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Article ; Online: Moral Distress and Moral Injury in Pharmacy and Why the Academy Needs to Care.

Alvarez, Nancy A / Gaither, Caroline A / Schommer, Jon C / Lee, SuHak / Shaughnessy, April M

American journal of pharmaceutical education

2023 Volume 87, Issue 12, Page(s) 100610

Abstract: Pharmacists and other pharmacy personnel are experiencing job stress and burnout, and in some instances, suicidal ideation and death by suicide. However, the described lived experiences of pharmacists and other pharmacy personnel are not defined by ... ...

Abstract	Pharmacists and other pharmacy personnel are experiencing job stress and burnout, and in some instances, suicidal ideation and death by suicide. However, the described lived experiences of pharmacists and other pharmacy personnel are not defined by burnout. Thus, consideration of and research about whether pharmacy personnel are possibly experiencing moral distress or moral injury is necessary and urgent. The pharmacy academy is served by considering workplace conditions and lived experiences of pharmacists because of the potential, negative impact on prospective student recruitment, quality of experiential sites and preceptors, sites for clinical faculty placement, and the well-being of alumni. Understanding phenomena occurring for pharmacy personnel and determining how they impact the pharmacy academy can lend itself to the future development of solutions.
MeSH term(s)	Humans ; Stress Disorders, Post-Traumatic ; Education, Pharmacy ; Pharmacy ; Pharmacies ; Burnout, Professional ; Morals
Language	English
Publishing date	2023-10-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	603807-4
ISSN	1553-6467 ; 0002-9459
ISSN (online)	1553-6467
ISSN	0002-9459
DOI	10.1016/j.ajpe.2023.100610
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Article ; Online: Improving the Experience of Providing Care in Community-Based Pharmacies.

Schommer, Jon C / Lee, SuHak / Gaither, Caroline A / Alvarez, Nancy A / Shaughnessy, April M

Pharmacy (Basel, Switzerland)

2022 Volume 10, Issue 4

Abstract: This study applied a human factors and ergonomics approach to describe community-based pharmacy personnel perspectives regarding how work environment characteristics affect the ability to perform the duties necessary for optimal patient care and how ... ...

Abstract	This study applied a human factors and ergonomics approach to describe community-based pharmacy personnel perspectives regarding how work environment characteristics affect the ability to perform the duties necessary for optimal patient care and how contributors to stress affect the ability to ensure patient safety. Data were obtained from the 2021 APhA/NASPA National State-Based Pharmacy Workplace Survey, launched in the United States in April 2021. Promotion of the online survey to pharmacists and pharmacy technicians was accomplished through social media, email, and online periodicals. Responses continued to be received through the end of 2021. A data file containing 6973 responses was downloaded on 7 January 2022 for analysis. Qualitative thematic analysis was applied for developing operational definitions and coding guidelines for content analysis of the data. The patterns of responses for the dependent variables were compared among community-based practice setting types (chain, supermarket/mass merchandiser, and independent) and work positions (manager, staff pharmacist, technician/clerk, and owner). Chi-square analysis was used for determining statistically significant differences. The findings showed that personnel working in community-based pharmacies reported undesirable work environments and work stress that affected their ability to perform assigned duties for optimal patient care and ensure patient safety. Four work system elements were identified that were both facilitators and barriers to the ability to perform duties and ensure patient safety: (1) people, (2) tasks, (3) technology/tools, and (4) organizational context. Acknowledging local contexts of workplaces, giving adequate control, applying adaptive thinking, enhancing connectivity, building on existing mechanisms, and dynamic continuous learning are key elements for applying the HFE (human factors ergonomics) approach to improving the experience of providing care in community-based pharmacies.
Language	English
Publishing date	2022-06-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2737194-3
ISSN	2226-4787 ; 2226-4787
ISSN (online)	2226-4787
ISSN	2226-4787
DOI	10.3390/pharmacy10040067
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Article ; Online: Characterizing factors associated with high authorship in contemporary anesthesia literature: a cross-sectional study.

