Comparison of hospital course and outcome in hospital-acquired vs pre-existing delirium.

Background: Delirium is a major source of morbidity in the inpatient hospital setting. This study examined differences between patients with delirium present prior to hospital admission and those with hospitalacquired delirium in several health outcomes.

Methods: A total of 12,529 patients on 2 inpatient units were included in this retrospective cohort study.

Evaluation of the Role and Impact of Ambulatory Clinical Pharmacists in an Academic Comprehensive Cancer Center.

Introduction: In recent years, there has been significant growth of ambulatory oncology pharmacy, yet there is a paucity of published studies on the clinical activities and impact of ambulatory oncology clinical pharmacists. At Duke Cancer Center, dedicated pharmacist services are embedded in specialized outpatient oncology areas. Pharmacists document their clinical and administrative activities in the electronic health record.

Prevalence and risk factors of burnout in community pharmacists.

Objectives: This study aimed to identify the prevalence and risk factors for occupational burnout in community pharmacists.

Methods: Community pharmacists were solicited through a professional network e-mail Listserv to complete an anonymous, electronic survey on burnout. The survey included the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and a work-factors-based questionnaire.

Evidence of burnout in critical care pharmacists.

Purpose: Studies of critical care physicians and nursing personnel indicate a potentially high rate of burnout. To date there is a paucity of data in critical care pharmacists assessing burnout in this group. The purpose of this study was to assess the incidence of risk of burnout in critical care pharmacists.

Digital content delivery in a pharmacy technician training program in a health system.

Purpose: Development and implementation of a pharmacy technician training program are described.

Summary: As key members of the healthcare team, pharmacy technicians are integral to a pharmacy's operation. Training programs allow technicians to assume roles that support pharmacists practicing "at the top of their license," assist in providing optimal patient care, and serve as an important tool for retaining trained pharmacy technicians.

Evidence of burnout in health-system pharmacists.

Purpose: Results of a study to determine levels of and risk factors for professional burnout among health-system pharmacists are reported.

Methods: The Maslach Burnout Inventory Human Services Survey (MBI-HSS) was distributed to a target population of health-system pharmacists to assess study participants for burnout, which is characterized by feelings of emotional exhaustion, depersonalization, and reduced personal accomplishment. Health-system pharmacists were solicited via email through a professional network listserver to complete an anonymous, electronic questionnaire regarding burnout.

Evaluation of the value of team-based psychiatric consultation in a general hospital setting.

Background With the increase use of pay for performance in healthcare, 30-day readmissions after discharges are critically important. Objective A team-based psychiatric consultation approach was tested in an inpatient hospital setting. This is the first study that examines 30-day readmission rate with this approach.

Health Care Systems and Transitions of Care: Implication on Interdisciplinary Pharmacy Services.

Effective medication management is critical to successful patient outcomes. Pharmacists and pharmacy technicians working within North Carolina Health Systems provide a variety of services that aid in those successful outcomes. By leveraging the North Carolina Clinical Pharmacist Practitioner designation along with integrated health records, health system pharmacists are uniquely positioned to provide expert clinical support to patients.

Comparison of a Pharmacist-Performed and Physician or Advanced Practice Provider-Performed Medication History in Pediatric Patients.

In the adult population, a high rate of discrepancies exists between provider-performed and pharmacist-performed medication histories. Limited data exist regarding pharmacist-performed medication histories in hospitalized pediatric patients. Identify the incidence and severity of discrepancies in medication histories performed by practitioners compared with pharmacists in the pediatric population.

Columnar architecture improves noise robustness in a model cortical network.

Cortical columnar architecture was discovered decades ago yet there is no agreed upon explanation for its function. Indeed, some have suggested that it has no function, it is simply an epiphenomenon of developmental processes. To investigate this problem we have constructed a computer model of one square millimeter of layer 2/3 of the primary visual cortex (V1) of the cat.

Coping with critical drug shortages: an ethical approach for allocating scarce resources in hospitals.

The number of critical medication shortages in the United States has reached an unprecedented level, requiring decisions about allocating limited drug supplies. Ad hoc decisions are susceptible to arbitrary judgments, revealing preformed biases for or against groups of people. Health care institutions lack standardized protocols for rationing scarce drugs.

Simulations of a Reconstructed Cerebellar Purkinje Cell Based on Simplified Channel Kinetics.

When cerebellar Purkinje cells are depolarized with a constant current pulse injected at the soma, complex spike discharge patterns are observed (Llinas and Sugimori 1980b). A computer model has been constructed to analyze how the Purkinje cell ionic conductance identified to date interact to produce the observed firing behavior. The kinetics of voltage-dependent conductance used in the model were significantly simpler than Hodgkin-Huxley kinetics, which have many parameters that must be experimentally determined.

Synchronization of Bursting Action Potential Discharge in a Model Network of Neocortical Neurons.

We have used the morphology derived from single horseradish peroxidase-labeled neurons, known membrane conductance properties and microanatomy to construct a model neocortical network that exhibits synchronized bursting. The network was composed of interconnected pyramidal (excitatory) neurons with different intrinsic burst frequencies, and smooth (inhibitory) neurons that provided global feedback inhibition to all of the pyramids. When the network was activated by geniculocortical afferents the burst discharges of the pyramids quickly became synchronized with zero average phase-shift.