"Vital in today's time": Evaluation of a disaster table-top exercise for pharmacists and pharmacy staff.

BACKGROUND: While the importance of pharmacists' involvement in disaster management is becoming increasingly recognised in the literature, there remains little research on methods for preparing pharmacists and pharmacy staff for disasters. OBJECTIVE(S): To investigate the use of a table-top disaster exercise to improve disaster awareness and preparedness for pharmacists and pharmacy staff attending The Society of Hospital Pharmacists of Australia (SHPA) Medicine Management conference 2019. METHODS: A table-top disaster exercise was developed by the research team and presented as a workshop at the SHPA's annual conference in 2019. The workshop presented attendees with the hypothetical 'Cyclone Oma' that was tracking across the fictional state of 'New Cardiff'. Each workshop table was assigned a different hospital and was required to respond to Cyclone Oma as the scenario evolved. Workshop attendees were invited to complete a pre- and post-survey assessing their perceptions of disaster management and preparedness for pharmacists and pharmacy staff. RESULTS: The pre- and post-workshop survey was completed by 41 out of the 47 attendees. Participants' assessments of their understanding of disaster management activities increased after attending the workshop (p< 0.001). Most participants felt the workshop improved their understanding of their role in a disaster (87.8%, 36/41) and allowed them to identify their strengths and weaknesses in disaster management (90.2%, 37/41). The workshop was well received with 92.7% (38/41) of participants stating they would like further continuing professional development opportunities in disaster management. CONCLUSIONS: This is the first disaster table-top exercise in Australia targeted specifically at the pharmacy workforce to be conducted and evaluated. The exercise improved understanding of disaster management and was well received by the participants. This research calls for further education and training opportunities in disaster management targeted at the pharmacy workforce.

Using the big five inventory to evaluate the personality traits of Australian pharmacists.

OBJECTIVES: Pharmacist personality traits may explain the incomplete uptake of extended scope pharmacy practice roles. The objective of this study was to explore the personality traits of Australian pharmacists using the Big Five Inventory (BFI). METHODS: A cross-sectional survey of Australian pharmacists was undertaken. Pharmacists were asked to complete a short demographic survey and the BFI, a 44-item survey that measures the Big Five personality traits: extraversion, agreeableness, conscientiousness, neuroticism and openness. Each trait can be scored out of a maximum of 5. The BFI and multivariate linear regression were used to assess associations between personality traits and demographic variables. KEY FINDINGS: A total of 122 responses were available for analysis. The majority of study participants were female (79.5%), were aged between 30 and 39 years (32.0%) and worked in hospital pharmacy (46.7%). Pharmacists scored (mean (standard deviation)) 3.4 (0.7) for extraversion, 3.9 (0.5) for agreeableness, 4.2 (0.5) for conscientiousness, 2.5 (0.8) for neuroticism and 3.5 (0.6) for openness. Associations were found between agreeableness and qualifications and location of pharmacy practice, neuroticism and working in a practice location (rural versus metropolitan) and age, and openness and practice location (rural versus metropolitan) and principle role in pharmacy. CONCLUSIONS: Pharmacists displayed high scores on the traits of extraversion, agreeableness, conscientiousness and openness and scored moderately on the trait of openness. Confirmation with a larger sample size and evaluation in the context of pharmacy practice change may assist in overcoming barriers to change in the pharmacy profession.

Opposing effects of glutamatergic and GABAergic pharmacological manipulations on a visual perception task with relevance to schizophrenia.

