A Scoping Review for Debate-Style Journal Clubs in Health Professional Education.

OBJECTIVES: The objectives of this scoping review are to (1) describe the available literature regarding the utility of the debate-style journal club for health professional learners on literature evaluation skills and (2) report the themes found within debate-style journal club research and assessments in the context of professional education. FINDINGS: A total of 27 articles written in the English language were included in this scoping review. Published evaluations of debate-style journal clubs have been predominantly based in the pharmacy profession (48%, n = 13), but are reported in other health professions, such as medicine (22%, n = 6), dentistry (15%, n = 4), nursing (7%, n = 2), occupational therapy (4%, n = 1), and physical therapy (4%, n = 1), as well. The skills assessed in these studies often included critical literature evaluation, application of literature to patient care, critical thinking, knowledge retention, use of supporting literature, and debate-specific skills. Learners typically reported better understanding and application of the literature, and enjoying the experience more than traditional journal clubs, but note the increased assessor and learner time requirement for debating. Pharmacy learner-specific articles more often utilized a traditional, team-based debate format, incorporated grading rubrics for skill assessment and debate performance, and included a grading component for the debate in the course. SUMMARY: Debate-style journal clubs are well-received by learners but require an additional time commitment. Debate platforms, format, rubric use and validation, and outcome assessment vary across published reports.

A Curriculum Crosswalk of the Core Entrustable Professional Activities for New Pharmacy Graduates.

Objective. To cross reference the core entrustable professional activities (EPAs) to a complete set of educational guidance documents for the Doctor of Pharmacy (PharmD) curriculum to create a map for pharmacy educators.Methods. The Mapping EPAs Task Force consisted of nine members who first worked independently and then together in small working groups to map five assigned educational guidance documents (eg, Center for the Advancement of Pharmacy Education [CAPE] Outcomes, Accreditation Council for Pharmacy Education [ACPE] Standards 1-4, and the Essential Elements for Core Advanced Pharmacy Practice Experiences [APPEs]) to the Core Entrustable Professional Activities for New Pharmacy Graduates. Four working groups completed the mapping process during phases 1 and 2, which was followed by an independent quality assurance review and consensus in phase 3.Results. All 15 core EPA statements were mapped to one or more of the educational documents. One item from the CAPE Outcomes could not be mapped to a core EPA statement. The first five EPA statements mapped directly to the five elements of the Pharmacists' Patient Care Process: collect, assess, plan, implement, and follow-up: monitor and evaluate.Conclusion. This comprehensive EPA map is the first curriculum crosswalk that encompasses a complete set of educational guidance documents including the Essential Elements for Core APPEs for the Doctor of Pharmacy curriculum. If adopted by the Academy, this curriculum crosswalk will provide pharmacy schools with a common interpretation of important educational guidance documents; serve as the foundation for curricular development, revision, and assessment; and ensure student pharmacists are prepared to enter the pharmacy profession.

Academic success plans in advanced pharmacy practice experiences to promote self-awareness and improve performance.

INTRODUCTION: Pharmacy schools should encourage self-awareness, provide exposure to the continuous professional development cycle, and intervene early when students exhibit performance deficiencies. Academic success plans (ASPs) have been shown in other disciplines to be successful intervention tools which encourage student reflection and self-awareness. This study evaluates the impact of ASPs used during the advanced pharmacy practice experience (APPE) curriculum at two schools. METHODS: ASPs were assigned to students who had either a "needs development" or lower documented for the same learning outcome during more than one APPE, for poor overall performance during an APPE, or for documented professionalism issues. Average scores were calculated by assigning point values to each learning outcome assessment score (exceeds expectations = 1; competent = 0; needs development, needs significant development, remediation required = -1). RESULTS: During AY2014-2015 and AY2015-2016, 104 ASPs were assigned to 75 students (13.5% of students). The majority (89.6%) were assigned due to repeated deficiencies in the same learning outcome(s), with the most frequent being "Develop, Implement, and Monitor Drug Therapy Plans." After completion of an ASP, average scores significantly improved (p < 0.05) in 9 out of 12 learning outcomes among all students who completed an ASP. Thirteen students completed 15 ASPs for professionalism reasons, most commonly punctuality. CONCLUSIONS: Prior to 2015, Experiential Education Office interventions were primarily grades-based, not necessarily based on achievement of specific learning outcomes. ASPs were successfully used to allow students to practice self-awareness skills, to engage in the CPD process, and to improve APPE performance.

