Rebecca J. Gryka

Student Perceptions of Team-based Learning vs Traditional Lecture-based Learning

Objective. To evaluate pharmacy student perceptions of team-based learning (TBL) vs traditional lecture-based learning formats. Methods. First professional year pharmacy students (N=111) at two universities used TBL in different courses during different semesters (fall vs spring). Students completed a 22-item team perceptions instrument before and after the fall semester. A 14-item teaching style preference instrument was completed at the end of the spring semester. Data were analyzed using Wilcoxon signed rank test and Mann-Whitney U test. Results. Students who experienced TBL in the fall and went back to traditional format in the spring reported improved perceptions of teams and preferred TBL format over a traditional format more than students who experienced a traditional format followed by TBL. Students at both universities agreed that the TBL format assists with critical-thinking, problem-solving, and examination preparation. Students also agreed that teams should consist of individuals with different personalities and learning styles. Conclusion. When building teams, faculty members should consider ways to diversify teams by considering different views, perspectives, and strengths. Offering TBL early in the curriculum prior to traditional lecture-based formats is better received by students, as evidenced by anecdotal reports from students possibly because it allows students time to realize the benefits and assist them in building teamwork-related skills.

Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning

Objective. To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. Methods. Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura’s Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. Results. Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. Conclusion. Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students’ skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations.

Vorapaxar: The Current Role and Future Directions of a Novel Protease-Activated Receptor Antagonist for Risk Reduction in Atherosclerotic Disease

IntroductionDespite the current standard of care, patients with cardiovascular disease remain at a high risk for recurrent events. Inhibition of thrombin-mediated platelet activation through protease-activated receptor-1 antagonism may provide reductions in atherosclerotic disease beyond those achievable with the current standard of care.ObjectiveOur primary objective is to evaluate the clinical literature regarding the role of vorapaxar (Zontivity™) in the reduction of cardiovascular events in patients with a history of myocardial infarction and peripheral artery disease. In particular, we focus on the potential future directions for protease-activating receptor antagonists in the treatment of a broad range of atherosclerotic diseases.Data SourcesA literature search of PubMed and EBSCO was conducted to identify randomized clinical trials from August 2005 to June 2016 using the search terms: ‘vorapaxar’, ‘SCH 530348’, ‘protease-activated receptor-1 antagonist’, and ‘Zontivity™’. Bibliographies were searched and additional resources were obtained.ResultsVorapaxar is a first-in-class, protease-activated receptor-1 antagonist. The Thrombin Receptor Antagonist for Clinical Event Reduction (TRACER) trial did not demonstrate a significant reduction in a broad primary composite endpoint. However, the Thrombin-Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P-TIMI 50) trial examined a more traditional composite endpoint and found a significant benefit with vorapaxar. Vorapaxar significantly increased bleeding compared with standard care. Ongoing trials will help define the role of vorapaxar in patients with peripheral arterial disease, patients with diabetes mellitus, and other important subgroups. The use of multivariate modeling may enable the identification of subgroups with maximal benefit and minimal harm from vorapaxar.ConclusionVorapaxar provides clinicians with a novel mechanism of action to further reduce the burden of ischemic heart disease. Identification of patients with a high ischemic risk and low bleeding risk would enable clinicians to maximize the utility of this unique agent.

The antiproliferative and apoptotic effects of apigenin on glioblastoma cells

Glioblastoma (GBM) is highly proliferative, infiltrative, malignant and the most deadly form of brain tumour. The epidermal growth factor receptor (EGFR) is overexpressed, amplified and mutated in GBM and has been shown to play key and important roles in the proliferation, growth and survival of this tumour. The goal of our study was to investigate the antiproliferative, apoptotic and molecular effects of apigenin in GBM.

Comparison of Student Confidence and Perceptions of Biochemistry Concepts Using a Team-based Learning Versus Traditional Lecture-based Format

PURPOSE To evaluate differences in student confidence and perceptions of biochemistry concepts using a team-based learning (TBL) format versus a traditional lecture-based format at two universities. EDUCATIONAL ACTIVITY Two pedagogies (TBL vs lecture-based) were utilized to deliver biochemistry concepts at two universities in a first-professional year, semester-long biochemistry course. A 21-item instrument was created and administered pre-post semester to assess changes in confidence in learning biochemistry concepts using Banduras Social Cognitive Theory (eight items, 5-point, Likert-type) and changes in student perceptions of biochemistry utilizing the theory of planned behavior (TPB) domains (13 items, 7- point, Likert-type). Wilcoxon signed-rank tests were used to evaluate pre-post changes, and Mann Whitney U tests for differences between universities. FINDINGS All students (N=111) had more confidence in biochemistry concepts post-semester, but TBL students (N=53) were significantly more confident. TBL students also had greater agreement that they are expected to actively engage in science courses post-semester, according to the perceptions of biochemistry subscale. No other differences between lecture and TBL were observed post-semester. SUMMARY Students in a TBL course had greater gains in confidence. Since students often engage in tasks where they feel confident, TBL can be a useful pedagogy to promote student learning.

