Adults with Trisomy 21 Have Differential Antibody Responses to Influenza A.

Down syndrome is caused by an extra copy of chromosome 21. In the past two decades, the life expectancy of individuals with Down syndrome has significantly increased from early 20s to early 60s, creating a population of individuals of which little is known about how well they are protected against infectious disease. The goal of this work is to better understand if adults with Down syndrome are well protected against influenza following vaccination. We obtained plasma samples from 18 adults (average age = 31yo) with Down syndrome and 17 age/gender-matched disomic individuals, all vaccinated against influenza. Antibody concentration to influenza A was measured using ELISA and antibody titers were measured using a hemagglutinin inhibition assay. Statistical analysis was performed using Stata Statistical Software. Adults with Down syndrome had a significantly increased concentration of antibodies to a mixture of influenza A viral proteins; however, they had a significantly decreased titer to the Influenza A/Hong Kong compared to disomic controls. These findings suggest that more vigorous studies of B- and T-cell function in adults with Down syndrome with respect to influenza vaccination are warranted, and that this population may benefit from a high-dose influenza vaccine.

Does Team Based Learning (TBL) in the Pharmacy Classroom Foster Leadership Skills in the Workplace?

Objective: A well-functioning healthcare team is important to optimizing the health outcomes of patients. As such, the use of Team Based Learning (TBL) in the education of health professionals has emerged as one of the more common active learning strategies. In various anecdotes with preceptors, it had been observed that student pharmacists educated in a TBL classroom exhibited increased skills in the affective domain. This qualitative pilot study begins to examine affective domain skills that are important to pharmacy practice and which of those skills may be developed uniquely through TBL. Methods: Random samples of preceptors and students (first through fourth-year cohorts), were engaged using a predesigned interview protocol to guide the discussion. Ad hoc questions resulting from the interview were also captured. A grounded theory approach was utilized to develop an a priori theme codebook that was utilized to analyze the interviews with preceptors and focus groups with students. Results: Nine preceptors were interviewed, and 23 student pharmacists participated in focus groups. Preceptors identified 1) communication, 2) emotional intelligence, 3) education, 4) time management, and 5) advocacy as the top themes important to being a leader. While students identified 1) communicate with or listen to others, 2) accountability/responsibility, 3) patience, 4) self-reflection / feedback as skills developed by TBL. Participants indicated that they believed that TBL was a contributor to the development of affective domain skills among student pharmacists. Conclusion: Among preceptors and student pharmacists, this initial study found both alignment and divergence with identified skills in the affective domain related to the development of leadership skills. Additional research is needed to further explore and develop an instrument to measure the role of TBL in affective skill development, in the context of being a leader in the pharmacy profession.

Peer Evaluation Instrument Development, Administration, and Assessment in a Team-based Learning Curriculum.

Objective. To design and implement an instrument capable of providing students with valuable peer feedback on team behaviors and to provide results of the administration of the instrument. Methods. A three-part instrument was designed that requires teammate rankings with justification on attributes aligned with school outcomes and team functioning, reporting of student behaviors, and provision of feedback on the value of peer contributions to their team. Score results after three years of administration were analyzed. Results. Six evaluations per year were completed by members of four different professional classes over a three-year time period. Mean scores increased slightly as students progressed through the program. Students were able to differentially score peers on attributes and behaviors. Conclusion. The peer evaluation instrument presented here provides formative and summative feedback through qualitative and quantitative scores that allow students to acknowledge differential contributions of individual team members.

Assessing Emotionally Intelligent Leadership in Pharmacy Students.

Objective. To determine the frequency distribution of pharmacy students across Emotionally Intelligent Leadership Inventory (EILI) measures. Methods. The EILI was administered to 235 pharmacy students at two schools. The instrument was systematically compared to the 2013 CAPE Outcomes and analyzed by confirmatory factor analysis. Results. The EILI has primary connections with pharmacy competencies related to interprofessional communication and leadership. The three facets of the EILI were verified for internal consistency (Context, α=.78; Self, α=.74; Others, α=.79). Student scores were the highest for the consciousness of self facet, with a mean score of 31.4 out of 40. Conclusion. The EILI shows promise as an instrument for use in assessing pharmacy students' emotional intelligence and leadership skills.

Development of a capstone course to improve student confidence and pharmacotherapy knowledge prior to advanced pharmacy practice experiences.

OBJECTIVE: To describe a capstone course designed to improve student confidence with clinical skills, improve confidence with providing medication therapy, and evaluate student knowledge. DESIGN: A 2-week capstone course was incorporated into the third-year pharmacotherapy course in a Doctor of Pharmacy program. Students evaluated complex patient cases and developed pharmacotherapy care plans. Pre- and post-capstone course survey results were used to assess change in student confidence using clinical skills and providing medication therapy, and quiz and exam results were used to assess student knowledge. RESULTS: Student confidence significantly improved from baseline for clinical skills (p < 0.02 across all clinical skills domains) and providing medication therapy (p < 0.01 across all disease states). Students reported the largest improvement in confidence for the clinical skill of creating a Subjective/Objective/Assessment/Plan (SOAP) note on a patient with multiple disease states (p < 0.001). Students reported the highest confidence increase for acute kidney injury (p < 0.001). The average written exam score was 87.2% (standard deviation ± 8.0) and the average verbal exam score was 79.1% (standard deviation ± 15.7). CONCLUSION: A 2-week capstone course can be valuable to improve confidence and assess student knowledge prior to advanced pharmacy practice experiences (APPEs).

High-energy neutron spectroscopy with thick silicon detectors.

The high-energy neutron component of the space radiation environment in thick structures such as the International Space Station contributes to the total radiation dose received by an astronaut. Detector design constraints such as size and mass have limited the energy range of neutron spectrum measurements in orbit to about 12 MeV in Space Shuttle studies. We present a new method for high-energy neutron spectroscopy using small silicon detectors that can extend these measurements to more than 500 MeV. The methodology is based on measurement of the detector response function for high-energy neutrons and inversion of this response function with measured deposition data to deduce neutron energy spectra. We also present the results of an initial shielding study performed with the thick silicon detector system for high-energy neutrons incident on polyethylene.