Independent Setting Research Articles

Implementation of a text message reminder service in an independent community pharmacy: A retrospective analysis of time to prescription pickup and satisfaction

ObjectiveApproximately 30% of individuals admit that their medication nonadherence is due to forgetfulness, and 20%-30% of new prescriptions are never picked up. The primary objective of this study is to determine the impact of a text messaging reminder service on time to prescription pickup in an independent community pharmacy setting. MethodsWe conducted a retrospective evaluation using a pre-post design involving 42 individuals who voluntarily enrolled in a text messaging reminder service. The periods 3 months before and 3 months after the initiation of the service were compared. Text messages were sent to individuals when their prescriptions were ready to be picked up. Time to prescription pickup was the primary dependent variable, and the number of medications, distance from the pharmacy, age, and sex were examined. In addition, we sent a text message inquiring about satisfaction with the service. ResultsIn an analysis of 487 prescription pickup instances, 212 occurred before and 275 after the service for the 42 enrolled individuals. The average time to prescription pickup significantly improved by 12.3 hours (P = 0.001) after implementing the service. After adjusting for age, sex, distance to the pharmacy, number of medications per instance, and number of text messages per instance, the time to prescription pickup improved significantly by 15.8 hours (P = 0.03) after implementation. Thirty-three individuals (79%) reported satisfaction with the text messaging service, whereas 9 patients (21%) did not respond to the survey. Individuals living between 2 and 5 miles from the pharmacy and those 50-64 years old were less likely to respond to the satisfaction survey compared with the other distance and age categories. ConclusionA text message reminder service significantly improved the time to prescription pickup by almost 16 hours in an independent pharmacy. Overall, individuals were satisfied with the service.

Award for Distinguished Professional Contributions to Independent Practice: Paula E. Hartman-Stein.

The Award for Distinguished Professional Contributions to Independent Practice is intended to recognize outstanding independent practitioners in psychology. The award is given to a psychologist working in an area of clinical specialization, health services provision, or consulting, and services provided to any patient population or professional clientele in an independent setting. The 2018 recipient is Paula E. Hartman-Stein, "for her exceptional leadership in the field, and for making an impact that has led to positive outcomes in the health and well-being of older adults." Her award citation, biography, and a selected bibliography are presented here. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Award for Distinguished Professional Contributions to Independent Practice.

This award is intended to recognize outstanding independent practitioners in psychology. Nominations are considered for psychologists working in any area of clinical specialization, health services provision, or consulting, and services provided to any patient population or professional clientele in an independent setting. Services provided to diverse client groups or patient populations, including but not limited to children/adolescents/adults/older adults, urban/rural/frontier populations, minority populations, and persons with serious mental illness are considered. Contributions are judged distinguished by virtue of peer recognition, advancement of the public's recognition of psychology as a profession, relevant professional association honors, or other meritorious accomplishments denoting excellence as a practitioner, including advancement of the profession. The 2018 recipients of the APA Professional Contributions Awards were selected by the 2017 Board of Professional Affairs (BPA). (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Evaluation of deep convolutional neural networks for detection of freezing of gait in Parkinson’s disease patients

Abstract Background and objective Freezing of gait (FOG) is a symptom that manifests as an episodic inability to move. It happens typically in patients with advanced Parkinson’s disease (PD), and it is a common cause of falls in PD patients. The management of FOG is extremely difficult due to its sudden and transient property. Methods In this study, we implemented a novel FOG detection system that was based on deep convolutional neural network (CNN). By taking data segments from 1-dimensional (1D) acceleration signals as its inputs, the proposed CNN-based approach can realize automatic feature learning and discrimination of FOG events from normal walking in a streamline manner. By this way, it can remove the need for extracting hand-crafted features and the time-consuming feature selection. The proposed method was tested on a dataset comprised of more than eight hours of recorded lab data from 10 PD patients that experience FOG in their daily life. Results The final system achieved more than 99% classification accuracy in a patient-dependent setting, and an average of 80.70% accuracy in the patient -independent setting. The time for classification of a 4 s data segment is only 3.6 ms without the acceleration of graphics processing unit (GPU). Conclusions These results indicate that the proposed CNN-based system can provide satisfactory effectivity and efficiency in detecting FOG gaits if used suitably and can be beneficial to realize an accurate monitoring and gait assistance during daily living and rehabilitation therapy.

