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Showcase Health Sciences Spokane

Exploring the Use and Opinions of Digital Communication in Student Pharmacists

Exploring the Use and Opinions of Digital Communication in Student Pharmacists

Primary author: Pari Iverson
Co-author(s): Maggie Godsey; Arliegh Cayanan
Faculty sponsor: Dr. Jennifer Robinson

Primary college/unit: College of Pharmacy and Pharmaceutical Sciences
Campus: Spokane

Abstract:

Background: Digital communication is any form of communication that is written word. In-person communication includes face-to-face conversations, video chats, and phone calls. This study was focused on the differences in technical aspects of communication such as wording, phrasing, and tone when delivered digitally versus in-person. Additionally, emotional aspects of communication were explored as well. These aspects included anxiety related to each type of communication, fear of miscommunication, or being perceived as unprofessional.

Results: On a pre-course survey, 60% of students identified that the statement, “I sometimes worry that my digital communications will be perceived negatively (angry, sarcastic, annoyed, etc.) even though that is not my intent” either describes them or often describes them while on a post-course survey, 70% of students responded that the statement describes or often describes them. For the following statement, “When speaking with a peer face-to-face, I rely on the actual words I’m saying to convey the message I am trying to send”, 27% students responded that this statement describes them on a pre-course survey whereas on a post-course survey 43% students identified that this statement describes them.

Conclusions: Following the educational intervention, the number of students who were concerned that their communications would be perceived negatively regardless of their intent increased by 10%. This indicates that the educational intervention was effective in demonstrating to student pharmacists the importance of tone and wording when communicating digitally. Additionally, students recognized the importance of the actual words that they say when communicating face-to-face with their peers.

The Contribution of Sleep to the Development of Post-traumatic Stress Disorder

The Contribution of Sleep to the Development of Post-traumatic Stress Disorder

Primary author: William Vanderheyden

Primary college/unit: Elson S. Floyd College of Medicine
Campus: Spokane

Abstract:

Post-traumatic stress disorder (PTSD) arises as the result of experiencing a physical and/or psychological trauma. Human populations with PTSD show features of sleep disturbance that include insomnia, nightmares, and difficulty staying asleep through the night. Sleep disturbances are considered a hallmark feature of PTSD, yet little is known about the contribution of sleep to the pathogenesis of the disorder.

Using a rodent model of PTSD called “Single Prolonged Stress” we have begun examining if 1) sleep deprivation prior to trauma exposure has any impact on the development of PTSD and 2) if increasing sleep quantity via optogenetics in trauma exposed animals can improve the outcomes associated with trauma exposure.

Preliminary data show that pre-trauma-exposure sleep deprivation has no impact on subsequent PTSD-like cognitive impairments. However, post-trauma-exposure sleep improvements are able to restore cognitive function back to non-trauma exposed levels.

These data identify sleep as a potential therapeutic for trauma exposed populations.

Cannabis Use and Metabolic Syndrome Among Clients with First Episode Psychosis

Cannabis Use and Metabolic Syndrome Among Clients with First Episode Psychosis

Primary author: Erik Stiles
Co-author(s): Karl Alcover; Oladunni Oluwoye
Faculty sponsor: Michael McDonell, PhD

Primary college/unit: Elson S. Floyd College of Medicine
Campus: Spokane

Abstract:

Aim: We sought to explore the relationship between cannabis use and metabolic syndrome (MetS) among those with a first episode psychosis (FEP).

Background: Individuals diagnosed with a psychotic disorder are three times more likely to suffer from cardiovascular disease (CVD) than the general population. CVD accounts for approximately 16% of deaths among individuals diagnosed with schizophrenia-spectrum disorders.

Methods: We conducted a retrospective analysis of 404 participants enrolled in the Recovery After Initial Schizophrenia Episode – Early Treatment Program. Metabolic syndrome was defined according to the Adult Treatment Panel III guidelines. Using multiple logistic regression, we investigated the correlation between cannabis use and rate of metabolic syndrome. Demographics, time, baseline MetS and potential confounders were separated and analyzed. Finally, we explored the derangement of MetS components among cannabis users and abstainers.