Lee, Jerry Y / Rahouma, Mohamed / O'Shaughnessy, Sinead M / Lopes, Alexandra J / Pryor, Kane O / Gaudino, Mario / Rong, Lisa Q

Minerva cardiology and angiology

2022 Volume 70, Issue 1, Page(s) 123–124

MeSH term(s)	Anesthesia ; Anesthesiology ; Authorship ; Bibliometrics ; Cross-Sectional Studies
Language	English
Publishing date	2022-03-09
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3059238-0
ISSN	2724-5772
ISSN (online)	2724-5772
DOI	10.23736/S2724-5683.21.05937-8
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Article ; Online: Quality of recent clinical practice guidelines in anaesthesia publications using the Appraisal of Guidelines for Research and Evaluation II instrument.

O'Shaughnessy, Sinead M / Lee, Jerry Y / Rong, Lisa Q / Rahouma, Mohamed / Wright, Drew N / Demetres, Michelle / Kachulis, Bessie

British journal of anaesthesia

2022 Volume 128, Issue 4, Page(s) 655–663

Abstract: Clinical practice guidelines are a valuable resource aiding medical decision-making based on scientific evidence. In anaesthesia, guidelines are increasing in both number and scope, influencing individual practice and shaping local departmental policy. ... ...

Abstract	Clinical practice guidelines are a valuable resource aiding medical decision-making based on scientific evidence. In anaesthesia, guidelines are increasing in both number and scope, influencing individual practice and shaping local departmental policy. The aim of this review is to assess the quality of clinical practice guidelines published in high impact anaesthesia journals over the past 5 yr using the internationally validated Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A literature search was conducted in Scopus to identify all guidelines published in the top 10 anaesthesia journals as per Clarivate Analytics Impact Factor from 2016 and 2020. Fifty-one guidelines were included for analysis by five independent appraisers using AGREE II. Each guideline was assessed across six domains and 23 items. Individual domain scores were calculated with a threshold agreed via consensus to represent high-quality guidelines. There was a significant increase in overall score over time (P=0.041), driven by Domain 3 (Rigour of Development, P=0.046). The raw overall score for Domain 3, however, was low. The other domains performed as expected based on previous studies, with Domains 1, 4, and 6 achieving high scores and Domains 2 and 5 incurring poor ratings. Most guidelines studied involved international collaboration but emerged from a single professional society. Use of an appraisal tool was stated as high but poorly detailed. The improvement in the overall score of guidelines and rigour of development is promising; however, only seven guidelines met high-quality criteria, suggesting room for improvement for the overall integrity of guidelines in anaesthesia.
MeSH term(s)	Anesthesia ; Consensus ; Humans
Language	English
Publishing date	2022-01-26
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2021.11.037
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Article ; Online: Early antimicrobial prophylaxis in autologous stem cell transplant recipients: Conventional versus an absolute neutrophil count-driven approach.

Horowitz, Justin G / Gawrys, Gerard W / Lee, Grace C / Ramirez, Brittney A / Elledge, Carole M / Shaughnessy, Paul J

Transplant infectious disease : an official journal of the Transplantation Society

2021 Volume 23, Issue 4, Page(s) e13689

Abstract: Background: Autologous hematopoietic stem cell transplantation (HSCT) recipients are at increased risk of developing life-threatening infections. There is discordance in published recommendations for timing of pre- and post-transplant antimicrobial ... ...

