A Mixed Methods Study of Resources Available for the Professional Development of Mid-Career Faculty.

OBJECTIVE: To determine what resources are available and useful for the professional development of mid-career faculty (MCF) in pharmacy education to foster career advancement. METHODS: A 37-question survey was sent to 7236 members of the American Association of Colleges of Pharmacy, an estimated 4640 of whom represented the target population of associate professors, full professors, and administrators. Semi-structured focus groups involving these 3 groups of faculty were held to provide additional insight. RESULTS: Of 4640 targeted pharmacy faculty, 825 completed the survey (18% response rate). At least one response was received from 98% of colleges and schools of pharmacy. Over 75% of MCF indicated a goal to advance to full professor, of whom only 55% were very or extremely confident they would be promoted. Clarity in expectations for advancement was identified as the most important factor for advancement; however, only 57% of MCF respondents agreed that their department/division has clearly delineated expectations for promotion. Protected time for research/scholarship was perceived by MCF as another important factor for advancement but was not provided as a resource to 61% of faculty. Thematic analysis of 7 focus groups including 31 faculty revealed 10 themes reinforcing the survey results. CONCLUSION: This study identified misalignment between the needs of MCF and the resources available to facilitate development/advancement.

A Call to Action for the Professional Development of Mid-Career Faculty.

Despite taking on heavier teaching and service loads, an expanding research program, and serving as mentors to junior faculty, mid-career faculty often feel unsupported. Providing a solid foundation through resource allocation and sharing between and within institutions can facilitate establishment or improvement of faculty development initiatives, workload equity, transparent policies, routine performance evaluation, a process for faculty recognition, and a system of mentoring to create an environment where this essential group of faculty can continue to grow. The following discussion, which includes suggested methods to achieve these goals with a focus on mid-career faculty, serves as a call to action for pharmacy school administrators to assess the state of mid-career faculty at their institution, and if indicated, implement systems that promote success among this group.

Best Practices in Syllabus Design.

The syllabus is the cornerstone for directing faculty and student interaction within the didactic and experiential settings. Within each syllabus is both essential and optional information to guide students, faculty, and administration in course expectations as well as to explain how the course aligns within current curricular requirements to maintain program accreditation. Most syllabi contain a plethora of information that continues to grow each year, warranting concerns of syllabus bloat combined with dwindling student attention to syllabus detail. This paper summarizes best practices related to designing effective course syllabi and recommendations to promote clear and concise communication between students, faculty, and administrators involved in pharmacy education.

Dysregulation of iron metabolism in cardiovascular diseases: From iron deficiency to iron overload.

Iron deficiency and iron overload are the most prevalent and opposite forms of dysregulated iron metabolism that affect approximately 30 percent of the world population, in particularly, elderly and patients with chronic diseases. Both iron deficiency and overload are frequently observed in a wide range of cardiovascular diseases, contributing to the onset and progression of these diseases. One of the devastating seqeulae for iron overload is the induction of ferroptosis, a newly defined form of regulated cell death which heavily impacts cardiac function through ferroptotic cell death in cardiomyocytes. In this review, we will aim to evaluate iron deficiency and iron overload in cardiovascular diseases. We will summarize current therapeutic strategies to tackle iron deficiency and iron overload, major pitfalls of current studies, and future perspectives.

Knockout of macrophage migration inhibitory factor accentuates side-stream smoke exposure-induced myocardial contractile dysfunction through dysregulated mitophagy.

Second hand smoke exposure increases the prevalence of chronic diseases partly attributed to inflammatory responses. Macrophage migration inhibitory factor (MIF), a proinflammatory cytokine, is involved in the pathogenesis of multiple diseases although its role in second hand smoke exposure-induced cardiac anomalies remains elusive. This study evaluated the impact of MIF knockout on side-stream smoke exposure-induced cardiac pathology and underlying mechanisms. Adult WT and MIF knockout (MIFKO) mice were placed in a chamber exposed to cigarette smoke for 1 h daily for 60 consecutive days. Echocardiographic, cardiomyocyte function and intracellular Ca2+ handling were evaluated. Autophagy, mitophagy and apoptosis were examined using western blot. DHE staining was used to evaluate superoxide anion (O2-) generation. Masson trichrome staining was employed to assess interstitial fibrosis. Our data revealed that MIF knockout accentuated side-stream smoke-induced cardiac anomalies in fractional shortening, cardiomyocyte function, intracellular Ca2+ homeostasis, myocardial ultrastructure and mitochondrial content along with overt apoptosis and O2- generation. In addition, unfavorable effects of side-stream smoke were accompanied by excessive formation of autophagolysosome and elevated TFEB, the effect of which was exacerbated by MIF knockout. Recombinant MIF rescued smoke extract-induced myopathic anomalies through promoting AMPK activation, mitophagy and lysosomal function. Taken together, our data suggest that MIF serves as a protective factor against side-stream smoke exposure-induced myopathic changes through facilitating mitophagy and autophagolysosome formation.

Marijuana Use in the Elderly: Implications and Considerations.

