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1.  Correlation of the Health Sciences Reasoning Test With Student Admission Variables 
Objectives. To assess the association between scores on the Health Sciences Reasoning Test (HSRT) and pharmacy student admission variables.
Methods. During the student admissions process, cognitive data, including undergraduate grade point average and Pharmacy College Admission Test (PCAT) scores, were collected from matriculating doctor of pharmacy (PharmD) students. Between 2007 and 2009, the HSRT was administered to 329 first-year PharmD students. Correlations between HSRT scores and cognitive data, previous degree, and gender were examined.
Results. After controlling for other predictors, 3 variables were significantly associated with HSRT scores: percentile rank on the reading comprehension (p<0.001), verbal (p<0.001), and quantitative (p<0.001) subsections of the PCAT.
Conclusions. Scores on the reading comprehension, verbal, and quantitative sections of the PCAT were significantly associated with HSRT scores. Some elements of critical thinking may be measured by these PCAT subsections. However, the HSRT offers information absent in standard cognitive admission criteria.
doi:10.5688/ajpe776118
PMCID: PMC3748299  PMID: 23966721
Health Sciences Reasoning Test (HSRT); critical thinking; admissions; Pharmacy College Admission Test (PCAT)
2.  Glucocorticoid-Dependent Hippocampal Transcriptome in Male Rats: Pathway-Specific Alterations With Aging 
Endocrinology  2013;154(8):2807-2820.
Although glucocorticoids (GCs) are known to exert numerous effects in the hippocampus, their chronic regulatory functions remain poorly understood. Moreover, evidence is inconsistent regarding the long-standing hypothesis that chronic GC exposure promotes brain aging/Alzheimer disease. Here, we adrenalectomized male F344 rats at 15 months of age, maintained them for 3 months with implanted corticosterone (CORT) pellets producing low or intermediate (glucocorticoid receptor–activating) blood levels of CORT, and performed microarray/pathway analyses in hippocampal CA1. We defined the chronic GC-dependent transcriptome as 393 genes that exhibited differential expression between intermediate and low CORT groups. Short-term CORT (4 days) did not recapitulate this transcriptome. Functional processes/pathways overrepresented by chronic CORT–up-regulated genes included learning/plasticity, differentiation, glucose metabolism, and cholesterol biosynthesis, whereas processes overrepresented by CORT–down-regulated genes included inflammatory/immune/glial responses and extracellular structure. These profiles indicate that GCs chronically activate neuronal/metabolic processes while coordinately repressing a glial axis of reactivity/inflammation. We then compared the GC transcriptome with a previously defined hippocampal aging transcriptome, revealing a high proportion of common genes. Although CORT and aging moved expression of some common genes in the same direction, the majority were shifted in opposite directions by CORT and aging (eg, glial inflammatory genes down-regulated by CORT are up-regulated with aging). These results contradict the hypothesis that GCs simply promote brain aging and also suggest that the opposite direction shifts during aging reflect resistance to CORT regulation. Therefore, we propose a new model in which aging-related GC resistance develops in some target pathways, whereas GC overstimulation develops in others, together generating much of the brain aging phenotype.
doi:10.1210/en.2013-1139
PMCID: PMC3713214  PMID: 23736296
3.  Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension 
Background
Nonsteroidal anti-inflammatory drugs (NSAIDs) may disrupt control of blood pressure in hypertensive patients and increase their risk of morbidity, mortality, and the costs of care. The objective of this study was to examine the association between incident use of NSAIDs and blood pressure in patients with hypertension.
Methods
We conducted a retrospective cohort study of adult hypertensive patients to determine the effects of their first prescription for NSAID on systolic blood pressure and antihypertensive drug intensification. Data were collected from an electronic medical record serving an academic general medicine practice in Indianapolis, Indiana, USA. Using propensity scores to minimize bias, we matched a cohort of 1,340 users of NSAIDs with 1,340 users of acetaminophen. Propensity score models included covariates likely to affect blood pressure or the use of NSAIDs. The study outcomes were the mean systolic blood pressure measurement after starting NSAIDs and changes in antihypertensive therapy.
Results
Compared to patients using acetaminophen, NSAID users had a 2 mmHg increase in systolic blood pressure (95% CI, 0.7 to 3.3). Ibuprofen was associated with a 3 mmHg increase in systolic blood pressure compared to naproxen (95% CI, 0.5 to 4.6), and a 5 mmHg increase compared to celecoxib (95% CI, 0.4 to 10). The systolic blood pressure increase was 3 mmHg in a subgroup of patients concomitantly prescribed angiotensin converting enzyme inhibitors or calcium channel blockers and 6 mmHg among those prescribed a beta-adrenergic blocker. Blood pressure changes in patients prescribed diuretics or multiple antihypertensives were not statistically significant.
Conclusion
Compared to acetaminophen, incident use of NSAIDs, particularly ibuprofen, is associated with a small increase in systolic blood pressure in hypertensive patients. Effects in patients prescribed diuretics or multiple antihypertensives are negligible.
doi:10.1186/1471-2261-12-93
PMCID: PMC3502533  PMID: 23092442
NSAIDs; Hypertension; Blood pressure; Propensity score
4.  Patient Race, Reported Problems in Using Glaucoma Medications, and Adherence 
ISRN Ophthalmology  2012;2012:902819.