Abstract	Background: Autologous hematopoietic stem cell transplantation (HSCT) recipients are at increased risk of developing life-threatening infections. There is discordance in published recommendations for timing of pre- and post-transplant antimicrobial prophylaxis in this patient population, and these recommendations are unsubstantiated by any published comparative analyses. Methods: An observational, pre- and post-intervention study of consecutive autologous HSCT recipients was conducted over a 2-year period. In the pre-intervention cohort, antimicrobial prophylaxis was initiated on the day prior to transplant. In the post-intervention cohort, antimicrobials were initiated once absolute neutrophil count (ANC) reached ≤500 cells/mm Results: A total of 208 patients were included in the final analysis, with 105 and 103 patients in the pre- and post-intervention cohorts, respectively. The majority of patients included were male. Lower rates of fever occurrences were observed in the post-intervention cohort (83% pre- vs. 69% post-intervention; p = 0.019). A significant reduction in the mean antibacterial days per patient was identified (9.7 vs. 4.6 days; p < 0.001). Other than lower rates of febrile neutropenia in the post-intervention cohort, no differences were identified in secondary outcomes. In multivariable analyses, ANC-driven prophylaxis was independently associated with decreased febrile events. Conclusions: Delaying prophylaxis until severe neutropenia was not associated with increased febrile events or other secondary clinical outcomes evaluated. This approach is associated with a significant reduction in antimicrobial exposure.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents ; Female ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Male ; Neutrophils ; Retrospective Studies ; Transplant Recipients
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2021-07-30
Publishing country	Denmark
Document type	Journal Article ; Observational Study
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.13689
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Article ; Online: Pharmacy Workplace Wellbeing and Resilience: Themes Identified from a Hermeneutic Phenomenological Analysis with Future Recommendations.

Schommer, Jon C / Gaither, Caroline A / Alvarez, Nancy A / Lee, SuHak / Shaughnessy, April M / Arya, Vibhuti / Planas, Lourdes G / Fadare, Olajide / Witry, Matthew J

Pharmacy (Basel, Switzerland)

2022 Volume 10, Issue 6

Abstract: This study applied a hermeneutic phenomenological approach to better understand pharmacy workplace wellbeing and resilience using respondents' written comments along with a blend of the researchers' understanding of the phenomenon and the published ... ...

Abstract	This study applied a hermeneutic phenomenological approach to better understand pharmacy workplace wellbeing and resilience using respondents' written comments along with a blend of the researchers' understanding of the phenomenon and the published literature. Our goal was to apply this understanding to recommendations for the pharmacy workforce and corresponding future research. Data were obtained from the 2021 APhA/NASPA National State-Based Pharmacy Workplace Survey, launched in the United States in April 2021. Promotion of the online survey to pharmacy personnel was accomplished through social media, email, and online periodicals. Responses continued to be received through the end of 2021. A data file containing 6973 responses was downloaded on 7 January 2022 for analysis. Usable responses were from those who wrote an in-depth comment detailing stories and experiences related to pharmacy workplace and resilience. There were 614 respondents who wrote such comments. The findings revealed that business models driven by mechanized assembly line processes, business metrics that supersede patient outcomes, and reduction of pharmacy personnel's professional judgement have contributed to the decline in the experience of providing patient care in today's health systems. The portrait of respondents' lived experiences regarding pharmacy workplace wellbeing and resilience was beyond the individual level and revealed the need for systems change. We propose several areas for expanded inquiry in this domain: (1) shared trauma, (2) professional responsibility and autonomy, (3) learned subjection, (4) moral injury and moral distress, (5) sociocultural effects, and (6) health systems change.
Language	English
Publishing date	2022-11-23
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2737194-3
ISSN	2226-4787 ; 2226-4787
ISSN (online)	2226-4787
ISSN	2226-4787
DOI	10.3390/pharmacy10060158
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Article ; Online: Weakness Is Associated with Time to Incident Chronic Heart Failure in Aging Americans.

McGrath, R / Lee, D-C / Kraemer, W J / Vincent, B M / Shaughnessy, K A / Terbizan, D J

The journal of nutrition, health & aging

2019 Volume 24, Issue 1, Page(s) 16–19

Abstract: Objective: Handgrip strength is considered a biomarker of nutritional status and strength capacity, which are both linked to heart complications. However, it is not well understood how weakness, as measured by handgrip strength, factors into common ... ...

