Should all asthma patients be switched to single maintenance and reliever therapy?

ABSTRACT: Recent data indicate that overuse of short-acting beta2-agonists (SABAs) results in an increased risk of asthma exacerbations and mortality. The use of inhaled corticosteroid-formoterol as both maintenance and reliever therapy has become a preferred regimen for asthma management. Clinicians should be aware of the pharmacology, dosing, and prescribing considerations regarding the use of budesonide-formoterol as the available combination in the United States.

Community pharmacists' perceptions on their role in counseling patients on lifestyle modifications.

BACKGROUND: Patients need an accessible health care provider who can assist in lifestyle counseling for chronic disease states. Pharmacists are easily accessible in the community, as a recent study found that nearly 90% of Americans live within 5 miles of a community pharmacy. Thus, pharmacists are ideally positioned to offer counseling on lifestyle modifications at this health care access point. OBJECTIVES: The study's primary objective was to identify common barriers that community pharmacists may face in regard to provision of lifestyle counseling. Secondary objectives included determining strategies to overcome barriers and examining community pharmacists' willingness and level of comfort in providing lifestyle counseling to their patients. METHODS: The study used mixed methods where pharmacists completed a survey and opted into a semi-structured interview. Survey results were analyzed with descriptive statistics and a paired t test. Interviews were recorded and transcribed in April and May 2022 until saturation. Three investigators coded each interview and conducted thematic analysis. Study design and procedures were approved by an institutional review board in December 2021. RESULTS: One hundred forty-one pharmacists completed the survey to yield a 53.2% response rate. A paired t test revealed a statistically significant difference between level of comfort and willingness to counsel (P < 0.001). Willingness to provide lifestyle counseling was higher than the level of comfort in counseling in all areas (alcohol moderation, exercise, nutrition, tobacco cessation, and weight loss). Thematic analysis of the semi-structured interviews revealed 5 dominant themes: increasing patient awareness, counseling due to a patient inquiry, increasing educational materials, aligning corporate measures, and counseling patients with an established relationship. CONCLUSION: Community pharmacists are willing to counsel on lifestyle modifications, however there is a gap between their willingness and comfort in counseling. The top 3 barriers to community pharmacists counseling on lifestyle modifications included time, workflow, and patient willingness. Further studies should explore strategies for implementing lifestyle counseling.

Investigating the Effects of Stealthing Justifications on Rape Perceptions.

The current research aimed to investigate justifications behind the perception of stealthing-the act of nonconsensual condom removal in previously consented intercourse. Based upon an article by Brodsky that conducted real-life interviews of stealthing activities, justifications for the act were experimentally manipulated after the participants read a scenario involving a depiction of stealthing. A four (Justification: Control, Instinct, Right, Pleasure) × two (Participant Gender: female, male) multivariate analysis on the assessment of various criminality, morality, harm, blame/responsibility items yielded a significant difference in terms of rape determination, but not other criminality measures. Implications for future research are discussed.

College students' barriers to seeking mental health counseling: Scale development and psychometric evaluation.

This article reports the development and psychometric properties of the 27-item Barriers to Seeking Mental Health Counseling (BMHC) scale, which assesses perceived help-seeking barriers among college-aged students. Across 2 studies involving ethnically diverse samples (e.g., Latinx majority students), the authors provided evidence for this new measure's validity and reliability. Exploratory and confirmatory factor analyses (including a bifactor analysis) provided support for the BMHC scale's multidimensionality reflecting 6 barriers: Negative Perceived Value, Discomfort with Emotions, Ingroup Stigma, Lack of Knowledge, Lack of Access, and Cultural Barriers. Evidence for criterion-related validity was shown through significant but differential correlations with self-stigma, emotional control, and the 4 components of Ajzen's (1991) Theory of Planned Behavior model-attitude, subjective norm of social stigma, perceived behavioral control, and mental health help-seeking intention. Discriminant evidence of validity was established through nonsignificant or small correlations between BMHC subscales and 2 measures of socially desirable responding. The authors also found evidence for incremental validity and measurement invariance across race, and evidence for internal reliability and temporal stability of the BMHC subscales. Findings are discussed in light of the conceptual, methodological, and clinical contributions of the BMHC scale. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Genomes of ubiquitous marine and hypersaline Hydrogenovibrio, Thiomicrorhabdus and Thiomicrospira spp. encode a diversity of mechanisms to sustain chemolithoautotrophy in heterogeneous environments.

