Campus-community pharmacy partnership to foster awareness and use of MedlinePlus.

OBJECTIVE: To determine the impact of a campus-community pharmacy partnership to foster awareness and use of National Library of Medicine (NLM) databases, including MedlinePlus, among minority populations. DESIGN: Uncontrolled study with pretest and posttest. SETTING: Two community pharmacies and Bethel World Ministry in the Washington, D.C., metropolitan area. PARTICIPANTS: 8 student pharmacists and pharmacy residents and 92 patients. INTERVENTION: Training of patients by student pharmacists and pharmacy residents in the use of NLM databases during prescription-fill wait time. MAIN OUTCOME MEASURES: Pre- and post-survey responses and telephone followup designed to assess familiarity with NLM databases, including MedlinePlus. RESULTS: Overall, the familiarity of the participants with MedlinePlus and NLM databases increased fivefold before versus after training. The 1-week follow-up confirmed this trend. However, no statistically significant differences in responses (pre-and posttest/follow-up) to the surveys were observed in regard to specific questions on daily and future use of the NLM databases available on the Internet. CONCLUSION: Awareness and use of MedlinePlus by study participants increased.

African-American men and their reflections and thoughts on prostate cancer.

The purpose of this study was to assess African-American males' knowledge, attitudes, and beliefs regarding prostate cancer and early detection methods. This was a cross sectional study conducted with 67 (N = 67) African-American men to assess their knowledge, attitudes, and beliefs regarding prostate cancer and prostate cancer early detection methods Data collection occurred at several urban churches in the Washington, D.C., metropolitan area. Findings from this study suggest that 91% of the men did not consider prostate cancer screening embarrassing or painful; 86.9% agreed that their physician would think they should have a Digital Rectal Exam (DRE) and Prostate Specific Antigen (PSA) tests performed, and believed in the efficacy of early prostate cancer screening However, 30% of the men would not want to know if they had prostate cancer, and 53.2% did not believe they were likely to get prostate cancer in the future. The implications and results of this study support the need for ongoing prostate education and screening programs for African-American men.

Stress in health professions students: myth or reality? A review of the existing literature.

The purpose of this literature review was to determine the extent to which health profession students experience counterproductive stress and to examine the existing gaps in the literature concerning all health profession students and stress. The literature search process included using Eric, Education Abstracts, Psyc INFO, ABIN, WebSpirs Databases, FactSearch, Biological Sciences, International Pharmaceutical Abstracts, MEDLINE, Lexis-Nexis, CINAHL and Registry of Nursing Research. Key articles were identified that documented stress, the causes of stress or "stressors," and psychiatric symptoms as a result of counterproductive stress in the disciplines of medicine, dentistry, nursing, and allied health. Findings from this analysis of the literature indicated that the highest incidence of stress occurred in medical students followed by dental and then nursing students. There was, however, a dearth of studies related to stress in pharmacy students alone, despite the fact that pharmacology requires a rigorous educational process that is similar to that of the other health professions. While it may be argued that pharmacy students may not be experiencing the detrimental levels of stress that affect other medical students, a study by Henning Ey, & Shaw (1998) found a disproportionately high level of distress in pharmacy students. The Henning study also compared the stress levels of medical, dental, nursing, and pharmacy students. This literature review documents that health profession students suffer from high levels of stress during their training. A comprehensive list of "stressors" is delineated for the health education profession students. However, there appears to be a lack of emperical evidence with regards to stress and stressors in pharmacy students. Although it can be extrapolated that pharmacy students may be suffering from similar levels of stress, there is a definite need for research in pharmacy students specifically.

Self-management in African American women with diabetes.

PURPOSE: This study describes demographic and medical characteristics, self-efficacy, locus of control, self-management defined by functional status, hemoglobin HbA1c outcomes, and the relationships among these variables based on age group differences (25-44 years, 45-64 years, and 65-84 years) in African American women with type 2 diabetes. METHODS: Subjects (n = 75) in community medical practices were interviewed to complete a demographic and medical form, the Diabetes Self-efficacy Outcomes Expectancy Questionnaire (DSEQ), the Diabetes Locus of Control Scale, and the Medical Outcomes-Short Form 36 (SF-36). A venous blood sample was taken following the interview. Data were analyzed for the total sample and separately for age groups. RESULTS: Scores on the self efficacy (DSEQ) and the locus of control (LOC) were above average for all 3 groups. Significant correlations were found among subscales of the LOC, SF-36, and HbA1c. HbA1c scores were abnormally high across groups. Significant group differences were found in duration of diabetes and number of medications used. CONCLUSIONS: Despite high levels of internal locus of control and self-efficacy and scores indicating good mental, physical, emotional, and social health, self-management among the women was inadequate, as indicated by abnormally high HbA1c levels.

