A Subgroup Analysis of the Impact of Self-testing Frequency on Examination Scores in a Pathophysiology Course

Objective: To determine if the frequency of self-testing of course material prior to actual examination improves examination scores, regardless of the actual scores on the self-testing. Methods: Practice quizzes were randomly generated from a total of 1342 multiple-choice questions in pathophysiology and made available online for student self-testing. Intercorrelations, 2-way repeated measures ANOVA with post hoc tests, and 2-group comparisons following rank ordering, were conducted. Results: During each of 4 testing blocks, more than 85% of students took advantage of the self-testing process for a total of 7042 attempts. A consistent significant correlation (p≤0.05) existed between the number of practice quiz attempts and the subsequent examination scores. No difference in the number of quiz attempts was demonstrated compared to the first testing block. Exam scores for the first and second testing blocks were both higher than those for third and fourth blocks. Conclusion: Although self-testing strategies increase retrieval and retention, they are uncommon in pharmacy education. The results suggested that the number of self-testing attempts alone improved subsequent examination scores, regardless of the score for self-tests

Exacerbation of Celecoxib-Induced Renal Injury by Concomitant Administration of Misoprostol in Rats

Nonsteroidal anti-inflammatory drugs (NSAIDs) can produce adverse effects by inhibiting prostaglandin (PG) synthesis. A PGE1 analogue, misoprostol, is often utilized to alleviate NSAID-related gastrointestinal side effects. This study examined the effect of misoprostol on celecoxib renal toxicity. Additionally, the effects of these drugs on cardiovascular parameters were evaluated. Four randomized rat groups were orally gavaged for 9 days, two groups receiving vehicle and two groups receiving misoprostol (100 μg/kg) twice daily. Celecoxib (40 mg/kg) was co-administered once daily to one vehicle and one misoprostol group from days 3 to 9. Urine and blood samples were collected and blood pressure parameters were measured during the study period. Hearts and kidneys were harvested on final day. Day 2 urinary electrolyte samples revealed significant reductions in sodium excretion in misoprostol (0.12±0.05 μmol/min/100 g) and misoprostol+celecoxib groups (0.07±0.02 μmol/min/100 g). At day 3, all treatment groups showed significantly reduced sodium excretion. Potassium excretion diminished significantly in vehicle+celecoxib and misoprostol+celecoxib groups from day 3 onward. Urinary kidney injury molecule-1 levels were significantly increased in vehicle+celecoxib (0.65±0.02 vs. 0.35±0.07 ng/mL, p = 0.0002) and misoprostol+celecoxib (0.61±0.06 vs. 0.37±0.06 ng/mL, p = 0.0015) groups when compared to baseline; while plasma levels of cardiac troponin I increased significantly in vehicle+celecoxib (p = 0.0040) and misoprostol+misoprostol (p = 0.0078) groups when compared to vehicle+vehicle. Blood pressure parameters increased significantly in all misoprostol treated groups. Significant elevation in diastolic (p = 0.0071) and mean blood pressure (p = 0.0153) was noted in misoprostol+celecoxib compared to vehicle+celecoxib. All treatments produced significant tubular dilatation/necrosis compared to control. No significant myocardial changes were noticed; however, three animals presented with pericarditis. Kidney, heart, and plasma celecoxib levels revealed no significant change between vehicle+celecoxib and misoprostol+celecoxib. Concomitant misoprostol administration did not prevent celecoxib renal toxicity, and instead exacerbated renal side effects. Misoprostol did not alter plasma or tissue celecoxib concentrations suggesting no pharmacokinetic interaction between celecoxib and misoprostol

Does Human Nature Conflict with Itself?: Human Form and the Harmony of the Virtues

Does possessing some human virtues make it impossible for a person to possess other human virtues? Isaiah Berlin and Bernard Williams both answered “yes” to this question, and they argued that to hold otherwise—to accept the harmony of the virtues—required a blinkered and unrealistic view of “what it is to be human.” In this essay, I have two goals: (1) to show how the harmony of the virtues is best interpreted, and what is at stake in affirming or denying it; and (2) to provide a partial defense of the harmony of the virtues. More specifically, I show how the harmony of the virtues can be interpreted and defended within the kind of Aristotelian naturalism developed by philosophers such as Philippa Foot, Rosalind Hursthouse, and Michael Thompson. I argue that far from being an embarrassing liability for Aristotelianism—based in an “archaic metaphysical biology”—the harmony thesis is an interesting and plausible claim about human excellences, supported by a sophisticated account of the representation of life, and fully compatible with a realistic view of our human situation

