Assessing Multiple-Mini Interview Performance Across Pharmacy Admissions Pathways.

OBJECTIVE: To assess whether students who are admitted to a Doctor of Pharmacy program through different admissions pathways (early assurance vs other pathways) have significantly different affective domain competencies, as measured by multiple-mini interview (MMI) evaluations. METHODS: A secondary analysis of existing data was conducted at a single pharmacy school in the upper Midwestern U.S. over 3 admissions cycles. The program offers a 6-year, early assurance admission pathway as well as more traditional admissions pathways which can be completed in 7-8 years. Differences in MMI scores, overall and by individual question, were assessed using the Kruskal-Wallis test. RESULTS: No differences in total MMI scores exist between individuals applying through the program's early assurance pathway and those applying through other pathways. In the first admissions cycle, early assurance applicants performed significantly lower on the responsibility MMI item (mean = 7.01 vs 8.50) and significantly higher on the cross-cutting MMI item (mean = 6.95 vs 5.45). In the second admissions cycle, early assurance applicants scored significantly higher on the self-awareness MMI item than other applicants (mean = 8.22 vs 7.14). No statistically significant differences were found between early assurance and non-early assurance applicants during the final admissions cycle. CONCLUSION: Individuals applying through an early assurance pathway produce MMI scores that are similar to individuals applying through other admissions pathways.

Appraisal of the entrustable professional activities interprofessional team member domain performed by North Dakota pharmacists

OBJECTIVE: To quantify the use of the interprofessional team member (ITM) domain of entrustable professional activities (EPAs) by North Dakota pharmacists across practice sites, roles in practice, and by preceptor status. METHODS: Survey methods were used to characterize the self-reported frequency with which pharmacists undertake core EPAs and supporting tasks in the ITM domain. The survey was administered to registered pharmacists practicing in North Dakota (n=990) during the fall of 2018, of which 457 (46.1%) responded. After eliminating responses with incomplete or missing information, 119 responses were available for analysis. RESULTS: For the overall EPA ITM domain, "Collaborate as a member of an interprofessional team population" pharmacists reported performing these activities an average (mean) of 3.3 times per month (SD=2.3). Within this domain, the highest reported example activity was "Use setting appropriate communication skills when interacting with others" (mean=4.1, SD 1.8), followed by "Communicate a patient's medication-related problem(s) to another health professional" (mean=3.3, SD 2.0), and "Contribute medication-related expertise to the team's work" (mean=3.1, SD=2.2). ITM domain and supporting example activities were performed at a greater rate in hospitals, community health centers and long-term-care facilities. For most items, preceptors reported a greater use of activities, than did non-preceptors. CONCLUSIONS: North Dakota pharmacists currently complete tasks outlined in the ITM domain of the EPAs, although their contributions are varied by task, role, and preceptor status

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Appraisal of the entrustable professional activities interprofessional team member domain performed by North Dakota pharmacists.

OBJECTIVE: To quantify the use of the interprofessional team member (ITM) domain of entrustable professional activities (EPAs) by North Dakota pharmacists across practice sites, roles in practice, and by preceptor status. METHODS: Survey methods were used to characterize the self-reported frequency with which pharmacists undertake core EPAs and supporting tasks in the ITM domain. The survey was administered to registered pharmacists practicing in North Dakota (n=990) during the fall of 2018, of which 457 (46.1%) responded. After eliminating responses with incomplete or missing information, 119 responses were available for analysis. RESULTS: For the overall EPA ITM domain, "Collaborate as a member of an interprofessional team population" pharmacists reported performing these activities an average (mean) of 3.3 times per month (SD=2.3). Within this domain, the highest reported example activity was "Use setting appropriate communication skills when interacting with others" (mean=4.1, SD 1.8), followed by "Communicate a patient's medication-related problem(s) to another health professional" (mean=3.3, SD 2.0), and "Contribute medication-related expertise to the team's work" (mean=3.1, SD=2.2). ITM domain and supporting example activities were performed at a greater rate in hospitals, community health centers and long-term-care facilities. For most items, preceptors reported a greater use of activities, than did non-preceptors. CONCLUSIONS: North Dakota pharmacists currently complete tasks outlined in the ITM domain of the EPAs, although their contributions are varied by task, role, and preceptor status.

