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With over a third of the doctor of pharmacy curriculum relying on experiential education (EE), it is critical that students are assessed and graded in accordance with their actual performance. The objective of this paper is to review advanced pharmacy practice experience (APPE) grading across the Big Ten Academic Alliance to describe how APPE grading occurs at these institutions and highlight differences in approach and outcomes.Experiential directors/deans were asked to import de-identified data (e.g., APPE curriculum, midpoint and final evaluation score and grade, number of preceptors, number of students, number of years of pharmacy school, total hours of APPEs offered, number and duration of APPEs per year, grading scale information). A chi-square test including pairwise comparisons with a Bonferroni p-value adjustment for multiple comparisons was performed.Seven college/schools submitted data from over 3600 students between 2012-2015. The distribution of letter grades differed significantly across all colleges/schools in 2012-2013, 2013-2014 and 2014-2015 (p 0.0001). Similarly, the distribution of letter grades by rotation type varied significantly for all colleges/schools (p 0.0001). Students in acute care, ambulatory care, and other patient care rotation types were less likely to obtain an "A" and more likely to obtain a "B" compared to students in other rotation types.When letter grades are used for APPEs, the trend suggests over 95% of students receive an "A" or "B" grade. Final grades varied by rotation type with more "B" grades observed in patient care rotations than "A" grades over the three-year period.

Objectives: The primary objective of the study is to identify the barriers to providing Introductory Pharmacy Practice Experiences (IPPEs) in the hospital setting. Methods: Potential barriers to IPPEs were identified via literature review and interviews with current IPPE preceptors from various institutions. Based on this information, an electronic survey was developed and distributed to IPPE preceptors in order to assess student, preceptor, logistical and college or school of pharmacy related barriers that potentially exist for providing IPPE in the hospital setting. Results: Sixty-eight of the 287 eligible survey respondents (24%) completed the electronic survey. Seventy-six percent of respondents agreed or strongly agreed that available time was a barrier to precepting IPPE students even though a majority of respondents reported spending a third or more of their day with an IPPE student when on rotation. Seventy-three percent of respondents disagreed or strongly disagreed that all preceptors have consistent performance expectations for students, while just 46% agreed or strongly agreed that they had adequate training to precept IPPEs. Sixty-five percent of respondents agreed that IPPE students have the ability to be a participant in patient care and 70% of preceptors believe that IPPE students should be involved in patient care. Conclusions: Conducting IPPEs in the institutional setting comes with challenges. Based on the results of this study, experiential directors and colleges/schools of pharmacy could make a positive impact on the quality and consistency of IPPEs by setting student expectations and training preceptors on appropriate and consistent expectations for students. Type: Original Research

Objective To assess the effect of didactic business management material on students' pre- and postcourse self-perceived level of knowledge on 17 pharmacy business management topics, including inventory, personnel, and cash flow management. Methods A pre- and posttest 17-question survey design was used at two different US pharmacy schools to evaluate the study's primary objective. Students were asked to rate on a 5-point scale their current knowledge of a given business management topic (1 = Limited, 2 = Somewhat Limited, 3 = Adequate, 4 = Somewhat Extensive, 5 = Extensive). Results Overall, including both institutions, every business management knowledge–dependent variable measured significantly improved between pre- and postsurvey measurement ( p Conclusion Didactic business management material significantly improved students' self-perceived knowledge of business management topics. Most concerning was that students' precourse mean knowledge level of the given business management topics was limited to somewhat limited. Schools and colleges of pharmacy, especially those newly developing, should evaluate their curriculum to ensure business management is sufficiently covered so as to meet current Accreditation Council for Pharmacy Education standards as well as to not disadvantage their graduates in today's unstable economy.