Coordination of Supply Chains With a Retailer Under the Mean-CVaR Criterion

We consider a single-period supply chain with a newsvendor retailer taking mean-conditional value-at-risk criterion. We characterize the retailer’s risk preference with respect to two risk parameters including risk coefficient and pessimistic coefficient which could jointly model risk-neutral, risk-averse, and risk-taking behavior in a unified framework. Based on this framework, we further analyze the impact of risk preference on the optimal order quantity of the retailer under an independent setting as well as in a supply chain. We then investigate how a supply chain with such a retailer could be coordinated by wholesale price contracts, buy-back contracts and revenue-sharing contracts, respectively. We introduce the notion of risk price which characterize the relations between the contract parameters and the wholesale price simply. And then we analytically derive the coordination contracts depending on the risk price and demonstrate how it affects the supply chain coordination. In the numerical examples, we analyze the impacts of the risk parameters on the wholesale price, buy-back price and revenue fraction as well as the corresponding performance of supply chain members in the coordinated supply chain, respectively. It shows that this paper presents a generalized framework of that in the case of risk-neutrality and risk-aversion.

Community Pharmacist Preferences in Transition of Care Communications

Objective: To determine community pharmacist preferences in transition of care (TOC) communications. Methods: In this cross-sectional study, data were gathered via electronic survey of community pharmacists regarding their preferences for TOC communications. The survey was distributed via email by the North Carolina Board of Pharmacy. Results were analyzed using descriptive statistics. Results: Survey responses were received from 343 community pharmacists (response rate = 6.1%). Responders most commonly worked in an independent, single store (29.2%, n = 100) or national chain (29.2%, n = 100) pharmacy setting. Preferred method for a TOC communication was via electronic health record (63.0%, n = 184). Preferred TOC communication content are mentioned as follows: active (93.2%, n = 274) and discontinued (86.4%, n = 254) medications and reason for hospitalization (85.0%, n = 250). The top 3 self-identified barriers to utilizing a TOC communication: lack of care coordination with community pharmacy (35.0%, n = 14), lack of support from other health-care providers (22.5%, n = 9), and absence of compensation for providing the service (17.5%, n = 7). When asked if TOC communications were available, 97.5% (n = 278) indicated it would be useful. Conclusion: Community pharmacists acknowledged a need for TOC communications and shared their preferences in the content and method of communication. Future research is warranted to implement TOC communications between a health system and community pharmacy.

Coherent properties of a tunable low-energy electron-matter-wave source

A general challenge in various quantum experiments and applications is to develop suitable sources for coherent particles. In particular, recent progress in microscopy, interferometry, metrology, decoherence measurements and chip based applications rely on intensive, tunable, coherent sources for free low energy electron matter waves. In most cases, the electrons get field emitted from a metal nanotip where its radius and geometry towards a counter electrode determines the field distribution and the emission voltage. A higher emission is often connected to faster electrons with smaller de Broglie wavelengths, requiring larger pattern magnification after matter wave diffraction or interferometry. This can be prevented with a well-known setup consisting of two counter electrodes that allow independent setting of the beam intensity and velocity. However, it needs to be tested if the coherent properties of such a source are preserved after the acceleration and deceleration of the electrons. Here, we study the coherence of the beam in a biprism interferometer with a single atom tip electron field emitter if the particle velocity and wavelength varies after emission. With a Wien filter measurement and a contrast correlation analysis we demonstrate that the intensity of the source at a certain particle wavelength can be enhanced up to a factor of 33 without changing the transverse and longitudinal coherence of the electron beam. In addition, the energy width of the single atom tip emitter was measured to be 377 meV, corresponding to a longitudinal coherence length of 82 nm. The design has potential applications in interferometry, microscopy and sensor technology

Effects of Flipped Learning Using Online Materials in a Surgical Nursing Practicum: A Pilot Stratified Group-Randomized Trial.