Patient perceptions of student pharmacist-run mobile influenza vaccination clinics.

OBJECTIVE: To assess patients' perceptions of student pharmacist-run mobile influenza immunization clinics, including satisfaction, comfort, comparison to other experiences, and the views of pharmacists as immunizers. METHODS: A 7-item survey was designed to assess patient satisfaction with receiving influenza vaccinations from student pharmacists, to compare the experience with vaccines received in nonpharmacy settings, and to determine the impact of the experience on patients' views of pharmacist-administered vaccines. The anonymous survey was provided to patients in the postvaccination monitoring area for campus and non-campus mobile clinics from September through October of 2017. RESULTS: Student pharmacists administered 1303 immunizations to patients at 27 campus or community-based mobile clinics. Of 928 patients (71.2% response rate) completing the survey, 90.9% had previously received at least 2 prior influenza vaccinations. More than 98% of patients were very satisfied or satisfied with the student pharmacist-run mobile flu clinic. Similarly, more than 98% of patients were very comfortable or comfortable receiving immunizations from a student pharmacist, and 99.9% of patients rated the experience as either better or similar to previous vaccinations received in nonpharmacy settings. Although 53.4% already used pharmacists as an immunization resource, an additional 38.5% reported they were more comfortable with pharmacists providing vaccinations as a result of the experience. Only 8.1% of patients reported that they would rather receive vaccinations from a physician or nurse. Reasons cited for choosing the mobile clinic for vaccination included convenience (92.2%), cost (35.8%), and positive past experience (28.9%). CONCLUSION: Patients were very satisfied with influenza vaccinations provided by student pharmacists in mobile clinics. The experience appeared to positively affect participants' views of pharmacists as vaccine providers. Proper training, education, and skill development of student pharmacists are essential for ensuring patient safety and for obtaining and maintaining the trust of the patient and health care community.

A proof of principal study on the use of direct PCR of semen and spermatozoa and development of a differential isolation protocol for use in cases of alleged sexual assault.

Sexual assault samples are some of the most common samples encountered in forensic analysis. These samples can require a significant time investment due to differential extraction processes. We report on the first record of successful direct amplification of semen for STR analysis. Neat seminal fluid, dilutions ranging from 1:5 to 1:160 and GEDNAP samples were successfully amplified using a direct method. A mild differential isolation technique to enrich spermatozoa was developed and successfully implemented to separate and directly amplify a mixture of semen and female epithelial cells. Aliquots of samples subjected to the differential isolation protocol were stained with Haemotoxylin and Eosin for sperm scoring. Samples stained after PCR showed a complete lack of intact spermatozoa demonstrating that the cells are lysed during the PCR process. This paper demonstrates the potential to incorporate direct PCR in cases of sexual assault to more rapidly obtain results and achieve a higher sensitivity.

Recovery of human DNA profiles from poached deer remains part 2: improved recovery protocol without the need for LCN analysis.

Although poaching is a common wildlife crime, the high and prohibitive cost of specialised animal testing means that many cases are left un-investigated. We previously described a novel approach to wildlife crime investigation that looked at the identification of human DNA on poached animal remains (Tobe, Govan and Welch, 2011). Human DNA was successfully isolated and amplified from simulated poaching incidents, however a low template protocol was required which made this method unsuitable for use in many laboratories. We now report on an optimised recovery and amplification protocol which removes the need for low template analysis. Samples from 10 deer (40 samples total - one from each leg) analysed in the original study were re-analysed in the current study with an additional 11 deer samples. Four samples analysed using Chelex did not show any results and a new method was devised whereby the available DNA was concentrated. By combining the DNA extracts from all tapings of the same deer remains followed by concentration, the recovered quantity of human DNA was found to be 29.5pg±43.2pg, 31× greater than the previous study. The use of the Investigator Decaplex SE (QIAGEN) STR kit provided better results in the form of more complete profiles than did the AmpFℓSTR® SGM Plus® kit at 30cycles (Applied Biosystems). Re-analysis of the samples from the initial study using the new, optimised protocol resulted in an average increase of 18% of recovered alleles. Over 17 samples, 71% of the samples analysed using the optimised protocol showed sufficient amplification for comparison to a reference profile and gave match probabilities ranging from 7.7690×10(-05) to 2.2706×10(-14). The removal of low template analysis means this optimised method provides evidence of high probative value and is suitable for immediate use in forensic laboratories. All methods and techniques used are standard and are compatible with current SOPs. As no high cost non-human DNA analysis is required the overall process is no more expensive than the investigation of other volume crime samples. The technique is suitable for immediate use in poaching incidents.

