Schools In USA Research Articles

A comprehensive survey of penicillin allergy education among United States Colleges and Schools of Pharmacy

AbstractBackgroundPharmacy students should be prepared to evaluate, manage, and de‐label penicillin allergies. It is unknown if, and to what extent, education about allergy management is included within the curriculum of United States Colleges and Schools of Pharmacy (USCSP). This study sought to evaluate if and how penicillin allergy education is delivered and assess faculty perceptions of student readiness.MethodsA cross‐sectional, multicenter, observational survey was developed by infectious diseases (ID) pharmacy faculty and sent to ID faculty or department chairs at 138 USCSP. The 39‐item questionnaire was divided into demographics, incorporation of targeted or aligned penicillin allergy education in the program, penicillin allergy topics delivered, and respondents' perceptions of penicillin allergy education.ResultsThe survey response rate was 53% (73/138). The USCSP demographics included established for >20 years (65.8%), curriculum length of 4 years (83.6%), semester format (74.0%), and class size of 51–100 students (42.5%). Respondents described the incorporation of targeted or aligned penicillin allergy delivery (47.9%). Targeted delivery occurred in either the required (57.5%) or elective curriculum (31.4%). Topics included definitions/epidemiology (92.8%), cross‐reactivity (92.8%), pathophysiology (88.1%), patient assessment (73.8%), skin testing (71.4%), and desensitization (71.4%). Delivery methods were lecture‐based (92.8%) and case‐based (66.7%). The median perception (scale of 1–10) of student preparedness for evaluating and managing penicillin allergies after completion of the required and elective curriculum was 5.0 (interquartile range [IQR] 3.7–7.0) and 5.0 (3.0–7.3), respectively. Most (52.1%) perceived that penicillin allergy education deserves more time. Faculty from 45% of responding USCSP perceived students to be prepared to evaluate and manage penicillin allergies. Prepared students were more likely to have received case‐based education (54.5% vs. 25.0%, p < 0.01).ConclusionPenicillin allergy education in USCSP varies considerably. Most ID pharmacist faculty perceived that many students were unprepared to evaluate and manage penicillin allergies, and that more time should be allocated to penicillin allergy education.

Цифровая и логистическая инфраструктуры Арктической зоны: современное состояние исследований и пути развития

The subject of the article is the analysis of the current state of research and practice in the field of transport, logistics and digital infrastructures in the Russian Arctic. The authors consider logistic and digital infrastructures as key communication subsystems that ensure the movement of material values, people and information, and thus serve as a prerequisite for the development of the macro-region under consid-eration. The research methods used were literature review of scientific sources and analysis of the ob-tained material. A systematic literature mapping was carried out on Scopus, Google Scholar, Elibrary data-bases. Aspects of the Arctic region development, including the role of logistics and digital infrastructures in this process, are described by scientific schools of Russia, Canada, Norway, China, USA and other countries. The analysis has shown the highly variable state of the subsystems under consideration depending on the specific region, as well as the lack of a comprehensive approach to their joint development and integration. It was stated that there is no such problem statement about the development of communication subsystems of the Arctic zone. On the basis of the analysis, the key directions for the development of logistics and digital infrastructure of the Arctic zone of the Russian Federation were formulated. The authors’ recommendations, apart from the obvious tasks of developing sea routes, building and modernizing roads, railways and airports, expanding access to broadband internet and other widely discussed measures, describe the need to integrate the communication subsystems under consideration and focus on the potential of digital technologies to replace and/or supplement the logistics infrastructure in certain aspects.