Clinical Applications of Iontophoretic Devices in Rehabilitation Medicine

Interest within the healthcare profession in transdermal delivery of pharmaceuticals through passive, mechanical (phonophoresis) or electromotive (iontophoresis) forces has increased significantly throughout the past decade. The current review will examine the histology and cellular biology of the integument system as related to regulation of transcutaneous delivery of pharmaceutics, and examine currently accepted mechanism(s) of iontophoretic delivery. Additionally, a survey of current iontophoretic devices and electrodes available within the U.S. market, and the limitations of current technology will be presented. Experimental research supporting the use of iontophoresis for local delivery of pharmaceuticals will also be presented in conjunction with the outcomes of clinical investigations where iontophoresis was utilized for the local delivery of these pharmaceuticals. Topic areas to be covered within this section include iontophoresis of antibiotics into integument wounds, local anesthetics, and steroidal and nonsteroidal anti- inflammatory drugs. Finally, an examination of the benefits of combining various forces to enhance transcutaneous drug delivery and future direction(s) of research within this field will be discussed. The purpose of the present review is to provide both researchers and clinical practitioners with an objective basis for the current use of iontophoresis in rehabilitation medicine

Student Performance in a Pharmacotherapy Oncology Module Before and After Flipping the Classroom

Objectives: To determine if a flipped classroom improved student end of module exam performance in a pharmacotherapy oncology module. Method: Third year pharmacy students in the Class of 2013experienced the Pharmacotherapy Oncology Module (15 contact hours) as traditional lectures with optional case studies as supplemental homework (ungraded). The Class of 2014 experienced the same module content with a flipped classroom approach. The middle 10 contact hours were flipped as follows: 10 Vodcasts (8 hours total time) and 6 hours of in-class case studies in place of optional case studies. Students were instructed to watch Vodcasts before in-class case studies, but were not held accountable (i.e. quizzed) for pre-class preparation. The exam questions were identical in both cohorts. Performance on exam questions covered with the flipped approach was compared between the two cohorts using ANCOVA with prior academic performance variables (GPA) as covariates. Results: The students experiencing the flipped classroom approach performed poorer on exam questions covering flipped topics than the cohort that received traditional lecture with optional case studies with previous GPA used as a covariate (p , 0.05). Implications: A flipped classroom approach to incorporate active learning does not necessarily improve student performance. Limitations of this flipped classroom experiment include long vodcasts (30 to 50 minutes) and lack of student accountability for watching vodcasts. Further research is needed to determine optimal classroom flipping techniques that result in improved student performance

Iontophoretic Devices: Clinical Applications and Rehabilitation Medicine

Interest within the healthcare profession in transdermal delivery of pharmaceuticals through passive, mechanical (phonophoresis) or electromotive (iontophoresis) forces has increased significantly throughout the past decade. The current review will examine the histology and cellular biology of the integument system as related to regulation of transcutaneous delivery of pharmaceutics, and examine currently accepted mechanism(s) of iontophoretic delivery. Additionally, a survey of current iontophoretic devices and electrodes available within the U.S. market, and the limitations of current technology will be presented. Experimental research supporting the use of iontophoresis for local delivery of pharmaceuticals will also be presented in conjunction with the outcomes of clinical investigations where iontophoresis was utilized for the local delivery of these pharmaceuticals. Topic areas to be covered within this section include iontophoresis of antibiotics into integument wounds, local anesthetics, and steroidal and nonsteroidal anti-inflammatory drugs. Finally, an examination of the benefits of combining various forces to enhance transcutaneous drug delivery and future direction(s) of research within this field will be discussed. The purpose of the present review is to provide both researchers and clinical practitioners with an objective basis for the current use of iontophoresis in rehabilitation medicine

An Analysis of Student Performance with Podcasting and Active Learning in a Pharmacotherapy Module

Objectives: The objective was to determine the effect of podcasting, with resultant increased in-class active learning time, on student performance. Methods: In an effort to increase in-class active learning time and improve understanding of the material in a third-year pharmacotherapy course, podcasts were developed to cover specific topics and were made available outside-of-class for students in 2010. Students in the same course in the year 2009 had received identical in-class didactic instruction for these topics. End-of-course exam scores were adjusted using analysis of covariance and compared using the t-test. Results: The class averages on the end-of-course exams were significantly higher at 77.5 ± 1.2 (n = 65) for the class of 2009 compared to 72.9 ± 1.5 (n = 71) for the class of 2010 (p = 0.019). This difference remained significant after adjusting the 2009 and 2010 classes for the covariates. The difference between the classes was further magnified when using the covariate of GPA, 78.3 ± 1.2 compared to 72.2 ± 1.1 (p \u3c 0.001) for the classes of 2009 and 2010, respectively. Rank ordering resulted in a significant difference in the exam grade in the lower 50th percentile 73.2 ± 1.6 (n = 34, 2009 class) compared to 65.8 ± 1.9 (n = 34, 2010 class), p = 0.004. No significant differences were noted between the two classes for those students in the upper 50th percentile. Conclusion: Increased in-class active learning time led to decreased examination scores for the lower 50th percentile of students in the 2010 cohort. One potential explanation is that students were not held accountable for completing the out-of-class preparatory exercises