Pilot Evaluation of Generation Rx Ambassadors Virtual Training to Prepare Students for Medication Safety Outreach.

Objective. To describe the creation of a virtual training program (Generation Rx Ambassadors) and evaluate a pilot offering's impact on knowledge and perceived abilities in delivering medication safety outreach through the Generation Rx program.Methods. Generation Rx (GenRx) is a prevention education program used by student pharmacists to teach safe medication practices in the community. An asynchronous virtual course, called Generation Rx Ambassadors (Ambassadors), was developed to train facilitators on best practices for GenRx delivery. The training was piloted in a mixed student cohort and evaluated using a preprogram/postprogram survey assessing participants' objective knowledge gains and self-perceived abilities to appropriately deliver GenRx education.Results. Fifty-two health sciences undergraduate and graduate students as well as Doctor of Pharmacy (PharmD) students completed the pilot offering of Ambassadors. Regardless of degree status or discipline, participants demonstrated significant knowledge gains for all outcomes except defining medication misuse behaviors (for which there was initial strong mastery). Prior to Ambassadors training, many participants indicated a perceived ability to effectively deliver GenRx education; however, corresponding objective knowledge assessment did not support this belief. Training through the Ambassadors program appropriately aligned participants' perceived abilities with actual content knowledge for most program learning outcomes.Conclusion. These pilot findings suggest that Ambassadors is an effective training tool on best practices for GenRx delivery. More generally, this work reiterates a need to formally train student pharmacists ahead of community outreach activities, particularly in the prevention education arena. Future evaluation will focus on replicating this study with an expanded cohort size and assessing participants' ability to deliver GenRx education in community-based settings.

Massive open online courses in U.S. healthcare education: Practical considerations and lessons learned from implementation.

BACKGROUND AND PURPOSE: Massive Open Online Courses (MOOCs) offer an innovative approach to pharmacy education and are expected to challenge traditional pedagogy and foundational knowledge acquisition practices. A survey of the literature reveals no current publications describing implementation of MOOCs in pharmacy education and limited information about MOOC implementation in other healthcare disciplines in the United States. EDUCATIONAL ACTIVITY AND SETTING: A few colleges of pharmacy (COPs) and other health professions' educational programs have recently started offering MOOCs. FINDINGS: Herein we provide an overview of MOOCs and describe the early implementation stages of MOOCs being conducted at two COPs, an interprofessional MOOC, and a variety of MOOCs offered by a public health program. This overview and the four case studies on MOOC implementation in healthcare education provide practical information about course development, descriptions of selected course engagement outcomes, insight into lessons learned by the institutions, and practical considerations for development of future MOOCs. DISCUSSION: MOOCs prompt diversification of models of teaching and learning, transformation of pedagogical frameworks, and innovation in the scholarship of teaching and learning. SUMMARY: MOOCs offer exciting opportunities to distribute knowledge on a massive and global scale to a diverse population of learners.

Nonmedical use of over-the-counter medications is significantly associated with nonmedical use of prescription drugs among university students.

OBJECTIVE: To examine the association between nonmedical use of over-the-counter medications (NMUOTC) and nonmedical use of prescription drugs (NMUPD). PARTICIPANTS: University students surveyed on NMUOTC and NMUPD between August and December 2011 (N = 939). METHODS: Cross-sectional data analysis of online survey. RESULTS: The majority of respondents were women, undergraduate, Caucasian, and not affiliated with Greek life. NMUPD and NMUOTC were reported by 21.4% and 11.2% of students, respectively. NMUOTC was significantly associated with NMUPD in unadjusted analyses and after adjustment for gender, age, race/ethnicity, and Greek membership (odds ratio: 3.37, 95% confidence interval: 2.17, 5.23). Secondary analyses showed a relationship between over-the-counter (OTC) cough medication misuse and NMUPD, OTC stimulant misuse and prescription stimulant misuse, and OTC sleep aid misuse with prescription depressant misuse. CONCLUSIONS: Results suggest the importance of both measuring the prevalence of OTC misuse and incorporating its misuse into assessments of polydrug use in the university population.

High levels of self-reported prescription opioid use by HIV-positive individuals.

