The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University

Objective: Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending historically Black colleges and universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling. Methods: Participants were 287 undergraduate students attending an HBCU in the southern United States (M_age = 22.5, 66.3% female, 93.7% Black). Results: Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse. Conclusions: These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.     

沟通在临床药学工作中的作用

目的:探讨加强沟通技巧和沟通能力培养在临床药学工作中的重要性。方法:结合笔者自身的工作经历,介绍临床药学中的沟通方法。结果与结论:临床药学工作中的沟通能力包括与医师、护士之间的专业沟通和与患者用药的心理沟通。临床药师可在临床医师的配合下,通过完善自身的专业知识、心理学知识,提高临床沟通技巧。沟通能力培养是临床药学培训的一项重要内容。     

Cultural Competency in Health Care and Its Implications for Pharmacy

As the United States becomes more diverse, a patient's cultural influences on health outcomes and health care decision-making and delivery need to be considered. Cultural influences affect a patient's decision to take drug therapy and concomitant alternative therapies. Seven components have been identified to improve culturally competent care in a variety of practice sites. The first component to developing culturally competent practices involves the analysis of self and system attitudes and practices toward various cultures. In the second component, health care providers should increase their knowledge about the cultures they serve through different patient assessment techniques, readings, and community activities. The third component involves improving cross-cultural communication by being aware of differences in social norms, assessing health literacy, using interpreters, knowing another language, and using bilingual patient education materials. In the fourth component, pharmaceutical care plans should accommodate cultural preferences such as the use of herbs, spiritual healers, and additional family decision-makers. Therapeutic plans should be negotiated between patient and provider to optimize outcomes. The fifth component discusses health care provider and system involvement in the community through health fairs, ethnic festival participation, and communication with cultural decision-makers to help provide culturally competent care by fostering communication ties. In the sixth component, knowing and following regulations such as the federal Culturally and Linguistically Appropriate Services and the Joint Commission standards for organizational cultural competency can help enhance care for patients from various cultures. In the last component, quality assurance assessments of procedures to improve care for various diverse cultures should be conducted, with findings (in terms of strengths and areas of improvements) shared with other providers and systems. Pharmacists and pharmacy technicians in a variety of systems and practices can improve care to patients with differing cultures by using these seven components to enhance culturally competent care.     

Trends in Pharmacy College Admission Test Requirements and Utilization Across Colleges and Schools of Pharmacy

Objective. To identify national trends among US pharmacy schools and colleges in their requirements for the Pharmacy College Admission Test (PCAT) and underlying rationales for not requiring pharmacy school applicants to take it.Methods. An electronic survey regarding the following was sent to all US pharmacy programs: current and future PCAT requirements for applicants, use of the PCAT or other means to assess applicants’ written communication skills, use of unofficial PCAT scores, and, if applicable, the rationale for not requiring applicants to submit PCAT scores. Data analysis was performed using Excel.Results. One hundred five (73%) of 144 schools and colleges of pharmacy responded to the survey. Twelve institutions discontinued the PCAT requirement between the 2018-2019 and 2019-2020 admissions cycles. The most commonly selected reason for discontinuation was a desire to increase pharmacy applications by reducing admission barriers. Pharmacy schools nationwide had concerns regarding high PCAT registration fees. The majority of pharmacy programs that used PCAT scores in their application process indicated that they always, often, or sometimes invited applicants for an interview before they had received the applicant’s official PCAT scores. The majority of pharmacy programs considered applicants’ PCAT writing score in making their admissions decisions. Other methods used included onsite essays and personal statements.Conclusion. At the time of this study the majority of US pharmacy schools required applicants to submit the PCAT scores before being considered for admission to pharmacy school; however, the use of this examination has declined nationally.     

The Influence of Religious Attendance on Smoking Among Black Men

Background: Cigarette smoking poses a major public health problem that disproportionately affects Blacks and men. Religious attendance has been shown to be positively associated with health promotion and disease prevention among the Black population. In light of this evidence, this study examined if a similar relationship could be found for religious attendance and smoking in Black men. Methods: The National Survey of American Life (NSAL) study sampled 1,271 African American men and 562 Black Caribbean men. Multivariate logistic regression was used to determine the association between religious attendance and cigarette smoking. Results: After adjusting for age, marital status, household income, education, foreign born status, importance of prayer and major stress, men who reported attending religious services almost every day (odds ratio (OR) = 0.21, 95% confidence interval (CI) = 0.07, 0.62) and weekly (OR = 0.47, 95% CI = 0.29, 0.77) had lower odds of being a current smoker compared to men who reported never attending religious services. Conclusions/Importance: Findings suggest a health benefit in attending religious services on cigarette smoking among Black men in a nationally representative sample. In spite of lower church attendance in Black men in general, our results demonstrate that religious service attendance may still serve as a buffer against cigarette use. Given the emergent attention on faith-based health promotion among men, this conclusion is relevant and timely.     

