Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

www.mobilehealthmap.org 617‐442‐3200 New research shows that mobile health clinics improve health outcomes for hard to reach populations in cost‐effective and culturally competent ways . A Harvard Medical School study determined that for every dollar invested in a mobile health clinic, the US healthcare system saves $30 on average. Mobile health clinics, which offer a range of services from preventive screenings to asthma treatment, leverage their mobility to treat people in the convenience of their own communities. For example, a mobile health clinic in Baltimore, MD, has documented savings of $3,500 per child seen due to reduced asthma‐related hospitalizations. The estimated 2,000 mobile health clinics across the country are providing similarly cost‐effective access to healthcare for a wide range of populations. Many successful mobile health clinics cite their ability to foster trusting relationships. Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves. A communications academic argued that mobile health clinics’ unique use of space is important in facilitating these relationships. Mobile health clinics park in the heart of the community in familiar spaces, like shopping centers or bus stations, which lend themselves to the local community atmosphere.

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

BACKGROUND: The delivery of effective, high-quality patient care is a complex activity. It demands health and social care professionals collaborate in an effective manner. Research continues to suggest that collaboration between these professionals can be problematic. Interprofessional education (IPE) offers a possible way to improve interprofessional collaboration and patient care. OBJECTIVES: To assess the effectiveness of IPE interventions compared to separate, profession-specific education interventions; and to assess the effectiveness of IPE interventions compared to no education intervention.
SEARCH METHODS: For this update we searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE and CINAHL, for the years 2006 to 2011. We also handsearched the Journal of Interprofessional Care (2006 to 2011), reference lists of all included studies, the proceedings of leading IPE conferences, and websites of IPE organisations. SELECTION CRITERIA: Randomised controlled trials (RCTs), controlled before and after (CBA) studies and interrupted time series (ITS) studies of IPE interventions that reported objectively measured or self reported (validated instrument) patient/client or healthcare process outcomes. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed the eligibility of potentially relevant studies. For included studies, at least two review authors extracted data and assessed study quality. A meta-analysis of study outcomes was not possible due to heterogeneity in study designs and outcome measures. Consequently, the results are presented in a narrative format. MAIN RESULTS: This update located nine new studies, which were added to the six studies from our last update in 2008. This review now includes 15 studies (eight RCTs, five CBA and two ITS studies). All of these studies measured the effectiveness of IPE interventions compared to no educational intervention. Seven studies indicated that IPE produced positive outcomes in the following areas: diabetes care, emergency department culture and patient satisfaction; collaborative team behaviour and reduction of clinical error rates for emergency department teams; collaborative team behaviour in operating rooms; management of care delivered in cases of domestic violence; and mental health practitioner competencies related to the delivery of patient care. In addition, four of the studies reported mixed outcomes (positive and neutral) and four studies reported that the IPE interventions had no impact on either professional practice or patient care. AUTHORS' CONCLUSIONS: This updated review reports on 15 studies that met the inclusion criteria (nine studies from this update and six studies from the 2008 update). Although these studies reported some positive outcomes, due to the small number of studies and the heterogeneity of interventions and outcome measures, it is not possible to draw generalisable inferences about the key elements of IPE and its effectiveness. To improve the quality of evidence relating to IPE and patient outcomes or healthcare process outcomes, the following three gaps will need to be filled: first, studies that assess the effectiveness of IPE interventions compared to separate, profession-specific interventions; second, RCT, CBA or ITS studies with qualitative strands examining processes relating to the IPE and practice changes; third, cost-benefit analyses.

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Interprofessional education: effects on professional practice and healthcare outcomes (update)

Data analysis is central to credible qualitative research. Indeed the qualitative researcher is often described as the research instrument insofar as his or her ability to understand, describe and interpret experiences and perceptions is key to uncovering meaning in particular circumstances and contexts. While much has been written about qualitative analysis from a theoretical perspective we noticed that often novice, and even more experienced researchers, grapple with the ‘how’ of qualitative analysis. Here we draw on Braun and Clarke’s (2006) framework and apply it in a systematic manner to describe and explain the process of analysis within the context of learning and teaching research. We illustrate the process using a worked example based on (with permission) a short extract from a focus group interview, conducted with undergraduate students.

Doing a thematic analysis: A practical, step-by-step guide for learning and teaching scholars.

Coronavirus disease 2019 (COVID-19): A literature review.

