Topic of Choice 2021

As I became older, I started to realize that not a lot of people valued communication as much as I do. I noticed that people didn’t want to initiate any serious conversations or be confrontational. They would rather bottle their feelings in and hope that their problems would go away. Trust me, it never went away. If anything, they would hold it in for so long that one day they would eventually blow up and have a mental breakdown. I believe people do this because no one really talks about mental health and building healthy coping mechanisms. This only happens in therapy which not everyone does because of the stigma. The reason I think this is an important topic is because I’ve seen people with pharmacy leadership roles not have the basic communication skills to be a leader. This can be detrimental to not only them, but to their coworkers as well. For example, I had a pharmacy lead intern favor only one employee and devote most of their time training that person while there were three ...

Mental Health and Care in Mainland China: Apps filling the gap?  By: Vince Alessi,   April 14th 2021     Mental health has historically been a highly stigmatized topic in developing nations that have recently undergone rapid transitions from being labeled a '3rd world' to a '1st world nation'. There are several examples of this, albeit predominantly in sino-eurasian nations. Historically, China has been amongst the most outwardly intolerant of mental health illness as comparable to more demonstrable physical maladies. In 2011, a study performed by  Whittington and Higgins indicated that the majority of Chinese nurses in nationally supported hospitals exhibited minimal or "zero-tolerance" for multiple behaviors commonly associated with one or more mental illness. Even to do this day, overall the Chines population does not engage in mental health services or make visits to a care provider with any frequency, as shown in the figure.    ...

Our recent conversations in class concerning systemic racism have caused me to think more about the topic, its origins, and its place in healthcare. One of the major contributors in my opinion is implicit bias. Implicit bias describes the attitudes and stereotypes held by an individual without conscious knowledge. This bias can influence the perception of others as well as contribute to expectations and assumptions for other individuals. Typically, implicit bias manifests in physical and social characteristics, such as race, gender, age, and ethnicity. On a day-to-day basis, implicit bias can appear as a non-threatening aspect of social interactions, but that is not the case in healthcare. Healthcare providers, like all individuals, have implicit bias, but in their case, perceptions could influence clinical decisions. These affects have been noted in studies concerning statin prescription rates as well as diabetes treatment. When thinking about racism and its various impacts, it is imp...

In the FDA 2018 Drug Trial Snapshots report, it was demonstrated that there’s a significant imbalance in the representation of racial and ethnic minorities in clinical research. Participants in clinical trials should reflect the diversity of the population, but this lack of representation has led to the development of drug interventions that may cause safety or efficacy issues for underrepresented populations. It's not just potential genetic predispositions of certain racial/ethnic groups to specific adverse events, but differences in experiences and exposure to environmental stressors among racial/ethnic groups may not be accounted for when clinical trials do not test their drug interventions on diverse participants.  A 2021 cross-sectional study looked at 230 vaccine clinical trials between 2011 and 2020, and the results highlighted disparities over the past decade where Black or African American, American Indian or Alaska Native, Hispanic or Latinx populations, and old...

 I am writing this blog about the current state of Georgia politics. I chose this topic for 2 purposes. The first being that Georgia is my home state and secondly to display the style of systemic oppression that our nation still bolsters today in various ways.  Background: On March 26th, 2021 the governor of Georgia passed a series of laws in regards to voting rights. At face value the laws present as a series of unique changes that should be enacted to help secure and validate elections in the state of Georgia. However, once the 98 page document is broken down into layman's terms it is apparent that the laws have been reorganized to benefit the republican party in areas where they fell short during the 2020 election. I've listed some of the laws below for anyone to explore if they are interested.  Voters will now have less time to request absentee ballots. There are strict new ID requirements for absentee ballots. It’s now illegal for election officials to mail out absen...

  For decades, there has been a general mistrust in science and healthcare among the general American public. This trend has been highlighted especially regarding the coronavirus pandemic, as many Americans refuse to receive the COVID-19 vaccine, acknowledge the reality of the virus, or listen to recommendations from the CDC and healthcare providers. But why do Americans have trust issues with scientists and the healthcare system? The answer is not simple but lies in the idea that the average American feels that science has failed them. Science is messy and convoluted. It’s not simple enough to say that the public should “just trust” scientists because they “know better.” Trust, like in any relationship, must be earned. Unfortunately, not everyone has access to an education and cannot easily seek out scientific information and understand it. This is something most scientists know, but do not do anything about. Some scientists and healthcare providers tend to use technical terms, ...

When the Center for Disease Control (CDC) came out with this statement I was not at all surprised about this statement. As an African American woman, I know that racism is a threat to not only the public but to individual’s mental health. In pharmacy school we learn about social determinants of health (SDOH) which are all factors that are interrelated to public health. Dr. Rochelle Walensky, Director of the CDC, addressed this statement of “racism is a serious public health threat” with Times News. Dr. Walensky acknowledge the fact that although COVID-19 pandemic has brought to light the disparities communities of color face but also states that it is a long problem that was perpetuated by racism.   When I first read the titles of this article I got a little annoyed because racism has been around for years and I was thinking “why is this just now coming up?” However, I read the article and saw that Dr. Walensky is making an effort to incorporate interventions that are measurable ...

For thousands of years humans have been molding much of the life around us to better suit our needs. From the domestication of animals to the selective breeding of fruits & vegetables; much of the life we interact with today was molded by people of the past to better suit our needs in the present. In the previous century we made even further progress in this field with the discovery of DNAs function and double helix structure. This of course begs the question. What if we could alter that structure thereby changing the characteristics of the organisms carrying the DNA? Enter CRISPR.             CRISPR is a technology derived from bacteria which developed a way to combat bacteriophages using the Cas9 protein. The Cas9 protein serves to cut the DNA while a guide RNA recognizes the sequence of DNA that is to be removed and edited. By replacing the natural anti-bacteriophage guide RNA with our own specifically chosen guide RNA t...