Chemolithoautotrophic bacteria from the genera Hydrogenovibrio, Thiomicrorhabdus and Thiomicrospira are common, sometimes dominant, isolates from sulfidic habitats including hydrothermal vents, soda and salt lakes and marine sediments. Their genome sequences confirm their membership in a deeply branching clade of the Gammaproteobacteria. Several adaptations to heterogeneous habitats are apparent. Their genomes include large numbers of genes for sensing and responding to their environment (EAL- and GGDEF-domain proteins and methyl-accepting chemotaxis proteins) despite their small sizes (2.1-3.1 Mbp). An array of sulfur-oxidizing complexes are encoded, likely to facilitate these organisms' use of multiple forms of reduced sulfur as electron donors. Hydrogenase genes are present in some taxa, including group 1d and 2b hydrogenases in Hydrogenovibrio marinus and H. thermophilus MA2-6, acquired via horizontal gene transfer. In addition to high-affinity cbb3 cytochrome c oxidase, some also encode cytochrome bd-type quinol oxidase or ba3 -type cytochrome c oxidase, which could facilitate growth under different oxygen tensions, or maintain redox balance. Carboxysome operons are present in most, with genes downstream encoding transporters from four evolutionarily distinct families, which may act with the carboxysomes to form CO2 concentrating mechanisms. These adaptations to habitat variability likely contribute to the cosmopolitan distribution of these organisms.

Hybrid molecular brushes with chitosan backbone: facile synthesis and surface grafting.

We developed a facile route toward amphiphilic hybrid molecular brushes (HMB) with chitosan backbone and concurrently grafted chains of poly(acrylamide) and polystyrene. The grafting occurs through amino groups of chitosan; no extra modification of chitosan is required. The kinetic and molecular weight characteristics of the primary molecular brush CHI-graft-PAAm are studied. The second step is grafting of PS by emulsion polymerization. The resulting HMB CHI-graft-PAAm-graft-PS form very stable emulsions. We attached the HMB on solid substrates using chitosan backbone by the "grafting to" approach. Thin films of the immobilized HMB of 3-11 nm thickness completely cover the surface. Being amphiphilic by nature, the immobilized HMB reveal the ability to adapt to the medium, which results in shifting of the hydrophobic/hydrophilic balance over a wide range.

Identification of pBC218/pBC210 Genes of Bacillus cereus G9241 in Five Florida Soils Using qPCR.

The distribution of the virulent plasmid pBC210 of B. cereus that carries several B. anthracis genes and has been implicated in lethal anthrax-like pulmonary disease is unknown. We screened our collection of 103 B. cereus isolates and 256 soil samples using a quantitative PCR (qPCR) assay that targeted three open reading frames putatively unique to pBC210. When tested with DNA from 2 B. cereus strains carrying pBC210, and 64 Gram-positive and 55 Gram-negative bacterial species, the assay had 100% sensitivity and specificity. None of the DNA from the B. cereus isolates yielded positive amplicons but DNA extracted from five soils collected in Florida gave positive results for all three target sequences of pBC210. While screening confirms that pBC210 is uncommon in B. cereus, this study is the first to report that pBC210 is present in Florida soils. This study improves our knowledge of the distribution of pBC210 in soils and, of public health importance, the potential threat of B. cereus isolates carrying the toxin-carrying plasmid. We demonstrated that sequences of pBC210 can be found in a larger geographical area than previously thought and that finding more B. cereus carrying the virulent plasmid is a possibility in the future.