ObjectivesThis study examined the effect of flipped learning in comparison to traditional learning in a surgical nursing practicum.MethodsThe subjects of this study were 102 nursing students in their third year of university who were scheduled to complete a clinical nursing practicum in an operating room or surgical unit. Participants were randomly assigned to either a flipped learning group (n = 51) or a traditional learning group (n = 51) for the 1-week, 45-hour clinical nursing practicum. The flipped-learning group completed independent e-learning lessons on surgical nursing and received a brief orientation prior to the commencement of the practicum, while the traditional-learning group received a face-to-face orientation and on-site instruction. After the completion of the practicum, both groups completed a case study and a conference. The student's self-efficacy, self-leadership, and problem-solving skills in clinical practice were measured both before and after the one-week surgical nursing practicum.ResultsParticipants' independent goal setting and evaluation of beliefs and assumptions for the subscales of self-leadership and problem-solving skills were compared for the flipped learning group and the traditional learning group. The results showed greater improvement on these indicators for the flipped learning group in comparison to the traditional learning group.ConclusionsThe flipped learning method might offer more effective e-learning opportunities in terms of self-leadership and problem-solving than the traditional learning method in surgical nursing practicums.

Award for Distinguished Professional Contributions to Independent Practice: Mary O'Leary Wiley.

The Award for Distinguished Professional Contributions to Independent Practice is intended to recognize outstanding independent practitioners in psychology. The award is given to a psychologist working in an area of clinical specialization, health services provision, or consulting, and services provided to any patient population or professional clientele in an independent setting. The 2017 recipient is Mary O'Leary Wiley, who has demonstrated exemplary service in the areas of child treatment and trauma as well as adoption, raising awareness of social contexts. She has also contributed significant leadership in areas of professional practice such as mentorship and ethics. Wiley's award citation, biography, and a selected bibliography are presented here. (PsycINFO Database Record

Priority interventions to improve maternal and child diets in Sub-Saharan Africa and South Asia.

Nutrition‐sensitive interventions to improve overall diet quality are increasingly needed to improve maternal and child health. This study demonstrates feasibility of a structured process to leverage local expertise in formulating programmes tailored for current circumstances in South Asia and Africa. We assembled 41 stakeholders in 2 regional workshops and followed a prespecified protocol to elicit programme designs listing the human and other resources required, the intervention's mechanism for impact on diets, target foods and nutrients, target populations, and contact information for partners needed to implement the desired programme. Via this protocol, participants described 48 distinct interventions, which we then compared against international recommendations and global goals. Local stakeholders' priorities focused on postharvest food systems to improve access to nutrient‐dense products (75% of the 48 programmes) and on production of animal sourced foods (58%), as well as education and social marketing (23%) and direct transfers to meet food needs (12.5%). Each programme included an average of 3.2 distinct elements aligned with those recommended by United Nations system agencies in the Framework for Action produced by the Second International Conference on Nutrition in 2014 and the Compendium of Actions for Nutrition developed for the Renewed Efforts Against Child Hunger initiative in 2016. Our results demonstrate that a participatory process can help local experts identify their own priorities for future investments, as a first step in a novel process of rigorous, transparent, and independent priority setting to improve diets among those at greatest risk of undernutrition.

Exploring anomaloushbb¯andhbb¯γcouplings in the context of the LHC and ane+e−collider

In the light of the 125 GeV Higgs ($h$) discovery at the Large Hadron Collider (LHC), one of the primary goals of the LHC and possible future colliders is to understand its interactions more precisely. Here we have studied the $h$-$b$-$\bar b$-$\gamma$ effective interaction terms arising out of gauge invariant dimension six operators in a model independent setting, as a potential source of new physics. Their role in some detectable final states have been compared with those coming from anomalous $h$-$b$-$\bar b$ interactions. We have considered the bounds coming from the existing collider and other low energy experimental data in order to derive constraints on the potential new physics couplings and predict possible collider signals for the two different new physics scenarios in the context of 14 TeV LHC and and a future $e^+e^-$ machine. We conclude that the anomalous $h$-$b$-$\bar b$-$\gamma$ coupling can be probed at the LHC at 14 TeV at the 3$\sigma$ level with an integrated luminosity of $\sim 2000~{\rm fb}^{-1}$, which an $e^+e^-$ collider can probe at the 3$\sigma$ level with $\sim 12(7)~{\rm fb}^{-1}$ at $\sqrt{s}=250(500)~{\rm GeV}$. It is also found that anomalous $h$-$b$-$\bar b$ interactions, subject to the existing LHC constraints, can not compete with the rates driven by $h$-$b$-$\bar b$-$\gamma$ effective interactions.