OBJECTIVE: This article reviews the literature on the use of marijuana in the elderly. Pharmacists play an important role in the management of medications including drug use of potentially illegal drugs, including marijuana. The use of both recreational and medical marijuana has grown exponentially in the general population, including in older adults. As of 2017, marijuana for medical use is legal in 26 states and the District of Columbia. DATA SOURCES: PubMed and Internet search using the following terms: marijuana, cannabis, delta-9-tetrhydrocannabinol (THC), cannabidiol, cannabinoid, elderly, geriatric, and pharmacology. Findings are based on data collected from older adults (65 years of age and older) through August 2016. STUDY SELECTION: Because of the lack of research and funding, reputable literature on the impact of marijuana on older adults is scarce. The available evidence suggests that elderly individuals should be cautious when consuming marijuana, especially those who have certain comorbid conditions. DATA EXTRACTION: The geriatric population has a higher likelihood of having multiple comorbidities and is subject to polypharmacy. Marijuana use, medicinal or recreational, complicates the picture with additive central nervous system side effects. DATA SYNTHESIS: This article reviews the growing information on marijuana use and discusses issues to consider and cautions in usage that can apply to day-to-day clinical practice and geriatric care. The role of the pharmacist in educating patients, caregivers, and health care providers is expanding with the growing number of states that have legalized medical marijuana (26 states and the District of Columbia, as of 2017). Important education points including drug-drug interactions, drug-disease interactions, and signs and symptoms of acute overdose should be considered. CONCLUSION: With this review, pharmacists will be informed on recommendations on the use of marijuana in the older adult. Monitoring of therapy, as well as adverse effects, will be reviewed, including some legal issues and challenges.

ACCP Template for Evaluating a Clinical Pharmacist.

ACCP is committed to ensuring that clinical pharmacists possess the competencies necessary to deliver comprehensive medication management in team-based, direct patient care environments. These competencies are divided into six essential domains: direct patient care, pharmacotherapy knowledge, systems-based care and population health, communication, professionalism, and continuing professional development. The 2016 ACCP Clinical Practice Affairs Committee has developed an evaluation tool that includes the assessable tasks of today's clinical pharmacists that fall within each domain. This instrument can be used by institutions, organizations, and others responsible for clinical pharmacist performance evaluation and professional development.

A Self-Assessment Guide for Resident Teaching Experiences.

The 2015 American College of Clinical Pharmacy (ACCP) Educational Affairs Committee was charged with developing a self-assessment guide for residency programs to quantitatively and qualitatively evaluate the outcomes of resident teaching curricula. After extensively reviewing the literature, the committee developed assessment rubrics modeled after the 2013 ACCP white paper titled "Guidelines for Resident Teaching Experiences" and the revised American Society of Health-System Pharmacists (ASHP) 2014 accreditation standards for PGY1 residencies, which place greater emphasis on the teaching and learning curriculum (TLC) than the previous accreditation standards. The self-assessment guide developed by the present committee can serve as an assessment tool for both basic and expanded TLCs. It provides the criteria for program goals, mentoring, directed readings with topic discussions, teaching experiences, and assessment methodology. For an expanded TLC, the committee has provided additional guidance on developing a teaching philosophy, becoming involved in interactive seminars, expanding teaching experiences, developing courses, and serving on academic committees. All the guidelines listed in the present paper use the measures "not present," "developing," and "well developed" so that residency program directors can self-assess along the continuum and identify areas of excellence and areas for improvement. Residency program directors should consider using this new assessment tool to measure program quality and outcomes of residency teaching experiences. Results of the assessment will help residency programs focus on areas within the TLC that will potentially benefit from additional attention and possible modification.

Cholesterol management in geriatric patients: new guidelines.

Pharmacists play an important role in the management of primary care disease states such as hypercholesterolemia. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines provide the pharmacist with pertinent treatment recommendations relevant to day-to-day clinical practice and geriatric care. This article reviews these new evidencebased guidelines for cholesterol management in general and for the elderly specifically. The new guidelines have implications for older adults remaining on or starting statin therapy. With this review, and based on the new guidelines, pharmacists will be informed on how to provide hyperlipidemia recommendations for the older adult. Monitoring of therapy, as well as adverse effects, will be reviewed, including differences among various practice settings.

Essential elements for a pharmacy practice mentoring program.

Formal guidelines for mentoring faculty members in pharmacy practice divisions of colleges and schools of pharmacy do not exist in the literature. This paper addresses the background literature on mentoring programs, explores the current state of mentoring programs used in pharmacy practice departments, and provides guidelines for colleges and schools instituting formal mentoring programs. As the number of pharmacy colleges and schools has grown, the demand for quality pharmacy faculty members has dramatically increased. While some faculty members gain teaching experience during postgraduate residency training, new pharmacy practice faculty members often need professional development to meet the demands of their academic responsibilities. A mentoring program can be 1 means of improving faculty success and retention. Many US colleges and schools of pharmacy have developed formal mentoring programs, whereas several others have informal processes in place. This paper discusses those programs and the literature available, and makes recommendations on the structure of mentoring programs.

Treatment of migraine headaches with sumatriptan in pregnancy.

OBJECTIVE: To review the literature for treatment of migraine headaches with sumatriptan during pregnancy. DATA SOURCES: Studies and reports were located in International Pharmaceutical Abstracts (1970-September 2003) and MEDLINE (1966-week 3 September 2003). DATA SYNTHESIS: Research has been performed to evaluate the risk of teratogenesis after sumatriptan exposure in pregnant patients. Data have been collected in areas including placental transmission of sumatriptan, prospective pregnancy registries, open-labeled and controlled prospective studies, and a retrospective prescription-linked study. As of August 6, 2004, no randomized controlled trials have been conducted with exposure to sumatriptan during pregnancy. CONCLUSIONS: Teratogenesis occurs in approximately 150 000 births per year which represents an incidence of 3-5%. Available literature to date indicates that exposure to sumatriptan during pregnancy has no additional risk of birth defects compared with the incidence in the general population.