Thesis--Wisconsin. / Includes bibliographical references (leaves 60-64).

Class of 2014 Abstract / Specific Aims: Tetanus, diphtheria, and pertussis are diseases, which are preventable through proper vaccination. In spite of the availability these vaccines, however, there has recently been a surge in the number of pertussis cases in the United States. The objective of this study is to determine provider adherence to tetanus, diphtheria and pertussis guidelines set forth by the Advisory Committee on Immunization Practices in a primary care setting before and after a clinical pharmacist intervention. Methods: A retrospective cohort of chart reviews was conducted between January 1 – September 30, 2013 to determine immunization adherence to tetanus, diphteria, and pertussis vaccination guidelines. A clinical pharmacist then preformed a series of cross-sectional chart reviews as an intervention. Following the intervention, a retrospective chart review was conducted to evaluate if Tdap vaccination rates improved between March 17-23, 2014. Main Results: Overall immunization rates greatly improved following the intervention (p<0.0001; x2=44.988). For non-pregnant adults between the ages of 19-64 the vaccination rate improved from 26% to 61.1% (p<0.0001; x2=47.07). A statistically significant improvement was not seen in the groups with patients 65 or older or pregnant women (p>0.05). Tdap vaccination status was appropriately evaluated and vaccinations given by primary doctors improved from 17.7% to 61.2% and those prescribed by nurse practitioners improved from 22.4% to 56.3%. Conclusion: Intervention by a Clinical Pharmacist helped improve overall provider adherence to the tetanus, diphteria, and pertussis vaccination guidelines.

Class of 2016 Abstract / Objectives: To describe the patterns of benzodiazepine use at a community health center in adults and to identify common demographic factors and chronic conditions that are associated with an increased usage rate. Subjects: Patients 18 years and older who had been treated at El Rio Community Health Center with an active benzodiazepine prescription on file. Methods: Data were collected from patient charts using a data collection form. Assessment included current benzodiazepine patients were taking, concurrent use of opiates and/or antispasmotics, indication for benzodiazepine use, concurrent medications for anxiety, depression, or insomnia, and prescriber type. Demographic data on age, gender, race, ethnicity, insurance type, and use of tobacco or alcohol were also collected. Results: Data were collected on 102 patients currently taking a benzodiazepine; 60 patients (mean age = 61.2, SD = 13.6) had concurrent first-line therapy for anxiety, depression, or insomnia and 42 patients (mean = 61.1, SD = 13.6) did not. There were a significantly higher proportion of women taking a benzodiazepine with first-line therapy than without first-line therapy (88.3% vs. 71.4%; p = 0.031). Additionally, higher proportion of benzodiazepine was prescribed with first-line therapy for depression than other indications (p = 0.002). Conclusions: More patients were prescribed benzodiazepines with concurrent first-line therapy for depression than other indications such as anxiety, insomnia, or other panic disorders. For this reason, health care professionals should be aware of the patterns of benzodiazepine use and comply with current recommended practice guidelines.

Class of 2005 Abstract / Objectives: To describe the dosing of atypical antipsychotics among outpatients diagnosed with schizophrenia at a community mental health center in Tucson, AZ, and to contrast this to dosing recommendations set by the manufacturer during clinical trials. Methods: A prescription database from January 01, 2004 to July 31, 2004 was used to evaluate the dosing of atypical antipsychotics (Abilify®, Clozaril®, Geodon®, Seroquel®, and Zyprexa®) in patients with schizophrenia. The average daily doses were evaluated for differences from recommended dosing using the physician desk reference. Differences in dosing were also analyzed for gender and monotherapy vs. patients taking multiple atypical antipsychotics. Results: Overall differences in dosing when comparing gender and monotherapy vs. patients on multiple atypicals were not significant for all five atypical antipsychotics studied. Overall, Geodon® had the highest percentage (51.9%) of patients above recommended guidelines while Clozaril® and Seroquel® had the highest percentage (70.6% and 47.4% respectively) below recommended guidelines. Implications: This study illustrates that dosing of these atypical antipsychotics at this outpatient community mental health center differs for many patients with schizophrenia from the guidelines set by the companies during clinical trials. This information will aid in the prescribing of physicians at this community mental health center and will possibly lead to larger studies to further look at reasons for these differences in dosing.

