use of crossword puzzles provides a simple and creative way to incorporate active learning into pharmacy classroom instruction.     

不同护理技能实训环境对护理专业学生学业情绪的影响

目的 观察不同技能实训环境对护理专业学生学业情绪的影响.方法 将本院2011级护理专科学生作为被试对象,其中3班设为研究班,4班设为对照班.研究班在临床技能中心采用高仿真模拟人系统进行实习上岗前技能训练,对照班则在一般的护理实验室利用模型人及其他传统教学媒体进行实习上岗前技能训练.两班学生均统一操作项目和每项操作所用的时间;并于培训结束后,均采用大学生一般学业情绪问卷进行施测.比较两班学生在不同实训环境下学业情绪方面的差异.结果 两班学生在不同实训环境下培训后,学业情绪各维度得分差异有统计学意义（P＜0.01）,其中两班积极高唤醒维度得分比较,差异有统计学意义（P＜0.01）.结论 利用技能中心高仿真模拟系统进行上岗实习前技能操作演练,可有效激发学生的学业情绪.     

Relationship between regulatory barriers to entry and pharmacy technician wages

BackgroundPharmacy technicians are vital to the operation of pharmacies, and national pharmacy associations have advocated for mandatory education and training requirements. While these requirements may improve patient safety, there is a risk that laws and regulations which impose substantial education and training requirements on technicians could create barriers to entry which restrict the workforce and increase wages.ObjectiveThis study has two objectives: 1) Describe changes in barriers to entry and wages over time; and 2) Evaluate the correlation between changing barriers to entry and pharmacy technician wages.MethodsData come from Bureau of Labor Statistics Occupational Employment Statistics from 1997 to 2017 and National Association of Boards of Pharmacy Surveys of Pharmacy Law from 1997 to 2014. A barrier to entry was defined as adoption of registration, licensure, or certification. Wage data was adjusted to 2017 dollars using the Consumer Price Index. Ordinary least squares regression evaluated the correlation between the proportion of states which had at least one barrier to entry and wages. An interrupted time series model estimated the impact of adopting a barrier to entry on the trend in technician wages over time.ResultsTechnician wages increased between 1997 and 2007 but remained flat between 2008 and 2017. A strong correlation was observed between the proportion of states which had at least one barrier to entry and technician wages (R2 = 0.93, p < 0.0001). However, the interrupted time series models did not identify any relationship between adoption of a barrier to entry and the trend in technician wages (p = 0.363).ConclusionsThis research suggests adoption of legal/regulatory barriers to entry did not have a significant influence on the trend in technician wages over time. More research is needed to evaluate the impact of barriers to entry on non-wage practice variables, such as privileges and satisfaction.