Global research on type 1 diabetes: A bibliometric study during 2001-2022

Objective. Type 1 diabetes (T1D) publications have increased over the past three decades. However, there is no study to address and identify gaps in this area and to plan future research. This study aims to analyze the global scientific production of T1D in terms of overall structure and hotspots. Methodology. The research literature on T1D from 2001 to 2022 was obtained and examined from the Scopus database. We then performed bibliometric analysis and network visualization using MS Excel and VOSviewer software. Results and Discussion. The global T1D research comprised 20473 publications, which witnessed 6.19% and 58.91% annual average and 10-year cumulative growth during 2001-2022. These together received 596950 citations, with an average Citation Per Paper (CPP) of 29.16. Of the total global publications, 6030 (29.45%) received external funding support from international agencies and 19553 citations (with an average CPP of 32.43). The global publications were sourced from more than 150 countries and were published in 2665 journals by 63747 authors from 24899 organizations. There is an uneven distribution of countries, organizations, and authors in T1D research, wherein 88.37%, 45.15%, and 20.66% of the global literature was contributed by the top 12 countries and top 30 organizations and authors each. The most productive countries were the USA and UK, with a global share of 30% and 11.1% respectively. The most impactful countries were Finland and the UK regarding CPP & Relative Citation Index (RCI). The Barbara Davis Center for Childhood Diabetes, USA, and the University of Colorado Anschutz Medical Campus, USA, were the most productive organizations, with 735 and 679 publications. Jaeb Center for Health Research, USA (77.03 and 2.64) and Harvard Medical School, USA (67.42 and 2.31) were the most impactful organizations regarding CPP & RCI. Pediatric Diabetes (n=1447) and Diabetes Care (n=1191) were the most productive journals, with 1447 and 1191 papers. Diabetes and Diabetes Care registered the highest CPP (81.54 and 73.88 CPP). The most significant and frequently appearing keywords were “diabetes mellitus, type 1”) (92441), “insulin dependent diabetes mellitus” (95750), “metabolism” (24911), “genetics” (11229), “autoantibodies” (8942), “c peptide” (9931) and “pancreas islet beta cell” (7191). Only 5.54% (1134) of the global publications (considered highly-cited papers) received 100 to 4654 citations since their publications and registered a total of 220.28 CPP. Conclusion. This bibliometric study indicated that most of the contributions came from developed countries and only a meager contribution from developing countries, especially South Asia, despite a significant disease burden. This analysis provides a comprehensive overview of the present status of T1D research. It enables a better understanding of T1D research over the years. It should give the researchers structured information and a comprehensive analysis to help identify gaps in the research and the hot spots in this area of research.

A commercial tobacco and alcohol use intervention for urban Native American youth

ObjectiveWesternized alcohol and commercial tobacco use prevention approaches for Native Americans have not been effective, or sustainable. The overall objective of this study examined the effect of the culturally based Urban Talking Circle (UTC) intervention versus standard education (SE) program for the prevention of alcohol and commercial tobacco use among urban Native American youth. DesignThe study employed a 2-condition quasi-experimental design and utilized convenience and snowball sampling methods for recruiting 100 urban Native American youth participants in two urban Native American community program locations in Florida. Study participants were randomized by their urban Native American community program location to one of the 2-conditions. These included the standard education (SE) program used within United States school systems (drug abuse resistance education) and the Urban Talking Circle (UTC) intervention, culturally tailored and developed for urban Native American youth from the culturally based Talking Circle Intervention for rural Native American Youth. The Native American Alcohol Measure for Youth (NAAMY) and Native Reliance Questionnaire were utilized to collect participants' data. Participants' data was analyzed using multivariate analysis of variance to determine differences between the scores on all measures at pre/post-intervention for the 2-conditions. ResultsStudy findings indicate that a culturally based intervention was more effective for the reduction of commercial tobacco and alcohol use than a non-culturally based intervention for urban Native American youth. ConclusionThe study findings emphasized that the utilization of the culturally tailored UTC intervention reduced involvement associated with alcohol and commercial tobacco use.

Integration of Virtual and Traditional Medical Education: Scholarship Pivots from the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic required an unprecedented transformation of medical education, shifting from traditional, in-person learning to distanced, online learning. This study aimed to review changes to medical education and describe the advantages and disadvantages of virtual medical education experienced by medical students during the pandemic. An online survey study was conducted at two medical schools, University of Michigan Medical School in the United States and Koc University School of Medicine in Turkey. Medical students completed questionnaires regarding their educational experience before and during the pandemic. Survey instruments were designed to assess differences in the educational curriculum, study methods, clinical skills self-evaluations, perceptions of the quality of in-person and online learning, and overall satisfaction. A total of 184 medical students completed the survey. There was an increase in the use of online study tools since the pandemic. There was no statistically significant difference in self-reported assessments of clinical preparedness and overall clinical competence during surgical clerkship. The percentage of students interested in pursuing a career in surgery has nearly doubled from 34% to 63%. A majority of students (83%) believed that the time available for self-study and research increased during the pandemic. Fifty-two percent of students believed that online education is less efficacious than in-person education, but 86% of students still preferred a blended approach. Medical schools have continued to update their curricula following the COVID-19 pandemic. This study illustrates the transformations in medical education to ensure that the most effective and suitable teaching is delivered.

