Evaluation of a Resident-led Residency Preparation Series for Fourth Year Pharmacy Students.

DESCRIPTION OF PROBLEM: The increased interest in residency programs nationwide has made the application process more competitive and complex. STATEMENT OF INNOVATION: In 2015, Wake Forest Baptist Health (WFBH) created a resident-led residency preparatory series (RPS) to assist advanced pharmacy practice experience (APPE) students in preparing for residency applications. This study sought to evaluate the perceived value of the resident-led RPS by fourth year APPE students. INNOVATION: This single-center, survey-based, descriptive study aimed to evaluate the perceived impact of a resident-led RPS. All APPE students during the 2016-2017 and 2017-2018 academic years who completed rotations in the Triad region of North Carolina were invited to participate in the RPS. Surveys were sent to eligible students and data was captured for respondents who indicated an interest in pursuing residency and attendance to at least one RPS. Survey questions evaluated satisfaction with the RPS. Survey data was collected and analyzed using Qualtrics©. CRITICAL ANALYSIS: A total of 84 students were invited to attend the RPS. Thirty-three respondents participated in the RPS and indicated an interest in applying for a residency. The resident-led RPS was consistently well received by the majority of students over the course of two years, with over two-thirds of all respondents finding every session extremely or very useful. The majority of students agreed or strongly agreed with all confidence statements. CONCLUSION: A resident-led RPS resulted in positive student perceptions and increased confidence in the residency application process.

The Role of Baclofen in the Treatment of Gastroesophageal Reflux Disease.

Objective. To describe the evidence for baclofen in the treatment of gastroesophageal reflux disease (GERD). Data Sources. A search of PubMed and Google Scholar was performed using the terms baclofen, gastroesophageal reflux disease, and treatment. Study Selection and Data Extraction. Publications were reviewed manually for relevance, and studies that addressed the use of baclofen in the treatment of adult symptomatic GERD patients were included. Data Synthesis. Nine studies were evaluated. Baclofen was shown to significantly reduce transient lower esophageal sphincter relaxations (TLESRs), postprandial acid reflux events, and median number of acid-related symptoms in 6 studies evaluating either a single dose of baclofen or short courses of 2 days or less. Three studies followed patients over a slightly longer period of time. These studies confirmed the results of the shorter trials by finding a decrease in supine duodenal reflux episodes, decreased periods when the pH was less than 4, and improvements in symptom scores in patients refractory to proton pump inhibitors. Side effects most frequently reported included drowsiness and dizziness. Conclusions. Baclofen can be considered for the treatment of refractory GERD following diagnostic evaluation. It has been shown to reduce TLESRs, reflux episodes, and reflux-related symptoms with minimal side effects in short-term trials. Future studies demonstrating the long-term efficacy and tolerability of baclofen in the treatment of GERD would help solidify its place in therapy.

Risks and benefits of connecting an implant and natural tooth.

PURPOSE: The purpose of this article was to review the current literature on the topic of tooth-implant supported fixed partial dentures (FPD) to determine risks and benefits for treatment planning considerations and weighing potential complications. MATERIALS AND METHODS: A PubMed search (April-August 2013) was performed using the keywords "tooth-implant fixed partial denture" and "tooth-implant bridge" in addition to manual searches of bibliographies of full text articles and related reviews from the electronic search. RESULTS: A total of 21 relevant articles were selected for inclusion in the topic of tooth-implant supported FPD. Although risks such as intrusion of the natural tooth existed when using tooth-implant FPD, however, current evidence supports its clinical usage. Nonetheless, to prevent potential complications, careful planning and prosthetic design are essential. CONCLUSION: Tooth-implant supported FPDs can have the similar success like conventional FPDs or implant-implant supported FPDs. However, careful planning and prosthetic reconstruction are required to ensure long-term success. Additional research is needed to gain a greater understanding of the biological and biomechanical factors affecting tooth-implant FPDs.

Use of harsh physical discipline and developmental outcomes in adolescence.

A history of exposure to harsh physical discipline has been linked to negative outcomes for children, ranging from conduct disorder to depression and low self-esteem. The present study extends this work into adolescence, and examines the relationship of lifetime histories of harsh discipline to adolescents' internalizing and externalizing symptoms and to their developing capacities for establishing autonomy and relatedness in family interactions. Adolescent and parent reports of harsh discipline, independently coded observations of conflictual interactions, and adolescent reports of symptoms were obtained for 141 adolescents at age 16. Both parents' use of harsh discipline was related to greater adolescent depression and externalizing behavior, even when these effects were examined over and above the effects of other parenting measures known to account for these symptoms. Adolescents exposed to harsh discipline from mothers were also less likely to appear warm and engaged during an interaction task with their mothers. It is suggested that a history of harsh discipline is associated not only with social and emotional functioning, but also with the developmental task of autonomy and relatedness.

Aortic arch atheroma and the risk of stroke.

Brain infarction of unknown cause, known as cryptogenic stroke, represents 30% to 40% of all ischemic strokes, or approximately 400,000 cases each year in western Europe. In this category of patients new potential causes, such as aortic arch atheroma in the elderly, have been investigated in the past two decades.

Potentially inappropriate prescribing for geriatric inpatients: an acute care of the elderly unit compared to a general medicine service.

OBJECTIVE: To compare potentially inappropriate medication prescribing, as defined by the updated Beers criteria, in an acute care of the elderly (ACE) unit and a general medicine service. DESIGN: Non-concurrent cohort study of admitting and discharge summaries from an electronic medical record system. SETTING: A general medicine service and ACE unit at an 880-bed, tertiary care, teaching hospital. PARTICIPANTS: 176 patients from the ACE unit and 173 from the general medicine service who were 65 years of age or older, admitted after October 1, 1999, and discharged before February 29, 2000. MAIN OUTCOME MEASURE(S): Numbers of high- and low-severity potentially inappropriate medications (PIMs) and total medications on admission and discharge. RESULTS: The average number of all medications added on discharge was lower for the ACE unit versus general medicine service, 0.13 versus 0.75, respectively (P = .027). In the ACE unit, 11% of patients were prescribed PIMs with high-severity outcomes on discharge, either independent or dependent of diagnosis, compared with 12.7% in the general medicine service. The mean change in potentially inappropriate diagnoses independent medications upon discharge was - 0.09 in the ACE unit versus + 0.09 in the general medicine service (P = .011). CONCLUSION: Although detected differences were small, PIMs were less likely to be prescribed and more likely to be discontinued in the ACE unit. No differences were found in the majority of comparisons between groups.

Divalproex sodium therapy in elderly with dementia-related agitation.

OBJECTIVE: To review available literature regarding the use of divalproex sodium in the treatment of agitation in elderly patients with dementia. DATA SOURCES: Clinical trials and review articles were identified by MEDLINE search (1966 - March 2002). DATA SYNTHESIS: The literature provides information regarding the potential benefits and tolerability of divalproex sodium in the treatment of dementia-related agitation. This article analyzes 7 studies to better understand the role of divalproex sodium in the treatment of dementia. CONCLUSIONS: Divalproex sodium may offer a slight benefit to elderly patients suffering from dementia-related agitation. Until better-controlled trials demonstrate statistical significance and comparisons with established treatments are performed, practitioners should use divalproex sodium cautiously.