Objective. The objectives of the study were to (a) describe various factors potentially related to objectively measured adherence to glaucoma medications and self-reported glaucoma medication adherence self-efficacy and (b) examine the relationship between patient race, the number of patient reported-problems, and adherence in taking their glaucoma medication. This was a cross-sectional study conducted at two glaucoma subspecialist referral ophthalmology practices. Methods. We measured subjects' reported problems in using glaucoma medications, adherence to glaucoma medications utilizing the Medication Events Monitoring System (MEMS) devices, and general glaucoma medication adherence self-efficacy using a previously validated 10-item scale. Multivariable logistic and linear regression was used to analyze the data. Results. Seventy-one percent of patients self-reported at least one problem in using their glaucoma medications. White patients were more than 3 times more likely to be 80% adherent in using their glaucoma medications than non-White patients. Patients who had glaucoma longer reported significantly higher glaucoma medication adherence self-efficacy. Patients who reported more problems in using their medications had significantly lower glaucoma medication adherence self-efficacy. Conclusions. Eye care providers should assess patient reported problems and glaucoma medication adherence self-efficacy and work with patients to find ways to reduce the number of problems that patients experience to increase their self-efficacy in using glaucoma medications.
doi:10.5402/2012/902819
PMCID: PMC3914256  PMID: 24558595
5.  Patient decision making in the face of conflicting medication information 
When patients consult more than one source of information about their medications, they may encounter conflicting information. Although conflicting information has been associated with negative outcomes, including worse medication adherence, little is known about how patients make health decisions when they receive conflicting information. The objective of this study was to explore the decision making strategies that individuals with arthritis use when they receive conflicting medication information. Qualitative telephone interviews were conducted with 20 men and women with arthritis. Interview vignettes posed scenarios involving conflicting information from different sources (e.g., doctor, pharmacist, and relative), and respondents were asked how they would respond to the situation. Data analysis involved inductive coding to identify emergent themes and deductive contextualization to make meaning from the emergent themes. In response to conflicting medication information, patients used rules of thumb, trial and error, weighed benefits and risks, and sought more information, especially from a doctor. Patients relied heavily on trial and error when there was no conflicting information involved in the vignette. In contrast, patients used rules of thumb as a unique response to conflicting information. These findings increase our understanding of what patients do when they receive conflicting medication information. Given that patient exposure to conflicting information is likely to increase alongside the proliferation of medication information on the Internet, patients may benefit from assistance in identifying the most appropriate decision strategies for dealing with conflicting information, including information about best information sources.
doi:10.3402/qhw.v7i0.18523
PMCID: PMC3430944  PMID: 22943889
Medical decision making; medication adherence; doctor-patient communication; heuristics and biases; arthritis; information seeking
6.  The Status of PhD Education in Economic, Social, and Administrative Sciences Between 2005 and 2008 
Objectives
To describe the funding, education, enrollment, and graduation patterns from economic, social, and administrative sciences PhD programs in colleges and schools of pharmacy in the United States.
Methods
Economic, social, and administrative sciences PhD programs were identified from the American Association of Colleges of Pharmacy (AACP) Web site. A 41-item online survey instrument was sent to the director of graduate studies of each identified program. Only programs offering a PhD degree were included in the study.
Results
Of the 26 programs surveyed, 20 (77%) provided useable responses to the survey instrument. Approximately 91% of PhD programs guarantee funding to incoming students with an average commitment of 2.9 years. On average, students were paid a stipend of $18,000 per year for commitments to research and teaching assistantships, each averaging approximately 2 years in length. Programs admitted an average of 3.5 students per year and graduated approximately 85% of entering students. The majority of students are non-US citizens and accept positions in either academic or industrial positions after graduation.
Conclusions
Most economic, social, and administrative sciences PhD programs guarantee funding to incoming PhD candidates. Programs offering funding packages significantly below the average may be at a competitive disadvantage. It is unclear whether the number of students graduating from PhD programs is adequate to fulfill academic and industrial needs.
PMCID: PMC2972521  PMID: 21088732
graduate education; academia; social and administrative sciences; doctor of philosophy
7.  Practice Settings, Job Responsibilities, and Job Satisfaction of Nontraditional PharmD and BS Pharmacy Graduates 
Objectives
To assess differences in the practice of pharmacy and in job satisfaction between graduates of a nontraditional doctor of pharmacy (PharmD) program and a bachelor of science (BS) in pharmacy program.
Methods
Two separate survey instruments were mailed to 293 PharmD graduates and 293 BS graduates.
Results
Two hundred fourteen (73.0%) of the 293 nontraditional PharmD graduates and 189 (64.5%) of the 293 BS graduates completed the survey instruments. Nontraditional PharmD graduates expressed greater satisfaction, both in their current position and with pharmacy as a career, compared to BS graduates. Nontraditional PharmD graduates were more likely than BS graduates to practice in a hospital and have more clinical responsibilities.
Conclusions
Nontraditional PharmD graduates are more likely to have greater satisfaction with their job and with pharmacy as a career compared to BS-trained pharmacists.
PMCID: PMC2690895  PMID: 19513171
nontraditional PharmD degree; job responsibilities; job satisfaction
8.  The Structured Interview and Interviewer Training in the Admissions Process 
Objectives
To determine the extent to which the structured interview is used in the PharmD admissions process in US colleges and schools of pharmacy, and the prevalence and content of interviewer training.
Methods
A survey instrument consisting of 7 questions regarding interviews and interviewer training was sent to 92 colleges and schools of pharmacy in the United States that were accredited or seeking accreditation.
Results
Sixty survey instruments (65% response rate) were returned. The majority of the schools that responded (80%) used interviews as part of the PharmD admissions process. Of the schools that used an interview as part of the admissions process, 86% provided some type of interviewer training and 13% used a set of predefined questions in admissions interviews.
Conclusions
Most colleges and schools of pharmacy use some components of the structured interview in the PharmD admissions process; however, training for interviewers varies widely among colleges and schools of pharmacy.
PMCID: PMC2064881  PMID: 17998980
structured interview; interview; interviewer training; admissions

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