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  • Challenges and Limitations of the COVID-19 Vaccine Distribution in Arizona Federally Qualified Health Centers

    Hall-Lipsy, Elizabeth; Boucher, Brandon; Maloney, Patric; College of Pharmacy, The University of Arizona (The University of Arizona., 2022)
    The rollout of COVID-19 vaccines was a massive undertaking for Arizona’s healthcare providers. Clinics all over the state were tasked with ordering, storing, distributing, and administering the vaccines to protect Arizonans against the COVID-19 virus. Safety net clinics in particular were integral for getting the vaccine to the most vulnerable members of the population, both in urban and rural areas. Challenges faced by these clinics need to be quantified in order for effective support to be given in the future. Specific Aims: 1. To compare and contrast the identified challenges and opportunities described by FQHC clinics during the COVID-19 vaccine roll out in early 2021. 2. To make recommendations for future best practices in the event of another global pandemic.
  • Effect of a Virtual Game, "Name That Band" on Elders' and PharmD Students' Feelings of Social Isolation During COVID-19

    Campbell, Ashley; Lee, Jeannie; Weygint, Alison; Whittington, Brooke; College of Pharmacy, The University of Arizona (The University of Arizona., 2022)
    Specific Aims: To determine the effects of playing a virtual game, “Name That Band,” on St. Luke’s Home elders’ and the University of Arizona (UA) Doctor of Pharmacy (PharmD) students’ feelings of social isolation during the COVID-19 pandemic. To compare elders’ and PharmD students’ feelings of social isolation and loneliness pre-pandemic and before and after playing the game together and to assess which factors of the game make them feel more socially engaged. Methods: Questionnaires were administered before and after a virtual game to residents at St. Luke’s Home and PharmD students at the UA R. Ken Coit College of Pharmacy. Participants were asked about their mood before COVID-19 and pre- and post-game, as well as their social interactions and feelings of loneliness using the Modified UCLA Three-Item Loneliness Scale, which assesses a composite score of lack of companionship, feelings of being left out, and isolation. Results: Fifteen elders and eleven students participated in the game (n=26). All participants completed the pre-game survey and 25 completed the post-game survey. The elders reported a decreased total UCLA Loneliness Scale score post-game compared to pre-game (p=0.020). The students reported an increased total UCLA Loneliness Scale score during the pandemic than before COVID-19 (p=0.017). More elders and students felt ‘happy’ post-game compared with before the pandemic and pre-game. Playing a virtual game together helped elders and students feel more socially engaged. Conclusions: Virtual game social interventions decreased feelings of isolation and increased engagement for older adults and PharmD students during the COVID-19 pandemic.
  • Patterns of healthcare expenditures among older United States adults with pain and different perceived health status

    Axon, Rhys; Kamel, Anisa; College of Pharmacy, The University of Arizona (The University of Arizona., 2022)
    The objective of this study was to assess the pattern of healthcare expenditures among United States (U.S.) adults aged ≥ 50 years with pain and annual total positive healthcare expenditures with different levels of perceived health. The study used the 2018 Medical Expenditure Panel Survey data. Unadjusted and adjusted linear regression models were used to compare logarithmically transformed total healthcare expenditures between those with excellent, very good, good, and fair/poor health. The a priori alpha value was 0.05. The study included 5123 U.S. adults aged ≥50 with self‐reported pain (excellent = 8.9%, very good = 28.3%, good = 36.2%, fair/poor = 26.6%). In adjusted analyses, compared to fair/poor health, those with excellent health had the greatest adjusted reduction in expenditures (55% lower), followed by very good health (36.5% lower) and good health (24.9% lower). In conclusion, total positive healthcare expenditures were comparatively lower among those with better perceived health status for older (≥ 50 years) U.S. adults with pain that interfered with normal work in the past four weeks.
  • Assessing the Impact of an Advanced Clinical Decision Support System on Medication Safety and Hospital Readmissions in an Innovative Transitional Care Model: A Pilot Study

    Bingham, Jennifer; Baugham, Lindsey; Hilaneh, Andriana; College of Pharmacy, The University of Arizona (The University of Arizona., 2022)
    Abstract: Background: Adverse drug events and inappropriate use of medications lead to hospitalizations, medication-related morbidity, and mortality. This study examined whether a novel medication risk prediction tool, the MedWise Risk ScoreTM, was associated with medication safety-related problem (MRP) identification and whether integrating into an existing innovative transitions of care (TOC) program could decrease readmissions. (2) Methods: This retrospective comparator group study assessed patients discharged from a hospital in southern Arizona between January and December 2020. Participants were included in the study if they were 18 years of age or 19 older, referred to the pharmacist for TOC services, and received a pharmacist consultation within one-week post discharge. Patients were categorized into two groups: 1) medication safety review (MSR)-TOC service (intervention), or 2) existing innovative TOC program (control). (3) Results: Of 164 participants, most were male (57%) and were between 70 - 79 years of age. Overall, there were significantly more DDI MRPs identified per patient in the intervention vs control group for those who were readmitted (3.7±1.5 vs 0.9±0.6, p<0.001) and those who were not readmitted (2±1.3 vs 1.3±1.2, p=0.0120). Furthermore, of those who were readmitted, the average number of identified MRPs per patient was greater in the intervention group compared to the control (6.3 vs 2.5 respectively, p>0.05). Relative to control, readmission frequency was 30% lower in the treatment group; however, there was insufficient power to detect significant differences between groups. (4) Conclusion: Integration of a medication risk prediction tool into this existing TOC model identified more DDI MRPs compared to the previous innovative TOC program, which lends evidence to support its ability to prevent readmissions. Future work is warranted to demonstrate the longitudinal impact of this intervention in a larger sample size.

    Wilson, Jean; Blum, Isabella Rosario (The University of Arizona., 2019)
    Differential membrane trafficking and modulation of lipid domains establishes and maintains cellular polarity in epithelial cells – these events are controlled largely by small GTPases. We have shown previously that Rab14 acts upstream of Arf6 in the establishment of the apical membrane, but how it interacts with other trafficking machinery is unknown. Rab22 has a polarized distribution in activated T-cells, but its role in epithelial polarity is not known. Here we report the colocalization of Rab14 with Rab22a in endosomes of Madin Darby canine kidney (MDCK) cells. Interestingly, Rab22 localizes to the cell:cell interface of polarizing cell pairs, and Rab14 and Rab22 colocalize in adjacent endosomes. Knockdown of Rab22 results in a multi-lumen phenotype in 3D culture, and overexpression of Rab22 in Rab14 knock down cells, results in the production of Rab22-positive extensions. Because of the relationship between Rab14, Rab22, and Arf6, we investigated the interaction of Rab22 with Arf6 GEFs and found that Rab22 co-immunoprecipitates with the Arf6 GEF EFA6. Furthermore, EFA6 is retained in intracellular puncta in Rab22 KD cells. These results suggest that Rab22 acts downstream of Rab14 to regulate Arf6 activity in the establishment of polarity.

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