A tale of two cities

ABSTRACT The purpose of this article is to examine the critical components to successfully serving on a school board or leadership roles, as a member of the Latino(a) community. According to a 2010 national school board survey, only 3% of the 900 board respondents identified as Latino(a) compared with almost 80% who identified as White. The first author employs her personal narrative as a method for describing the process of becoming an effective school board member in two different settings, while the second author discusses the contributions of relevant literature, drawing from her experience as a district leader and professor in higher education. Once selected as a board member and district leader, respectively, the authors share the challenges, achievements, and lessons learned from their experiences that can inform others. As demographics in the United States school districts shift, the call for district leaders and school board members to reflect the communities of which they serve, is vital.

Experimental investigation to understand the effect of fracturing fluid on the geomechanical behavior of mowry shale

Hydraulic fracturing of shale reservoirs is one of the important technologies in the oil and gas industry. To ensure the safe operation of oil and gas recovery, it is important to study the shale-fluid interactions on the geomechanical behavior of shale. This study investigated the effect of fracturing fluid treatment on the mechanical and elastic properties of the Mowry Shale formation, Wyoming, USA. Cylindrical Mowry Shale specimens with a diameter of 12.5 mm collected from the United States Geological Survey (USGS) and School of Energy Resources (SER) of the University of Wyoming were treated with brine and brine + stimulation fluid for one month each at pressures of 9 and 11.7 MPa and temperatures of 96 and 66 °C, respectively. Triaxial compression experiments were conducted on the specimens. Results showed that all Mowry Shale specimens experienced an increase in maximum volumetric strain with the increase in effective confining pressure (Pd). Regardless of aging fluids, the maximum deviatoric stress (Δσd) of most Mowry Shale specimens increases with the increase in Pd. At a lower Pd, the USGS specimen aged with brine and stimulation fluid exhibits higher maximum Δσd than those aged with brine only. However, at a higher Pd, the USGS specimen aged with brine exhibits a higher maximum Δσd. SER specimens aged with brine and stimulation fluid exhibit higher maximum Δσd values than those aged with brine for all three Pd values. Regardless of the aging fluids, most USGS specimens experience a brittle failure mode, while SER specimens aged with brine and stimulation fluid experienced a more ductile behavior.

Performance of Artificial Intelligence Chatbots on Glaucoma Questions Adapted From Patient Brochures.

Introduction With the potential for artificial intelligence (AI) chatbots to serve as the primary source of glaucoma information to patients, it is essential to characterize the information that chatbots provide such that providers can tailor discussions, anticipate patient concerns, and identify misleading information. Therefore, the purpose of this study was to evaluate glaucoma information from AI chatbots, including ChatGPT-4, Bard, and Bing, by analyzing response accuracy, comprehensiveness, readability, word count, and character count in comparison to each other and glaucoma-related American Academy of Ophthalmology (AAO) patient materials. Methods Section headers from AAO glaucoma-related patient education brochures were adapted into question form and asked five times to each AI chatbot (ChatGPT-4, Bard, and Bing). Two sets of responses from each chatbot were used to evaluate the accuracy of AI chatbot responses and AAO brochure information, and the comprehensiveness of AI chatbot responses compared to the AAO brochure information, scored 1-5 by three independent glaucoma-trained ophthalmologists. Readability (assessed with Flesch-Kincaid Grade Level (FKGL), corresponding to the United States school grade levels), word count, and character count were determined for all chatbot responses and AAO brochure sections. Results Accuracy scores for AAO, ChatGPT, Bing, and Bard were 4.84, 4.26, 4.53, and 3.53, respectively. On direct comparison, AAO was more accurate than ChatGPT (p=0.002), and Bard was the least accurate (Bard versus AAO, p<0.001; Bard versus ChatGPT, p<0.002; Bard versus Bing, p=0.001). ChatGPT had the most comprehensive responses (ChatGPT versus Bing, p<0.001; ChatGPT versusBard p=0.008), with comprehensiveness scores for ChatGPT, Bing, and Bard at 3.32, 2.16, and 2.79, respectively. AAO information and Bard responses were at the most accessible readability levels (AAO versus ChatGPT, AAO versusBing, Bard versusChatGPT, Bard versusBing, all p<0.0001), with readability levels for AAO, ChatGPT, Bing, and Bard at 8.11, 13.01, 11.73, and 7.90, respectively. Bing responses had the lowest word and character count. Conclusion AI chatbot responses varied in accuracy, comprehensiveness, and readability. With accuracy scores and comprehensiveness below that of AAO brochuresand elevated readability levels, AI chatbots require improvements to be a more useful supplementary source of glaucoma information for patients. Physicians must be aware of these limitations such that patients are asked about existing knowledge and questions and are then provided with clarifying and comprehensive information.

