Exploring the effects of a smartphone-based meditation app on stress, mindfulness, well-being, and resilience in pharmacy students.

PURPOSE: The purpose of this study was to investigate the effects of the smartphone-based meditation app Ten Percent Happier on stress, mindfulness, well-being, and resilience in pharmacy students. METHODS: Pharmacy students in a professional year of study were recruited to participate. Students were instructed to meditate using the Ten Percent Happier app for at least 5 days a week for 4 weeks. Students could use the app at their discretion for weeks 5 to 12. Baseline, week 4, and week 12 responses were collected from the following instruments: the Perceived Stress Scale, the Five-Facet Mindfulness Questionnaire-15, the Flourishing Scale, and the Brief Resilience Scale. RESULTS: Eighty-nine pharmacy students volunteered for the study. Sixty (67%) enrolled by completing the baseline survey. Of these, 28 (47%) completed the week 4 survey and 22 (37%) completed the week 12 survey. Participants experienced a reduction in perceived stress (P = 0.0005) and increases in resilience (P < 0.0001) and well-being (P = 0.0006). Increases in mindfulness were seen in 4 of the 5 subscales of the Five-Facet Mindfulness Questionnaire-15 (P ≤ 0.05). These benefits were noted at week 4 and maintained at week 12. CONCLUSION: Pharmacy students who practiced mindful meditation through the Ten Percent Happier app for an average of 5 days a week for 4 weeks experienced reduced stress and improved mindfulness, well-being, and resilience. Benefits experienced during the intervention were maintained at the 8-week follow-up, despite app usage decreasing to an average of 4 days a week.

Transgender health education for pharmacy students and its effect on student knowledge and attitudes.

BACKGROUND AND PURPOSE: Increased student pharmacist education on health issues and concerns of the underserved Lesbian, gay, bisexual, transgender, and queer (LGBTQ) population is needed. We incorporated pharmacy-specific, transgender-focused education into the curriculum and sought to identify whether pharmacy students' knowledge and attitudes towards LGBTQ individuals were affected by: (1) required online module or in-class lecture and (2) student demographics. Educational activity and setting: Pharmacy student attitudes and perceptions towards transgender individuals and the LGBTQ population were assessed before and after online (video) and in-person education using a modification of the Attitudes towards Lesbian Gay Bisexual Transgender Patients Scale. Wilcoxon test for non-parametric paired data was used to test for statistically significant changes between the pre- and post-education surveys, while two-way analysis of variance was used to analyze correlations between student demographics and responses. FINDINGS: Changes in students' knowledge and attitudes were observed after exposure to either online or in-person education. Increases in students' perceived competence to provide care to patients identifying as LGBTQ were associated with both teaching methods. Significant demographic associations were seen with specific attitudes; female students and students who knew a transgender person were more likely to strongly disagree that discussing sexual behavior with LGBTQ patients is challenging. SUMMARY: Delivery of transgender-focused education produced observable changes in student pharmacist perceptions and attitudes towards working with the LGBTQ patient population. Demographic characteristics, such as being female or knowing a transgender individual, positively correlated with student pharmacists' feeling more comfortable discussing sexual behavior with LGBTQ persons.

Pharmacists can improve medication management in the vulnerable population of foster care youth.

OBJECTIVE: The objective of this commentary is to recommend that pharmacists take a larger role in medication management for the vulnerable patient population of youth in foster care. To support this objective, it is important to understand (1) what foster care is, (2) the vulnerabilities of youth in foster care, (3) medication use among youth in foster care, and (4) how the foster care system complicates medication management. SUMMARY: Foster care youth are not yet considered a vulnerable patient population from the pharmacy perspective, despite a high rate of prescriptions and medications without proper indication. By virtue of being removed from their homes, foster youth experience trauma and are placed into a system that can be inconsistent, lead to further disruption, and create gaps in their medical care and management. Despite federal mandates, foster youth medication use remains drastically higher than that of the general population. Pharmacists' skills in medication therapy management, medication reconciliation, patient and caregiver education, and interprofessional collaboration can and should be used to reduce overmedication in the foster care population. CONCLUSION: Pharmacists can provide valuable therapeutic services and bring increased attention to the medication needs of foster care patients by assuming a more active role as a member of their care team.

A pilot workshop to help refugees navigate the U.S. pharmacy system.