Objectives To determine pharmacists' opinions toward implementation of a behind-the-counter (BTC) category of medications and assess pharmacists' level of agreement with dispensing certain medications in this category. Methods 473 licensed pharmacists from Ohio were randomly selected for inclusion in the study, 248 of whom completed the survey (52.4% response rate). A self-administered, mailed questionnaire was used to collect data on pharmacists' opinions toward a BTC category, including usefulness to patients, reimbursement issues, impact on patient care, and access issues. The researchers also assessed the degree to which pharmacists felt educationally prepared regarding a BTC category and the potential need for further training and/or education. The questionnaire also included 25 prescription drugs identified from pharmacist focus groups to evaluate appropriateness for inclusion in a BTC category. Results Pharmacists moderately agreed (5.78±1.33 [mean ± SD]) that introducing a BTC category of medication would advance the profession's goals of providing more pharmacist-directed patient care. Pharmacists also moderately agreed (6.09 ± 1.71) that patient counseling should be mandatory before providing any medications in a BTC category. At their current practice site, pharmacists moderately agreed (5.65 ± 1.62) that they would participate in providing BTC medications; however, they felt the largest issue pertaining to a BTC category of medications was the added amount of time that would be spent with patients (5.34 ± 1.53). On the other hand, pharmacists moderately agreed (5.82 ± 1.26) that they would take the time to counsel patients on BTC medications. Prescription prenatal vitamins (1mg folic acid), triamcinolone cream, silver sulfadiazine cream, mometasone nasal inhalation, fluconazole 150mg, epinephrine injection, promethazine, and mebendazole were considered the most appropriate for a BTC category of medications. Conclusion Ultimately, pharmacists moderately agreed that a BTC category is a change in the pharmacy profession that they were willing to embrace.

In addition to the approved package inserts, manufacturers of certain prescription drug products provide approved patient instructions for use inserts to increase patients’ understanding of their medication, aid in its use, and improve compliance. However, the extent to which consumers understand and use the information provided in these inserts is not known. The purpose of this study was to assess these patient instructions for use in inserts supplied in addition to the normal package inserts from the manufacturer. Ohio consumers between the ages of 18 and 70 were randomly selected for inclusion. Two diverse patient instructions for use from the same product class, Flonase and Nasonex, were evaluated in the study. Sixty-three consumers completed and returned the self-administered questionnaire, which contained 47 questions and used a Likert-type scale with 1 = strongly disagree to 6 = strongly agree. After data analysis was completed, it was found the inserts were not too complex, and were viewed as educational and a reliable source of drug information. Also, consumers felt very confident that they could use the products correctly. In conclusion, these inserts appear to be well understoud, informative, educational, and a useful source of drug information.

Pharmacists are considered the most accessible health care professional. Immunizations create an opportunity for the profession to grow and develop toward direct patient care. Between 1995 and 2004 programs involving immunizations led to a national initiative to train pharmacists that became a significant leap toward pharmacist's involvement in direct patient care. Although immunizations can be considered a catalyst to change the pharmacist's role, little was known about pharmacist's attitudes and the barriers involved with immunizing. Few studies have assessed barriers, attitudes, and practice issues experienced by immunizing pharmacists. The objective of this study was to determine pharmacists' attitudes toward immunizations and more specifically to assess possible barriers involved with this practice. Five hundred pharmacists were randomly selected for inclusion in the study from the State of Ohio Board of Pharmacy Database, of which 137 (27.4%) completed the survey. A 37- item questionnaire was administered via an e-mail invitation to take an online survey using Qualtrics software with a Likert-type scale, where 1 = strongly disagree and 7 = strongly agree. Several topics were assessed regarding immunizations including time constraints, workflow constraints, adequacy of training, technician support, worksite conditions and space, immunization processes, reimbursement issues, safety issues, documentation issues, and the future direction of immunizations. Demographics included gender, age, degree, number of years practicing, practice site, and number of years immunizing. Seventy-three percent of pharmacists believed that immunizing could lead to prescription filling errors (mean=4.45, SD=1.79). Pharmacists strongly agreed that having more technicians on staff would make providing immunizations easier (mean=5.80, SD=1.39) and that they play a vital role in keeping the process running smoothly (mean=6.08, SD=1.16). Also, pharmacists strongly agreed that they would feel more comfortable providing immunizations with another pharmacist on duty (mean=5.77, SD=1.39). Currently, less than ten percent of patients complete the immunization paperwork in advance; pharmacists strongly agreed that having patients complete the paperwork ahead of time would make the process more efficient (mean=5.76, SD=1.20). Pharmacists agreed that they feel adequately trained on their pharmacy's emergency protocol if patients were to have an adverse reaction to an immunization (mean=5.17, SD=1.60) although, seventy-three percent are only comfortable immunizing patients sixteen years and older. Most pharmacists agreed that they felt comfortable allowing interns to give immunizations under supervision (mean=5.23, SD=1.79). Pharmacists agreed that they should be able to provide the measles (mean=5.04, SD=2.07) and Tdap (mean=5.31, SD=2.00) vaccinations. Finally, most pharmacists agreed that the best way to compensate immunizing pharmacists was through a performance-based bonus. Pharmacist's attitudes toward immunizations are generally positive, however, more technician help and overlap of pharmacists would greatly benefit the immunization process. Type: Student Project