Magister Pharmaceuticae - MPharm / Medication labels are often the only information available to patients after obtaining medication 3 from the pharmacy or other healthcare practitioners. Inappropriately designed medicine labelling 4 contributes to poor interpretation and improper use, which could adversely affect patient health 5 outcomes. In developing countries, pictograms (pictures representing words or phrases), on 6 medicine labels tend to support patients’ ability to read, understand and recall information. 7 8 Objective 9 This comparative study examined low-literate participants’ interpretation of ‘text-and-pictogram’ 10 instructions versus ‘routine text-only’ instructions relative to the intended medicine use 11 instructions on an oral rehydration (OR) dry mixture sachet in public sector Community Health 12 Centres (CHCs) in Cape Town

Over 11 million undocumented immigrants live in the shadows all across America. They live with the fear of being separated from their families and the risk of being detained or deported back to a country they escaped. This thesis explores ideas of home, safety, and belonging through different elements in architecture, utilized to create welcoming and safe spaces. The community and health center is designed to reach, support, and empower immigrants, while acting as a new home where immigrants access a variety of health, education, and social programs. The project reuses and re-purposes an abandoned building, which was originally designed to welcome immigrants, by carving out historic spaces while creating a new addition that gives it new life. To create a more welcoming experience, the existing brick building is integrated with the new through the use of natural materials, color, and the addition of large openings that allow natural light to fill the interiors. The design of large gathering areas both inside and outside allow people to come together and create a sense of community. Located in the center of immigrant neighborhoods, the proposed community and health center acts as a new beacon of hope and tranquility for immigrants in the District of Columbia. / Master of Architecture / Everyday more than 11 million undocumented children and adults face the fear of being separated from their families and the risk of being placed in caged-like cells called immigrant detention centers. Rather than having more spaces that criminalize and treat immigrants inhumanely, this thesis seeks to design a space that welcomes and supports undocumented immigrants. A proposed community and health center is designed to reach, support, and empower immigrants, while acting as a new home where immigrants could access a variety of health, education, and social programs. The project reuses and repurposes a section of an abandoned building, originally built to provide housing and health services to immigrants, and introduces a new addition with the goal to preserve and continue its history as a place for immigrants. In order to create a more welcoming and safe experience, the design of the proposed building integrates three different strategies. First, the integration of sustainable natural materials and warm colors in the structure of the new addition and the interiors of the existing building. Second, the integration of large operable openings that frame views of the exterior landscape and allow natural light and fresh air to fill the interiors. Lastly, the integration of gathering spaces in the landscape and interiors that allow people to come together and create a sense of community. The proposed community and health center would become a new beacon of hope and tranquility for undocumented immigrants that live with fear and face different obstacles due to their legal status.

Class of 2010 Abstract / OBJECTIVES: To identify and describe practical incentives and barriers for community health center pharmacists in adopting a practice based research network (PBRN) that facilitates sustainable collaboration. METHODS: Directors of pharmacy at Community health centers listed as members of Arizona Association of Community Health Centers (AACHC), with on-site pharmacies, were contacted via telephone. During initial contact an IRB approved script was used to recruit the pharmacy director’s participation, at which time the subject’s disclaimer form was read and an appointment for a future phone interview was scheduled. Phone Interviews were conducted using a standardized questionnaire, and all results were manually recorded on a standardized data collection form. Data collected included, site specific information including the: educational background of the pharmacy director, and his or her perceived inducements and barriers to participating in a pharmacy based PBRN with the University of Arizona. RESULTS: Phone interviews were completed by 8 directors of pharmacy, 4 women (50%) and 4 men (50%). A total of 5 participants (62.5%) had a BS degree, 2 (25%) had PharmD degrees and 1 (12.5%) had both as BS and a PharmD degree. The mean length of time in current position was 5.56 yrs (SD= 4 yrs.). 75% of the participants indicated that they considered working with the University of Arizona (UofA) as an inducement, the same number of participants felt that their staff and practice as a whole would also consider it an inducement. Overall participants indicated that both their personal (75%) and staff‘s (87.5%) motivation to improve the pharmacy profession was considered an inducement, as well as their opportunity for professional growth (75%). All of the participants (100%) indicated they did not have adequate staffing to support research at this time and therefore felt it was a barrier to participation. When asked about resources as a whole, including staff, time and technology 87.5% of the participants felt this was a barrier. Other common barriers were; anticipated time requirements (75%), current schedule/time allowances (75%), staff’s outside commitments (75%). Out of the 8 participants only 2 (25%) are currently participating in PBRNS at this time, 3(37.5%) have research ideas that they are interested in working on, and 3(37.5%) indicated that they were not currently participating nor did they have any current interests. The major themes identified as inducements to participation were patient benefit, time/staffing involvement, and professional growth. CONCLUSIONS: The most common barriers to participating in a PBRN were: working with the UofA, motivation to improve the profession of pharmacy and the opportunity for professional growth. The most common inducements were staffing, current resources, anticipated time requirements, current schedules and outside commitments.

No description available.

Thesis (M.H.A.)--University of Michigan, 1973.

Thesis (M.H.A.)--University of Michigan, 1972.