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Supplementation with exogenous creatine (Cr) has shown physiological benefits in humans, but little is known about the pharmacokinetics of Cr in humans. Six healthy males completed an open-label study consisting of a full pharmacokinetic analysis following a single oral dose of Cr monohydrate (71 mg kg-1) and at steady-state after 6 days of Cr administration (71 mg kg-1 qid). After the single oral dose, the clearance (CL/F) was 0.20 +/- 0.066 L h-1 kg-1, tmax was 1.9 +/- 0.88 hours, and Cmax = 102.1 +/- 11.2 mg h L-1. At steady-state, CL/F decreased to 0.12 +/- 0.016 L h-1 kg-1, tmax did not change, and Cmax increased to 162.2 +/- 30.0 mg L-1. Penetration (AUCMUSCLE/AUCPLASMA) of Cr into the interstitial muscle space, as determined by microdialysis, was 0.47 +/- 0.09 and 0.37 +/- 0.27 for the single dose and at steady-state, respectively. Plasma and muscle data were simultaneously fitted with a model incorporating a saturable absorption and first-order elimination process. In conclusion, repeated dosing of Cr caused a reduction in clearance that could result from saturation of the skeletal muscle pool of Cr. [ABSTRACT FROM AUTHOR]

Individuals in positions of leadership, of which there are a myriad of these positions in pharmacy education, will experience a transition from this position in most situations. This transition from a leadership position, be it voluntary or involuntary, can be challenging time. It can leave an individual wondering how to either channel their passion to new areas or recognize a new passion for future opportunities. The 2 questions this individual will need to answer is "what is next" and what is needed for them to feel valued and engaged in their future academic career or alternative career paths. The what is next challenge is not unique to pharmacy education. In reflecting on this question, the authors found examples of individuals who struggled with what is next after they left their leadership position. These individuals were 7 former presidents of the United States. As discussed in the book titled Life After Power, Seven Presidents and their Search for Purpose Beyond the White House by Jared Cohen, each of these presidents went through a unique journey of either rediscovery or self-discovery during their postpresidency years. Their stories offer important insights into answering the question what is next when an individual is considering opportunities after their leadership transition in our colleges or schools of pharmacy., (Copyright © 2024 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Declaration of Competing Interest Elizabeth Alida Stern is the AACP Editorial Director for the American Journal of Pharmaceutical Education but otherwise has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Gayle A. Brazeau is the Editor-in-Chief of the American Journal of Pharmaceutical Education but otherwise has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Competing Interests: Declaration of Competing Interest Gayle A. Brazeau is the Editor-in-Chief of the American Journal of Pharmaceutical Education but otherwise has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Elizabeth Alida Stern is the AACP Associate Editorial Director for the American Journal of Pharmaceutical Education but otherwise has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ghosting, professionally and personally, occurs when there is an abrupt end to communication between 2 individuals without any explanation or when an individual does not follow through on commitments to others associated with their communication. The increase in the available communication channels and speed at which messages can now be transmitted between individuals is resulting in a greater incidence of ghosting or perceived ghosting in our colleges/schools of pharmacy. The impact of ghosting is the disruption of effective communication and communication strategies that are essential to the development of positive and thriving cultures and subcultures in our institutions. The causes of ghosting (real or perceived) in our pharmacy academy could be attributed to increased workload and speed of communication, increased workload and productivity expectations, and increased workload and information volume. The consequences of ghosting in our colleges/schools can result in decreased psychological safety in our cultures, adversely impacting individual well-being, resiliency, grit, and satisfaction and adversely impacting student academic performance and success. There are simple steps that individuals and institutions can implement to minimize ghosting or the perception of ghosting that may occur with online communication channels used by our faculty, staff, students, and outside individuals., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2024 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Leadership is many things. It is fun, exciting, rewarding, and oftentimes, it can be challenging. Those challenges, especially within higher education and pharmacy, have been well documented and the turbulent times are likely to continue. It is therefore important to consider how leaders learn to lead. Within this article, the authors explore learning leadership and applying the leadership principles of a leader who led what can best be defined as a successful failure, Ernest Shackleton's Endurance expedition to the South Pole. The well-documented journey of the Endurance did not meet its goals but instead endured a nearly 2-year odyssey during which survival was the goal. The success was measured in that not a soul was lost during this 2-year period. The success of the Endurance measured by the return of the entire crew has been linked to the leadership of Ernest Shackleton and his approaches to leadership as relates to his attributes, work with individuals, and work on the culture of the crew. The leadership lessons from Shackleton can provide useful insights toward successful leadership in contemporary higher and pharmacy education., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2023 