RATIONALE: Numerous psychiatric disorders and neurodegenerative diseases have been associated with differences in visual perception, and it has been proposed that the treatment of these differences may represent a novel means to treat disorders like schizophrenia. Unfortunately, few methods exist to study visual perception in pre-clinical species. OBJECTIVE: The purpose of the present study was to adapt a task of visual integration by proximity with relevance to schizophrenia to a rodent touchscreen environment to determine the effects of glutamatergic and GABAergic compounds. In this way, we could evaluate the effects of common models of cognitive impairment, as well as the effects of net excitation versus inhibition, on a task of visual integration. METHOD: Rats were trained to perform a visual discrimination where the stimuli were composed of rows of dots differing only in there horizontal and vertical proximity. Once stable performance had been achieved, animals were tested under the influence of glutamatergic or GABAergic drugs (ketamine, MK-801, PCP, memantine, chlordiazepoxide, or diazepam) while attempting to perform a visual discrimination with altered stimuli. RESULTS: Ketamine appeared to impair perceptual grouping in this paradigm, while the GABA agonist chlordiazepoxide enhanced grouping even in the presence of non-selective effects. CONCLUSIONS: In general, these findings support the theory that NMDA antagonists may disrupt visual grouping by proximity and highlight a potential beneficial effect of enhanced GABA activity in perception. However, additional research will be required to confirm the stimulus selectivity of this effect, and the clinical significance of this approach.

MK-801 and amphetamine result in dissociable profiles of cognitive impairment in a rodent paired associates learning task with relevance for schizophrenia.

RATIONALE: Paired associates learning (PAL) has been suggested to be predictive of functional outcomes in first episode psychosis and of conversion from mild cognitive impairment to Alzheimer's disease. An automated touch screen-based rodent PAL (rPAL) task has been developed and is sensitive to manipulations of the dopaminergic and glutamatergic system. Accordingly, rPAL when used with pharmacological models of schizophrenia, like NMDA receptor blockade with MK-801 or dopaminergic stimulation with amphetamine, may have utility as a translational model of cognitive impairment in schizophrenia. OBJECTIVE: The purpose of this study was to determine if amphetamine- and MK-801-induced impairment represent distinct models of cognitive impairment by testing their sensitivity to common antipsychotics and determine the relative contributions of D1 versus D2 receptors on performance of PAL. METHOD: Rats were trained in rPAL and were then treated with MK-801, amphetamine, risperidone, haloperidol, quinpirole, SK-82958, or SCH-23390 alone and in combination. RESULTS: While both amphetamine and MK-801 caused clear impairments in accuracy, MK-801 induced a profound "perseverative" type behavior that was more pronounced when compared to amphetamine. Moreover, amphetamine-induced impairments, but not the effects of MK-801, could be reversed by antipsychotics as well as the D1 receptor antagonist SCH-23390, suggesting a role for both the D1 and D2 receptor in the amphetamine impairment model. CONCLUSIONS: These data suggest that amphetamine and MK-801 represent dissociable models of impairment in PAL, dependent on different underlying neurobiology. The ability to distinguish dopaminergic versus glutamatergic effects on performance in rPAL makes it a unique and useful tool in the modeling of cognitive impairments in schizophrenia.

It is not just a meal, it is an emotional experience - a segmentation of older persons based on the emotions that they associate with mealtimes.

Worldwide, the group of older persons is growing fast. To aid this important group in their food and meal requirements, a deeper insight into the expectations and experiences of these persons regarding their mealtimes and snack times is needed. In the current study, we aim to identify consumer segments within the group of vital community-dwelling older persons on the basis of the emotions they associate with their mealtimes and snack times (from now on referred to as mealtimes). Participants (n = 392, mean age 65.8 (years) ± 5.9 (SD)) completed an online survey. The survey consisted of three questionnaires: emotions associated with mealtimes, functionality of mealtimes, and psychographic characteristics (health and taste attitudes, food fussiness, and food neophobia). Consumer segments were identified and characterised based on the emotions that the respondents reported to experience at mealtimes, using a hierarchical cluster analysis. Clusters were described using variables previously not included in the cluster analysis, such as functionality of mealtimes and psychographic characteristics. Four consumer segments were identified: Pleasurable averages, Adventurous arousals, Convivial indulgers, and Indifferent restrictives. These segments differed significantly in their emotional associations with mealtimes both in valence and level of arousal. The present study provides actionable insights for the development of products and communication strategies tailored to the needs of vital community-dwelling older persons.

Feasibility and biomechanical performance of a novel transdiscal screw system for one level in non-spondylolisthetic lumbar fusion: an in vitro investigation.