Results: Cannabis users versus abstainers had similar rates of MetS at baseline (10% versus 13.7%, p=0.520). Those who used cannabis at any time during the study period tended to have lower triglycerides (OR=0.3, p=0.001) and higher high-density lipoprotein (OR=0.4, p=0.017). Cannabis users were less likely to develop MetS, relative to non-users (OR = 0.42, 95% CI [0.22-0.80], p=0.008). This effect remained after controlling for type of psychiatric medication (e.g., first- or second-generation antipsychotics, long-acting injectables).

Conclusions: Cannabis use may be associated with lower incidence of MetS in patients experiencing psychosis. Our findings may contribute to mitigating the elevated CVD risk in this population. Further research is indicated to explore and develop these observations.

Examining pilot safety performance indicators at critical phases of flight across multiple flight legs during commercial airline trips

Examining pilot safety performance indicators at critical phases of flight across multiple flight legs during commercial airline trips

Primary author: Rhiannon Soriano Smith
Co-author(s): Amanda Lamp; Ian Rasmussen; Ewa Basiarz; Chandler Keller; Gregory Belenky

Primary college/unit: Elson S. Floyd College of Medicine
Campus: Spokane

Abstract:

Prior simulation and operational studies began to address whether the number of consecutive flight segments negatively affects cognitive performance, fatigue, and sleepiness, without reaching a clear consensus. This study expands this literature by determining whether there are significant changes in cognitive performance, fatigue, and sleepiness at critical phases of flight across multiple flight segments, while accounting for the number of segments, flight direction, trip day, and time-of-day.
Fifty commercial airline pilots were studied, each flying two separate short-haul trips ranging from 1-4 days and 1-10 flight segments. Cognitive performance, fatigue, and sleepiness were assessed at top-of-climb (TOC) and top-of-descent (TOD) of each flight segment and trip day. Cognitive performance, fatigue, and sleepiness were assessed using Psychomotor Vigilance Task (PVT) speed, Samn-Perelli (SP) ratings, and Karolinska Sleepiness Scale (KSS) ratings, respectively. Data were analyzed using Wilcoxon t-tests and verified using ANOVAs.
Mean PVT speed (d =0.57), SP (d = 0.73), and KSS (d = 0.63) were significantly worse at TOD than TOC (p < 0.001); and varied across flight segments (p<0.001). Cognitive performance, fatigue, and sleepiness were consistently degraded around the fifth flight segment, improved around the sixth to eighth flights segments, and were subsequently degraded around the eighth to tenth flight segments.
The results indicate that cognitive performance, fatigue, and sleepiness vary across flight segments, trip day, and phase of flight. Results suggest that these safety performance indices degrade after five segments, and further degrade after eight flight segments. The results presented could inform future airline scheduling and regulation.

Relationship between Sleepiness Symptoms Questionnaire Ratings and Psychomotor Vigilance Test Performance in a Laboratory-Based Sleep Deprivation Study

Relationship between Sleepiness Symptoms Questionnaire Ratings and Psychomotor Vigilance Test Performance in a Laboratory-Based Sleep Deprivation Study

Primary author: Alicja Skwara
Co-author(s): Lillian Skeiky; Hans Van Dongen; Devon Hansen

Primary college/unit: Elson S. Floyd College of Medicine
Campus: Spokane

Abstract:

Sleep deprivation has been demonstrated to adversely impact on cognitive performance and safety. Measuring the impairment caused by sleep deprivation is best done with objective performance assessments such as the psychomotor vigilance test (PVT), but subjective self-report assessments may provide a more practical alternative in real-world settings. The Sleepiness Symptoms Questionnaire (SSQ) is a self-report instrument based on ratings of observable symptoms of sleepiness and motor vehicle driving performance impairment. In a laboratory-based sleep deprivation study, we compared SSQ ratings to performance impairment on a 10min PVT.
Twelve healthy normal sleepers (ages 21-39y, 6 females) participated in a 4-day in-laboratory study. Between a baseline day and a recovery day, participants underwent 38 hours of total sleep deprivation. Participants completed the SSQ and PVT following 6.5, 14.5, 22.5, and 30.5 hours of sleep deprivation, and 6.5 hours after recovery sleep.
As sleep deprivation progressed, the SSQ sleepiness ratings and the number of lapses (reaction times > 500 ms) on the PVT were elevated, peaking after 22.5 hours awake. Both measures returned to baseline levels after recovery sleep. There was a moderate correlation between SSQ ratings and PVT lapses (r=0.44, F1,43=24.1, p<0.001). Subjective sleepiness on the SSQ and objective performance impairment on the PVT reflected expected changes by time awake and time of day during sleep deprivation and following recovery sleep. The moderate correlation we observed suggests that the SSQ may be reasonably reliable for measuring impairment under conditions of acute sleep deprivation.