BMI, eGFR, CrCl....all measurements used to analyze and categorize a patient's health in order to fit them into a specific treatment or dosing algorithm. Despite their longstanding use within the medical community, there have been countless claims stating that these calculations are not only inaccurate, but, at times, a false representation of a patient's health status. So why are they still being used? The body max index math or BMI was first coined in 1972 by a scientist named Ancel Keys who wanted to aid the government in developing a centralized method to monitor health risks among Americans. Today, it is still being used as a major indicator among medical professionals as well as a tool among the federal government to track obesity rates within the United States. According to the CDC, approximately 42.4% of Americans aged 20 years and older are considered obese, a statistic that has steadily risen over several decades. As more studies have been conducted regarding the rele...

  Within this past week, we have witnessed the rise and fall of the Johnson & Johnson vaccine. What once seemed as an attractive, one-dose, easier-temperature-requirements option has been removed from the market due to a serious side effect seen in 6 patients. There is a lot of backlash on taking this vaccination away for such a small amount of people with this response. This serious side effect is a rare form of blood clot called cerebral venous sinus thrombosis (CVST). A popular retort to this blood clot adverse effect is that many hormonal contraceptive products contain blood clot warnings. It is known that intake of estrogen-containing products can increase risk for deep vein thrombosis (DVT) and pulmonary embolism (PE), which are both forms of blood clots in the legs or lungs, respectively. While both of these are very concerning, CVST is most like an ischemic and hemorrhagic stroke, but instead of the clot happening in an artery and blocking blood flow to the brain, t...

According to the American Association of Colleges of Pharmacy (AACP), as of July 2020, there are 141 accredited colleges of pharmacy in the United States.  As a result, some 14,000+ new pharmacists are being rolled out into the workforce every year looking for jobs.  While it is great to have a fresh supply of new pharmacists each year, the number of available job openings is struggling to keep up.  In the early 2000s, pharmacists were a hot commodity in an era where the pharmacist demand far exceeded the supply.  Factors such as an aging population, better detections of chronic, treatable illnesses, and an ever increasing volume of prescriptions (including the implementation of Medicare Part D in 2006) all contributed to a rising demand in pharmacists.  The need was so great that some hospitals and pharmacies offered significant signing bonuses, like getting a new BMW (born in the wrong generation I suppose), to entice pharmacists to work for them.  At one...

     It seems like a popular item in the news recently is the COVID vaccine, and it’s no secret that many people are hesitant to get it. Whether that reason is because people believe the vaccine itself is too new, they’re scared of the side effects, they think the vaccine will change their DNA, or they just aren’t afraid of the virus in general, as pharmacy students we have the opportunity to educate the public with all the information we have available.Unfortunately, there is plenty of information circulating that may make the general public even more hesitant to get the vaccine. As we have learned in communication courses, educating people about the vaccine will only be productive if they are willing to listen, but it doesn’t hurt to try to have that conversation.       People may talk about how there is a decent number of health care professionals who are refusing to get the vaccine so this may deter the general public since it is health related. Wh...

  A lot is put on health care workers, especially since the onset of the COVID-19 pandemic. Initially, tons of recognition was given to frontline workers in honor of their sacrifices. Just last week at Michigan Medicine, there was a “record high” of admissions for COVID-19. As vaccines roll out and we face another surge of cases in the United States, health care workers continue to put themselves at risk everyday. Burnout can be found in any work environment, but there are certainly key factors that will accentuate it. Before COVID was even a concern, it was found that physicians had nearly double the rate of burnout symptoms when compared to the general population (54% vs. 28% in 2014) (Green-McKenzie et al., 2020) . Similarly, pharmacists were found to have rates of burnout over 50% before the pandemic. After COVID-19, we see levels of 64-70% in pharmacy and other healthcare professionals (Jones et al., 2021) .  Why are healthcare occupations so prone to burnout? Healt...

Historically women have been excluded from important rooms and important conversations. We have fought tooth and nail to get where we are but one area that still requires reform is healthcare. That exclusion of women throughout history has led to systems of healthcare and medical research which has been made by men for men. For example, drug development centers around male subjects meaning that the dosage levels are set by metabolism in the male body. It has been clearly established that mane and women often have differences in how they metabolize substances, think alcohol, so why would male metabolism be used as the standard for medications? This standard has led to dosage levels that are incorrect for female patients. Ambien was the first drug to correct this when a study found that the dosage prescribed for Ambien was far too high for women, and that it is safe/efficacious for women to be taken at a lower dose.   It is alarming that for decades women have been taking medications...

A month ago, NBC news published an article regarding the working conditions of community pharmacies. The issues highlighted in that article such as understaffing, unrealistic metrics, and high stress work environments just scratch the tip of the iceberg when it comes to challenges in community practice. With pharmacy chains such as CVS and Walgreens monopolizing the market, the emergence of Amazon pharmacy, and insurances pushing for patients to fill their medications via mail-order, the future of community pharmacy looks bleak. Community pharmacy gets a bad rap and with the unrealistic expectations set by pharmacy corporations, poor reimbursements due to unregulated PBMs, and issues with understaffing, the negatives greatly outweigh the positives. With attention turning to pharmacies at the forefront of the pandemic who are overwhelmed with administering COVID vaccines and tests, it is finally time to confront the harsh reality regarding the state of community pharmacies and to admit ...