Using the Taguchi method for rapid quantitative PCR optimization with SYBR Green I.

Here, we applied the Taguchi method, an engineering optimization process, to successfully determine the optimal conditions for three SYBR Green I-based quantitative PCR assays. This method balanced the effects of all factors and their associated levels by using an orthogonal array rather than a factorial array. Instead of running 27 experiments with the conventional factorial method, the Taguchi method achieved the same optimal conditions using only nine experiments, saving valuable resources.

A comparison of methods for forensic DNA extraction: Chelex-100® and the QIAGEN DNA Investigator Kit (manual and automated).

Efficient isolation of DNA from a sample is the basis for successful forensic DNA profiling. There are many DNA extraction methods available and they vary in their ability to efficiently extract the DNA; as well as in processing time, operator intervention, contamination risk and ease of use. In recent years, automated robots have been made available which speed up processing time and decrease the amount of operator input. This project was set up to investigate the efficiency of three DNA extraction methods, two manual (Chelex(®)-100 and the QIAGEN DNA Investigator Kit) and one automated (QIAcube), using both buccal cells and blood stains as the DNA source. Extracted DNA was quantified using real-time PCR in order to assess the amount of DNA present in each sample. Selected samples were then amplified using AmpFlSTR SGM Plus amplification kit. The results suggested that there was no statistical difference between results gained for the different methods investigated, but the automated QIAcube robot made sample processing much simpler and quicker without introducing DNA contamination.

A comparison between direct PCR and extraction to generate DNA profiles from samples retrieved from various substrates.

Direct PCR generates DNA profiles from samples without using the extraction process. During sample extraction, DNA may be lost due to the methods used, which can affect the quality of the DNA profile obtained. This is not the case with direct PCR, where the sample is transferred directly into the PCR tube. Here, we report on the ability of direct PCR to generate DNA profiles from low amounts of control DNA retrieved from various surfaces using PowerPlex 16 HS. A comparison is made with samples undergoing a preliminary extraction stage using QiaAmp DNA Micro kits. Samples subjected to direct PCR generated DNA profiles with higher peak heights and lower allele dropout on all the different substrates tested when compared to the samples subjected to extraction. The amount of DNA retrieved from each substrate also varied even though the same amount of starting material was deposited, proving that the type of substrate can affect the retrieval of DNA.

Recovery of human DNA profiles from poached deer remains: a feasibility study.

Poaching is a crime that occurs worldwide and can be extremely difficult to investigate and prosecute due to the nature of the evidence available. If a species is protected by international legislation such as the Convention on International Trade in Endangered Species of Wild Fauna and Flora then simply possessing any part of that species is illegal. Previous studies have focused on the identification of endangered species in cases of potential poaching. Difficulties arise if the poached animal is not endangered. Species such as deer have hunting seasons whereby they can legally be hunted however poaching is the illegal take of deer, irrespective of season. Therefore, identification of deer alone has little probative value as samples could have originated from legal hunting activities in season. After a deer is hunted it is usual to remove the innards, head and lower limbs. The limbs are removed through manual force and represent a potential source of human touch DNA. We investigate the potential to recover and profile human autosomal DNA from poached deer remains. Samples from the legs of ten culled deer were obtained (40 in total) using minitapes. DNA from samples was extracted, quantified and amplified to determine if it would be possible to recover human STR profiles. Low quantification data led to the use of an extended PCR cycling protocol of 34 cycles. Samples from seven deer amplified, however some samples were excluded from further analysis due to 'drop in' alleles or the low level of successfully amplified loci. Samples from five deer could be further analysed and gave match probabilities ranging from 6.37×10(-3) to 9.53×10(-11). This study demonstrates the potential of recovering human touch DNA from poached animal remains. There is the potential for this test to be used in relation to other species of poached remains or other types of wildlife crimes. This is the first time, to our knowledge, that human STR profiling has been successfully applied to touch DNA in regards to simulated wildlife crime.