Empoderando la Educación Culturalmente Receptiva: El Papel Vital de los Psicólogos Escolares

This article explores key components of the United States school system, emphasizing the role of school psychologists in supporting both general and special education. It highlights the framework of Multi-Tiered Systems of Support, demonstrating how it aids in identifying and addressing students' academic and socio-emotional needs. The importance of cultural and linguistic diversity is analyzed, with insights from a Latina school psychologist advocating for inclusive practices. The article also provides practical strategies for creating a supportive learning environment, emphasizing collaboration between teachers and parents to ensure the success and well-being of all students.

Use of social media by dental students: A comparative study

ObjectivesSocial media (SM) use is key part of modern pedagogical practice. This study designed to compare online activities of undergraduate dental students from two dental schools in Iraq and USA to compensate for the lack of primary literature on SM comportment of students in third-world countries which acts as a barrier to increasing SM awareness within dentistry. MethodsA questionnaire consisting of 18 questions has been made to assess SM usage among students from Mustansiriya University in Iraq (n = 149) and LECOM School in USA (n = 210). Chi-squared test was used to analyze data. Results125 students from Iraq vs 156 from the USA had participated in this study with a response rate of 84%, 74% respectively. The null hypothesis was partially rejected as half the collected answers showed significant differences. The findings reveal that SM platforms popularity has grown throughout today's society as students are increasingly using them for their studies. YouTube and Instagram were well known to majority of participants. American medical schools began to recognize lack of policies on SM use early, but these have since evolved into their own guidelines. Nevertheless, Iraqi health care system is not yet aware of e-professionalism concept both in education and practice. ConclusionSM is part of modern pedagogy; however, students should be aware of information quality that they obtain from it which may not be referenced from credible sources. The null hypothesis was partially rejected as half the answers showed significant differences between Iraqi and American students.

Cardiopulmonary Resuscitation Education in United States Schools: Shortcomings and Future Directions.

Cardiopulmonary resuscitation (CPR) is a lifesaving procedure that is performed during a cardiac arrest. CPR consists of chest compressions, rescue breaths, and the usage of an automated external defibrillator (AED) based on availability. Performance of CPR can greatly increase the chances of survival by enabling the manual perfusion of vital organs in lieu of the heart's normal function. Despite extensive studies demonstrating the efficacy and necessity of CPR in an emergency, most of the public across the United States is ill-equipped and/or educated on how to perform it. While there may be other contributing factors, the lack of CPR education across schools in the United States almost certainly furthers the CPR illiteracy of the general population. Although states require some degree of CPR training, the level of education that students receive varies widely across communities and school districts, largely dictated by the available funding for training courses. Despite the lack of CPR education in the United States, studies conducted abroad have shown the efficacy of a CPR course in preparing students to respond in emergencies-lending hope to mending the current situation in the United States. In this article, we analyze legislation dictating CPR instruction and hypothesize ways in which states' Department of Education might be able to promote education and hands-on experience for students across all ages of schooling. Ultimately, we hope to highlight the importance and feasibility of preparing the next generation of citizens across the United States to respond when their name is called upon in an emergency.