Evaluation of the entrustable professional activities (EPAs) of the population health promoter domain by North Dakota pharmacists

OBJECTIVE: Entrustable Professional Activities (EPAs) are a list of professional tasks (with associated competency ratings) that pharmacy educational organizations support, and accreditation organizations require, for assessment by colleges and schools of pharmacy. This manuscript assesses the perceived frequency of performing EPAs in the population health promoter (PHP) domain among pharmacists practicing in North Dakota. METHODS: This survey assessed the self-reported EPA activities (inclusive of the PHP domain) of registered pharmacists living and practicing in North Dakota. There were 990 pharmacists surveyed, and 457 (46.1%) of pharmacists responded. RESULTS: Within the PHP domain, pharmacists reported performing "Minimize adverse drug events and medication errors" most frequently (mean=3.4, SD=2.0), followed by "Ensure that patients have been immunized against vaccine-preventable diseases" (mean=2.3, SD 2.3), "Maximize the appropriate use of medications in a population" (mean=2.2, SD 2.3), and "Identify patients at risk for prevalent diseases in a population" (mean=1.3, SD=1.9). In these Core EPAs PHP domains, the clinical pharmacists reported the highest level, followed by pharmacy managers and staff pharmacists. CONCLUSION: Pharmacists in North Dakota reported that EPAs in the PHP domain are practiced regularly. Thus, EPAs in the PHP domain have potential as a means to assess outcomes in pharmacy education and practice

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Evaluation of the entrustable professional activities (EPAs) of the population health promoter domain by North Dakota pharmacists.

BACKGROUND: Entrustable Professional Activities (EPAs) are a list of professional tasks that pharmacy educational organizations support, and accreditation organizations encourage, for assessment by colleges and schools of pharmacy. OBJECTIVE: This manuscript evaluates the perceived frequency of performing EPAs in the population health promoter (PHP) domain among pharmacists practicing in North Dakota. METHODS: This survey evaluated the self-reported EPA activities of registered pharmacists living and practicing in North Dakota. For EPAs and supporting tasks in the 6 domains (including the PHP domain), respondents were asked to self-report the number of times during the last 30 days that they perform the task, using a 6 point response scale (0, 1, 2, 3, 4, 5 or more times). There were 990 pharmacists surveyed, and 457 (46.1%) of pharmacists responded. RESULTS: Within the PHP domain, pharmacists reported performing "Minimize adverse drug events and medication errors" most frequently (mean=3.4, SD=2.0), followed by "Ensure that patients have been immunized against vaccine-preventable diseases" (mean=2.3, SD 2.3), "Maximize the appropriate use of medications in a population" (mean=2.2, SD 2.3), and "Identify patients at risk for prevalent diseases in a population" (mean=1.3, SD=1.9). In these Core EPAs PHP domains, the clinical pharmacists reported the highest level, followed by pharmacy managers and staff pharmacists. CONCLUSIONS: Pharmacists in North Dakota currently perform some population health promoter activities, but not at a consistent and high level. Most of the health prevention activities were medication-related and oriented towards individual patients (micro-level), rather than at a community (population-based) macro-level.

Study Abroad Course for Pre-pharmacy and Pharmacy Students to Learn About Global Health.

Objective. To design, implement, and assess a study abroad course in Ireland for pre-professional and Doctor of Pharmacy (PharmD) students. Methods. An elective study abroad course was created for pre-professional and PharmD students at North Dakota State University. The course included comparison of the US and Ireland's health care delivery systems and participation in history and cultural experiences in Ireland. Prior to the trip, students and preceptors attended seminars related to the culture of Ireland. The three-week trip to Ireland took place between the spring and summer semesters in 2016. Student assignments while abroad included completion of a self-reflection journal with daily entries describing what the student learned and how the experience impacted them, and completion and presentation of a term paper comparing Ireland's pharmacy system with that in the United States. Pre- and post-travel surveys were conducted to assess students' perceptions of and learning from the experience, and to identify areas for course improvement. Results. Students' evaluations of the course and travel experiences were positive. However, students' perceptions of their cultural awareness were largely unchanged. Conclusion. The course was well received by students. Other PharmD programs may benefit from implementing similar study abroad experiences.