BACKGROUND CONTEXT: The bilateral pedicle screw system (BPSS) is currently the "gold standard" fusion technique for spinal instability. A new stabilization system that provides the same level of stability through a less invasive procedure will have a high impact on clinical practice. A new transdiscal screw system is investigated as a promising minimally invasive device. PURPOSE: To evaluate the feasibility of a novel transdiscal screw in spinal fixation as an alternative to BPSS, with and without an interbody cage, in non-spondylolisthesis cases. STUDY DESIGN: An in vitro biomechanical study in lumbar cadaveric spines. METHODS: Twelve lumbar cadaveric segments (L4-S1) were tested under flexion-extension (FE), lateral bending (LB), and axial rotation (AR). Six treatments were simulated as follows: (1) intact, (2) bilateral facetectomy at L4-L5, (3) transdiscal screw system, (4) BPSS, (5) BPSS with transforaminal lumbar interbody cage, and (6) transdiscal screws with transforaminal interbody cage. Specimens were randomly divided into two testing groups: Group 1 (n=6) was tested under the first five conditions, in the order presented, whereas Group 2 (n=6) was tested under the first, second, third, fourth, and sixth conditions, with the fourth condition preceding the third. Range of motion (ROM) and neutral zone stiffness (NZS) were estimated and normalized with respect to the intact condition to explore statistical differences among treatments using non-parametric approaches. RESULTS: Significant differences in FE ROM were observed in the pedicle screws-cage condition with respect to the facetectomy (p<.01), the pedicle screw (p=.03), and the transdiscal screw (p<.02) conditions. All fixation constructs significantly restricted LB and AR ROM (p<.01) with respect to facetectomy. In terms of stiffness, the pedicle screw and the transdiscal screw systems increased (p<.01) LB and AR NZS with respect to facetectomy. The pedicle screws-cage condition significantly increased flexion and extension stiffness with respect to all other conditions (p<.05). However, LB NZS for the pedicle screws-cage and the transdiscal screws-cage condition could not be explored due to a testing order bias effect. There was not enough evidence to state any difference between the pedicle and transdiscal screw conditions in terms of ROM or NZS. CONCLUSIONS: Transdiscal and pedicle screw systems showed comparable in vitro biomechanical performance in the immediate stabilization of a complete bilateral facetectomy. The pedicle screws-cage condition was the most stable in FE motion; however, comparison with respect to the transdiscal screws-cage condition could not be investigated.

Comparative analysis of posterior fusion constructs as treatments for middle and posterior column injuries: an in vitro biomechanical investigation.

BACKGROUND: Titanium pedicle screw-rod instrumentation is considered a standard treatment for spinal instability; however, the advantages of cobalt-chromium over titanium is generating interest in orthopedic practice. The aim of this study was to compare titanium versus cobalt-chromium rods in posterior fusion through in vitro biomechanical testing. METHODS: Posterior and middle column injuries were simulated at L3-L5 in six cadaveric L1-S1 human spines and different pedicle screw constructs were implanted. Specimens were subjected to flexibility tests and range of motion, intradiscal pressure and axial rotation energy loss were statistically compared among five conditions: intact, titanium rods (with and without transverse connectors) and cobalt-chromium rods (with and without transverse connectors). FINDINGS: All fusion constructs significantly (P<0.01) decreased range of motion in flexion-extension and lateral bending with respect to intact, but no significant differences (P>0.05) were observed in axial rotation among all conditions. Intradiscal pressure significantly increased (P≤0.01) after fusion, except for the cobalt-chrome conditions in extension (P≥0.06), and no significant differences (P>0.99) were found among fixation constructs. In terms of energy loss, differences became significant P≤0.05 between the cobalt-chrome with transverse connector condition with respect to the cobalt-chrome and titanium conditions. INTERPRETATION: There is not enough evidence to support that the cobalt-chrome rods performed biomechanically different than the titanium rods. The inclusion of the transverse connector only increased stability for the cobalt-chromium construct in axial rotation.