An exploratory mixed-methods evaluation of continuing education opportunities related to the care of sexual and gender minority patients from ACPE-accredited providers.

PURPOSE: The objective of this analysis was to describe trends in continuing education opportunities for pharmacy professionals across the US related to the care of sexual and gender minority (SGM) patients. METHODS: Continuing education programs offered by Accreditation Council for Pharmacy Education (ACPE)-accredited providers from 2012 through 2022 were identified by searching the ACPE database for titles containing SGM terminology. Data including ACPE provider classification, activity type, format, audience, ACPE topic designator, interprofessional accreditation, contact hours, and learning objectives were collected. Content analysis was used to categorize activities. RESULTS: Following removal of duplicates and non-SGM-focused programming, 726 programs were identified. The most commonly observed program characteristics included a live format (67.6%, n = 491), a pharmacist audience (77.1%, n = 560), knowledge-based activities (90.8%, n = 656), a college or school of pharmacy provider (21.6%, n = 157), an ACPE topic of pharmacy administration (50.6%, n = 367), and a focus on pharmacy rather than interprofessional audiences (87.1%, n = 632). The median program length was 1 hour (interquartile range, 1-1.25 hours). The qualitative analysis identified programs focused on topics of gender-affirming care (pharmacotherapy) (32.1%, n = 233), general SGM (26.7%, n = 194), gender-affirming care (nonpharmacotherapy), sexually transmitted infections (7.2%, n = 52), and health disparities (3.9%, n = 28). CONCLUSION: Advancement has occurred in the number of available continuing pharmacy education programs focused on the care of SGM patients. Further information regarding specific content and effectiveness of continuing education is necessary to determine strategies to better prepare pharmacy professionals to care for this growing patient population.

Factors Associated with Mental Health Outcomes in Hospital Workers during the COVID-19 Pandemic: A Mixed-Methods Study.

BACKGROUND: We investigated some of the factors associated with depression, perceived stress, and anxiety in clinical and nonclinical healthcare workers of two hospitals. METHODS: A mixed-methods approach was used. The sample included clinical (physicians, nurses, and others) and nonclinical (security and cleaning staff) healthcare workers of two tertiary hospitals in Peru. Participants completed an online self-survey. In the qualitative analysis, data were subjected to thematic analysis. RESULTS: We analyzed data from 613 participants, of which 8.6%, 9.0%, and 78.2% had moderate-to-severe anxiety, depression, and perceived stress, respectively. Having a previous mental health problem, being concerned about losing one's job, having at least two COVID-19 symptoms in the preceding two weeks, and being afraid of infecting family members increased the prevalence of experiencing moderate-to-severe depression and anxiety. The qualitative analysis allowed us to identify five recurring factors that caused a negative impact on workers' lives during the pandemic: emotional distress linked to hospital experiences of suffering and death, modification of routines, fear of COVID-19, exacerbation of mental disorders, and physical problems associated with emotional distress. CONCLUSIONS: Clinical and nonclinical healthcare workers in Peru have experienced depression, anxiety, and stress during the COVID-19 pandemic. Future research and interventions are necessary to improve psychological support for hospital workers.

Field evaluation of WALS truck-mounted A1 super duty mist sprayer® with VectoBac® WDG against Aedes aegypti (Diptera:Culicidae) populations in Manatee County, Florida.