Appraisal of the entrustable professional activities (EPAs) patient care provider domain by North Dakota pharmacists

BACKGROUND: Entrustable Professional Activities (EPAs) are the latest addition to a list of professional competencies that pharmacy educational organizations support, and accreditation organizations require, for assessment by colleges and schools of pharmacy. OBJECTIVE: The study's objective is to assess the use of Core EPAs in the patient care domain (by practice setting, position, and preceptor status) in contemporary pharmacy practice. METHODS: This survey assessed the EPA activities of pharmacists practicing in North Dakota. The pharmacists were asked "how many times in the past 30 days have you delivered the following services in your practice setting?" Response options were: 0, 1, 2, 3, 4, and 5 or more times. RESULTS: Of 990 potential respondents, 457 pharmacists (46.1%) returned a survey, and 107 (10.8%) answered every survey item in the patient care domain. Respondents reported that the highest rated activity items "Collect information to identify a patient's medication-related problems and health-related needs," and "Analyze information to determine the effects of medication therapy, identify medication-related problems, and prioritize health-related needs" were performed an average of 3.9 times per week (SD=1.8), and 3.8 times per week (SD=2.0), respectively. Both of these items, were reported for 70% of the respondents at 5 or more times per week. For these items, the highest reported practice setting was 'other' practice settings (e. g. , long-term care, community health centers) followed by chains, hospitals, and independent pharmacies. By position, clinical pharmacists and preceptors reported the highest activity levels for most EPAs and supportive example tasks. CONCLUSIONS: This study provides empirical evidence suggesting (but not proving) that EPAs have potential as a means to assess outcomes in pharmacy education and practice. Our study sets the stage for future work that further refines and assesses core EPA activities and supportive example tasks to measure the impact of how this process relates to outcomes of care

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Emergency department utilization among individuals with idiopathic intracranial hypertension.

PURPOSE: Idiopathic intracranial hypertension (IIH) can be a debilitating disorder that is difficult to identify and treat. Failure to adequately manage IIH symptoms may force patients to present at emergency departments (EDs) seeking symptom relief. The purpose of this paper is to empirically characterize ED use by previously diagnosed IIH patients. DESIGN/METHODOLOGY/APPROACH: Patients diagnosed with IIH, and who registered with the Intracranial Hypertension Registry by 2014, were solicited for study inclusion. A survey was designed to elicit ED use during the period 2010-2012. Information on demographic and socioeconomic characteristics, IIH signs and symptoms, time since diagnosis, perspectives of ED use and quality of life was collected. Quality of life was assessed using an adaptation of the Migraine-Specific Quality of Life Questionnaire. Data were analyzed using descriptive statistics and nonparametric hypothesis tests. FINDINGS: In total, 39 percent of IIH patients used emergency services over the study period; those that did used the services intensely. These patients were more likely to be non-white, live in households making less than $25,000 annually, have public insurance and have received a diversional shunt procedure. Patients who used the ED were less likely to live in households making $100,000, or more, annually and have private insurance. Participants who used the ED had significantly lower quality-of-life scores, were younger and had been diagnosed with IIH for less time. ORIGINALITY/VALUE: ED staff and outside physicians can utilize the information contained in this study to more effectively recognize the unique circumstances of IIH patients who present at EDs.

Assessment of Practice Management Entrustable Professional Activities by Pharmacists in North Dakota.