Abstract	Objective: Handgrip strength is considered a biomarker of nutritional status and strength capacity, which are both linked to heart complications. However, it is not well understood how weakness, as measured by handgrip strength, factors into common heart conditions seen in aging adults such as chronic heart failure (CHF). The purpose of this study was to determine the association between weakness and incident CHF for aging Americans. Design: Longitudinal-Panel. Setting: Physical measures were completed during enhanced face-to-face interviews. The core interview was typically conducted over the telephone. Participants: Data from 17,431 adults aged at least 50 years who identified as Black or White, completed interviews without a proxy, and participated in at least one wave of the 2006-2014 waves of the Health and Retirement Study were included. Measurements: Handgrip strength was measured with a hand-held dynamometer. Healthcare provider diagnosed CHF was self-reported at each wave. Sex- and race-specific maximal handgrip strength cut-points were used for determining weakness (Black men: <40-kilograms, Black women: <31-kilograms, White men: <35-kilograms, White women: <22-kilograms). A covariate-adjusted Cox model analyzed the association between weakness and incident CHF. Results: Of those included, 5,397 (31.0%) were weak and 327 (1.9%) developed CHF during the mean follow-up of 4.7±2.7 years. Those who were weak had a 35% higher risk (hazard ratio: 1.35; 95% confidence interval: 1.05, 1.74) of developing CHF, compared to those who were not-weak. Conclusion: Measures of handgrip strength should be utilized by healthcare providers for assessing age-related weakness, nutritional status, and CHF risk. Likewise, interventions aiming to prevent or treat CHF in aging adults should incorporate measures of handgrip strength for helping to determine efficacy of intervention programs.
MeSH term(s)	Black or African American ; Aged ; Aging/physiology ; Female ; Hand Strength/physiology ; Heart Failure/physiopathology ; Humans ; Male ; Middle Aged ; Muscle Weakness/physiopathology ; Nutritional Status/physiology ; Proportional Hazards Models ; Retirement ; Self Report ; Surveys and Questionnaires
Language	English
Publishing date	2019-09-23
Publishing country	France
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2081921-3
ISSN	1760-4788 ; 1279-7707
ISSN (online)	1760-4788
ISSN	1279-7707
DOI	10.1007/s12603-019-1266-y
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Article ; Online: Sertoli cell-enriched proteins in mouse and human testicular interstitial fluid.

O'Donnell, Liza / Dagley, Laura F / Curley, Michael / Darbey, Annalucia / O'Shaughnessy, Peter J / Diemer, Thorsten / Pilatz, Adrian / Fietz, Daniela / Stanton, Peter G / Smith, Lee B / Rebourcet, Diane

PloS one

2023 Volume 18, Issue 9, Page(s) e0290846

Abstract: Sertoli cells support the development of sperm and the function of various somatic cells in the interstitium between the tubules. Sertoli cells regulate the function of the testicular vasculature and the development and function of the Leydig cells that ... ...

Abstract	Sertoli cells support the development of sperm and the function of various somatic cells in the interstitium between the tubules. Sertoli cells regulate the function of the testicular vasculature and the development and function of the Leydig cells that produce testosterone for fertility and virility. However, the Sertoli cell-derived factors that regulate these cells are largely unknown. To define potential mechanisms by which Sertoli cells could support testicular somatic cell function, we aimed to identify Sertoli cell-enriched proteins in the testicular interstitial fluid (TIF) between the tubules. We previously resolved the proteome of TIF in mice and humans and have shown it to be a rich source of seminiferous tubule-derived proteins. In the current study, we designed bioinformatic strategies to interrogate relevant proteomic and genomic datasets to identify Sertoli cell-enriched proteins in mouse and human TIF. We analysed proteins in mouse TIF that were significantly reduced after one week of acute Sertoli cell ablation in vivo and validated which of these are likely to arise primarily from Sertoli cells based on relevant mouse testis RNASeq datasets. We used a different, but complementary, approach to identify Sertoli cell-enriched proteins in human TIF, taking advantage of high-quality human testis genomic, proteomic and immunohistochemical datasets. We identified a total of 47 and 40 Sertoli cell-enriched proteins in mouse and human TIF, respectively, including 15 proteins that are conserved in both species. Proteins with potential roles in angiogenesis, the regulation of Leydig cells or steroidogenesis, and immune cell regulation were identified. The data suggests that some of these proteins are secreted, but that Sertoli cells also deposit specific proteins into TIF via the release of extracellular vesicles. In conclusion, we have identified novel Sertoli cell-enriched proteins in TIF that are candidates for regulating somatic cell-cell communication and testis function.
MeSH term(s)	Humans ; Male ; Animals ; Mice ; Sertoli Cells ; Testis ; Extracellular Fluid ; Proteomics ; Semen
Language	English
Publishing date	2023-09-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0290846
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Article: Non-surgical Management of Complex Refractory Pyoderma Gangrenosum With Negative Pressure Wound Therapy With Instillation.