Abstract 3040: Functional genomic screening identifies USP11 as a novel regulator of ERα transcription in breast cancer

Abstract Approximately 70% of breast cancers overexpress the estrogen receptor α (ERα) and depend on this key transcriptional regulator for growth and differentiation. The discovery of novel mechanisms controlling ERα function represent major advances in our understanding of breast cancer progression and potentially offer attractive new therapeutic opportunities. Here, we investigated the role of deubiquitinating enzymes (DUBs), which act to remove ubiquitin moieties from proteins, in regulating transcriptional activity of ERα in breast cancer. To identify DUBs involved in the regulation of ERα transcriptional activity, we performed an RNAi loss-of-function screen using a library of shRNA vectors targeting all human DUB genes. The DUB library consisted of pools of four non-overlapping shRNAs targeting all 108 known or putative DUBs (432 shRNAs in total). We found that suppression of a number of DUBs markedly repressed or enhanced the activity of an estrogen-response-element (ERE) luciferase reporter following estradiol (E2) stimulation. Of particular interest, suppression of the BRCA2-associated DUB, USP11, was found to down-regulate ERα transcriptional activity. Subsequent validation using two individual siRNAs targeted to USP11 revealed a notable reduction in expression of endogenous ERα target genes in the ZR-75-1 cell line, as quantified using qRT-PCR. Immunoprecipitation of ERα revealed no physical interaction with USP11, however E2 stimulation resulted in translocation of USP11 to the nucleus, suggesting a potential role in E2-induced transcription. Furthermore, USP11 expression was found to be upregulated in the estrogen-independent cell line LCC1 when compared to their parental MCF7 cells. Knockdown of USP11 in LCC1 cells resulted in decreased mRNA expression of a panel of ERα target genes, suggesting a role for USP11 in an estrogen independent setting. To support the prognostic relevance of USP11, immunohistochemical staining of a breast cancer tissue microarray (n=144) was performed. Kaplan-Meier analysis of this cohort revealed a highly significant association between poor overall survival (OS) (p=0.030) and breast cancer-specific survival (BCSS) (p=0.041). In silico analysis of publically available breast cancer gene expression datasets further supported an association between high USP11 mRNA levels and poor prognosis. We observed a significant correlation between high expression of USP11 mRNA in ER-positive patients and poor distant metastasis-free survival (DMFS) (HR 2, CI 1.37-2.91, p=0.00023). This correlation was also significant in ER-positive patients who had received endocrine therapy only (HR 2.9, CI 1.63-5.15, p=0.00015). These results suggest a role for USP11 in driving cellular growth and identify USP11 as novel therapeutic target in breast cancer. Citation Format: Lisa Dwane, Aisling E. O'Connor, Laoighse Mulrane, Annette M. Dirac, Karin Jirstrom, John P. Crown, Rene Bernards, William M. Gallagher, Tríona Ní Chonghaile, Darran P. O'Connor. Functional genomic screening identifies USP11 as a novel regulator of ERα transcription in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3040. doi:10.1158/1538-7445.AM2017-3040

An effective invasive weed optimization algorithm for scheduling semiconductor final testing problem

Abstract In this paper, we address a semiconductor final testing problem from the semiconductor manufacturing process. We aim to determine both the assignment of machines and the sequence of operations on all the machines so as to minimize makespan. We present a cooperative co-evolutionary invasive weed optimization (CCIWO) algorithm which iterates with two coupled colonies, one of which addresses the machine assignment problem and the other deals with the operation sequence problem. To well balance the search capability of the two colonies, we adopt independent size setting for each colony. We design the reproduction and spatial dispersal methods for both the colonies by taking advantage of the information collected during the search process and problem-specific knowledge. Extensive experiments and comparison show that the proposed CCIWO algorithm performs much better than the state-of-the-art algorithms in the literature for solving the semiconductor final testing scheduling problem with makespan criteria.