Objective: To determine any differences in career paths and career attributes of pharmacists who have completed a PGY1 community pharmacy residency program (CPRP) as compared to those that have not completed a PGY1 CPRP. Methods: A web-based survey evaluating various aspects of community pharmacists' careers was distributed to 274 CPRP graduates in addition to a random sample of 7,376 community pharmacists. The survey contained 32 questions evaluating various career attributes. Questions that assessed level of agreement were on a 6-point Likert-type Scale (1=strongly disagree; 6=strongly agree). Results: A total of 353 participants completed the survey, with 224 indicating that they had not completed a CPRP. Pharmacists who completed a CPRP responded that they spend significantly more time on patient care services, teaching, and research, and spend less time dispensing medications compared to those that have not completed a CPRP. Compared to those that did not complete a CPRP, CPRP graduates were less likely to agree that current level of workload negatively impacts job performance, motivation to work, job satisfaction, mental/emotional health, and physical health. Conclusion: Pharmacists completing a CPRP noted significant differences in their current employment and job responsibilities. Additional expansion and education regarding the importance of CPRPs should be considered. Type: Original Research

The objective of this study was to determine if consumers retain risk information from direct-to-consumer advertising (DTCA). The study design utilized a postgroup only control group design. Study participants were randomly selected from a statewide database of men between the ages of 60–75. These sampling criteria were selected because the ads used in the study were related to Benign Prostatic Hyperplasia (BPH). The 1093 participants were randomly assigned to one of three groups: disease-specific institutional ad group, product-specific ad group, or the control group. Participants in the two treatment groups were sent ads at one-week intervals for three weeks. A self-administered mailed questionnaire was used for data collection and mailed one week after the last ad was sent. The results show there was no statistically significant difference among the three groups regarding the correct answering of any of the risk information questions. A post hoc analysis of the data by whether the respondents indicated they had seen an ad for the product or had used the product in the past, however, yielded different results. Respondents who reported they had seen an ad for the product could have seen the ad from some other media source other than the intervention used in this study. These results show that having seen an ad for the product in the past does increase risk information retention. Past experience in taking the product, however, provides an even greater degree of retention of risk information, but may also provide a false sense of knowledge regarding some types of risk information.

A procedure is described for determining the frequency of timpani sound spectral lines to accuracies on the order of 0.05 Hz. A peak tracking algorithm uses a fourth-degree polynomial fitted to a Hamming window Fourier transform as the model function for a least-squares fit to observed spectral peaks. Accuracies of the tracking process are estimated for single sinusoids with added Gaussian noise and for pairs of closely spaced sinusoids. Tracker results are presented for sounds from a good quality 26-in. drum with emphasis on the harmonicity, or lack thereof, of the various partials.

