A Quality Improvement Pilot of Pharmacist-Led Identification of an Inpatient Population for Opioid Stewardship and Pain Management.

The Joint Commission standards now include identification and monitoring patients at high-risk for adverse outcomes of opioid use. Our institution does not have a method to identify at-risk patients. This pilot aimed to assess feasibility of pharmacist-led identification of a population for pain management and opioid stewardship.

Functions and outcomes of a clinical medical ethics committee: a review of 100 consults.

Context: Established in 1997, Summa Health System's Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management.

A 4-year integrated curriculum in palliative care for medical undergraduates.

In order to graduate physicians prepared to effectively address clinical issues in palliative medicine and to comply with LCME requirements, the Northeastern Ohio Universities Colleges of Medicine and Pharmacy (NEOUCOM) integrated a coordinated four-year palliative care (PC) curriculum. This report describes the development of the longitudinal curriculum and provides helpful resources and strategies to guide clinicians and administrators undertaking similar efforts. This is a retrospective, descriptive report based on data collected throughout development of the new curriculum.

Peroneal tendons subluxation.

Subluxation of the peroneal tendons is uncommon. It occurs especially in skiing, soccer, basketball, rugby, ice skating, judo, sprint, water-skiing, mountaineering, and gymnastics. We present an overview of the injury, with the classification commonly used.

Demographics and distribution of dentists in Mississippi: a dental work force study.

Background: Many segments of the population experience one or more barriers to accessing quality oral health care, including availability of licensed dentists. The purpose of the authors' study was to analyze the availability of dentists in Mississippi by county over four decades to determine the geographic distribution of dentists, shifts in their distribution over time and how this distribution relates to population demographics.

Methods: Dentist-to-population ratios were determined by county from 1970 through 2000.

Geospatial information technology: an adjunct to service-based outreach and education.

This exemplar highlights how geospatial information technology was effective in supporting academic practice, faculty outreach, and education initiatives at the University of Mississippi School of Nursing. Using this cutting-edge technology created a community-based prototype for fully integrating point-of-service research, practice, and academics into a cohesive strategy to influence change within the health care delivery system. This exemplar discusses ways this knowledge benefits practice and curriculum development; informs critical decision making affecting the people we serve; underscores the vital role nurses play in linking this technology to practice; and develops community residents as partners in their own health and that of the community.

Bone mineral density in triathletes over a competitive season.

There is evidence from previous cross-sectional studies that high volumes of certain sports, including running, swimming and cycling, may have a negative impact on bone mineral density. The aim of the present study was to evaluate prospectively the effects of high athletic training in individuals who engage in high volumes of all three of these activities (triathletes). Bone mineral density for the total body, arms and legs was determined by dual-energy X-ray absorptiometry in 21 competitive triathletes (9 men, 12 women) at the beginning of the training season and 24 weeks later.

A community-based case management model for hypertension and diabetes.

Health research conducted over the past 15 years in the Mississippi Delta has continually documented a population experiencing poor health status (high rates of chronic diseases and excessive related mortalities). Both individual and health system resources are scarce in this region, posing barriers to effective chronic disease management. Two of the most significant chronic diseases that burden this population are hypertension and diabetes.

Pharmacy and herbal medicine in the US.

Herbal medicine is increasing in popularity in the United States. The market continues to grow, with a presence being established for commercially-prepared herbal products in community pharmacies throughout the nation. This survey was conducted to describe that presence in pharmacies and to describe pharmacists' perceptions of this product class.

Quality of life assessment by community pharmacists: an exploratory study.

Implicit in the evolving role of pharmacy is that its practitioners embrace the concept of quality of life (QoL). In recent years there has been an increased interest in incorporating health-related quality of life (HRQoL) measures into clinical practice, primarily focusing on the physician as the user of this information. Pharmacists may be able to use these instruments in their practices to provide better pharmaceutical care.

Use of plant-derived therapies in a rural, biracial population in Mississippi.

Exploring the use of plant-derived medicines has recently received much attention in both scientific and popular journals. A study conducted in central Mississippi on medicinal plants investigated the frequency of use, types of plants used, and symptoms treated. A randomly selected probability sample of 223 households found that over 70 percent of the adults used at least one plant-derived medicine during the past year.

Metals and school learning: a review of investigative techniques.

A growing body of literature suggests a relationship between metals and a threatened health status among children, adolescents, and adults. Recently, several investigators have reported a direct link between exposure to metal and diminished affective, behavioral, and cognitive performance of school children. The purpose of the present study was to review and analyze methods and procedures used to understand the relationship between exposure to metals and cognitive, social, and motor functioning of school children.

Rural Health Research Program--the University of Mississippi.

The Rural Health Research Program (RHRP) of the Research Institute of Pharmaceutical Sciences of the University of Mississippi has been designated by the State of Mississippi as a program mandated to conduct health research throughout rural Mississippi. The authors discuss the historical development of RHRP and describes its present capability for fulfilling this research mandate. They describe the opportunities presented by RHRP for collaborative research with other health care professionals interested in health care problems and solutions in rural Mississippi.

Progression of depression in the prenatal and postpartum periods.

Studies of birth related emotional disorders, which track a cohort of women prospectively throughout the prenatal and postpartum periods, have rarely been undertaken. We measured depression at six separate intervals in the prenatal and postpartum periods among an experimental cohort (n = 57) and at two separate intervals in a nonpregnant control cohort matched on age. Subjects with high levels of prenatal depression were three times more likely to report a past history of depression and two and one-half times more likely to have high depression levels at six weeks postpartum (indicating risk for a puerperal depression).

Solutions to the problems of chronic disease management in rural settings.

Recent changes in disease patterns in the United States from acute to chronic disorders and the maldistribution of medical manpower have disproportionately affected rural residents. Programmatic attempts to alter the medical care system in rural areas have traditionally centered on increasing the number of primary providers. In central Mississippi, two innovative alternative models of chronic disease management have been evaluated.

Geophagia in rural Mississippi: environmental and cultural contexts and nutritional implications.

We investigated geophagia in the black population of rural Holmes County, Mississippi. Twenty-five sources of geophagical clays were located and most of the sources are associated with rural settlements throughout the county. Clays are taken from subsurface soil horizons, and all but one of the sources come from the upland portion of the county.

Decision rules for hypertension screening: application in a poor community with endemic hypertension.

Data from a hypertension screening project involving 4,272 black residents of a rural southern community were analyzed to determine the effects of a set of admission-decision rules on the case load of a proposed hypertension clinic. Four decision rules were investigated: conjunctive (diastolic high or systolic high); disjunctive (diastolic and/or systolic high); additive (sum of diastolic and systolic high); and systolic only. Most information relevant to admission to treatment came from knowledge of systolic blood pressures, even though knowledge of the diastolic pressure is essential in individual diagnosis.