Prescription medication use (other than antiretroviral therapy (ART)) is highly prevalent among people living with HIV. Prescription medications may be used medically or non-medically: non-medical use includes using more medication than prescribed, using medication prescribed to someone else, or using medication for a purpose other than its prescribed use. During 12 weeks in 2014-2015, we characterized medical and non-medical prescription medication use among HIV-positive patients attending an academic medical center (n = 149) and a community clinic (n = 105). Separately for the past year and the past month, these 254 participants self-reported their use of prescription opioids, sedatives, stimulants, anti-anxiety medications, antipsychotic medications, and erectile dysfunction medications. Respondents were largely male (91%), aged 40 or older (61%), identified as gay or bisexual (79%), and were men who have sex with men (85%). ART use was nearly universal (95%). Nearly half (43%) of participants reported medical use of prescription opioids; 11% of the opioid use was reported as non-medical use. Anti-anxiety medication use was also frequent, and differed by site: 41% of community-clinic responders reported medical use of anti-anxiety medications compared to 23% of hospital clinic respondents who reported medical use. Prescription sedative use was also approximately twice as high among community-clinic participants, with medical use reported by 43% of respondents and non-medical use by 12%; in comparison, at the hospital clinic, sedative use was reported by 18% (medical) and 7% (non-medical) of participants. Stimulant use was rare in both sites. No demographic characteristic was significantly associated with medical or non-medical use of any prescription medication. The current focus of many studies on only non-medical prescription medication use not only underestimates the widespread exposure of HIV-positive individuals to these drugs, but may also underestimate potential adverse effects of prescription medications in this population.

Dual kinase-mediated regulation of PITK by CaMKII and GSK3.

Phosphatase Interactor Targeting K protein (PITK) was previously identified as a novel PP1 targeting subunit implicated in modulating the phosphorylation of the transcriptional regulator heterogeneous nuclear ribonucleoprotein K (hnRNP K) [Kwiek NC, Thacker DF, Datto MB, Megosh HB, Haystead TA. Cell Signal 18 (10) (2006) 1769.]. Through the phosphorylation of PITK at S1013 and S1017 (residues that flank or reside within a PP1C-binding motif), the binding of the PP1 catalytic subunit to PITK, and subsequently the activity of the holoenzyme, are discretely controlled. Herein, we demonstrate that PITK phosphorylation at S1013 and S1017 also dictates the subcellular localization of the holoenzyme. Whereas both wildtype-and an S1013,1017D-PITK mutant displayed a speckled nuclear localization, a constitutively dephosphorylated form of PITK (S1013,1017A-PITK) resulted in a diffuse localization throughout the cell including the cytoplasm. Additionally, through the use of unbiased proteomics techniques, we provide evidence for a dual kinase-mediated regulation of the PITK holoenzyme whereby PITK phosphorylation at S1017 is catalyzed by calcium/calmodulin-dependent kinase II-delta (CaMKIIdelta), promoting the subsequent phosphorylation of S1013 by glycogen synthase kinase-3 (GSK3) in vitro. Taken together, our findings provide further insight into the regulation of PITK, PP1, and hnRNP K by reversible phosphorylation.

PITK, a PP1 targeting subunit that modulates the phosphorylation of the transcriptional regulator hnRNP K.

Protein phosphatase-1 (PP1), through interactions with substrate targeting subunits, plays critical roles in the regulation of numerous cellular processes. Herein, we describe a newly identified regulatory subunit (PITK; Phosphatase Interactor Targeting K protein) that specifically targets the catalytic subunit of PP1 to nuclear foci to selectively bind and dephosphorylate the transcriptional regulator heterogeneous nuclear ribonucleoprotein K (hnRNP K) at a regulatory S284 site. Additionally, PITK is phosphorylated in vivo at S1013 and S1017, residues that flank or reside within the PP1C-binding motif, and this phosphorylation negatively regulates the binding of the phosphatase to PITK. A mutant variant, S1013,1017A-PITK, when expressed in intact cells, exhibited an increase in native PP1 binding and elicited a more profound dephosphorylation of hnRNPK at S284. A global analysis of transcription by Affymetrix microarray revealed that the expression of PITK resulted in the altered expression of 47 genes, including a marked induction of MEK5 (>14-fold, p<0.007). Additionally, the effects of PITK and S1013,1017A-PITK on transcription could be modulated by the co-expression of hnRNP K. Taken together, our findings provide a putative mechanism by which transcriptional activity of hnRNP K can be discretely controlled through the regulation of PP1 activity.