Objective. To quantify the use of core entrustable practice activities (EPAs) in contemporary pharmacy practice in North Dakota. Methods. Given the large number of core EPAs, this study focused on those supporting tasks categorized within the practice manager domain. The survey instrument was sent to all registered pharmacists living and practicing in North Dakota (n=990). This manuscript reports on the practice manager domain and the activities and examples of supportive tasks in this domain. Results. Four hundred fifty-seven (46.1%) of the pharmacists responded; however, only 102 survey instruments were fully completed and usable. Respondents rated the "fulfill a medication order" activity the highest EPA overall (mean=9.1, SD=2.7). The "oversee the pharmacy operations for an assigned work shift" activity (mean=7.8, SD=3.9) was also rated highly. Responses to "oversee the pharmacy operations for an assigned work shift" were significantly different between independent practice settings and all other practice settings. The manager was more likely than other pharmacy positions to report performing seven of the nine tasks within this EPA. Significant differences in five of nine tasks were found across pharmacies located in rural or more urban communities, including "assist in the evaluation of pharmacy technicians" and "identify pharmacy service problems and/or medication safety issues." Conclusion. This study provides empirical evidence suggesting that EPAs can be a useful means to assess outcomes in pharmacy education.

Impact of Achieved Tenure and Promotion on Faculty Research Productivity at a School of Pharmacy.

OBJECTIVE: Critics of the promotion and tenure system contend that promotion and tenure may lead to a decline in research productivity ("dead wood phenomena") by those faculty. To assess this perception, we compiled the publications and grants at the time of application for promotion, and again through 2017 for the same faculty following promotion and/or tenure. METHODS: Promotion documents at a school of pharmacy at a public Midwestern university were assessed. Mean publication rates and grant dollars per year per faculty member were compared to the same group of faculty (n=13) pre and post-promotion. RESULTS: At the time of promotion to associate professor, mean numbers of total publications per year per faculty in the pharmacy practice department were 1.1, compared to 1.4 post-promotion. For pharmaceutical sciences department faculty, corresponding means were 5.0 and 4.1, respectively. At the time of promotion to full professor, mean numbers of total publications per year for pharmacy practice faculty were 7.0, compared to 7.2 post-promotion. For pharmaceutical sciences faculty, corresponding means were 3.5 and 4.7, respectively. For grant activity, both associate professors and full professors increased the mean total dollars per year from pre-promotion to post-promotion for both departments. CONCLUSION: Research productivity at this school of pharmacy continues to be either maintained or increased since promotion for the collective group of faculty. This evidence runs counter to the perception that promotion and tenure may lead to decreased scholarly productivity. The study provides a roadmap for other schools/colleges to quantify research productivity and make comparisons to national mean levels reported in the literature.

Appraisal of the entrustable professional activities (EPAs) patient care provider domain by North Dakota pharmacists.

BACKGROUND: Entrustable Professional Activities (EPAs) are the latest addition to a list of professional competencies that pharmacy educational organizations support, and accreditation organizations require, for assessment by colleges and schools of pharmacy. OBJECTIVE: The study's objective is to assess the use of Core EPAs in the patient care domain (by practice setting, position, and preceptor status) in contemporary pharmacy practice. METHODS: This survey assessed the EPA activities of pharmacists practicing in North Dakota. The pharmacists were asked "how many times in the past 30 days have you delivered the following services in your practice setting?" Response options were: 0, 1, 2, 3, 4, and 5 or more times. RESULTS: Of 990 potential respondents, 457 pharmacists (46.1%) returned a survey, and 107 (10.8%) answered every survey item in the patient care domain. Respondents reported that the highest rated activity items "Collect information to identify a patient's medication-related problems and health-related needs," and "Analyze information to determine the effects of medication therapy, identify medication-related problems, and prioritize health-related needs" were performed an average of 3.9 times per week (SD=1.8), and 3.8 times per week (SD=2.0), respectively. Both of these items, were reported for 70% of the respondents at 5 or more times per week. For these items, the highest reported practice setting was 'other' practice settings (e.g., long-term care, community health centers) followed by chains, hospitals, and independent pharmacies. By position, clinical pharmacists and preceptors reported the highest activity levels for most EPAs and supportive example tasks. CONCLUSIONS: This study provides empirical evidence suggesting (but not proving) that EPAs have potential as a means to assess outcomes in pharmacy education and practice. Our study sets the stage for future work that further refines and assesses core EPA activities and supportive example tasks to measure the impact of how this process relates to outcomes of care.

Perceived sustainability of community telepharmacy in North Dakota.

