Curriculum mapping of accredited pharmacy programs in the United States.

INTRODUCTION: No current guidance exists to inform the content area credit hours for doctor of pharmacy (PharmD) programs in the United States (US). METHODS: Public websites were accessed for all Accreditation Council for Pharmacy Education (ACPE) accredited PharmD programs in the US to record the credit hours devoted to drug therapy, clinical skills, experiential learning, scholarship, social and administrative sciences, physiology/pathophysiology, pharmacogenomics, medicinal chemistry, pharmacology, pharmaceutics, and pharmacokinetics/pharmacodynamics in the didactic curricula. Due to the high prevalence of programs that integrate drug therapy, pharmacology, and medicinal chemistry into a single course, we subdivided programs based upon whether drug therapy courses were "integrated" or "non-integrated." A regression analyses was conducted to explore the relationship between each content area and North American Pharmacist Licensure Examination (NAPLEX) pass rates and residency match rates. RESULTS: Data were available for 140 accredited PharmD programs. Drug therapy had the highest credit hours in programs with both integrated and non-integrated drug therapy courses. Programs with integrated drug therapy courses had significantly more credit hours in experiential and scholarship and fewer credit hours in stand-alone courses for pathophysiology, medicinal chemistry, and pharmacology. Credit hours in content areas did not predict NAPLEX pass rate nor residency match success rate. CONCLUSIONS: This is the first comprehensive description of all ACPE accredited pharmacy schools with credit hours broken down by content areas. While content areas did not directly predict success criteria, these results may still be useful to describe curricular norms or inform the design of future pharmacy curricula.

The effect of unilateral blood flow restriction on temporal and spatial gait parameters.

Blood flow restriction walking (BFR-W) is becoming more frequently used in aerobic and strength training and it has been proposed that BFR-W can be used in clinical populations. BFR-W may change gait stability yet few studies have assessed gait changes during or following BFR-W. The aim of this study was to assess if spatial-temporal gait parameters change during and following BFR-W. Twenty-four participants completed two walking sessions (>48-hours apart); 1) Unilateral BFR-W applied at the dominant thigh, 2) walking without BFR. In each session participants performed a 5-min warmup, 15-min walking intervention and 10-min active recovery. The warmup and active recovery were performed without BFR on both days. Measurements were attained at baseline, during the intervention and post-intervention using the GAITRite®. Linear mixed models were applied to each measured variable. Fixed factors were timepoint (warmup, intervention, and active recovery), condition (BFR-W and control walking) and condition × timepoint. Random factors were subject and subject × condition. Participants took shorter (3.2-cm (mean difference), CI95%: 0.8-5.6-cm) and wider strides (1.4-cm, CI95%: 0.9-1.9-cm) during BFR-W. For single leg measures, participants took shorter steps (2.8-cm, CI95%: 1.7-4.0-cm) with a faster single support time (7.5-ms, CI95%: 2.9-12.0-ms) on the non-dominant (unoccluded) leg during BFR-W compared to the non-dominant leg during control walking. There were no differences in step length and single support time between the dominant (occluded) leg during BFR-W compared to the dominant leg during control walking. There were no significant changes in velocity, cadence or double support time between BFR-W and control walking (P > 0.05). BFR-W caused small transient changes to several gait parameters. These changes should be considered when using BFR-W in clinical populations.

Between session reliability of heel-to-toe progression measurements in the stance phase of gait.

The objective of the current study was to determine the test-retest reliability of heel-to-toe progression measures in the stance phase of gait using intraclass correlation coefficient (ICC) analysis. It has been proposed that heel-to-toe progression could be used as a functional measure of ankle muscle contracture/weakness in clinical populations. This was the first study to investigate the test-retest reliability of this measure. Eighteen healthy subjects walked over the GAITRite® mat three times at a comfortable speed on two sessions (≥ 48 hours apart). The reliability of the heel-to-toe progression measures; heel-contact time, mid-stance time and propulsive time were assessed. Also assessed were basic temporal-spatial parameters; velocity, cadence, stride length, step length, stride width, single and double leg support time. Reliability was determined using the ICC(3,1) model and, fixed and proportional biases, and measures of variability were assessed. Basic gait temporal-spatial parameters were not different between sessions (p > 0.05) and had excellent reliability (ICC(3,1) range: 0.871-0.953) indicating that subjects walked similarly between sessions. Measurement of heel-to-toe progression variables were not different between sessions (p > 0.05) and had excellent reliability (ICC(3,1) range: 0.845-0.926). However, these were less precise and more variable than the measurement of standard temporal-spatial gait variables. As the current study was performed on healthy populations, it represents the 'best case' scenario. The increased variability and reduced precision of heel-to-toe progression measurements should be considered if being used in clinical populations.

Effect of rainfall patterns on soil surface CO2 efflux, soil moisture, soil temperature and plant growth in a grassland ecosystem of northern Ontario, Canada: implications for climate change.

BACKGROUND: The effect of rainfall patterns on soil surface CO2 efflux, soil moisture, soil temperature and plant growth was investigated in a grassland ecosystem of northern Ontario, Canada, where climatic change is predicted to introduce new precipitation regimes. Rain shelters were established in a fallow field consisting mainly of Trifolium hybridum L., Trifolium pratense L., and Phleum pratense L. Daytime ambient air temperatures within the shelters increased by an average of 1.9 degrees C similar to predicted future increases in air temperatures for this region. To simulate six precipitation regimes which cover the maximum range to be expected under climate change, a portable irrigation system was designed to modify the frequency of monthly rainfall events with a constant delivery rate of water, while maintaining contemporary average precipitation volumes. Controls consisted of blocks irrigated with frequencies and total monthly precipitation consistent with the 25 year average rainfall for this location. RESULTS: Seasonal soil moisture correlated with soil surface CO2 efflux (R = 0.756, P < 0.001) and above ground plant biomass (R = 0.447, P = 0.029). By reducing irrigation frequency, soil surface CO2 efflux decreased by 80%, P < 0.001, while soil moisture content decreased by 42%, P < 0.001. CONCLUSIONS: Manipulating the number of precipitation events and inter-rainfall intervals, while maintaining monthly rainfall averages impacted CO2 efflux and plant growth. Even with monthly rainfall averages that are similar to contemporary monthly precipitation averages, decreasing the number of monthly rainfall events reduced soil surface CO2 efflux and plant growth through soil moisture deficits. Although many have speculated that climate change will increase ecosystem productivity, our results show that a reduction in the number of monthly rainfall events while maintaining monthly averages will limit carbon dynamics.