OBJECTIVES: To assess refugees' understanding of the U.S. pharmacy system; to determine whether an educational workshop improved understanding. SETTING: U.S. Committee for Refugees and Immigrants-affiliated institute, Manchester, NH. PRACTICE INNOVATION: Student pharmacist-led workshops for refugees, including slide presentation, interactive activities, and demonstration. MAIN OUTCOME MEASURES: Comparison of pre- and post-workshop responses to knowledge-based questions about the U.S. pharmacy system; ability to interpret a medication label pictogram; comfort level and willingness to speak to a pharmacist. RESULTS: Significant post-workshop increases were seen in awareness that identification is needed when filling a prescription, that prescription medication labels have refill information, and that a translator can be requested in U.S. pharmacies. Participants who had not used a U.S. pharmacy before the workshop showed significant improvement after the workshop in mean percentage of correct responses to knowledge-based questions; those who had previously used a U.S. pharmacy did not. Participants who were in the U.S. for less than 3 months showed significant improvement in mean correct responses to knowledge-based questions after the workshop; those who were in the U.S. for 3 months or more did not. Participants' comfort level and willingness to speak to a pharmacist were not significantly increased after the workshop. CONCLUSION: Participants who were in the U.S. for the least time and those who had never used a U.S. pharmacy showed significant increases in understanding specific aspects of the U.S. pharmacy system after an educational workshop. Participants' comfort level and willingness to speak with a pharmacist did not change post-workshop.

Nonprescription medication use and literacy among New Hampshire eighth graders.

OBJECTIVES: To assess whether New Hampshire (NH) eighth graders were self-medicating with over-the-counter (OTC) medications, had literacy skills necessary to safely and accurately interpret OTC medication labels, and showed improvement in OTC medication safe use and literacy skills after student pharmacist-led education. DESIGN: Cross-sectional repeated-measures study. SETTING: NH, five separate sessions, in 2010 and 2011. PARTICIPANTS: 101 NH eighth grade students. INTERVENTION: Participants answered questions derived from OTC drug facts labels that assessed OTC medication safe use and literacy before and after a student pharmacist-led presentation describing each section of the labels. MAIN OUTCOME MEASURES: Participant use of OTC medications, whether participants interpreted OTC drug facts labels correctly, and whether participants were able to identify safe use of OTC medications before and after instruction about OTC drug facts labels. RESULTS: 57% of participants reported taking OTC medications in the previous month, 22% reported taking OTC medications autonomously, and 43% reported checking with a trusted adult before self-administration. After student pharmacist-led education, significant improvements were seen in identifying product indications, calculating adult doses, interpreting adverse effects, knowing when to call a medical provider, understanding proper medication storage, identifying expiration dates, and identifying duplicate medications in products. CONCLUSION: NH eighth graders were self-medicating with OTC medications. Significant improvements in OTC medication label literacy were seen after student pharmacist-led education. These results provide evidence of the need for, and positive effects of, OTC medication education among U.S. adolescents.

The effects of yoga on anxiety and stress.

Stress and anxiety have been implicated as contributors to many chronic diseases and to decreased quality of life, even with pharmacologic treatment. Efforts are underway to find non-pharmacologic therapies to relieve stress and anxiety, and yoga is one option for which results are promising. The focus of this review is on the results of human trials assessing the role of yoga in improving the signs and symptoms of stress and anxiety. Of 35 trials addressing the effects of yoga on anxiety and stress, 25 noted a significant decrease in stress and/or anxiety symptoms when a yoga regimen was implemented; however, many of the studies were also hindered by limitations, such as small study populations, lack of randomization, and lack of a control group. Fourteen of the 35 studies reported biochemical and physiological markers of stress and anxiety, but yielded inconsistent support of yoga for relief of stress and anxiety. Evaluation of the current primary literature is suggestive of benefits of yoga in relieving stress and anxiety, but further investigation into this relationship using large, well-defined populations, adequate controls, randomization and long duration should be explored before recommending yoga as a treatment option.

Treatment of schizophrenia in the 21st Century: beyond the neurotransmitter hypothesis.