OBJECTIVES: To assess the sustainability of the business model underlying the North Dakota Telepharmacy Project (NDTP). SETTING: Of the 38 community pharmacy organizations (14 central, 24 remote), 27 organizations (11 central and 16 remote sites) in North Dakota provided a useable set of responses (71.1% response rate). A twelfth organization (a community pharmacy) ceased operations over the study's time frame and was not included in the data analysis. PRACTICE DESCRIPTION: Emphasis is placed on NDTP community telepharmacies, because the community telepharmacy business model is more established than hospital telepharmacies. Yet little is known about the long-run financial viability of telepharmacies. PRACTICE INNOVATION: Originally funded by a series of federal grants, the goal of the NDTP was to create the infrastructure necessary to support the development of telepharmacy sites. A 48-item questionnaire assessed the self-reported operational, financial, and community impacts of a community telepharmacy. EVALUATION: The questionnaire was administered from December 2015 to February 2016 to all NDTP community telepharmacy owners-managers. Thus, 1 participant (owner-manager) addressed both central and remote-site locations served by a pharmacy. RESULTS: Most respondents reported that their telepharmacy sites (especially remote sites) generate small positive financial returns for the organization. Respondents also reported that the closure of their remote sites would significantly harm the communities they serve. CONCLUSION: NDTP aims of restoration and retention have been achieved via the investment and shared decision making with pharmacy owners in North Dakota. The telepharmacy model is sustainable, even if it does not generate significant economic profit.

Opioid misuse among adolescents: new evidence from a misclassification analysis.

BACKGROUND: Non-medical prescription-opioid (NMPO) use has been declared a national epidemic in the US. Opioid misuse is associated with substantial physiological, psychological, and concomitant economic implications. NMPO use among adolescents warrants special attention given its prevalence and the high risk of addiction. OBJECTIVES: Our objectives were to: (a) identify factors associated with adolescent NMPO use after controlling for misclassification, while simultaneously identifying characteristics that affected the likelihood of misreporting use; and (b) identify factors associated with an individual misusing their own versus a diverted prescription, and the likelihood that the prescription source was misreported. METHODS: Data come from the Washington State Healthy Youth Survey. A maximum likelihood estimation technique for systematically misclassified binary-dependent variables was utilized. Covariates were chosen to represent influential factors identified in the theoretical adolescent development literature. RESULTS: An estimated 35 % of respondents who stated that they had never misused prescription opioids most likely had. An estimated 17 % of those who admitted to NMPO use claimed to have misused a diverted prescription, but most likely misused their own. Various demographic, school, neighborhood, family, substance-use, personality/attitude, and social factors were identified as potential predictors of adolescent NMPO use, opioid-prescription source, and misclassification of responses to each outcome. CONCLUSIONS: The finding that a self-reported survey failed to identify over one-third of individuals at risk for NMPO use is concerning, as is the finding that approximately 17 % of those who admitted to NMPO use may have misstated their prescription-opioid source. The findings presented here are critical to focus prevention efforts, especially for identifying at-risk youths who may misrepresent their use.

The health sciences reasoning test in the pharmacy admissions process.

OBJECTIVE: To evaluate the impact of including Health Sciences Reasoning Test (HSRT) scores in the doctor of pharmacy (PharmD) admissions process compared with other criteria used. METHODS: The HSRT was administered to all prepharmacy students who were selected for an interview (n=122) as part of the PharmD program admissions process. The HSRT score and other evaluation criteria were used to establish candidate rankings. The correlation between total HSRT scores and other measures used in the admissions process then was evaluated. RESULTS: Candidate rankings were not noticeably different when the HSRT scores were excluded from the admission process. The HSRT scores were significantly and highly correlated with applicants' Pharmacy College Admission Test (PCAT) cumulative percentile scores. CONCLUSIONS: The HSRT can be an effective method to evaluate critical-thinking ability as part of the admissions process into a PharmD program. However, the usefulness of the HSRT as an admissions screening tool is mitigated by information redundancies with other evaluation criteria, specifically the PCAT.

Medication error reporting in rural critical access hospitals in the North Dakota Telepharmacy Project.