Rest-Activity Patterns in Adults Receiving Methadone for Medication-Assisted Treatment of Opioid Use Disorder

Rest-Activity Patterns in Adults Receiving Methadone for Medication-Assisted Treatment of Opioid Use Disorder

Primary author: Lillian Skeiky
Co-author(s): Marian Wilson; Matthew Layton; Raymond Quock; Hans Van Dongen; Devon Hansen
Faculty sponsor: Devon A. Hansen, PhD, LMHC

Primary college/unit: Arts and Sciences
Campus: Spokane

Abstract:
Individuals with opioid use disorder (OUD) report significant sleep/wake disturbances, which continue even when they stabilize with medication-assisted treatment. However, the nature of reported sleep/wake disturbances has not been well documented. We compared rest/activity patterns observed with a wrist-worn activity monitor, which provides objective estimates of sleep/wake disturbances, to control groups comprised of nurses working day or night shifts.

Seven adults undergoing methadone treatment for OUD wore a wrist activity monitor continuously for 7 days. Hospital nurses – 7 on a day shift schedule and 7 on a night shift schedule (six 12-hour shifts within a two-week period) – also wore a wrist activity monitor continuously for 14 days. The observed rest/activity patterns were analyzed through cosinor analysis to evaluate circadian rhythmicity, and through analysis of the distribution of inactive periods to estimate sleep continuity.

As expected, nurses working day shifts displayed strong circadian rhythmicity and high sleep continuity. Nurses working night shifts showed dampened circadian rhythmicity, but exhibited high sleep continuity. For the OUD methadone treatment group, the strength of circadian rhythmicity was between that of nurses on day versus night shifts, and this group experienced reduced sleep continuity.

These findings suggest disturbed sleep in individuals receiving methadone for medication-assisted treatment of OUD. This may interfere with their ability to achieve OUD recovery goals, and is worthy of investigation in a laboratory setting. This research was partially supported by the State of Washington via the Alcohol and Drug Abuse Research Program.

Community Organizing: A Novel Approach to Identifying Healthcare Needs

Community Organizing: A Novel Approach to Identifying Healthcare Needs

Primary author: Katie Schmidt
Co-author(s): Carly Celebrezze; Kelly Anne Hennessey; Andrew Liechty; Courtney Roberts
Faculty sponsor: Dr. Luis Manriquez

Primary college/unit: Elson S. Floyd College of Medicine
Campus: Spokane

Abstract:
The Spokane Alliance is a non-partisan organization of religious institutions, educators, unions and other civic non-profits organizing for the common good in Spokane, Washington. The Healthcare Research Action Team (HRAT) was formed in response to Alliance members attesting that healthcare is a significant stressor in their lives.

The HRAT, led by medical students from WSU and UW, conducted a health needs assessment of its 31 member organizations. Listening sessions were held with 13 Spokane Alliance organizations in 2018 to qualitatively ascertain healthcare needs among community members.

111 Spokane community members participated. Three themes emerged as common issues: healthcare system complexity, affordability, and mental health needs.

Forty-six stories were shared regarding healthcare system complexity. Members stated they had difficulty navigating both the healthcare and insurance systems. They also expressed frustration with the lack of communication between providers and confusion related to healthcare paperwork.

Twenty-six Spokane Alliance members shared about issues with healthcare affordability, regardless of their health insurance status. Eight members stated they experienced challenges accessing mental health services and stigma surrounding mental health needs.

Community organizing methods can yield rich qualitative data on healthcare needs. The issues identified by Spokane Alliance members indicate a need for improvements in healthcare system navigability, affordability, and access to mental health services in Spokane. Since this needs assessment was conducted, the WSU mobile medicine program has launched its first mobile medical unit, which is equipped to provide primary care and reproductive health services, informed, in part, by the results of this needs assessment.

