This article addresses social work's place in the movement to "defund the police." We argue that social work's collaboration with police and use of policing constitutes carceral social work. In ...defining carceral social work, we specify the ways in which coercive and punitive practices are used to manage Black, Indigenous, other people of color, and poor communities across four social work arenas - gender-based violence, child welfare, schools, and health and mental health. To inform anti-carceral social work, we provide examples of interventions in these arenas that dismantle police collaborations and point to life-affirming, community-centered, and mutual aid alternatives.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Characterization of a pulmonary lesion is a well-established indication for metabolic imaging with 18F-FDG. There is extensive literature on the use of PET and CT in the characterization of a ...solitary pulmonary nodule (SPN). The performance of dual-modality imaging with PET/CT for characterizing SPNs was investigated in a clinical referral setting.
We performed a retrospective study involving patients referred for SPN characterization with PET/CT between September 2002 and June 2004, for whom a pathologic diagnosis was available. The group consisted of 12 men and 30 women whose age ranged from 35 to 84 y (mean age +/- SD, 67 +/- 11 y). A dual-slice CT/lutetium oxyorthosilicate PET system was used for imaging. CT images were acquired without intravenous contrast. Blinded interpretation was performed by 1 chest radiologist for CT and 2 nuclear medicine physicians for PET. PET/CT images were read in consensus. Lesions were analyzed by location, texture, axial dimension, and metabolic activity and visually scored on a 5-point scale from benign to malignant; the maximum standardized uptake value (SUVmax) was measured.
Lesion diameter varied from 7 to 30 mm (mean +/- SD, 15 +/- 6 mm). The SUVmax ranged from 0.5 to 17.2 (mean +/- SD, 3.0 +/- 3.0). SUVmax corrected for lean body mass was 0.4-12.1 (mean +/- SD, 2.1 +/- 2.0). Comparison of CT versus PET versus PET/CT yielded accuracies of 74%, 74%, and 93%, respectively. PET and CT correctly characterized 31 and PET/CT correctly characterized 39 of the 42 lesions as malignant or benign. The sensitivity and specificity for CT, PET, and PET/CT was 93%/31%, 69%/85%, and 97%/85%, respectively. There were significant differences (P < 0.05) between PET/CT and PET for accuracy, sensitivity, and specificity. Accuracy did not improve by quantitative analysis using an SUVmax cutoff of 2.0 for malignancy. Lean body mass correction of the SUVmax did not change accuracy.
PET/CT demonstrates an excellent performance in classifying SPNs as benign or malignant. The combination of anatomic and metabolic imaging is synergistic by maintaining the sensitivity of CT and the specificity of PET, resulting in an overall significantly improved accuracy. Visual interpretation is sufficient for characterizing an SPN. Quantitative analysis does not improve accuracy of PET/CT for SPN characterization.
Rural Health in Pharmacy Curricula Thrasher, Kim; O’Connor, Shanna K.; Joyner, Pamela U.
American journal of pharmaceutical education,
11/2012, Volume:
76, Issue:
9
Journal Article
Peer reviewed
Open access
The 2010 Patient Protection and Affordable Care Act proposes strategies to address the workforce shortages of primary care practitioners in rural America. This review addresses the question, “What ...specialized education and training are colleges and schools of pharmacy providing for graduates who wish to enter pharmacy practice in rural health?” All colleges and schools accredited by the Accreditation Council for Pharmacy Education or those in precandidate status as of December 2011 were included in an Internet-based review of Web sites. A wide scope of curricular offerings were found, ranging from no description of courses or experiences in a rural setting to formally developed programs in rural pharmacy. Although the number of pharmacy colleges and schools providing either elective or required courses in rural health is encouraging, more education and training with this focus are needed to help overcome the unmet need for quality pharmacy care for rural populations.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, VSZLJ, ZAGLJ, ZRSKP
To determine prospective student pharmacists’ interest in a rural pharmacy health curriculum.
All applicants who were selected to interview for fall 2011 enrollment at the UNC Eshelman School of ...Pharmacy were invited to participate in a Web-based survey. Questions addressed participants’ willingness to participate in a rural health pharmacy curriculum, interest in practicing in a rural area, and beliefs regarding patient access to healthcare in rural areas.
Of the 250 prospective student pharmacists invited to participate, 91% completed the survey instrument. Respondents agreed that populations living in rural areas may have different health needs, and students were generally interested in a rural pharmacy health curriculum.