Assessment of targeted automated messages on herpes zoster immunization numbers in an independent community pharmacy

ObjectivesTo evaluate the impact of an automated phone call by a pharmacy owner on the number of herpes zoster vaccinations given in the independent community pharmacy setting, compare herpes zoster immunization numbers in the 3 months during the previous year to the 3 months during the intervention, and assess patient satisfaction with the automated phone call service. MethodsThis prospective study took place in an independent community pharmacy. A message was recorded by the pharmacy owner using a telephone-message program that notified patients aged 60 and older that the herpes zoster vaccine is recommended for them. This message was sent out monthly for a total of 3 months. Patients who received this vaccine in the 3 months following the initial phone call were surveyed to determine their reason for receiving the vaccine, and to assess satisfaction with the phone call. The total number of herpes zoster immunizations given at the pharmacy during the study period was compared to the total given at the pharmacy during the same period of the previous year. ResultsA total of 25 participants received the herpes zoster vaccine at the pharmacy during the study period, compared to 16 during the control period. Receiving the phone call was the most commonly cited reason for receiving the vaccine, followed by doctor recommendation. Of the 18 participants who received the call, 12 stated that they would be very likely to respond to similar phone calls in the future. ConclusionThese results demonstrate that using a targeted, automated phone call directed at eligible patients appears to have a positive effect on their willingness to receive the herpes zoster vaccine and may lead to an increase in vaccination numbers among eligible patients. Various factors must be considered before implementation of this service, including cost and added call volume.

Accountability in an Independent Regulatory Setting: The Use of Impact Assessment in the Regulation of Financial Reporting in the UK

The growing reliance on non-governmental independent regulators in many social and economic domains, including corporate financial reporting, has brought to the fore concerns over their regulatory accountability. This study looks at one aspect of the regulatory due process-regulatory impact assessment (IA). Drawing on the analytical framework developed by Bovens (Public accountability: a framework for the analysis and assessment of accountability arrangements in the public domain. CONNEX papers, Research Group 2, Democracy and Accountability in the EU, 2006, Eur Law J 13(4): 447–468, 2007), we evaluate the contribution of IA as an instrument for enhancing regulatory accountability in the context of the Financial Reporting Council, an independent regulator for the accountancy profession in the UK. The study’s findings suggest that, despite an increasing level of sophistication in the manner in which IA is used within FRC, the contribution of IA to regulatory accountability remains limited. Specifically, there are concerns as to whether IA is used to achieve a transparent and fair regulatory process or simply to maintain an image of good governance and justify policy decisions that would have been made even in the absence of IA.

PD51-09 CONDITIONAL PROBABILITY OF BIOCHEMICAL RECURRENCE-FREE SURVIVAL AND CANCER-SPECIFIC MORTALITY AFTER RADICAL PROSTATECTOMY AT LONG TERM FOLLOW-UP

