Impact of Collaborative Inpatient Pairing Between Pharmacy Students and Family Medicine Residents on Perceptions of Interprofessional Care.

Introduction: Interprofessional education (IPE) and collaborative practice increasingly inform accreditation standards for pharmacy and medical education, grounded in evidence of benefits to patients and learners. Optimizing models that meaningfully provide this type of practice remains a challenge. This study examines the impact of inpatient collaboration between pharmacy students and family medicine residents on perceptions of interprofessional care. Methods: Pharmacy students and family medicine residents were invited to participate in an IPE experience during their medicine rotation, in which student-resident pairs worked collaboratively on patient care for a block rotation. We used a Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education Instrument (SPICE-2) survey instrument and included an opportunity for open comments by participants. We performed statistical analysis using paired t tests. Results: We observed statistically significant changes (P<.05) in four of the 10 survey items for pharmacy students and two out of 10 in family medicine residents. Narrative comments provided by both students and residents were positive regarding the IPE experience. Conclusion: This pilot provides preliminary evidence to support an IPE care model that integrates pharmacy students by pairing them with family medicine residents on an inpatient adult family medicine teaching service. Implementation of a paired-IPE model changed both professions' perception of their roles within the team and appreciation of training requirements. Larger studies could be done to further evaluate the outcomes of this and similar models.

Tips and tools for safe opioid prescribing.

This review-with tables summarizing opioid options, dosing considerations, and recommendations for tapering-will help you provide rigorous Tx for noncancer pain while ensuring patient safety.

Progressive Politics and Humanistic Psychology in the Trump/Coronavirus Era.

In this article, the author discusses the relationship of progressive politics to humanistic psychology in the Trump/Coronavirus era. The harsh realities of personal fears and severe challenges to our mental health evoked by both the United States presidency of Donald Trump and the coronavirus pandemic are described initially. Then, a number of self-care practices that are consistent with the basic values of humanistic psychology and that we can undertake to help us meet these harsh realities are illustrated. Next, the author describes his own personal engagement and self-care in the world of progressive politics and humanistic psychology in the context of the Resisting Trump movement. The article concludes with the author suggesting that perhaps it may be worthwhile for politically like-minded others to also consider finding ways of merging their progressive politics with humanistic psychology in order to enhance their self-care through these turbulent times in the Trump/Coronavirus era.

"Without any indication": stigma and a hidden curriculum within medical students' discussion of elective abortion.

Pregnancy termination is a common, beneficial medical procedure, but abortion care in the United States is stigmatized. Language, including categorization of some abortions as elective, may both reflect and convey stigma. We present a history of the term "elective" in reference to abortion, followed by data demonstrating its use by a sample of contemporary medical trainees and an analysis of the term's relationship to abortion stigma, medical training, and patient access to abortion care. We analyzed interviews with 41 U.S. medical students who had applied to residency programs in obstetrics and gynecology. Participants discussed experiences with, and attitudes toward, abortion before and during medical school, and plans to perform abortions in future practice. We inductively coded participants' use of "elective" in reference to abortion and analyzed their meanings. Participants did not use "elective" according to its medical definition, which conveys an absence of urgency for surgery. Instead, "elective" identified a subset of abortions that lacked maternal or fetal medical indications. "Elective" negatively marked and isolated some abortions, and participants used the term to convey judgment about patients' social and reproductive histories. Participants saw medical and psychosocial indications as mutually exclusive, and became confused when interrelated factors influenced patients' abortion decisions. They ignored the voluntary nature of abortion in the setting of medical illness, sexual violence, or fetal complications, and accepted discrimination against women seeking abortion for psychosocial indications as normal and ethical. The term "elective" enables the creation and perpetuation of abortion stigma, and contributes to a hidden curriculum for abortion training in medical education that distracts from core content, incorporates social judgment of patients into medical practice, and promotes normative gender concepts. Our findings support calls to improve the language of abortion care to ensure policies and training environments are consistent with professional standards.

Viagra deafness--sensorineural hearing loss and phosphodiesterase-5 inhibitors.

BACKGROUND: Viagra and PDE-5 inhibitors use has mushroomed since its launch over a decade ago. A growing body of evidence indicates significant morbidity associated with the side effect profile of this class of drug. Hearing loss associated with PDE-5 inhibitor use has recently been reported, but few studies have evaluated the causal link. AIM: To review and scrutinise the current literature on the subject and propose possible physiologic mechanisms and to investigate the global reporting of this side effect. METHODS AND MATERIALS: Pharmacovigilance agencies around North America, Europe, and Australasia were contacted requesting reports of hearing loss associated with PDE-5 inhibitors. Reports were scrutinised to exclude those where others causes of hearing loss existed. RESULTS: Forty-seven cases of sensorineural hearing loss with a temporal association with PDE-5 inhibitor ingestion were obtained from both published literature and pharmacovigilance agencies. Cases had a mean age 56.6 years, male-to-female ratio of 7:1. Eighty-eight percent of reports were unilateral with an even left/right distribution. Hearing loss occurred within 24 hours of ingestion of PDE-5 inhibitor in 66.7% (n = 18) of cases. Sildenafil accounted for over 50% of cases. CONCLUSION: There is increasing evidence that PDE-5 inhibitors may induce sensorineural hearing loss via plausible physiological mechanisms. There needs to be more awareness of this disabling side effect among healthcare professionals responsible for prescribing this drug.

A head and neck cancer database for the 21st century.

A versatile, hand-held computerised database is described. Its use for general patient management, audit and as a tool for clinical governance is illustrated.