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Science is a process by which society advances knowledge of the physical and natural world through observation, experimentation, and testing of theories based on evidence. This process forms the foundation of the biomedical, clinical, and social sciences, which together provide an ever-changing knowledge base for health care professionals, like pharmacists, to use to provide evidence-based care to patients and communities. Yet, despite the essential and integrated application of science to improve health-related knowledge and care delivery, the utility and viability of science itself are under threat. Science as a broad discipline continues to be subject to politicization, misinformation, and persisting inequities among its beneficiaries. Science remains the subject of disparate perspectives regarding its societal benefits and expected roles. Pharmacists, given their education, training, and earned trust, can help to address these challenges by engagement as citizen scientists. Citizen scientists, through involvement with related initiatives, promote and advance all aspects of the public good, which are essential to the continued smooth functioning of our society. Pharmacists are well positioned to be engaged in various citizen scientist roles available in their communities that promote the public good economically, politically, and culturally. Involvement in citizen science activities is not without personal cost. This can be challenging, depending upon the level of involvement. It might take time away from other desired activities and generate perceived deficits of self-efficacy. Yet pharmacists who engage in the process of scientific discovery at any level as citizen scientists can experience personal and professional benefits, engage with other members of their communities, and provide an opportunity to serve as role models to others considering a career in pharmacy., Competing Interests: Disclosure The authors declare no relevant conflicts of interest or financial relationships., (Copyright © 2023 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Faculty retention is an issue of concern to schools and colleges of pharmacy. The reasons why faculty leave are multifactorial but often involve a breach of unwritten contract obligations between the faculty member and the organization. This article provides strategies for retaining faculty based on published literature that include perceived breaches of unwritten contracts and our own perspectives as departmental and university administrators and senior faculty members who have been involved in devising and implementing institutional change. Retention begins with recruitment but then needs to be nurtured during onboarding and as part of the overall enculturation process for new faculty members. Particular attention to the factors that influence the retention of underrepresented minorities must be incorporated to help ensure that pharmacy educators reflect the diversity of the US population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Objective: This integrative review will examine the current literature assessing student workload, outcomes of increased workload and cognitive load, and approaches to evaluate and reduce student workload. Recommendations to better inform curriculum planning efforts will be presented along with a call to action to address the dilemma of student workload and curricular efficiency efforts., Findings: Literature supports that perceptions of heavy workload can influence students' approach to learning and lead to the adoption of surface learning rather than a deep approach that involves higher-order processing and critical thinking. Additionally, ongoing evidence suggests that workload expansion affects student well-being and potential burnout in professional programs, and specifically that students perceive workload as directly related to their well-being and satisfaction. Intentional planning by faculty and programs can address this issue through streamlining classroom content, reducing lecture time, and modifying preclass work to allow for efficient learning. Even if the curriculum is lecture-based, workload perceptions can be affected by developing clearer guidance to set expectations for learners, intentionality in classroom design, and creating opportunities for student engagement., Summary: Cognitive overload is multifactorial and complicated, given the increased standards of professional education accreditation and licensure requirements. As the Academy deliberately considers methods to improve curricular efficiency, there is an opportunity to focus on curriculum delivery with an appropriate balance of breadth and depth of instruction to ensure effective assessment and cognitive load., (Copyright © 2023 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Faculty, staff, and administrators in our pharmacy colleges and schools work in well-known organizational structures that form the foundations for cultures and subcultures. The importance of promoting a positive culture and subculture is a frequent discussion in our own institutions and across the academy. However, the impact of these cultures and subcultures on individual and collective success and how they influence inclusion and innovation in our organizations are often not considered in these conversations. Psychological safety promotes an environment in an organization where an individual feels included in the culture or subculture; is safe to learn; is safe to contribute; and is safe to challenge the status quo all without the fear of being embarrassed, marginalized, or penalized in some way. Psychological safety is the foundation for enabling learning, innovation, and change in our colleges and schools of pharmacy. This commentary will highlight elements of cultures and subcultures, the importance of fostering a psychologically safe environment in our colleges and schools, and suggestions for success., (Copyright © 2023 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