Over the last six decades, the treatment of schizophrenia has focused primarily on interactions at monoamine neurotransmitter receptor sites, including those for dopamine and serotonin. While first-generation antipsychotics demonstrate antagonism at the dopamine 2 receptor, newer atypical agents involve multiple receptors at various neurotransmitter sites. Despite the advent of these newer agents, the treatment of schizophrenia continues to elude clinicians, perhaps owing to a lack of information about the factors contributing to the development of the disease. While the etiology is complex and not yet fully delineated, we suggest that treating clinicians be willing to look beyond neurotransmitters and entertain other potential factors involved in the pathogenesis of schizophrenia. One such factor that is often overlooked is the possible contribution of autoimmunity to disease development in at least a subset of patients. In this article we make an argument for consideration of immune dysfunction in the development of schizophrenia and suggest future directions for the field.

The case for autoimmunity in the etiology of schizophrenia.

The treatment of schizophrenia has frustrated clinicians for over 50 years. Despite advances in neurotransmitter identification and the development of drugs targeting these transmitters, total remission of the disease is not always achieved. Potential etiologies other than neurotransmitter dysfunction merit consideration. One intriguing concept is the possible contribution of autoimmunity in patients with the disease. This breakdown of self-tolerance has been implicated in patients with other chronic diseases, such as type 1 diabetes mellitus and myasthenia gravis. The literature on autoimmunity as a possible mechanism in the pathogenesis of schizophrenia can be conflicting, but there is a substantial amount of circumstantial, although not conclusive, evidence of immune dysfunction in patients with schizophrenia.

Air pollution particles diminish bacterial clearance in the primed lungs of mice.

Epidemiological studies reveal increased incidence of lung infection when air pollution particle levels are increased. We postulate that one risk factor for bacterial pneumonia, prior viral infection, can prime the lung for greater deleterious effects of particles via the interferon-gamma (IFN-gamma) characteristic of successful host anti-viral responses. To test this postulate, we developed a mouse model in which mice were treated with gamma-interferon aerosol, followed by exposure to concentrated ambient particles (CAPs) collected from urban air. The mice were then infected with Streptococcus pneumoniae and the effect of these treatments on the lung's innate immune response was evaluated. The combination of IFN-gamma priming and CAPs exposure enhanced lung inflammation, manifest as increased polymorphonuclear granulocyte (PMN) recruitment to the lung, and elevated expression of pro-inflammatory cytokine mRNAs. Combined priming and CAPs exposure resulted in impaired pulmonary bacterial clearance, as well as increased oxidant production and diminished bacterial uptake by alveolar macrophages (AMs) and PMNs. The data suggest that priming and CAPs exposure lead to an inflamed alveolar milieu where oxidant stress causes loss of antibacterial functions in AMs and recruited PMNs. The model reported here will allow further analysis of priming and CAPs exposure on lung sensitivity to infection.

The Mammalian Phenotype Ontology as a tool for annotating, analyzing and comparing phenotypic information.

The Mammalian Phenotype (MP) Ontology enables robust annotation of mammalian phenotypes in the context of mutations, quantitative trait loci and strains that are used as models of human biology and disease. The MP Ontology supports different levels and richness of phenotypic knowledge and flexible annotations to individual genotypes. It continues to develop dynamically via collaborative input from research groups, mutagenesis consortia, and biological domain experts. The MP Ontology is currently used by the Mouse Genome Database and Rat Genome Database to represent phenotypic data.

Combined air pollution particle and ozone exposure increases airway responsiveness in mice.

We investigated whether coexposure to inhaled ambient particles and ozone affects airway responsiveness (AR, measured as enhanced pause, Penh) and allergic inflammation (AI) in a murine model of asthma. Ovalbumin-sensitized mice were challenged with either ovalbumin ("asthmatic") or phosphate-buffered saline (PBS) aerosols for 3 successive days. Immediately after daily challenge, mice were exposed for 5 h to concentrated ambient particles (CAPs), or 0.3 ppm ozone, or both, or neither (n > or = 61/group, 12 experiments). Exposure to CAPs alone or coexposure to CAPs + O(3) caused an increase in Penh in both normal and "asthmatic" mice. These responses were transient and small, increasing approximately 0.9% per 100-microg/m(3) increase in CAPs. Analysis of the effects of particle composition on AR revealed an association between the AlSi particle fraction and increased AR in "asthmatic" mice exposed to ozone and particles. No effects of pollutants on AI were noted. We conclude that (1) particle exposure causes an immediate, short-lived (<24 h) increase in AR in mice; (2) these responses are small; and (3) changes in AR may be correlated with specific elements within the particle mixture.