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VI1 Apr 2017PD51-09 CONDITIONAL PROBABILITY OF BIOCHEMICAL RECURRENCE-FREE SURVIVAL AND CANCER-SPECIFIC MORTALITY AFTER RADICAL PROSTATECTOMY AT LONG TERM FOLLOW-UP Silvia Garcia-Barreras, Rafael Sanchez-Salas, Igor Nunes-Silva, Fernando Secin, Victor Srougi, Mohammed Baghdadi, Eric Barret, François Rozet, Marc Galiano, and Xavier Cathelineau Silvia Garcia-BarrerasSilvia Garcia-Barreras More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , Igor Nunes-SilvaIgor Nunes-Silva More articles by this author , Fernando SecinFernando Secin More articles by this author , Victor SrougiVictor Srougi More articles by this author , Mohammed BaghdadiMohammed Baghdadi More articles by this author , Eric BarretEric Barret More articles by this author , François RozetFrançois Rozet More articles by this author , Marc GalianoMarc Galiano More articles by this author , and Xavier CathelineauXavier Cathelineau More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2209AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To estimate the conditional probability of biochemical recurrence (BCR) free survival and cancer-specific mortality (CSM) for men with clinically localized prostate cancer (PCa) treated with radical prostatectomy (RP). METHODS The study population consisted of 3576 consecutive patients who underwent laparoscopic radical prostatectomy (LARP) and 2619 men treated with robotic radical prostatectomy (RARP) in the last 15 years at our institution. BCR was defined as PSA≥0.2 ng/dl. PCa death was defined as patients who died with metastasis in an androgen independent setting. Kaplan Meier and Cox regression methods was used to estimate BCR and CSM conditional probabilities. RESULTS Median follow-up was 8.49 years (IQR 4.01-12.97). Positive surgical margins (PSM) were identified in 1202 patients (19.4%); of these, 664 (55.24%) had organ confined disease and 523 (43.51%) had extraprostatic extension (EPE). BCR-free survival rate was significantly higher with RARP (83% vs 77% for laparoscopic surgery at 10 years; p<0.001). Patients with PSA<10 ng/dl BCR-free survival at 10 years was 80% vs 64% for PSA 10-20 ng/dl, and 59% for PSA >20ng/dl; p>0.001. Negative margins, Gleason≤6 and no extracapsular extension in the specimen were found to have higher BCR-free survival (all p< 0.001). Conditional probability of BCR after surgery 1st year is 6.7%. Those who reach the 2nd year without recurrence have a relapse probability of 4%, (cumulative probability 9.8%) That probability falls to 3.5% after the 3rd year (cumulative probability 13%), 2% after the 4th year (cumulative probability 15%) and is 2.1% after the 5th year (cumulative probability 17%). After 10 years of follow-up without recurrence, the subsequent probability of relapse is 0.8%, (cumulative probability 21%). A total of 92 (1.48%) patients died of disease. Among patients with BCR, those who recur within the first three years of follow-up had higher CSM (9% vs 4% for BCR after 3 years; p=0.04). The table shows the variables associated with CSM in multivariable analysis. CONCLUSIONS We found a 50% decrease in BCR probability in patients who had not recurred with the first 3 years. Similar drop was identified for CSM. This is not only useful for patients counseling but also to optimize postoperative follow-up strategies. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e987 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Silvia Garcia-Barreras More articles by this author Rafael Sanchez-Salas More articles by this author Igor Nunes-Silva More articles by this author Fernando Secin More articles by this author Victor Srougi More articles by this author Mohammed Baghdadi More articles by this author Eric Barret More articles by this author François Rozet More articles by this author Marc Galiano More articles by this author Xavier Cathelineau More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Conditional biochemical recurrence-free survival and cancer-specific mortality after radical prostatectomy at long term follow-up.

55 Background: To estimate the conditional biochemical recurrence-free survival (BCR) rates and cancer-specific mortality (CSM) for men with clinically localized prostate cancer (PCa) treated with radical prostatectomy (RP) at our institution. Methods: A total of 3576 patients underwent laparoscopic radical prostatectomy (LARP) and 2619 men were treated with robotic radical prostatectomy (RARP) in the last 15 years. BCR of primary treatment was defined as PSA &gt; 0.2 ng/dl. PCa death was defined as patients who died with metastasis in an androgen independent setting. Kaplan-Meier and Cox regression methods were used to estimate the conditional survival probabilities and CSM. Results: The median follow-up was 8.49 years (IQR 4.01-12.97). A total of 92 (1.48%) patients (80 LARP and 12 RARP) died of disease. Positive surgical margins (PSM) were identified in 1202 patients (19.4%); of these, 664 (55.24%) had organ confined disease and 523 (43.51%) had extraprostatic extension (EPE). BCR-free survival rate was found significantly higher with RARP (83% vs 77% for LARP at 10 years; p &lt; 0.001). For patients with PSA &lt; 10 ng/dl BCR-free survival at 10 years was 80% vs 64% for PSA 10-20 ng/dl, and 59% for PSA &gt; 20ng/dl; p &gt; 0.001. Conditional probability of BCR after surgery 1st year was 6.7%. Those who reach the 2nd year of surgery without recurrence had a relapse probability of 4%, (cumulative probability 9.8%) That probability falls to 3.5% after the 3rd year (cumulative probability 13%), 2% after the 4th year (cumulative probability 15%) and is 2.1% after the 5th year (cumulative probability 17%). After 10 years of follow-up without recurrence, the possibility of relapse was 0.8%, (cumulative probability 21%). Men without BCR had a clinical trend of higher CSM at 10 years (7% vs 2% no BCR; p 0.06). Within the patients who develop BCR, those with BCR in the first three years of follow-up had higher CSM (9% vs 4% for BCR after 3 years; p 0.04). Conclusions: BRC free survival outcomes are affected by risk factors associated with type of surgery and prognosis in PCa. The period elapsed from RP is associated with BCR-free survival and the risk of recurrence decrease with increasing survival.

