Background:The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services.Objective:To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas.Methods:This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota.Results:Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (P<0.05). For some public health services, pharmacists in rural areas reported higher frequency of delivery than did pharmacists in urban areas (P < .05) that included: medication therapy management, immunizations, tobacco counseling, and medication take-back programs. For some essential services, pharmacists (particularly independents) in rural areas reported more frequent delivery than did pharmacists in urban areas (P < .05), these included: evaluate the services the pharmacy provides, partner with the community to identify and help solve health problems, and conduct needs assessments to identify health risks in my community.Conclusion:Rural pharmacists more frequently deliver public health services than urban in both Iowa and North Dakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking.

As patient advocates, nurses are responsible for speaking up against unsafe practices. Nursing students must develop the confidence to speak up for patient safety so that they can hold themselves, as well as their peers and coworkers, accountable for patients' well-being. The purpose of this study was to examine the effects of a senior practicum course on confidence for speaking up for patient safety in nursing students. Confidence in speaking up for patient safety was measured with the Health Professional Education in Patient Safety Survey. The study showed a significant increase in nursing students' confidence after the senior practicum course, but there was no significant change in students' confidence in questioning someone of authority.

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A model was developed to simulate the combination of Davis's electrical model of cochlear excitation and the electrical model of a neuron; both afferent and efferent fibers were included. The resulting model was stimulated by varying the hair cell resistance. This is equivalent to varying the sound pressure level presented to the cochlea in the physiological system. It was found that, in the normal ear, there was a critical level of hair cell resistance below which no firings were obtained (no information transmitted). The scala media potential was varied and the previous tests repeated. This was done to simulate changes in the stria vascularis of the physiological system. It was found that as the scala media potential decreased, the critical value of the hair cell resistance increased. Two clinical procedures are proposed: the first is a procedure to improve hearing for persons with a "linear or flat loss"; the second is a procedure for improving the hearing for persons with a "ski slope loss."