Objective: To describe successes and barriers with the development and implementation of a community pharmacy medication therapy management-based transition of care program in the managed Medicaid population. Setting: A single supermarket chain pharmacy Practice description: Community pharmacists provide dispensing and non-dispensing pharmacy services including medication therapy management, biometric wellness screenings, and immunizations. Practice innovation: Developed and implemented a community pharmacy medication therapy management-based transition of care program for patients with managed Medicaid Main outcome measures: Feasibility of developing and implementing a transition of care service in a community pharmacy Results: During the first six months, a total of 17 patients were seen as part of the program. Study pharmacists identified successes and potential strategies for overcoming barriers. Conclusion: Developing and implementing a community pharmacy transition of care program for patients with managed Medicaid was logistically feasible. Type: Original Research

OBJECTIVE: To evaluate evidence from the medical literature that metformin is effective in preventing type 2 diabetes. DATA SOURCES: Primary literature was accessed via a MEDLINE search (1966—December 2003) using the terms metformin, type 2 diabetes, and prevention. DATA SYNTHESIS: Two studies evaluated metformin's potential to prevent type 2 diabetes, finding that metformin maintained or reduced fasting blood glucose in non-diabetics. Recently, a large study by the Diabetes Prevention Program showed that metformin may reduce the incidence of diabetes. Researchers compared lifestyle changes, metformin therapy, and placebo groups. They found that both lifestyle changes (58%) and metformin therapy (31%) significantly reduced the occurrence of type 2 diabetes versus placebo. CONCLUSIONS: These studies provide evidence that metformin may reduce the occurrence of type 2 diabetes. Because long-term efficacy has not been determined, further studies are needed.

An analytical expression is derived for the alignment of optical elements, such as the Dove or Pechan prism, that are used to rotate optical images. Improper alignment is characterized by a nutation of the system boresight as the prism is rotated. An analytical description is developed for this nutational boresight error in terms of specific misalignments between the prism, mechanical, and optical axes. This error is shown to be similar in form to that given by a mathematical expression commonly known as the limacon of Pascal. Unique nutation patterns are noted by which one can distinguish and measure specific misalignments. Proper alignment is seen to involve both lateral and angular adjustments. Appropriate adjustment axes are chosen, and suitable alignment procedures are developed.

Objective. To implement a pharmacy business management simulation exercise as a practical application of business management material and principles and assess students’ perceived value. Design. As part of a pharmacy management and administration course, students made various calculations and management decisions in the global categories of hours of operation, inventory, pricing, and personnel. The students entered the data into simulation software and a realistic community pharmacy marketplace was modeled. Course topics included accounting, economics, finance, human resources, management, marketing, and leadership. Assessment. An 18-item posttest survey was administered. Students’ slightly to moderately agreed the pharmacy simulation program enhanced their knowledge and understanding, particularly of inventory management, cash flow statements, balance sheets, and income statements. Overall attitudes toward the pharmacy simulation program were also slightly positive and students also slightly agreed the pharmacy simulation program enhanced their learning of pharmacy business management. Inventory management was the only area in which students felt they had at least “some” exposure to the assessed business management topics during IPPEs/internship, while all other areas of experience ranged from “not at all” to “a little.” Conclusion. The pharmacy simulation program is an effective active-learning exercise and enhanced students’ knowledge and understanding of the business management topics covered.

Objective: To determine the frequency and severity of sexual harassment in the pharmacy workplace for both male and female pharmacists, and to identify: (1) instigators, (2) places of occurrence, and (3) pharmacists' responses. Design: Mailed survey using elements of the Sexual Experience Questionnaire (SEQ). One repeat mailing to nonrespondents. Setting: Community pharmacies, hospital pharmacies, other pharmacies in the state of Ohio. Patients and Other Participants: 789 randomly selected pharmacists registered in Ohio. Interventions: Not applicable. Main Outcome Measures: Amount of gender harassment, unwanted sexual attention, and sexual coercion; differences in occurrences of sexual harassment between men and women; identification of instigators as colleagues, patients, or supervisors; identification of place of occurrence as community pharmacy, hospital pharmacy, or elsewhere; pharmacists' responses and reactions. Results: After two mailings, 265 usable surveys were returned for a response rate of 34%. Women differed significantly from men in total occurrences of sexual harassment, with men reporting 183 instances of sexual harassment and women reporting 281 such experiences. Instigators were colleagues (43%). patients (30%), and superiors (27%). Men reported 143 experiences of unwanted sexual attention, whereas women reported 272 such occurrences. Colleagues were responsible for 47% of instances of unwanted sexual attention, patients were responsible for 37%, and superiors 16%. No significant differences were found between men and women in total number of occurrences of sexual coercion. Conclusion: Sexual harassment in the workplace has been experienced by both male and female pharmacists. Women experienced more hostile work environment harassment than did men. However, quid pro quo harassment did not differ significantly between the sexes.J Am Pharm Assoc. 1999;39:677-82

