Publications by authors named "Georgina Lynch"

4 Publications

  • Page 1 of 1

Impact of pharmacist involvement on medication safety in interprofessional transfer of care activity.

N Z Med J 2021 Jul 30;134(1539):9-20. Epub 2021 Jul 30.

Associate Dean Medical Education, University of Otago, Christchurch, Specialist Respiratory Physician, Canterbury District Health Board.

Aim: Any transition of patient care is a high-risk time for communication error. This paper explores whether the presence of a pharmacist as part of an interprofessional group provides additional benefit and safety in transitions of care.

Method: Six pharmacy interns and newly qualified pharmacists joined participants from seven other health professional training programmes to take part in an interprofessional education activity. Participants were assigned to 24 mixed-professional groups. Each group was required to craft a discharge summary for the same simulated patient. Groups without a pharmacist were given additional written documentation, including medication reconciliation, discharge prescription and discharge recommendations. The 24 discharge summaries were assessed for any medication-related information, both positive and negative. Groups with a pharmacist (6) were compared with groups who did not have a pharmacist (18) for completeness and accuracy of medication management.

Results: An in-person pharmacist provided more thorough, comprehensive, accessible and accurate information for the community team (p=0.003). Although there was no difference in the absolute number of medication errors between the groups (p=0.057), the groups with a pharmacist showed a significant reduction in the severity of the errors (p=0.009). This result happened despite the groups without a pharmacist being provided with all the required medication information for safe transition of care.

Conclusion: These findings support the case for greater involvement from a pharmacist in a patient's healthcare team, particularly for any transition of care. Healthcare teams that include a pharmacist are more likely to exceed minimum safety expectations and make less severe errors.
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July 2021

Using Pupillometry to Assess the Atypical Pupillary Light Reflex and LC-NE System in ASD.

Georgina Lynch

Behav Sci (Basel) 2018 Nov 21;8(11). Epub 2018 Nov 21.

Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99210-1495, USA.

With recent advances in technology, there has been growing interest in use of eye-tracking and pupillometry to assess the visual pathway in autism spectrum disorder (ASD). Within emerging literature, an atypical pupillary light reflex (PLR) has been documented, holding potential for use as a clinical screening biomarker for ASD. This review outlines dominant theories of neuropathology associated with ASD and integrates underlying neuroscience associated with the atypical PLR through a reciprocal model of brainstem involvement and cortical underconnectivity. This review draws from animal models of ASD demonstrating disruption of cranial motor nuclei and brain imaging studies examining arousal and the influence of the locus coeruleus norepinephrine (LC-NE) system on the pupillary response. Pupillometry methods are explained in relation to existing data examining the PLR in ASD and pupillary parameters of constriction latency and tonic pupil diameter as key parameters for investigation. This focused review provides preliminary data toward future work developing pupillometry metrics and offers direction for studies aimed at rigorous study replication using pupillometry with the ASD population. Experimental conditions and testing protocol for capturing pupil parameters with this clinical population are discussed to promote clinical research and translational application.
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November 2018

Intervention Techniques Used With Autism Spectrum Disorder by Speech-Language Pathologists in the United States and Taiwan: A Descriptive Analysis of Practice in Clinical Settings.

Am J Speech Lang Pathol 2018 08;27(3):1091-1104

Department of Speech and Hearing Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane.

Purpose: This study examined intervention techniques used with children with autism spectrum disorder (ASD) by speech-language pathologists (SLPs) in the United States and Taiwan working in clinic/hospital settings. The research questions addressed intervention techniques used with children with ASD, intervention techniques used with different age groups (under and above 8 years old), and training received before using the intervention techniques.

Method: The survey was distributed through the American Speech-Language-Hearing Association to selected SLPs across the United States. In Taiwan, the survey (Chinese version) was distributed through the Taiwan Speech-Language Pathologist Union, 2018, to certified SLPs.

Results: Results revealed that SLPs in the United States and Taiwan used 4 common intervention techniques: Social Skill Training, Augmentative and Alternative Communication, Picture Exchange Communication System, and Social Stories. Taiwanese SLPs reported SLP preparation program training across these common intervention strategies. In the United States, SLPs reported training via SLP preparation programs, peer therapists, and self-taught.

Conclusions: Most SLPs reported using established or emerging evidence-based practices as defined by the National Professional Development Center (2014) and the National Standards Report (2015). Future research should address comparison of SLP preparation programs to examine the impact of preprofessional training on use of evidence-based practices to treat ASD.
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August 2018

Pupillary Response and Phenotype in ASD: Latency to Constriction Discriminates ASD from Typically Developing Adolescents.

Autism Res 2018 02 31;11(2):364-375. Epub 2017 Oct 31.

Department of Speech and Hearing Sciences, Washington State University, Spokane, WA.

Brain imaging data describe differences in the ASD brain, including amygdala overgrowth, neural interconnectivity, and a three-phase model of neuroanatomical changes from early post-natal development through late adolescence. The pupil reflex test (PRT), a noninvasive measure of brain function, may help improve early diagnosis and elucidate underlying physiology in expression of ASD endophenotype. Commonly observed characteristics of ASD include normal visual acuity but difficulty with eye gaze and photosensitivity, suggesting deficient neuromodulation of cranial nerves. Aims of this study were to confirm sensitivity of the PRT for identifying adolescents with ASD, determine if a phenotype for a subtype of ASD marked by pupil response is present in adolescence, and determine whether differences could be observed on a neurologic exam testing cranial nerves II and III (CNII; CNIII). Using pupillometry, constriction latency was measured serving as a proxy for recording neuromodulation of cranial nerves underlying the pupillary reflex. The swinging flashlight method, used to perform the PRT for measuring constriction latency and return to baseline, discriminated ASD participants from typically developing adolescents on 72.2% of trials. Results further confirmed this measure's sensitivity within a subtype of ASD in later stages of development, serving as a correlate of neural activity within the locus-coeruleus norepinephrine (LC-NE) system. A brainstem model of atypical PRT in ASD is examined in relation to modulation of cranial nerves and atypical arousal levels subserving the atypical pupillary reflex. Autism Res 2018, 11: 364-375. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Lay Summary: Milder forms of autism spectrum disorder (ASD) can be difficult to diagnose based on behavioral testing alone. This study used eye-tracking equipment and a hand-held penlight to measure the pupil reflex in adolescents with "high functioning" ASD and in adolescents without ASD. The ASD group showed a delay in pupil response. This is the first eye-tracking study to conduct this test as typically performed by a clinical provider, demonstrating differences in older individuals with a subtype of ASD.
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February 2018