United States Schools and the Opioid Crisis: Charting New Directions

ABSTRACT Background The opioid epidemic has created unprecedented challenges in the United States (US), including hundreds of thousands of lives lost to overdose in the past five years. Expansion of prevention and treatment for opioid use disorder (OUD) is urgently needed, as evidence-based strategies exist but many remain unable to access life-saving services. Purpose To inform school health and mental health providers, educators and school administrators about the causes and consequences of the US opioid epidemic and to provide practical solutions for engineering multi-tiered systems of support for children and families affected by the epidemic, including through opioid misuse, OUD, and opioid overdose. Methods We review the literature on the history of and current challenges associated with the opioid epidemic in the US. Results The collateral damage of OUD is pervasive, impacting children and families across the US. We found no health education programs focusing on this topic in US schools, underscoring a critical need and cogent practice/policy avenue. Discussion Schools are uniquely positioned to respond to the opioid epidemic, but school health and mental health providers, educators, and other professionals who work in schools must have accurate knowledge of the opioid epidemic, understand the challenges it is causing for children and families, and be familiar with best practices in prevention and treatment. Translation to Health Education Practice This review provides a succinct overview of the history of the opioid epidemic, examines its impacts on children and families, and provides a call to action for schools to partner in our national response.

Peer observation to foster collective teacher efficacy: teachers' perceptions about collegial visits

PurposeThis study explored teachers' perceptions of a specific, collaborative peer observation structure, collegial visits, and collegial visits' connection to collective teacher efficacy (CTE). The research question was: how do teachers perceive collegial visits, particularly with respect to their influence on CTE?Design/methodology/approachWithin this qualitative descriptive study, 13 K-12 educators from three northeastern USA schools (one urban high school and a suburban middle and elementary school) were interviewed individually and/or in a focus group.FindingsUtilizing social cognitive theory as a framework for analysis, the authors found a theme of a shift from uninformed to informed perceptions of the collective. Results demonstrated that collegial visits foster positive CTE beliefs.Practical implicationsSince collegial visits were found to increase participants' CTE, a construct others have associated with increased student achievement, school leaders should consider implementing collegial visits as a professional learning structure in their schools after considering their specific context.Originality/valueThough there has been recent scholarship connecting peer observations and CTE, there has been no research, to date, to examine the effect of the specific structure of collegial visits on CTE.

A preliminary characterization of and call for benchmarking pharmacy alumni engagement

IntroductionAlumni are essential but often overlooked stakeholders for pharmacy programs, and engaging alumni in philanthropy, volunteerism, events, and communication may have important implications for the growth and success of pharmacy programs. This research aims to preliminarily characterize pharmacy alumni engagement across four metrics and provide a call to action for standardized tracking and reporting of alumni engagement efforts across the Academy. MethodsA cross-sectional survey was sent to alumni relations and advancement personnel at United States schools and colleges of pharmacy. The survey gathered information on the accuracy of pharmacy alumni records, alumni engagement within four categories (philanthropy, communication, events, and volunteering), alumni relations personnel, and barriers to alumni engagement efforts. ResultsRespondents reported using various database systems to track and measure alumni engagement, and 41% noted having accurate pharmacy alumni records. Opportunities for alumni engagement within the four categories varied across institutions. Fifty percent of respondents indicated that one full-time equivalent position is allocated to pharmacy alumni engagement efforts at their institution. Barriers to alumni engagement efforts included limited budgets, and staff, engaging alumni via in-person events, and maintaining accurate alumni records. ConclusionsThe Academy may benefit from expanding the annual alumni survey and developing a consistent tracking mechanism to capture and report alumni engagement activities. Additionally, education on alumni engagement metrics and potential collaborative efforts with institutional alumni relations personnel would be of value. This is vital in developing and optimizing alumni relations efforts and engaging pharmacy alumni bases.

Comparison of the different types of visual representations integrated into the contents of the United States and Turkish middle school life science textbook units

The goal of the study was to compare how visual representations were integrated into the contents of the U.S. and Turkish textbooks used in life science. Data was collected from 6th, 7th, and 8th grade middle school topics common to both countries. Content analysis was used to analyse visual representations in textbooks. The visual representations were coded into five categories representative of the level of integration. Findings of the study revealed that many representations in Turkish textbooks were not designed with enough labels and captions compared to the U.S. one. This limited the function of the images in the textbook. The implications for textbook revisions aimed at improving the use of visual representations in the classrooms are discussed.