Treatment perceptions and attitudes of older human immunodeficiency virus-infected adults.

OBJECTIVE: To apply the Health Belief Model (HBM) in assessing the association of health beliefs, perceived benefits, perceived barriers, alternative therapy use, and sexual risk behaviors in relation to the treatment of human immunodeficiency virus (HIV) in a group of older HIV-infected patients. METHODS: A convenience sample of 100 older (50 years and above) HIV-infected patients in 2 Washington, DC, clinics was enrolled. A cross-sectional methodology used structured interviews to investigate the association among antiretroviral adherence, use of alternative therapies, treatment perceptions, and risk behaviors. Student t tests were conducted to examine significant relationships between HBM perceptions and demographic characteristics. Logistic regressions were conducted to assess likelihood of antiretroviral and alternative therapy use. RESULTS: The majority of the participants were black and had a high school education. Although participants believed that HIV was a severe disease, they did not perceive themselves to be susceptible to early progression to acquired immunodeficiency syndrome. Participants believed that antiretrovirals were beneficial, and they were not particularly burdened by perceived costs of antiretrovirals. The perceived costs (or barriers) of antiretrovirals were inversely associated with CD4 count (r=-0.25, P=.01) and positively associated with viral load (r=0.33, P < .01). Overall 21% of patients in this population indicated use of alternative therapies. Patients who tended to have a higher perception of severity of HIV and a higher perceived burden in using antiretrovirals were more likely to use alternative therapy. There was no difference in HBM perceptions among antiretroviral users and nonusers. CONCLUSIONS: In general, the benefits of taking antiretrovirals were clear to most patients, and the same patients did not view access to antiretrovirals as a significant barrier to treatment. Many patients, although aware of the severity of HIV disease, were not seeking modifications to sexual behavior. Furthermore, the actual medication-taking behavior of these patients resulted in significant impacts to their clinical status. Study results can be applied in the development of specific interventions that are intended to decrease HIV transmission among older adults and to improve medication-taking behavior among those who are already infected with HIV.

Geriatric education in US schools of pharmacy: a snapshot.

OBJECTIVE: The objective of this study was to assess the structure, resources, and activities of academic geriatrics courses in U.S. pharmacy schools. DESIGN: A cross-sectional study. PARTICIPANTS: Schools of pharmacy in the United States identified through the American Association of Colleges of Pharmacy (AACP). The survey was e-mailed (May 2003) to the academic chairs of the clinical pharmacy department and/or the head of geriatric pharmacy practice at each of the 84 schools of pharmacy in the United States. MEASURES: The primary measure was to assess the nature and extent of geriatrics course content in the responding schools. In addition, we elicited information on the type of geriatrics material taught, faculty involvement, student population, type of school, academic requirements, and experiential education. The questionnaire items were based on the current course content in geriatrics courses taught at the institution. Content validity of the questionnaire was assessed by administering the survey to three survey experts (including one in geriatrics); their suggestions were incorporated in redesigning the questionnaire. RESULTS: A total of 42 (50%) out of 84 schools responded. All responding schools had some form of geriatric education incorporated into their curriculum. However, the depth and breadth of the geriatric curriculum reported by the responding schools did not seem to be that different from results obtained by a 1985-1986 survey. CONCLUSION: Geriatric education in pharmacy schools has not increased proportionally with the expected increase in the geriatric population in the United States. Schools of pharmacy should make geriatric education a priority because the majority of patients whom pharmacists need to monitor or counsel currently are, and will continue to be, 65 years and older. Compared with a past study, the focus of current geriatrics education in pharmacy schools does not seem to have improved much despite the increasing need for geriatric practitioners and drug misadventures in the elderly.

Complementary and alternative medicine instruction in nursing curricula.

With an ever-increasing number of consumers reportedly using non-conventional methods of disease management, nurses have now been recognized as key providers in education on complimentary and alternative medicine (CAM). The risk of herb-drug interactions secondary to consumer use of alternative medicines further increases the need for nurses to assume the role of patient educators in the area of CAM. Many nurses, however, feel rather ill-prepared to properly care for patients using CAM due to inadequate instruction on the subject matter during their training. Many nursing educators have now moved to address such concerns by considering including education on CAM therapies in the nursing school curriculum. This study evaluated CAM education in US nursing schools to gain a perspective on how nursing students are currently being trained. A survey questioning CAM education was administered to 148 nursing schools and collected over a 3-month period. The results indicate that nearly half of the responding schools offered some form of education on CAM in their curriculum with electives being the primary form of instruction. Teaching methodologies on CAM instruction in the curriculum included group discussion on CAM topics, lectures, and review of case studies. The majority of faculty respondents in this study held Ph.D. degrees followed by instructors holding a MS, DNS, and/or MSN degree.