Interprofessional Approach to Increase Billable Care-Events in a Rural Community

Objectives: The study was designed to build a financially stable, replicable, and interprofessional program around a Center of Excellence (COE) model exclusively in a community pharmacy setting. This involved creating a separate pharmacy-based clinic within the community pharmacy with recognized rendering providers by payers allowing pharmacists to bill incident to for services and increase the quality of patient clinical outcomes.&#x0D; Setting: Apple Discount drugs in Salisbury, MD is a multi-site independent community pharmacy setting offering traditional pharmacy services along with several pharmacist run clinical programs.&#x0D; Practice Innovation: The pharmacy developed an interprofessional team around a Center of Excellence (COE) model as a separate medical clinic within the community pharmacy as a subsidiary of the parent company that was staffed with healthcare providers that are recognized by payers to bill for services.&#x0D; Main Outcome Measures: Outcomes of the study included analysis of the number of patients seen, the ability to obtain reimbursement for the clinical services offered, and changes in A1C and BMI to support the clinical value of pharmacist intervention.&#x0D; Results: A total of 309 patients with diabetes were seen over a 16 month period, including 120 patients who completed the 10 hour diabetes training program. Clinical outcomes showed an improvement in A1C from 9.1 pre enrollment to 7.5 post intervention, and a drop in BMI from 35.7 pre enrollment to 32.4 post intervention. The pharmacy was also able to increase the amount of reimbursement for services provided.&#x0D; Conclusions: The development of a pharmacy based clinic business model inside of a community pharmacy has increased the amount of clinically billed services for the pharmacy. Improvements in clinical outcomes led to an acceptance of the pharmacist as a member of the patient’s care team by patients, local physician’s offices, and third party payers.&#x0D; Funding: This work was supported by the Community Pharmacy Foundation [grant #143 , 2015]&#x0D; &#x0D; Type: Commentary

Discrimination via Symmetric Auctions

Discrimination (for instance, along the lines of race or gender) is often prohibited in auctions. This is legally enforced by preventing the seller from explicitly biasing the rules in favor of bidders from certain groups (for example, by subsidizing their bids). In this paper, we study the efficacy of this policy in the context of a single object: independent private value setting with heterogeneous bidders. We show that restricting the seller to using an anonymous, sealed bid auction format (or, simply, a symmetric auction) imposes virtually no restriction on her ability to discriminate. Our results highlight that the discrepancy between the superficial impartiality of the auction rules and the resulting fairness of the outcome can be extreme. (JEL D44, D82)

Interprofessional Approach to Increase Billable Care-Events in a Rural Community

Objectives: The study was designed to build a financially stable, replicable, and interprofessional program around a Center of Excellence (COE) model exclusively in a community pharmacy setting. This involved creating a separate pharmacy-based clinic within the community pharmacy with recognized rendering providers by payers allowing pharmacists to bill incident to for services and increase the quality of patient clinical outcomes. Setting: Apple Discount drugs in Salisbury, MD is a multi-site independent community pharmacy setting offering traditional pharmacy services along with several pharmacist run clinical programs. Practice Innovation: The pharmacy developed an interprofessional team around a Center of Excellence (COE) model as a separate medical clinic within the community pharmacy as a subsidiary of the parent company that was staffed with healthcare providers that are recognized by payers to bill for services. Main Outcome Measures: Outcomes of the study included analysis of the number of patients seen, the ability to obtain reimbursement for the clinical services offered, and changes in A1C and BMI to support the clinical value of pharmacist intervention. Results: A total of 309 patients with diabetes were seen over a 16 month period, including 120 patients who completed the 10 hour diabetes training program. Clinical outcomes showed an improvement in A1C from 9.1 pre enrollment to 7.5 post intervention, and a drop in BMI from 35.7 pre enrollment to 32.4 post intervention. The pharmacy was also able to increase the amount of reimbursement for services provided. Conclusions: The development of a pharmacy based clinic business model inside of a community pharmacy has increased the amount of clinically billed services for the pharmacy. Improvements in clinical outcomes led to an acceptance of the pharmacist as a member of the patient’s care team by patients, local physician’s offices, and third party payers. Funding: This work was supported by the Community Pharmacy Foundation [grant #143 , 2015] Type: Commentary