Expressive language of hard of hearing toddlers as influenced by siblings

Expressive language of hard of hearing toddlers as influenced by siblings

Primary author: Allison Saur
Faculty sponsor: Dr. Mark Vandam

Primary college/unit: Elson S. Floyd College of Medicine
Campus: Spokane

Abstract:

Linguistic complexity is an indicator of language development in young children. Complexity of a child’s linguistic productions have been shown to increase with development, but may be affected by factors such as disability or environmental variables. In particular, hearing impairment may affect language and speech development. In a previous study, we investigated the effect of a siblings’ and sex of the child on the mean length of utterance (MLU) in typically developing children. Here, we look at the MLU of children who are hard-of-hearing compared to their typically developing peers in the context of siblings. MLUs were extracted from the public HomeBank database [http://homebank.talkbank.org] of transcribed natural child speech for both the target toddler and for siblings. A difference in expressive language was found between children who are hard-of-hearing and their typically developing peers. Findings are discussed in terms of language development and sibling presence on expressive language in children with hearing loss.

PRKAR1A deficiency delays postnatal heart growth

PRKAR1A deficiency delays postnatal heart growth

Primary author: Yuening Liu
Faculty sponsor: Zhaokang Cheng

Primary college/unit: College of Pharmacy and Pharmaceutical Sciences
Campus: Spokane

Abstract:

Aims: Protein kinase A (PKA) activity is pivotal for functioning of the human heart, and its dysregulation has been implicated in cardiac pathologies. PKA regulatory subunit 1a (R1a, encoded by the PRKAR1A gene) is highly expressed in the heart, and controls PKA kinase activity. Patients with PRKAR1A mutations are often diagnosed with Carney complex (CNC) in young adults, and may die prematurely from cardiac complications such as heart failure. However, no cardiac defect has been reported in adult animal models of PRKAR1A deficiency.
Methods and Results: To investigate the impact of PRKAR1A deficiency, we generated cardiac-specific PRKAR1A heterozygous knockout mice by breeding the floxed PRKAR1A mice with the Mlc2v-Cre mice. We also studied a cohort of young CNC patients with PRKAR1A mutations or deletions. Ablation of the PRKAR1A gene in mice increased cardiac PKA activity, reduced heart weight and cardiomyocyte size without altering contractile function at 3 months of age. Importantly, left ventricular mass was reduced in young patients diagnosed with CNC. Cardiomyocyte hypertrophy in response to activation of the a1-adrenergic receptor, which is necessary for heart growth after birth, was completely abolished by silencing of PRKAR1A, or stimulation with the PKA activator forskolin. Mechanistically, depletion of PRKAR1A provoked PKA-dependent phosphorylation of the mitochondrial fission protein Drp1 at S637, leading to suppression of mitochondrial fission and inhibition of cardiomyocyte hypertrophy.

Conclusions: PRKAR1A deficiency impedes postnatal myocardial development and physiological hypertrophy through modulation of mitochondrial dynamics. These findings provide a potential novel mechanism for the cardiac manifestations associated with CNC.

Evaluating the impact of pharmacist-led HIV and HCV screening and education on adults experiencing homelessness in Spokane, Washington

Evaluating the impact of pharmacist-led HIV and HCV screening and education on adults experiencing homelessness in Spokane, Washington

Primary author: Sorosh Kherghehpoush
Co-author(s): Kimberly McKeirnan

Primary college/unit: College of Pharmacy and Pharmaceutical Sciences
Campus: Spokane

Abstract:

Over half a million people experience homelessness on a given night in the United States. As a result of increased exposure to disease, violence, unsanitary conditions, stress, malnutrition and substance abuse, homeless persons experience medical problems and treatment complications at higher rates than the general population.

Chronic disease states that require uninterrupted treatment and high rates of adherence, such as Hepatitis C and HIV/AIDS, are more difficult to control in those with unstable housing. Individuals living with HIV/HCV who are unaware of their infection are more likely to transmit these diseases than persons who are aware of their HIV/HCV diagnosis. Gay and bisexual men account for the majority of new HIV diagnoses followed by injection drug users who account for the majority of Hepatitis C infection, two sub-populations that are also disproportionately affected by homelessness.

Given the barriers to clinical engagement and the persistent stigma, HIV and HepC provide an important opportunity for pharmacist involvement.

In this research study, participants will undergo an HIV and HCV point-of-care screening test complimented with comprehensive HIV and HCV education and personalized risk mitigation strategies. Study participants who have a reactive screening are referred to a partnering HIV/HCV specialist to establish care and the local health district for anonymous partner notification.

There are wide-ranging implications associated with this study. Early recognition and treatment to reduce transmission. Increased access to care even for the uninsured. Lower healthcare costs associated with emergency room visits. improved health literacy of a vulnerable population.