临床药师在外科ICU中的药学实践

目的:探讨我院临床药师在外科ICU中参与药物治疗的思路和方法。方法:通过临床药师参与外科ICU中的药学实践,分析临床药师在危重患者治疗中如何结合自身的特点充分发挥药师的作用。结果与结论:临床药师进行药物治疗需结合外科ICU危重病患者的生理、病理特点,对重点监护患者随时跟踪并及时调整用药方案,全程参与突发事件应急救治。     

在呼吸科开展临床药学工作的实践与感悟

目的:探讨和总结我院呼吸科临床药师开展药学服务的方法、内容及体会。方法:对临床药师干预的典型病例进行分析,从医师习惯性用药中发现问题,解决抗菌药物的使用问题,为临床医师提供有帮助的信息。结果与结论:临床药师应该抓住机遇,迎接挑战,不断提高药学和医学专业知识水平,为患者提供高质量的、全新的药学技术服务。     

The Past,Present, and Futurist Role of the Pharmacy Profession to Achieve Black Health Equity

Efforts to mitigate racial health inequities by the pharmacy profession are largely hollow. In recent years, the highly publicized murders of Black persons at the hands of police have become a worldwide rallying cry for institutions to make definitive statements that “Black Lives Matter.” The movement has, however, yet to manifest substantive institutional changes for entities to reassess the ways in which they, their methodologies, and their teachings have historically and contemporarily contributed to the dissolution of Black lives. The profession of pharmacy explicitly states it is committed to achieving optimal patient outcomes. However, teaching race as a socio-political construct is not an Accreditation Council for Pharmacy Education (ACPE) minimal standard requirement. This continued neglect is a disservice to the field and the communities served, and this informative article explores the role of pharmacy in perpetuating physical and psychological harm to patients within Black communities. Conflating race with ancestry and approaching race as a simple biological construction/predictor is misinformed, presumptuous, and simplistic, as well as physically and psychologically harmful to patients. Rather than default to racialized historical myths imbedded in contemporary society, pharmacy must answer the call and undertake definitive action to ensure comprehensive education to better care for Black communities. It is vital that schools and colleges of pharmacy actively seeks to correct curricular neglect based on negative, pseudo-scientific constructions of “race.” The field of pharmacy must understand its unique positionality within systems of power to adapt a wholistic and accurate view of race and racism to approach, achieve, and maintain health equity in the United States.     

Deficiencies in Immunization Education and Training in Pharmacy Schools: A Call to Action

Approximately 38% of US pharmacy schools provide immunization education and training to pharmacy students as part of their core curricula. These deficiencies in immunization education and training may contribute to low immunization rates for some groups of people, particularly hard-to-reach consumers and those with misconceptions about vaccinations. In this paper, we call upon all pharmacy schools to mandate immunization education and training as part of their core curricula, not just as an elective course. In doing so, we encourage pharmacy schools to adopt the Pharmacy-Based Immunization Delivery program developed by the American Pharmacists Association. We recognize that implementation of these recommendations will require sufficient resources and that it will take time to change the curricula in colleges and schools of pharmacy.     

社区药学服务必要且有旺盛需求

目的:分析社区药学服务的供求状况,为社区卫生服务中心开展药学服务提供参考和建议.方法:基于文献及作者之前的实践经验,对社区药学服务的现状、必要性、存在的问题及努力方向进行归纳和分析.结果:社区药学服务供需严重失衡,亟待开展和发展.结论:建议卫生行政部门基于社区药学服务的现实必要性,通过财政支持、人才培养等手段推动社区药学服务的发展.     

中药临床药师开展1例心内科黑苔患者药学服务

摘 要回顾性分析中药临床药师开展1例心内科黑苔患者的药学服务。中药临床药师根据患者病情建议医师调整中成药,并积极开展药学监护,为患者提供出院带药用药教育,促进了临床合理用药。说明药师和医师协作参与治疗方案的调整,可提高药物治疗水平,体现了开展临床药学服务的意义。     

循证药学在处理肿瘤患者药物不良反应中的应用

目的：临床药师通过参与临床药物治疗,对肿瘤患者进行药学监护,与临床医师一起在治疗中促进临床合理用药,减少药物不良反应对患者造成的损害。方法：以一位肺癌伴骨转移患者为例,临床药师介入临床,通过循证药学方法,结合临床数据分析唑来膦酸在眼部不良反应发生的原因,预防及治疗措施,并跟踪其效果,对药物治疗过程进行综合的评估。结果：分析检索到的关于唑来膦酸安全性的一个随机对照试验（RCT）和一个回顾性的队列研究以及5例个案并处理患者,患者的眼部不良反应症状消失,同时临床药师向医生及患者解释了不艮反应发生的原因,并且对今后类似患者预防这类不良反应制定了给药计划。结论：临床药师的参与使药物治疗更趋合理。可减少药物的不良反应,使得患者依从性更好,治疗效果更佳。临床药师加入治疗团队,参与临床治疗实践,对患者进行治疗监护,有利于提高临床的药物治疗水平。     