This issue of the American Journal of Pharmaceutical Education (AJPE) is the start of an empowering copublishing partnership of the American Association of Colleges of Pharmacy (AACP) with Elsevier. The Journal, since 1937, has been committed to providing the highest quality of scholarly publications in all facets of pharmacy education. Our partnership with Elsevier is the next step in our continued journey to publishing outstanding scholarship in teaching and learning across the pharmacy Academy. The Journal will now have greater impact and outreach through the ScienceDirect Freedom Collection. Authors, reviewers, editors, and our pharmacy Academy will benefit through enhanced services available through the Elsevier innovative publishing platform., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

The pharmacy academy works collectively to serve the educational needs of diverse stakeholders by promulgating expectations for professional programs to achieve standards for both practice and professional development. Building systems thinking into the learning process, with its associative benefits to postgraduate preparation and lifelong practice, offers a pathway to achieve this educational mission. The concept of systems citizenship has been suggested as a process for helping health professional students incorporate a meaningful professional identity and responsibly seek out an understanding of the connections between patients, communities, and the larger institutions and environments that affect each. Drawing on the discipline of systems thinking, the student and pharmacist learn to be effective locally by thinking globally. Systems thinking, a basis for effective citizenship, is a proactive and shared approach to problem-solving that integrates professional identity with the goal of closing gaps in care. Pharmacy colleges/schools provide an opportune forum for educating professional students and postgraduates with the knowledge, skills, and abilities critical to becoming valuable and contributing systems citizens., (Copyright © 2023 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Enrollment in pharmacy education has been a topic of extensive discussions as the number of applications has declined. Some pharmacy programs have either not met enrollment goals or decreased incoming class sizes. This Commentary poses two questions that we must ask ourselves as an Academy. First, is it possible to realistically do more to recruit our way out of this situation in the next three to five years and beyond. Second, how, if possible, will pharmacy colleges and schools avoid the significant and transformative forces that could impact higher education in the future. Forces that are impacting higher education include changing demographics, transitioning from an industrial-based economy to a knowledge-based economy, and the continuing advances in technology with increased globalization as a component of all three of these forces. To address these questions, the concepts of student retention and success as well as considerations for reframing current curricular and pedagogical models and beliefs are challenged. In that pharmacy enrollment challenges are not likely to be easily resolved in the next few years, the Academy must place additional emphasis on issues related to student success and the design of our educational models and programs., (© 2023 American Association of Colleges of Pharmacy.)

Objective. To investigate the number of authors and unique institutions per paper published in the American Journal of Pharmaceutical Education (AJPE) in 2015 through 2019, and to examine the number of authors and unique institutions for papers that were nominated for the Rufus A. Lyman Award in the same period. Methods. Articles published in AJPE from 2015 through 2019 were reviewed. Data collected for each article included article type, number of authors, and number of institutions. Results. Of the 811 articles published in AJPE during this period, the number of authors increased significantly from a mean (SD) of 3.5 (1.8) to 4.5 (2.2). The number of unique institutions also increased significantly from 1.7 (1.1) to 2.4 (1.8). Conclusion. There is a trend toward a greater number of authors and unique institutions for the publications in one pharmacy education journal. Explanations for this trend may include pressure to publish, increased research complexity, and expanded interprofessional collaboration., (© 2023 American Association of Colleges of Pharmacy.)

An academic career affords us the opportunity for continuous learning and professional growth throughout the ups and downs of our professional life, during good and bad times. A key element necessary to navigate an academic career is to always focus on excellence as the core principle underlying our actions and interactions with others along the journey. This Commentary reflects on four essential elements of excellence that can enhance our academic journey. We should always care more, risk more, dream more, and expect more than others think is possible as we approach the days and years of our academic careers., (© 2022 American Association of Colleges of Pharmacy.)