Highly potent human hematopoietic stem cells first emerge in the intraembryonic aorta-gonad-mesonephros region.

Hematopoietic stem cells (HSCs) emerge during embryogenesis and maintain hematopoiesis in the adult organism. Little is known about the embryonic development of human HSCs. We demonstrate that human HSCs emerge first in the aorta-gonad-mesonephros (AGM) region, specifically in the dorsal aorta, and only later appear in the yolk sac, liver, and placenta. AGM region cells transplanted into immunodeficient mice provide long-term high level multilineage hematopoietic repopulation. Human AGM region HSCs, although present in low numbers, exhibit a very high self-renewal potential. A single HSC derived from the AGM region generates at least 300 daughter HSCs in primary recipients, which disseminate throughout the entire recipient bone marrow and are retransplantable. These findings highlight the vast regenerative potential of the earliest human HSCs and set a new standard for in vitro generation of HSCs from pluripotent stem cells for the purpose of regenerative medicine.

Evaluation of nucleosome forming potentials (NFPs) of forensically important STRs.

Degraded forensic samples have proved difficult to analyze and interpret. New analysis techniques are constantly being discovered and improved but researchers have overlooked the structural properties that could prevent or slow the process of degradation. In theory, DNA that are bound to histones as nucleosomes are less prone to degradation, because nucleosomes prevent DNA from being exposed to degradative enzymes. In this study we determined the probability of 60 forensic DNA markers to be bound to histones based on their base sequence composition. Two web-based tools - NXSensor and nuScore - were used to analyze four hundred base pairs surrounding each DNA marker for properties that inhibit or promote the binding of DNA to histones. Our results showed that the majority of markers analyzed were likely to be bound as nucleosomes. Selection of the markers that are more protected to form a multiplex could increase the chance of obtaining a better balanced, easier to interpret DNA profile from degraded samples.

Adsorption and decomposition of cyclohexanone (C6H10O) on Pt(111) and the (2 × 2) and (√3 × âˆš3)r30°-Sn/Pt(111) surface alloys.

Adsorption and decomposition of cyclohexanone (C(6)H(10)O) on Pt(111) and on two ordered Pt-Sn surface alloys, (2 × 2)-Sn/Pt(111) and (√3 × âˆš3)R30°-Sn/Pt(111), formed by vapor deposition of Sn on the Pt(111) single crystal surface were studied with TPD, HREELS, AES, LEED, and DFT calculations with vibrational analyses. Saturation coverage of C(6)H(10)O was found to be 0.25 ML, independent of the Sn surface concentration. The Pt(111) surface was reactive toward cyclohexanone, with the adsorption in the monolayer being about 70% irreversible. C(6)H(10)O decomposed to yield CO, H(2)O, H(2), and CH(4). Some C-O bond breaking occurred, yielding H(2)O and leaving some carbon on the surface after TPD. HREELS data showed that cyclohexanone decomposition in the monolayer began by 200 K. Intermediates from cyclohexanone decomposition were also relatively unstable on Pt(111), since coadsorbed CO and H were formed below 250 K. Surface Sn allowed for some cyclohexanone to adsorb reversibly. C(6)H(10)O dissociated on the (2 × 2) surface to form CO and H(2)O at low coverages, and methane and H(2) in smaller amounts than on Pt(111). Adsorption of cyclohexanone on (√3 × âˆš3)R30°-Sn/Pt(111) at 90 K was mostly reversible. DFT calculations suggest that C(6)H(10)O adsorbs on Pt(111) in two configurations: by bonding weakly through oxygen to an atop Pt site and more strongly through simultaneously oxygen and carbon of the carbonyl to a bridged Pt-Pt site. In contrast, on alloy surfaces, C(6)H(10)O bonds preferentially to Sn. The presence of Sn, furthermore, is predicted to make the formation of the strongly bound C(6)H(10)O species bonding through O and C, which is a likely decomposition precursor, thermodynamically unfavorable. Alloying with Sn, thus, is shown to moderate adsorptive and reactive activity of Pt(111).