Aedes aegypti, the Dengue and Zika vector, is a domestic mosquito that is difficult to control. The challenge lies in the mosquito's preference to lay its eggs in cryptic habitats such as fence post openings, buckets and bird baths, cups. Additionally, current methods of control are labor-intensive. We employed the WALS strategy to evaluate the operational efficacy of applying VectoBac WDG using a truck-mounted mister to control local populations of Ae. aegypti in urban settings with difficult-to-reach larval mosquito habitats. Our study was conducted in Cortez (Manatee County), Florida, USA (27° 27' N, 82° 40' W). We selected two study sites, one untreated control (21.9 ha) and one treatment site (23.1 ha) where historical data have shown high populations of Ae. aegypti based on weekly ovitrap surveillance. Weekly BGs and ovitraps (10-15 traps/site) were deployed to monitor adult population dynamics. A total of 50 bioassay jars were placed in the field each afternoon of the Bti application (8 application events) at fixed locations to collect droplets and gauge efficacy. We found significant reduction in female adults (P = 0.0002) and landing rate counts (P = 0.0058) as a result of treatment. Larval bioassays during the eight applications confirmed Bti deposit in a variety of coverage types regardless of placement in the yards. WALS applications with a truck-mounted mister can be effective at reducing disease carrying mosquito populations in residential areas and can be implemented in an integrated vector management program. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42452-021-04893-x.

A Field Efficacy Evaluation of In2Care Mosquito Traps in Comparison with Routine Integrated Vector Management at Reducing Aedes aegypti.

Aedes aegypti is the predominant vector of dengue, chikungunya, and Zika viruses. This mosquito is difficult to control with conventional methods due to its container-inhabiting behavior and resistance to insecticides. Autodissemination of pyriproxyfen (PPF), a potent larvicide, has shown promise as an additional tool to control Aedes species in small-scale field trials. However, few large-scale field evaluations have been conducted. We undertook a 6-month-long large-scale field study to compare the effectiveness and operational feasibility of using In2Care Mosquito Traps (In2Care Traps, commercially available Aedes traps with PPF and Beauveria bassiana) compared to an integrated vector management (IVM) strategy consisting of source reduction, larviciding, and adulticiding for controlling Ae. aegypti eggs, larvae, and adults. We found that while the difference between treatments was only statistically significant for eggs and larvae (P < 0.05 for eggs and larvae and P > 0.05 for adults), the use of In2Care Traps alone resulted in 60%, 57%, and 57% fewer eggs, larvae, and adults, respectively, collected from that site compared to the IVM site. However, In2Care Trap deployment and maintenance were more time consuming and labor intensive than the IVM strategy. Thus, using In2Care Traps alone as a control method for large areas (e.g., >20 ha) may be less practical for control programs with the capacity to conduct ground and aerial larviciding and adulticiding. Based on our study results, we conclude that In2Care Traps are effective at suppressing Ae. aegypti and have the most potential for use in areas without sophisticated control programs and within IVM programs to target hotspots with high population levels and/or risk of Aedes-borne pathogen transmission.

Next-Generation Sequencing Identifies a Homozygous Nonsense p.Tyr370* Mutation of the TMC6 Gene in a Mexican Pedigree with Epidermodysplasia Verruciformis.

Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by abnormal susceptibility to infection with b-genotype human papillomavirus (HPV) and a particular propensity to develop cutaneous malignancies. Clinical manifestations include flat, scaly, reddish hypo- and hyperpigmented macules, verruca-like papillomatous lesions, seborrheic keratosis- like lesions, and pink-red pityriasis versicolor-like lesions1.

Sociodemographic and clinical characteristics of persons who experienced spontaneous hepatitis C viral clearance.

BACKGROUND: In the United States Hepatitis C virus (HCV) viral clearance is estimated to range between 20 and 30%. The objective of this study was to estimate the frequency of HCV clearance and identify correlates of viral clearance among patients newly identified as HCV antibody positive in a large urban health system in Los Angeles, California. METHODS: We identified patients between November 2015 and September 2017 as part of a newly implemented HCV screening and linkage-to-care program at University of California Los Angeles (UCLA) Health System. All patients were eligible for screening, though there were additional efforts to screen patients born between 1945 and 1965. We reviewed Medical records to categorize anti-HCV antibody positive patients as having spontaneously cleared HCV infection (HCV RNA not detected) or not (HCV RNA detected). We excluded those with a prior history of anti-HCV positivity or history of HCV treatment. We compared differences between those with and without detectable HCV RNA using chi-square test, Fisher's exact test, and t-test as appropriate. We assessed factors associated with HCV clearance using logistic regression analysis. RESULTS: Among the 320 patients included in this study, 56% were male. Baby boomers (52-72 years of age) comprised the single largest age group (62%). We found spontaneous HCV clearance in 58% (n = 185). HCV viral clearance was slightly higher among women as compared to men (63% vs. 53%; p value = 0.07) and varied by race/ethnicity: clearance among Blacks/African Americans was 37% vs. 58% among whites (p value = 0.02). After adjusting for age, race/ethnicity, and sex we found that those diagnosed with chronic kidney disease had a tendency of decreased HCV viral clearance (adjusted OR = 0.34; 95% CI 0.14-1.03). CONCLUSION: Of those patients newly identified as anti-HCV positive, 58% had cleared HCV virus, while the rest showed evidence of active infection. In addition, we found that clearance varied by race/ethnicity and clinical characteristics.