An online survey of prospective student pharmacists was an effective way to assess their interest in a rural pharmacy program being considered by the study institution. Location of the rural program at a satellite campus and availability of housing were identified as factors that could limit enrollment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, VSZLJ, ZAGLJ, ZRSKP
It is difficult to accurately forecast the clinical course of many patients presenting with mild cognitive problems. The utility in prognostic evaluation of various parameters of brain structure and ...function that can now be noninvasively measured remains to be clearly defined. The present work examined the value of regional cerebral metabolism, assessed with positron emission tomography (PET) and
18Ffluoro-2-deoxyglucose, in this context. PET scans of 167 patients (mean Mini-Mental State Examination (MMSE)=24 of 30 possible points) were classified as being positive or negative for evidence of progressive dementia. Results of scans were compared to patients’ subsequent clinical course in general and in particular, to their changes in MMSE scores, for up to 10 years following PET. Data were further stratified according to the predictions of referring physicians based upon clinical assessments that had been performed up until the time of PET. Among those patients for whom a progressive dementing course had been predicted by PET criteria (but not those who were predicted by PET criteria to remain stable) a significant decline in general cognitive performance and MMSE scores occurred in the period following PET. Among those patients predicted by clinical criteria to have a progressive dementing illness, 94% of those with positive PET scans did suffer a progressive decline, while only 25% of those with negative scans progressed (relative risk 3.8). Similarly, among those patients who had been predicted by clinical criteria to remain cognitively stable, 74% of those with positive PET scans nevertheless suffered progressive decline, compared with 4% of those with negative PET scans (relative risk 18.4). These data indicate that evaluation of brain metabolism by PET in appropriately selected patients may improve the accuracy of clinical prognostic assessment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Orofacial pain bridges an important gap between medicine and dentistry. This article presents the case of a man who reported preauricular pain, tinnitus, and vertigo that began after extraction of an ...impacted third molar and who was sent for evaluation of a possible temporomandibular joint disorder. However, he was subsequently found to have markers and imaging results consistent with recurrent and more centralized lupus and/or multiple sclerosis.
Rural Health in Pharmacy Curricula Thrasher, Kim; O'Connor, Shanna K; Joyner, Pamela U
American journal of pharmaceutical education,
10/2012, Volume:
76, Issue:
9
Journal Article
Peer reviewed
The 2010 Patient Protection and Affordable Care Act proposes strategies to address the workforce shortages of primary care practitioners in rural America. This review addresses the question, "What ...specialized education and training are colleges and schools of pharmacy providing for graduates who wish to enter pharmacy practice in rural health?" All colleges and schools accredited by the Accreditation Council for Pharmacy Education or those in precandidate status as of December 2011 were included in an Internet-based review of Web sites. A wide scope of curricular offerings were found, ranging from no description of courses or experiences in a rural setting to formally developed programs in rural pharmacy. Although the number of pharmacy colleges and schools providing either elective or required courses in rural health is encouraging, more education and training with this focus are needed to help overcome the unmet need for quality pharmacy care for rural populations. PUBLICATION ABSTRACT
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, VSZLJ, ZAGLJ, ZRSKP
More than 1 in 3 adults living in rural America is in poor to fair health, with nearly half having at least 1 major chronic illness.4 Individuals in rural areas have higher rates of smoking as well ...as obesity, diabetes, and other chronic diseases.5 In its 2005 report on rural health care, the Institute of Medicine asserted that many of the challenges faced by those living in rural areas can be attributed to the lack of access to basic health care services. Additionally, pharmacists are now included in theNationalHealth ServiceCorps (NHSC)StateLoan Repayment Program which gives grants to states to operate their own loan repayment programs for primary care providers in medically underserved areas.14 Partnerships with community colleges have proven successful for programs such as the one at the University of Nebraska Medical Center.12 Similarly, UNC operates the Carolina Student Transfer Excellence Program to engage students enrolled in some of the state's community colleges to transfer and graduate from UNC; this program may prove to be a future partner with a rural health pharmacy program.15 To highlight the unique characteristics of a rural applicant, use of a unique supplemental application in addition to a school's standard application should be considered.When determining the ideal applicant to a rural health program, the following factors should be considered: previous experience in a rural setting, an expressed commitment to rural health, leadership experience, and community service.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, VSZLJ, ZAGLJ, ZRSKP
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