PURPOSE: Results of a study of medication "quality-related events" (QREs) at critical access hospitals (CAHs) participating in a telepharmacy project are reported. METHODS: Rates and types of medication QREs (i.e., all types of drug therapy problems requiring pharmacist intervention) were evaluated at 17 CAHs receiving telepharmacy services from a central order-entry site in the North Dakota Telepharmacy Project (NDTP). During the 17-month study, remote pharmacists used telepharmacy technology to review medication orders prepared at the CAH sites, identify and address QREs, and code clinical interventions. The collected data were analyzed via chi-square testing. RESULTS: Cumulative monthly medication orders at the CAH study sites ranged from a low of 12,535 in the first month of the study to a high of 18,257. Monthly rates of visual medication verification and clinical intervention ranged from 8.0% to 14.2% and from 1.3% to 3.1%, respectively. Overall, the most frequently identified QREs were transcription errors, which accounted for 2,389 interventions (43.3%); 2,078 interventions (37.7%) targeted prescribing-related QREs. The most frequently cited intervention codes were for dosage adjustments (n = 547), deep venous thrombosis prophylaxis (n = 437), pharmacokinetic consultation (n = 268), renal dosing (n = 182), and the prevention of minor (n = 148) and major (n = 94) adverse drug events. CONCLUSION: The study results indicate that the NDTP telepharmacy model is effective in identifying and resolving QREs in CAHs. The use of the telepharmacy services increased over the study period, suggesting that CAH practitioners became more comfortable using the technology on a regular basis to enhance patient safety.

What types of nursing facilities are more likely to adopt a pharmacist's medication review recommendations?

BACKGROUND: Few studies in the literature have analyzed the determinants of pharmacist drug therapy recommendations in nursing facility settings, and those that have focus primarily on accepted/rejected recommendations by disease state. OBJECTIVE: To identify the set of nursing facility characteristics that are more likely to adopt a pharmacist's medication review recommendations. DESIGN: Cross-sectional, retrospective methods are used to examine 53 licensed nursing facilities receiving medication review services from a small independent consultant pharmacist practice with no ties to vendor pharmacy functions. SETTING: Nursing facilities in rural areas of central and western Minnesota in 2008. INTERVENTION: Medication review services. MAIN OUTCOME MEASURES: The number of recommendations made and accepted, which are aggregated to the level of the nursing facility. Poisson regression analysis is used to identify those nursing facility characteristics that predict total recommendations and total accepted recommendations. Data obtained from Medicare's Web site on each nursing facility's operating characteristics and quality indicators serve as covariates. RESULTS: At the 5% level, patient census (positively), greater certified nursing assistant staffing hours (positively), multisite facilities (positively), resident residency councils (negatively), and greater perceptions of registered nurse quality (negatively) predict a greater number of recommendations. Patient census (positively), greater licensed practical nurse staffing (negatively), having residency councils (negatively), and greater perceptions of registered nurse quality (negatively) significantly predict the number of accepted and implemented recommendations. CONCLUSION: Institutional specific factors, most notably, quality-of-care indicators, may affect a nursing facility's acceptance of a pharmacist's drug therapy review.

Differences in medication errors between central and remote site telepharmacies.

OBJECTIVE: To examine differences in dispensing errors within community telepharmacy practices by comparing error rates across central sites (community telepharmacy sites with pharmacists present) and the corresponding remote sites, which are staffed by registered technicians and overseen by the central site pharmacist. DESIGN: Cross-sectional pilot study with a test group (remote sites) and comparison group (central sites). SETTING: 24 rural community telepharmacies (14 remote sites and 10 central sites). PARTICIPANTS: Pharmacy staff. INTERVENTION: The Pharmacy Quality Commitment (PQC) reporting system was integrated into the North Dakota Telepharmacy Project and used to track dispensing errors over a 45-month period. Both pharmacists and pharmacy technicians were trained on the use of the PQC system. The PQC system focused on two quality-related events (QREs): a "near miss" (i.e., a mistake discovered by the pharmacy staff before a medication reaches the patient) and an "error" (i.e., a mistake discovered after the patient leaves the pharmacy with the medication). MAIN OUTCOME MEASURES: The distribution of QREs across central and remote sites. RESULTS: The remote (central) telepharmacy group reported 47,078 (62,480) prescriptions and a QRE rate of 1.34% (1.43%). QREs at the remote sites were more likely than at the central sites to be caught at the final pharmacist check (58.2% vs. 40.8%, P < 0.01) and less likely to be caught by the patient (0.17% vs. 0.28%, P < 0.01). Remote sites were more likely to include incorrect directions (18.9% vs. 13.4%, P = 0.01) in the medication entry process. CONCLUSION: QRE rates for remote site and central site telepharmacies were consistent with each other and with national estimates in traditional community pharmacies. However, significant differences between central and remote sites existed based on how QREs arose and how they were caught. Pharmacists must recognize this fact and use diligence when working in a telepharmacy setting.

