Objective. To implement a role-reversal exercise to increase first-year pharmacy students' awareness of communication barriers in the health care setting, especially for deaf and hard-of-hearing patients. Design. Volunteers from the local deaf community conducted Deaf Strong Hospital, a role-reversal exercise in which students were the ''patients.'' Students navigated through a reception area, encounter with a physician, and having a prescription filled at a pharmacy without receiving or using any spoken language. Assessment. A debriefing session was held in which small groups of students had the opportunity to ask questions of a panel of deaf and hard-of-hearing volunteers. On a survey administered to assess students' learning, 97% agreed or strongly agreed that the experience would likely impact their attitudes and behavior in future interactions with patients who did not speak English. Conclusions. The role-reversal exercise was an effective method of teaching students that the delivery of health care is dependent on adequate communication between health care providers and the patient.
Objectives. To examine the impact of a panel discussion on transgender health care on first-year (P1) pharmacy students' knowledge and understanding of transgender experiences in an Introduction to Diversity course. Design. The panel consisted of both transgender males and females. After panelists shared their healthcare experiences, students asked them questions in a moderated setting. Students completed evaluations on the presentation and learning outcomes. They also wrote a self-reflection paper on the experience. Assessment. Ninety-one percent of students agreed that they could describe methods for showing respect to a transgender patient and 91.0% evaluated the usefulness of the presentation to be very good or excellent. Qualitative analysis (phenomenological study) was conducted on the self-reflection papers and revealed 7 major themes. Conclusion. First-year students reported that they found the panel discussion to be eye opening and relevant to their pharmacy career. Our panel may serve as model for other pharmacy schools to implement.Keywords: health disparities, transgender, pharmacy education, panel discussion, reflection, qualitative analysis INTRODUCTIONThe topic of lesbian, gay, bisexual, and transgender (LGBT) health was added to the Healthy People 2020 initiative, indicating that the US Department of Health and Human Services considered it to be an emerging issue. 1 The document states that LGBT individuals encounter several health disparities linked to societal stigma, discrimination, and denial of human and civil rights. It also specifically mentions the need to provide medical students access to and training about LGBT patients to increase culturally competent care. As pharmacists are also an integral part of the healthcare system, this statement can be extrapolated to pharmacy students as well.Although it is undeniable that the lesbian, gay, and bisexual (LGB) populations have significant challenges within the healthcare system, the struggles that transgender individuals face are even more pronounced. A transgender individual can include anyone whose self-identity, behavior, or anatomy falls outside of societal gender norms and expectations (Appendix 1). Transgender individuals have a high prevalence of human immunodeficiency virus/sexually transmitted diseases, mental health issues, and suicide.1 A significant number (28%) of transgender patients have experienced verbal harassment in a medical setting.2 Additionally, transgender individuals are less likely to have health insurance than heterosexual or LGB individuals. Lesbian, gay, and bisexual individuals, if necessary, can choose not to disclose their sexual orientation to their healthcare providers and still receive adequate primary health care. However, transgender patients must disclose their transgender status to receive thorough and appropriate health care. Yet, fear of discrimination by healthcare providers once they do disclose their status may prevent individuals from seeking both urgent and preventative medical treatment.2, 3 Know...
GI manifestations were common in both DM1 and DM2, with a relatively high frequency of gallbladder removal in DM1 and DM2 occurring at a younger age compared to normative data in the literature. Studies are needed to determine the pathomechanism of how sex, weight gain, and duration of disease contribute to GI manifestations and how these manifestations affect quality of life and clinical care for patients with DM1 and DM2.
This review discusses the criteria for determining whether a binding site or functional response is directly mediated by either the mu, delta, or kappa opioid receptors. In 1988, Sibinga and Goldstein published the first review that addressed whether cells from the immune system express opioid receptors. The criteria that they used, namely, structure-activity relationships, stereoselectivity, dose- and concentration-dependence, and saturability are still relevant criteria today for determining if an immunological response is mediated by either the mu, delta or kappa opioid receptors. Radioligand receptor binding studies and functional studies that clearly show the presence of an opioid receptor on immunocytes are presented. Selective agonists and antagonists for the mu, delta, and kappa opioid receptors are discussed, and the need for their use in experiments is emphasized. Conditions used in functional assays are very important. Receptor desensitization and downregulation occur within minutes after the application of an agonist. However, many immunological assays are applying an agonist for days before measuring an immunological effect. The results obtained may reflect changes that are results of receptor desensitization and/or downregulation instead of changes that are observed with acute activation of the receptor. The future of receptor pharmacology lies in the crosstalk and dimerization of G protein-coupled receptors. In transfected systems, opioid receptors have been shown to dimerize with chemokine and cannabinoid receptors, resulting in crosstalk between different types of receptors.
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