Although there are at least twice as many non-tenure-track first-time pharmacy faculty as tenured and tenure-track first-time pharmacy faculty entering academia based on data collected from 2013 to 2019, there are ongoing equity, inclusion, and advancement issues between these categories of faculty that require consideration. Contracts with clear descriptions of responsibilities are needed along with regular evaluations and promotion opportunities based on the faculty member's performance of the assigned responsibilities, appropriate compensation including fringe benefits, inclusion in institutional voting and governance, and due process protections against abrupt termination. Further, universities and schools and colleges of pharmacy should foster a culture that values all faculty regardless of rank or position. The purpose of this commentary is to describe ongoing efforts and lessons learned by one public university with a college of pharmacy that has non-tenure-track and tenure-track faculty. Our hope is to provide insight into how these experiences could be used as a basis to inform changes in policy by other universities with a school or college of pharmacy, as well as to inform possible changes to the Academy's policies., (© 2021 American Association of Colleges of Pharmacy.)

The novel coronavirus 2019 (COVID-19) pandemic has changed the way we live, work, and study. As faculty members, staff members, and students attempt to create and maintain a new normal because of this pandemic, the preservation of wellbeing becomes the responsibility of each and every one of us. The pandemic has taught us not to presume the importance of wellbeing and has allowed us time to reflect on establishing new assumptions and beliefs about how and when we work and study; how to be more efficient in our work and home responsibilities; and above all, what is most important. We must support ourselves and our students by maintaining a routine, modifying work and coursework expectations, and seeking psychosocial support if needed. Focusing on promoting wellbeing through leadership will move our institutions forward to a brighter future beyond COVID-19., (© 2020 American Association of Colleges of Pharmacy.)

Context: Fatigue is highly prevalent in populations with advanced illness and is often associated with depressed mood. The role of psychostimulant therapy in the treatment of these conditions remains ill defined., Objectives: To evaluate the response of fatigue and depression in patients with advanced illness to titrated doses of methylphenidate (MP) as compared with placebo., Methods: In a randomized, double-blind, placebo-controlled trial, 30 hospice patients, both inpatients and outpatients, who had fatigue scores of at least four on a scale of zero to 10 (0=no fatigue and 10=worst fatigue), were randomly assigned to receive either 5mg of MP at 8 am and 1 pm or placebo. Doses of MP were titrated every three days according to response and adverse effects. Home care patients were monitored daily by telephone and visited by a research nurse on Study Days 0 (baseline), 3, 7, and 14. Fatigue was assessed using the Piper Fatigue Scale as the primary outcome measure and validated by the Visual Analogue Scale for Fatigue and the Edmonton Symptom Assessment Scale (ESAS) fatigue score. Subjects in inpatient facilities were interviewed or assessed by staff on an identical schedule. Depressive symptoms were assessed by the Beck Depression Inventory-II, Center for Epidemiologic Studies Depression Scale, and the ESAS depression score. Primary statistical analysis was conducted using repeated-measures multivariate analysis of the variance., Results: Both MP- and placebo-treated groups had similar measures of fatigue at baseline. Patients taking MP were found to have significantly lower fatigue scores (Piper Fatigue Scale, Visual Analogue Scale for Fatigue, and ESAS) at Day 14 compared with baseline. The improvement in fatigue with MP treatment was dose-dependent; the mean average effective dose was 10mg on Day 3 and 20mg on Day 14 (dose range of 10-40 mg). Placebo-treated individuals showed no significant improvement in fatigue. For patients with clinically significant depression on Day 0, treatment with MP was associated with a significant reduction in all test indices for depressed mood. For the placebo group, the changes in measures of depression were less than observed in the treatment group but were inconsistent between assessment tools. No significant toxicities were observed., Conclusion: MP reduced symptoms of fatigue and depression when compared with placebo. The effect of MP on fatigue was dose-dependent and sustained over the duration of the study., (Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.)