Design and Implementation of an Innovative, Rapid Data-Monitoring Strategy for Public Health Emergencies: Pilot of the United States School COVID-19 Mitigation Strategies Project.

During the COVID-19 pandemic, an urgent need existed for near-real-time data collection to better understand how individual beliefs and behaviors, state and local policies, and organizational practices influenced health outcomes. We describe the processes, methods, and lessons learned during the development and pilot testing of an innovative rapid data collection process we developed to inform decision-making during the COVID-19 public health emergency. We used a fully integrated mixed-methods approach to develop a structured process for triangulating quantitative and qualitative data from traditional (cross-sectional surveys, focus groups) and nontraditional (social media listening) sources. Respondents included students, parents, teachers, and key school personnel (eg, nurses, administrators, mental health providers). During the pilot phase (February-June 2021), data from 12 cross-sectional and sector-based surveys (n = 20 302 participants), 28 crowdsourced surveys (n = 26 820 participants), 10 focus groups (n = 64 participants), and 11 social media platforms (n = 432 754 503 responses) were triangulated with other data to support COVID-19 mitigation in schools. We disseminated findings through internal dashboards, triangulation reports, and policy briefs. This pilot demonstrated that triangulating traditional and nontraditional data sources can provide rapid data about barriers and facilitators to mitigation implementation during an evolving public health emergency. Such a rapid feedback and continuous improvement model can be tailored to strengthen response efforts. This approach emphasizes the value of nimble data modernization efforts to respond in real time to public health emergencies.

Challenges and Opportunities for Equity in US School Meal Programs: A Scoping Review of Qualitative Literature Regarding the COVID-19 Emergency.

The emergency school meals program provided free meals to children in the United States (US) during COVID-19-related school closures. This scoping review aims to synthesize the existing qualitative empirical evidence published between March 2020 and January 2023 on the operations and utilization of emergency school meal programs during the pandemic. Qualitative, US-based peer-reviewed literature was collected from three sources: (1) parent review of all federal nutrition assistance programs; (2) systematic search of four databases; and (3) manual search of grey literature. Identified scientific articles and grey literature reports (n = 183) were uploaded into Covidence and screened for duplicates and inclusion/exclusion criteria. Our final sample included 21 articles/reports, including 14 mixed methods and seven qualitative-only projects. Articles spanned all U.S. states. Articles had similar research questions to understand school meals and/or general food access during COVID-19, with an emphasis on long-term policy implications. Hybrid deductive/inductive analytic coding was used to analyze data, utilizing domains from the Getting to Equity Framework (GTE). GTE considers multi-level factors that influence nutrition behavior while centering more equitable pathways to improve nutrition security and reduce adverse health. Findings were sorted into two categories: operational challenges during the pandemic and solutions to address inequities in school meal distribution during and after the pandemic, particularly during school closures such as summers or future emergencies. Key challenges related to supply chain issues, safety, and balancing families' needs with limited staff capacity. Programs addressed equity by (a) reducing deterrents through federally issued waivers and increased communications which allowed the serving of meals by programs to families who previously did not have access, (b) building community capacity through collaborations and partnerships which allowed for increased distribution, and (c) preparing and distributing healthy options unless barriers in supply chain superseded the effort. This review highlights the importance of emergency school meal programs and provides insights into addressing challenges and promoting equity in future out-of-school times. These insights could be applied to policy and practice change to optimize program budgets, increase reach equitably, and improve access to nutritious meals among populations at highest risk for nutrition insecurity.