临床药师在临床路径实施中的作用初探

目的:对临床路径实施的各个环节中临床药师发挥的作用进行论述。方法:检索国内外相关文献并进行归纳总结。结果与结论:临床路径近年来在许多国家得以应用,临床药师应不断提高自身素质,积极参与到临床路径的制订、执行、检查、评估、修正过程中,通过开展临床药学服务,使临床药师成为治疗团队中不可缺少的成员。     

The Role of Academic Pharmacy in Tobacco Cessation and Control

Despite decades of public health initiatives, tobacco use remains the leading known preventable cause of death in the United States. Clinicians have a proven, positive effect on patients’ ability to quit, and pharmacists are strategically positioned to assist patients with quitting. The American Association of Colleges of Pharmacy recognizes health promotion and disease prevention as a key educational outcome; as such, tobacco cessation education should be a required component of pharmacy curricula to ensure that all pharmacy graduates possess the requisite evidence-based knowledge and skills to intervene with patients who use tobacco. Faculty members teaching tobacco cessation-related content must be knowledgeable and proficient in providing comprehensive cessation counseling, and all preceptors and practicing pharmacists providing direct patient care should screen for tobacco use and provide at least minimal counseling as a routine component of care. Pharmacy organizations should establish policies and resolutions addressing the profession’s role in tobacco cessation and control, and the profession should work together to eliminate tobacco sales in all practice settings where pharmacy services are rendered.     

临床药师对肾内科患者抗菌药物选用的药学服务

目的研究临床药师对肾内科患者抗菌药物选用的药学服务。方法选取我院肾内科2例患者对抗菌药物的选用进行药学服务,从药师对药物的选择、药物用量、出现不良反应的症状等方面进行观察。病例1患者由药师选择头孢哌酮舒巴坦、美洛培南等药物进对患者进行治疗;病例2患者药师给予氨曲南、法莫替丁、碳酸氢钠片、胃舒平片等药物进行治疗。并根据患者病情变化临床药师的经验选择用药时间。结果 2例患者经临床医师的用药指导后,未出现明显的不良反应症状,药效有效的得到发挥,提高了患者药物的依从性。病例1患者用药后临床症状基本消失,血压也得到有效控制。病例2患者临床症状基本好转,中性粒细胞、白细胞、血清生物化验指标均比治疗前明显改善(P<0.05)。结论对我院2例肾内科患者给予有效的药学服务,通过临床药师对肾内科患者进行抗菌药物的选择,用药方法指导、药物剂量及发生的不良反应症状给予分析,促使药物药效充分发挥,保证患者用药的安全、有效,减少病发症的产生。     

Black/African American patients with type 2 diabetes mellitus: study design and baseline patient characteristics from a randomized clinical trial of linagliptin

Objective: In the United States, black/African American individuals are more likely than whites to develop type 2 diabetes mellitus (T2DM), and have higher rates of complications, but are under-represented in clinical trials. The design of a trial comparing the efficacy and safety of the dipeptidyl peptidase-4 (DPP-4) inhibitor linagliptin 5 mg/day with placebo in this patient group, and the characteristics of the patients enrolled are reported.

Research design and methods: This United States, multicenter, 24-week, randomized, double-blind study enrolled adults with T2DM who self-reported their race as black or African American, were receiving ≤ 1 oral antidiabetes drug, had a body mass index ≤ 45 kg/m² and glycosylated hemoglobin (HbA_1c) of 7.5 – 11% at screening.

Main outcome measures: The primary efficacy endpoint is the change of HbA_1c from baseline to week 24.

Baseline data: A total of 226 patients were randomized and received ≥ 1 study drug dose. The mean age was 54 years (standard deviation: 9.9 years), and 54% were men. The mean HbA_1c was 8.75% (standard deviation: 1.10%). Approximately half the patients (52%) had mild or moderate renal impairment and the majority (72%) had hypertension.

Conclusions: To the authors' knowledge, this is the first trial of any oral antidiabetes drug specifically conducted in black/African American patients.     

Strength in the midst of pain: Abuse as a predictor of sexual relationship power among substance-abusing Black women

ABSTRACT

The aim of this research was to explore the association of abuse experiences (child sexual abuse and adult physical/sexual violence) to sexual relationship power among Black substance-abusing women. The study was a secondary analysis of baseline data collected from 124 Black women in 12 drug treatment programs across the United States who initially participated in an HIV risk reduction trial conducted within the National Drug Abuse Treatment Clinical Trials Network of the National Institute on Drug Abuse (NIDA). The findings revealed that adult sexual abuse, but not childhood sexual or adult physical abuse, was associated with lower relationship control and decision-making dominance as measured by the Sexual Relationship Power Scale. The findings suggest that designing and implementing sexual risk reduction interventions that address adult sexual violence may enhance the relationship power of Black substance-abusing women and in turn may promote safer sex practices.