Hepatitis C Virus Prevalence in Egyptian Americans in Southern California.

BACKGROUND: Hepatitis C virus (HCV) is a global medical health concern. Egypt has the highest HCV prevalence. Few studies have assessed the HCV prevalence rates among Egyptian-born expatriates. We sought to define the HCV prevalence Egyptian-born individuals residing in the Southern California area. PATIENTS AND METHODS: We screened Egyptian-born individuals in houses of worship in the Southern California area using a point of care test HCV antibody test. Results were confirmed by testing the blood for viral load. Demographic information including risk factors were also collected. Individuals were contacted with their results, and those found to be detectable HCV antibodies were referred for further testing and additional care. RESULTS: Three hundred twenty-six Egyptian expatriates from 7 houses of worship in Southern California were screened for the HCV infection. Most of the participants were screened at Coptic Churches. Nine of these individuals were found to be HCV infected (2.8%). We found an increased HCV seroprevalence in subjects were male and born in Egyptian urban areas. Five of the 9 subjects (56%) who tested positive were not baby boomers and only 2 of these 9 subjects (22%) had recognized Center for Disease Control risk factors. CONCLUSIONS: The HCV prevalence rate of Egyptian-born individuals living in the Southern California area was lower compared with the prevalence rate in the general Egyptian population, but higher than that seen in the general US population. The utility of using Center for Disease Control risk factors to define individuals at risk of HCV among Egyptian expatriates is not applicable.

Effectiveness of Ledipasvir/Sofosbuvir with/without Ribavarin in Liver Transplant Recipients with Hepatitis C.

Background and Aims: Recurrent infection of hepatitis C virus (HCV) in liver transplant (LT) recipients is universal and associated with significant morbidity and mortality. Methods: We retrospectively evaluated the safety and efficacy of ledipasvir/sofosbuvir with and without ribavirin in LT recipients with recurrent genotype 1 hepatitis C. Results: Eighty-five LT recipients were treated for recurrent HCV with ledipasvir/sofosbuvirwith and without ribavirin for 12 or 24 weeks. The mean (± standard deviation [SD]) time from LT to treatment initiation was 68 (±71) months. The mean (± SD) age of the cohort was 63 (±8.6) years old. Most recipients were male (70%). Baseline alanine transaminase, total bilirubin, and HCV ribonucleic acid (RNA) values (± SD) were 76.8 (±126) mg/dL, 0.8 (±1.3) U/L, and 8,010,421.9 (±12,420,985) IU/mL, respectively. Five of 43 recipients who were treated with ribavirin required drug cessation due to side effects, with 4 of those being anemia complications. No recipient discontinued the ledipasvir/sofosbuvir. Eighty-one percent of recipients had undetectable viral levels at 4 weeks after starting therapy, and all recipients had complete viral suppression at the end of therapy. The sustained viral response at 12 weeks after completion of therapy was 94%. Conclusion : Ledipasvir and sofosbuvir with and without ribavirin therapy is an effective and well-tolerated interferon-free treatment for recurrent HCV infection after LT. Anemia is not uncommon in LT recipients receiving ribavirin.