Lee, Frank G / Song, Ethan / Wallace, Sean J / Shaughnessy, Thomas J / Raj, Mamtha / Teixeira, Robert / Miles, Marshall G / Wojcik, Randolph

Cureus

2021 Volume 13, Issue 10, Page(s) e18951

Abstract: Pyoderma gangrenosum (PG) is a rare skin disorder primarily treated with immunosuppression medication. We report a case of a large, chronic PG wound treated with adjunct negative pressure wound therapy with instillation and dwell time (NPWTi-d) using ... ...

Abstract	Pyoderma gangrenosum (PG) is a rare skin disorder primarily treated with immunosuppression medication. We report a case of a large, chronic PG wound treated with adjunct negative pressure wound therapy with instillation and dwell time (NPWTi-d) using nonadherent dressing (Mepitel) and reticular open-cell foam with through holes (ROCF-CC) with positive outcomes. The patient was a 62-year-old female with rheumatoid arthritis, Hashimoto's thyroiditis, lymphedema, and morbid obesity who presented with a 19.5 cm x 13.2 cm x 2.1 cm wound of three years duration on the right posterolateral lower extremity that successfully responded to a multimodality approach of immunosuppression and wound vac therapy. We conclude in our case that NPWTi-d with Mepitel and ROCF-CC enhanced the wound healing process, and we discuss NPWTi-d's potential role and benefit as an adjunctive therapy option for chronic and poorly controlled PG on patients taking concurrent immunosuppression.
Language	English
Publishing date	2021-10-21
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.18951
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Article: Increased Plasma Cells and Decreased B-cells in Tumor Infiltrating Lymphocytes are Associated with Worse Survival in Lung Adenocarcinomas.

Lee, Hee Eun / Luo, Lei / Kroneman, Trynda / Passow, Marie R / Del Rosario, Kristina M / Christensen, Michael R / Francis, Mary E / O'Shaughnessy, John W / Blahnik, Anthony J / Yang, Ping / Yi, Eunhee S

Journal of clinical & cellular immunology

2020 Volume 11, Issue 1

Abstract: Introduction: Clinical significance of tumor-infiltrating plasma cells and B-cells in lung adenocarcinoma is not well known.: Methods: CD3, CD20 and MUM1 immunostains were performed on representative tumor blocks selected from 120 consecutive lung ... ...

Abstract	Introduction: Clinical significance of tumor-infiltrating plasma cells and B-cells in lung adenocarcinoma is not well known. Methods: CD3, CD20 and MUM1 immunostains were performed on representative tumor blocks selected from 120 consecutive lung adenocarcinoma cases treated by surgical resection at Mayo Clinic Rochester. CD3 Results: Median age of patients was 69 years (range, 46-91 years) and 52 were male. Median numbers (interquartile range) of CD20 Conclusion: High plasma cell % among TILs in the tumor area and low IE B-cell count were associated with worse prognosis in lung adenocarcinoma patients.
Language	English
Publishing date	2020-01-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2684688-3
ISSN	2155-9899
ISSN	2155-9899
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