Exploration of the effects of an innovative mentalization-based training on patient-centered communication skills of pharmacy staff:A video-observation study

OBJECTIVE: To explore whether a mentalization-based communication training for pharmacy staff impacts their ability to elicit and recognize patients' implicit and explicit medication related needs and concerns.METHODS: A single-arm intervention pilot study was conducted, in which pre-post video-recordings of pharmacy counter-conversations on dispensed-medication (N = 50 and N = 34, respectively; pharmacy staff: N = 22) were coded. Outcome measures included: detecting needs and concerns, and implicitly and explicitly eliciting and recognizing them. Descriptive statistics and a multi-level logistic regression were conducted. Excerpts of videos with needs or concerns were analyzed thematically on mentalizing attitude aspects.RESULTS: Indications show that patients more often express their concerns in an explicit way post-measurement, just as pharmacy staffs' explicit recognition and elicitation of needs and concerns. This was not seen for patients' needs. No statistically significant differences were found for determinants for detecting needs or concerns (i.e., measurement-, professional-type, or interaction). Differences in mentalizing attitude were observed between pre-post-measurements, e.g., more attention for patients.CONCLUSION: This mentalizing training shows the potential of mentalizing to improve pharmacy staff members' explicit elicitation and recognition of patients' medication-related needs and concerns.PRACTICE IMPLICATIONS: The training seems promising for improving patient-oriented communication skills in pharmacy staff. Future studies should confirm this result.</p

Developing Medication Reviews to Improve the Aruban Healthcare System:A Mixed-Methods Pilot Study

This study investigated whether and how medication reviews (MRs) conducted by pharmacists and general practitioners (GPs) with patient involvement can be performed on the island of Aruba (Dutch Caribbean). In this mixed-methods pilot study (both qualitative and quantitative), constructive and observational methodologies were combined. Healthcare providers' and patients' views on MRs and aspects of Aruban healthcare and culture relevant to MRs were examined. These insights were used to develop a protocol for conducting and implementing MRs in Aruba. Surveys were distributed and semi-structured interviews were held among Aruban community pharmacists and GPs, and a pilot program was created in which MRs were carried out with four Aruban patients and their GPs. According to the included healthcare providers, the main purpose of MRs is to optimize the patient experience and achieve concordance. Even though pharmacists and GPs consider their partnership equal, they have different views as to who should bear which responsibility in the MR process in matters regarding patient selection and follow-up. Common Aruban themes that were mentioned by the healthcare providers and deemed relevant for conducting MRs included behaviour/culture, healthcare, lifestyle, and therapy compliance. Anamnesis should be concise during the MR, and questions about medication storage, concerns, beliefs, and practical problems, as well as checks for limited health literacy, were considered important. In the pilot, at least three to, maximally, eight pharmacotherapy-related problems (PRPs) were detected per MR consultation, such as an incorrect dosage of acetylsalicylic acid, an inappropriate combination tablet for blood pressure regulation, and the absence of important laboratory values. All patients considered their consultation to be positive and of added value. In addition, it was observed that an MR can potentially generate cost savings. The information obtained from the healthcare providers and patients, together with the basic principles for MRs, as applied in the Netherlands, led to a definitive and promising MR format with practical recommendations for community pharmacists in Aruba: in comparison with the Dutch MR approach, GPs and pharmacists in Aruba could collaborate more on patient selection for MRs and their follow-up, because of their specific knowledge regarding the medications patients are taking chronically (pharmacists), and possible low levels of health literacy (GPs). Taking into account the Aruban culture, pharmacists could ask extra questions during MRs, referring to lifestyle (high prevalence of obesity), readability of medication labels (limited literacy), and herbal product use (Latin American culture). GPs and medical specialists sometimes experience miscommunication regarding the prescription of medication, which means that pharmacists must carefully take into account possible duplicate medications or interactions.</p

Mervin Duncan Oral History, November 17, 2009

This interview with Mervin Duncan, joined by his daughter Karrie Behling, chronicles his life in Ferron, Utah, beginning with his grandparents\u27 pioneer journey to Ferron in the 1870s and their contributions to the early settlement, including building the first barn without nails and the town hall. Duncan vividly describes his childhood in the Great Depression, his family\u27s farm life, the challenges of early living without modern conveniences, and his experiences riding racehorses and working in various jobs. He recounts his service in the Merchant Marines during World War II, his marriage to Ruth Harris, and their life in Idaho before returning to Ferron. The interview also covers his family\u27s deep roots in the Church of Jesus Christ of Latter-day Saints, his time as a Stake Patriarch, and the evolution of Ferron\u27s community life, including schools, local businesses, Peach Days celebrations, and significant historical events like the Wilberg mine fire and the building of Millsite Dam

The 2-aminotetralin system as a structural base for new dopamine- and melatonin-receptor agents

The research described in this thesis is divided into two parts. Part I (chapters 1-3) deals with the development of a novel 2-aminotetralin as a mixed dopamine Dl/D2-receptor agonist, whereas part I1 (chapters 4-6) concerns the development of 2-amidotetralins as nonindolic melatonin-receptor agents.

Optimal transport and applications in partial differential equations

honors thesisCollege of ScienceMathematicsWilliam feldmanIn the 18th century, Gaspard Monge created a mathematical framework to find the best way to describe the optimal way to rearrange the dirt dug out from the land into castle walls or other desired shapes. More recently, in the 20th century, Leonid Kantorovich explored infinite dimensional optimization and revisited Monge's framework in order to create his own framework that improved analysis and sparked new interest in the problem. The ideas generated from studying this problem, now called optimal transport or transportation theory, have proven useful in many fields of mathematics, from PDEs to image processing and machine learning. This paper introduces the Monge and Kantorovich problems and the ideas necessary to study them. Once the optimal transportation framework is defined, this paper introduces gradient flow theory