Objectives. The pharmaceutical industry traditionally hires pharmacists with bachelor of science (BS) degrees for formulation development, manufacturing, etc. As the BS in pharmacy degree is phased out, it is important to know if manufacturers still need employees with the expertise that the BS degree provides. Methods. Data were collected from a survey asking how pharmaceutical manufacturing scientists felt about employing persons with a BS in pharmacy, what persons with BS in pharmacy degrees currently do for their company, and what courses would be of value in a degree designed for industry employment. Demographic data were also collected. Results. Survey packets were mailed to 1,000 AAPS members and 255 surveys were returned. Eighty-three percent of respondents agreed that pharmacy schools should offer BS degrees specific for industry employment. Courses in drug development and organic chemistry were the most desirable, while radiopharmaceuticals and immunology were the least favored. Respondents indi...

The influence of fluctuations on microwave‐induced Josephson steps is treated phenomenologically and it is found that the center voltage of these steps is not shifted by the disturbance. Expressions governing the step shape are obtained for various noise spectra. The theory was checked by subjecting niobium point‐contact junctions to several forms of externally generated noise. The theory does not differentiate between internal and external noise sources, so that a number of the conclusions can be extended to intrinsic fluctuations.

Tunnel junctions with low background currents made by reacting active gas layer adsorbed on Nb film surface with Pb upper film to form barrier

The "D-Zero" compiler, used by the New Univac Computer to prepare its own programs, is the first"English"-- natural language -- compiler written for a computer having only punched card input and punched or printed output. The D-0 compiler is a member of the FlowMatic System of compilers. Processing statements are similar to those used by FlowMatic for Univac I and II and the Air Force AIMACO Compiler for the Univac 1105. Additional "verbs" have been added to the language which apply to the card input and output and the on-line printer.

This paper discusses some magnetostatic interactions between two thin films that are separated by a small distance between parallel film planes. The external field of a domain wall in one film is calculated using a simple wall model, and the effect of this field on a second adjacent film is determined. The conditions are investigated under which the wall field of the first film together with an external field can cause nucleation of a domain in the second film. The interaction energy between a movable wall in one film and a stationary wall or a linear imperfection in a second adjacent film is calculated using simple models. The equilibrium position of the movable wall as a function of an externally applied field is then determined. Means for electrically modifying the degree of interaction are investigated. Experimental results are presented illustrating the aforementioned interactions. The nucleation of long narrow domains in one film is achieved by the use of a domain wall, a scratch imperfection, or a film edge in a second adjacent film. The influence of a stationary wall in one film on the controlled wall motion of a wall in a second film is demonstrated. A comparison of theory and experiment is made. Mention is made of how the subject interactions might be utilized in new information storage devices.

Dense concentrations of walls were previously observed to appear in very thin magnetic films with the application of an ac demagnetizing field. Other observations showed roughly circular concentric walls around barely discernible imperfections. Particularly clear powder patterns of such walls that were obtained on the thin end of a Permalloy film of tapered thickness are presented. The patterns allow the deduction of the detailed magnetization distribution which takes the form of a pair of antiparallel domains that spiral in toward the central imperfection. A mechanism for the formation of spiral walls is presented, together with confirming experimental evidence. The experiments establish the nature of the central imperfection as a region of abnormally high uniaxial anisotropy where the magnetization is constrained to lie in one direction along the easy axis while the magnetization of the surrounding regions of the film can be rotated with an applied field.