Background Suicide remains a global issue with over 800,000 people dying from suicide every year. Youth suicide is especially serious due to the years of life lost when a young person takes their own life. Social interactions, perceived support, genetic predisposition and mental illnesses are factors associated with suicide ideation. Objectives To review and synthesize qualitative studies that explored the experiences and perceptions of suicide in people 25 years old and younger. Design Qualitative systematic review. Data sources PubMed, PsycINFO, Scopus and CINAHL were searched alongside hand-searching reference lists up to October 2018. Methods Methodological quality was assessed using the qualitative Critical Appraisal Skills Programme checklist. The 27 studies included in the review centered around youth suicide and included interviews with young people and members of the wider community. Thematic synthesis focused on factors leading to suicide attempts, elements important to recovery, beliefs within the community, and treatment/prevention strategies. Results Thematic analysis of the articles revealed four categories: i) triggers and risks leading to suicidality; ii) factors involved in recovery; iii) need for institutional treatment/prevention strategies; and iv) beliefs about suicide at a community level. The first category was further subdivided into: i) behaviours; ii) feelings/emotions; iii) family influences; iv) peer influences; and v) other. The second category was split into: i) interpersonal; ii) cultural; and iii) individual influences, while the third category was divided into i) education; and ii) treatment. Conclusion Youth suicide is a complex issue with many causes and risks factors which interact with one another. For successful treatment and prevention, procedural reform is needed, along with a shift in societal attitudes toward emotional expression and suicide.

Background: One of the primary barriers to medication adherence is traversing a physical distance to a pharmacy to pick-up medications. There are few studies that have examined how socioeconomic factors affect patient medication adherence in the context of student-run free clinics (SRFC).  Low medication adherence leads to poorer patient outcomes, especially in patients with chronic diseases. Methods: This retrospective chart review aims to quantify the rate of medication adherence at this student-run free clinic using prescription pick-up rate and medication possession ratio (MPR). This study involved review of medication documentation in the electronic medical record (EMR) and charge reports of dispensed medications from the clinic’s community partner, OneWorld pharmacy. Prescriptions written for and picked up by Student Health Alliance Reaching Indigent Needy Groups (SHARING) patients between January 1, 2018, and May 31, 2020, were included for analysis. Medication adherence was calculated using MPR. Results: 1,396 prescriptions were written for 37 patients over the study period and 177 prescriptions (12.7%) were dispensed. The MPR for the patient population is 0.1128 (Standard Deviation (SD) = 0.36159). It took patients an average of 29.4 days (SD = 44.3) to pick-up medications after the prescription was sent. Discussion: At an off-campus pharmacy, SRFC patients had a low prescription pick-up rate and low medication adherence, with delayed time to prescription pick-up. Further investigations are needed to identify barriers to prescription adherence and improve adherence rates.

The Student Health Alliance Reaching Indigent Needy Groups (SHARING) clinics are student run freeclinics (SRFCs) at the University of Nebraska Medical Center that serve low income, uninsured adultsin Omaha, Nebraska. Like many other SRFCs, they face multiple barriers to providing high quality care.To address this, the SHARING Quality Improvement (QI) Database was created. QI has many definitions,but, overall, it is a method of analyzing clinic performance and the changes made to improvethe clinic. Before this database, there was no way of continuously tracking clinic metrics over time, soprevious QI projects required timely data abstraction that often only evaluated retrospective outcomeswith limited real-time data to track clinical outcomes as changes were implemented therebylimiting our ability to implement further changes to improve patient health. A review of SRFC literaturereveals a lack of a model or guide on how to assess quality of care in SRFCs and track patient dataover time. This study seeks to fill this gap. Our database consists of a patient list of electronic medicalrecords that were compiled in the charting system Epic. The patient data is exported into a MicrosoftExcel document each month and clinic metrics are analyzed, thus providing a real-time dashboard ofquality metrics for the clinic. This database will be utilized to inform decisions regarding the reform ofclinic processes. This database model can be used at other SRFCs to monitor quality of care providedat their clinics and implement QI measures accordingly.