s and Posters: 1. Mah E, Rosenthal M, Tsuyuki RT. Study of Understanding Pharmacists’ Perspectives on Remuneration and Transition towards Chronic Disease Management (SUPPORT-CDM): Results of an Alberta-wide Survey on Community Pharmacists. Presented: CPhA 96 Annual National Conference, Victoria, BC, May 31 – June 3, 2008. 2. Rosenthal M, Grindrod KA, Marra CA, Lynd LD, Bougher D, Wilgosh C, Tsuyuki RT. Study of Understanding Pharmacists’ Perspectives on Remuneration and Transition towards Chronic Disease Management (SUPPORT-CDM): Remuneration. Presented: CPhA 96 Annual National Conference, Victoria, BC, May 31 – June 3, 2008. 3. Grindrod KA, Rosenthal M, Marra CA, Lynd LD, Bougher D, Wilgosh C, Tsuyuki RT. Study of Understanding Pharmacists’ Perspectives on Remuneration and Transition towards Chronic Disease Management (SUPPORT-CDM): Methods to Determine What Pharmacists Really Think About CDM. Presented: CPhA 96 Annual National Conference, Victoria, BC, May 31 – June 3, 2008. 4. Grindrod KA, Rosenthal M, Marra CA, Lynd LD, Bougher D, Wilgosh C, Tsuyuki RT. Study of Understanding Pharmacists’ Perspectives on Remuneration and Transition towards Chronic Disease Management (SUPPORT-CDM): Challenges and Enablers. Presented: CPhA 96 Annual National Conference, Victoria, BC, May 31 – June 3, 2008. 5. Grindrod KA, Rosenthal M, Marra CA, Tsuyuki RT, Lynd LD. Patient Perceptions of Pharmacists’ Involvement in Chronic Disease Management. Presented: CPhA 97 Annual National Conference, Halifax, NS, May 30 – June 2, 2009. 6. Grindrod KA, Rosenthal M, Marra CA, Tsuyuki RT, Lynd LD. Patient Perceptions of Pharmacists’ Involvement in Chronic Disease Management. Presented: CPhA 97 Annual National Conference, Halifax, NS, May 30 – June 2, 2009. 7. Rosenthal M, Tsuyuki RT, Ng KWK. Pharmacy faculty members’ perception of contemporary pharmacy practice. Presented: Canadian Pharmacists Association Annual National conference and Trade Show, Calgary, AB, May 1518, 2010. 8. Rosenthal M, Autsin Z, Tsuyuki RT. What does a pharmacist do? Insights into self perception of pharmacists. Presented: Canadian Pharmacists Association Annual National Conference and Trade Show, Calgary, AB, May 15-18, 2010. 9. Rosenthal M, Breault RR, Austin Z, Tsuyuki RT. Pharmacists’ self perception of their professional role: Insights into community pharmacy culture. Presented: Canadian Pharmacists Association Annual National Conference and Trade Show, Calgary, AB, May 15-18, 2010. 10. Charrois T, Rosenthal M, Tsuyuki R. Stories from the Trenches: Experiences of Alberta Pharmacists in Obtaining Additional Prescribing. (Poster) Presented: CV Meagen M. Rosenthal, November 2015 9 Canadian Pharmacists Association Annual National conference and Trade Show, Calgary, AB, May 15-18, 2010. 11. Al Hamarneh YN, Rosenthal M, McElnay JC, Tsuyuki RT. Pharmacists’ SelfPerception of Their Role in Professional Practice – A comparison between the UK and Canada. (Poster) Presented: Canadian Pharmacists Association Annual National conference and Trade Show, Calgary, AB, May 15-18, 2010. 12. Tsuyuki RT, Truong K, Rosenthal M. Asleep at the Wheel. Pharmacy Practice Research Advocacy and Knowledge Translation by Canadian Pharmacy Organizations. (Poster) Presented: Canadian Pharmacists Association Annual National conference and Trade Show, Calgary, AB, May 15-18, 2010.

Curriculum vitae for

for pharmacists to provide “optimal drug therapy outcomes for Canadians through patient-centred care” has been accepted by all Canadian pharmacy organizations This means a shift from dispensing and technical duties to a particular focus on services that improve patient outcomes However, practice change of this nature has been discussed for many years, and few programs have been fully successful or sustainable over the long term

Are Pharmacists the Ultimate Barrier to Pharmacy Practice Change

Qualitative research methods: Why, when, and how to conduct interviews and focus groups in pharmacy research

While collaborative, team-based care has the potential to improve medication use and reduce adverse drug events and cost, less attention is paid to understanding the processes of well functioning t...

Collaboration between pharmacists, physicians and nurse practitioners: a qualitative investigation of working relationships in the inpatient medical setting.

Background—Hypertension control rates remain suboptimal Pharmacists’ scope of practice is evolving, and their position in the community may be ideal for improving hypertension care We aimed to study the impact of pharmacist prescribing on blood pressure (BP) control in community-dwelling patients Methods and Results—We designed a patient-level, randomized, controlled trial, enrolling adults with above-target BP (as defined by Canadian guidelines) through community pharmacies, hospitals, or primary care teams in 23 communities in Alberta Intervention group patients received an assessment of BP and cardiovascular risk, education on hypertension, prescribing of antihypertensive medications, laboratory monitoring, and monthly follow-up visits for 6 months (all by their pharmacist) Control group patients received a wallet card for BP recording, written hypertension information, and usual care from their pharmacist and physician Primary outcome was the change in systolic BP at 6 months A total of 248 pat

Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood Pressure in the Community: The Alberta Clinical Trial in Optimizing Hypertension (RxACTION).

Meagen Rosenthal

Papers

Curriculum vitae for

Are Pharmacists the Ultimate Barrier to Pharmacy Practice Change

Qualitative research methods: Why, when, and how to conduct interviews and focus groups in pharmacy research

Collaboration between pharmacists, physicians and nurse practitioners: a qualitative investigation of working relationships in the inpatient medical setting.

Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood Pressure in the Community: The Alberta Clinical Trial in Optimizing Hypertension (RxACTION).