Impact of concomitant cardiovascular medications on overall survival in patients with liver cirrhosis

Objectives of the article Liver cirrhosis is the end-stage liver disease associated with poor prognosis and cardiovascular comorbidity could significantly impact mortality of cirrhotic patients. We conducted a large, retrospective study to investigate the survival impact of cardiovascular co-medications in patients with liver cirrhosis. Materials and methods A study-specific R package was processed on the local databases of partner institutions within the Observational Health Data Sciences and Informatics consortium, namely Columbia University, New York City (NYC), USA and Ajou University School of Medicine (AUSOM), South Korea. Patients with cirrhosis diagnosed between 2000 and 2020 were included. Final analysis of the anonymous survival data was performed at Medical Faculty Mannheim, Heidelberg University. Results We investigated a total of 32,366 patients with liver cirrhosis. Our data showed that administration of antiarrhythmics amiodarone or digoxin presented as a negative prognostic indicator (p = 0.000 in both cohorts). Improved survival was associated with angiotensin-converting enzyme inhibitor ramipril (p = 0.005 in NYC cohort, p = 0.075 in AUSOM cohort) and angiotensin II receptor blocker losartan (p = 0.000 in NYC cohort, p = 0.005 in AUSOM cohort). Non-selective beta blocker carvedilol was associated with a survival advantage in the NYC (p = 0.000) cohort but not in the AUSOM cohort (p = 0.142). Patients who took platelet inhibitor clopidogrel had a prolonged overall survival compared to those without (p = 0.000 in NYC cohort, p = 0.003 in AUSOM cohort). Conclusion Concomitant cardiovascular medications are associated with distinct survival difference in cirrhotic patients. Multidisciplinary management is needed for a judicious choice of proper cardiovascular co-medications in cirrhotic patients.

Unmuted: The racial politics of silent classrooms

Instructional resources often assume that students learn best when they have access to a quiet environment. This article interrogates silence’s presumed objectivity and innocuousness as the sonic backdrop for schooling. I argue that norms and expectations around silence in schools in the United States (US) inscribe a sonic color line. Such standards codify white, middle-class ways of sounding as an indicator of rationality. Simultaneously, they construct other ways of being sonically, particularly those traditionally associated with Black cultural norms, as generally unfit for school. The sanctioning of silent comportment in schools likely affects the academic achievement and sense of belonging of students whose sonic cultures differ from the schools’. I illustrate my argument with examples from classroom management resources published between 2001 and 2021. While silence’s role in constructing raced, gendered, and classed subjectivities prevails across school subjects, I focus specifically on materials for music educators. This school subject emphasizes sound production and reception, which makes its resources particularly explicit about sound management. I conducted a close reading of the materials informed by Foucault’s (1980, 1978/1991) approach to the analysis of discourses, paying close attention to how silence-related norms and expectations shape students’ academic and ontological horizons. By mapping out silence’s role in producing a racial color line, this article underscores the central role that anti-Blackness continues to play in US schools nearly 70 years after school segregation was ruled unconstitutional.

A lot in a little: Assessment of skills laboratory course structures and faculty workloads

IntroductionPharmacy skills development is essential to pharmacy programs to ensure “practice-ready” graduates. The objective was to describe the landscape of skills laboratory (lab) courses and faculty workload across United States schools and colleges of pharmacy (S/COP). MethodsThe American Association of Colleges of Pharmacy Laboratory Instructors Special Interest Group disseminated an anonymous questionnaire to collect faculty demographics, skills lab format, faculty workload, and job satisfaction. Descriptive statistics were generated, and paired t-tests were used to assess changes before and during COVID-19. ResultsFaculty from 44 of 142 S/COP responded. Participants (n = 45) were more frequently assistant professors (49%), non-tenure track (80%), and female (98%). A mean of 103 students per class, with a mean of two lab courses in both the first and second years and 1.6 in the third year were reported. Courses had a mean 1.6 lab coordinators each. Many institutions leverage non-lab faculty, pharmacy volunteers, post-graduate trainees, and senior professional students to assist. Faculty reported a mean 28.2 hours per week related to lab activities. The mean assigned percent effort was 44% for teaching in the skills lab, demonstrating consistency with effort calculations. Job satisfaction (scale 1–10) decreased from 7.6 before COVID-19 to 6.4 during COVID-19 (P < .01), with satisfaction specifically with their lab role decreasing from 7.5 to 6.6 (P = .003). ConclusionsSkills lab faculty reported significant time coordinating labs and identified the need for additional support. S/COP should ensure appropriate personnel resources are available to provide quality clinical skills training.