Glycosaminoglycan-mediated selective changes in the aggregation states, zeta potentials, and intrinsic stability of liposomes.

Though the aggregation of glycosaminoglycans (GAGs) in the presence of liposomes and divalent cations has been previously reported, the effects of different GAG species and minor changes in GAG composition on the aggregates that are formed are yet unknown. If minor changes in GAG composition produce observable changes in the liposome aggregate diameter or zeta potential, such a phenomenon may be used to detect potentially dangerous oversulfated contaminants in heparin. We studied the mechanism of the interactions between heparin and its oversulfated glycosaminoglycan contaminants with liposomes. Herein, we demonstrate that Mg(2+) acts to shield the incoming glycosaminoglycans from the negatively charged phosphate groups of the phospholipids and that changes in the aggregate diameter and zeta potential are a function of the glycosaminoglycan species and concentration as well as the liposome bilayer composition. These observations are supported by TEM studies. We have shown that the organizational states of the liposome bilayers are influenced by the presence of GAG and excess Mg(2+), resulting in a stabilizing effect that increases the T(m) value of DSPC liposomes; the magnitude of this effect is also dependent on the GAG species and concentration present. There is an inverse relationship between the percent change in aggregate diameter and the percent change in aggregate zeta potential as a function of GAG concentration in solution. Finally, we demonstrate that the diameter and zeta potential changes in POPC liposome aggregates in the presence of different oversulfated heparin contaminants at low concentrations allow for an accurate detection of oversulfated chondroitin sulfate at concentrations of as low as 1 mol %.

Fluorescent polymer-based post-translational differentiation and subtyping of breast cancer cells.

Herein, we report the application of synthesized fluorescent, water soluble polymers for post-translational subtyping and differentiation of breast cancer cells in vitro. The fluorescence emission spectra from these polymers were modulated differently in the presence of conditioned cell culture media from various breast cancer cells. These polymers differentiate at a post-translation level possibly due to their ability to interact with extracellular enzymes that are over-expressed in cancerous conditions.

Comparison of pharmacy students' perceived and actual knowledge using the Pharmacy Curricular Outcomes Assessment.

OBJECTIVE: To determine whether a correlation exists between third-year PharmD students' perceived pharmacy knowledge and actual pharmacy knowledge as assessed by the Pharmacy Curricular Outcomes Assessment (PCOA). METHODS: In 2010 and 2011, the PCOA was administered in a low-stakes environment to third-year pharmacy students at North Dakota State University College of Pharmacy, Nursing, and Allied Sciences (COPNAS). A survey instrument was also administered on which students self-assessed their perceived competencies in each of the core areas covered by the PCOA examination. RESULTS: The pharmacy students rated their competencies slightly higher than average. Performance on the PCOA was similar to but slightly higher than national averages. Correlations between each of the 4 content areas (basic biomedical sciences, pharmaceutical sciences, social/administrative sciences, and clinical sciences) mirrored those reported nationally by the National Association of Boards of Pharmacy (NABP). Student performance on the basic biomedical sciences portion of the PCOA was significantly correlated with students' perceived competencies in the biomedical sciences. No other correlations between actual and perceived competencies were significant. CONCLUSION: A lack of correlation exists between what students perceive they know and what they actually know in the areas of pharmaceutical science; social, behavioral, and administrative science; and clinical science. Therefore, additional standardized measures are needed to assess curricular effectiveness and provide comparisons among pharmacy programs.