Luteolin Decreases Epidermal Growth Factor Receptor-Mediated Cell Proliferation and Induces Apoptosis in Glioblastoma Cell Lines

Glioblastomas are a subtype of gliomas, which are the most aggressive and deadly form of brain tumours. The epidermal growth factor receptor (EGFR) is over‐expressed and amplified in glioblastomas. Luteolin is a common bioflavonoid found in a variety of fruits and vegetables. The aim of this study was to explore the molecular and biological effects of luteolin on EGF‐induced cell proliferation and the potential of luteolin to induce apoptosis in glioblastoma cells. In vitro cell viability assays demonstrated that luteolin decreased cell proliferation in the presence or absence of EGF. Immunoblots revealed that luteolin decreased the protein expression levels of phosphorylated Akt, mTOR, p70S6K and MAPK in the presence of EGF. Furthermore, our results revealed the ability of luteolin to induce caspase and PARP cleavages in glioblastoma cells in addition to promoting cell cycle arrest. Our results demonstrated that luteolin has an inhibitory effect on downstream signalling molecules activated by EGFR, particularly the Akt and MAPK signalling pathways, and provided a rationale for further clinical investigation into the use of luteolin as a therapeutic molecule in the management of glioblastoma.

Evaluation of the Anticancer Activity of Bioactive Fraction G Extracted from Pavetta crassipes in Malignant Brain Tumor Cell Lines

Objective: Natural products have served as sources of lead compounds that are commonly used in the treatment of human diseases including cancer. Pavetta crassipes has been widely demonstrated to have ethnopharmacological potential in the management of malaria, gastrointestinal conditions, central nervous system behavioral disorders, hypertension, and cancer. The goal of our study was to evaluate the biological and molecular effects of Fraction G, obtained from the plant Pavetta crassipes, on glioblastoma invasive growth and survival. Methodology: The antiproliferative effects of Fraction G, obtained from Pavetta crassipes, was evaluated using the trypan blue exclusion, (3-(4, 5-Dimethylthiazol- 2yl)-2, 5-Diphenyltetrazolium Bromide; MTT), and lactate dehydrogenase (LDH) assays. Flow cytometry and Western blotting analyses were carried out to examine the effects of Fraction G on cell cycle check-points and its effects on epidermal growth factor receptor-mediated signaling of AKT and MAPK pathways. Results: In this paper, we report that the Fraction G obtained from the plant Pavetta crassipes induced a reduction in glioma cell viability and proliferation as well as induced an increase in apoptosis as evidenced by cleaved PARP, increased caspase 3/7 activity, and cell cycle arrest in the G0/G1 check point. Furthermore, we report that Fraction G inhibited the phosphorylation of AKT and MAPK following EGF treatment. Conclusion: Taken together, our results demonstrate that Fraction G has potent inhibitory effects on pathways involved in glioblastoma proliferation and survival.

Standards 2016: Raising the Bar at Cedarville University

Traditional Diabetes Education and the Pharmacist’s Role • DM self-management education (DSME) is an ongoing process of teaching patients the knowledge, skills, and abilities necessary for diabetes self-care.4,5 • Group education has been shown to improve outcomes; however, this typically consists of lecturebased presentations with some interactive group discussion.6,7 • Studies have shown improvement of patient outcomes with a pharmacist-led DM care program.8,9is to describe a co-curricular legislative experience that can be mapped to the 2016 ACPE Standards 3.2, 4.2, and 4.4. Since 2004, the URI College of Pharmacy has participated in the Annual Face of Pharmacy event held at the Rhode Island State House. This event brings student pharmacists, faculty and members of state pharmacists associations together to rally behind issues and legislation affecting pharmacy practice. Demonstration tables, staffed by APPE students, preceptors and faculty showcase services to the legislators such as: hypertension screenings, diabetes education, body fat analysis, immunizations, medication therapymanagement services, and patient counseling. A speaking program highlights legislation and issues important to pharmacy and the future of health care. Past speakers have included Directors of the RI Department of Health, Governors, Lieutenant Governors, state Senators, state Representatives, members and staff from the Board of Pharmacy, Presidents of both state pharmacy associations (RIPA andRISHP), and selected student pharmacist leaders. Past Gubernatorial proclamations and citations have been issued to commemorate the event and pharmacists’ role in patient care. Throughout the afternoon, student pharmacists have the opportunity to interact with pharmacists at the tables, learn about legislative initiatives that impact pharmacy, and meet with state legislators. Student pharmacists have also been recognized on the House and Senate floors as the sessions open. To formally incorporate this experience into our curriculum as a co-curricular standard, students will be encouraged to perform a formal writing reflection after participation to self-evaluate their professional development. American Journal of Pharmaceutical Education 2015; 79 (5) Article S4.

Evaluation of Student Expectations of Team Members and Teamwork

• Changes in U.S. population demographics characteristics require the preparation of culturally diverse competent healthcare providers who are capable of practicing in an increasingly diverse society.1 • Training in cultural diversity competence has been recognized as a pre-requisite to fostering the transformation of healthcare1 • As response, the accreditation agencies of health-related academic programs have included new requirements of implementing cultural diversity competence along the curriculum.2,3 • Although demonstration of students’ cultural diversity competence and multicultural communication skills are required in most of the accreditation standards for healthrelated programs, more evidence is needed to determine the best teaching and learning practices for achieving these competencies.A Program to Foster Global Citizenship in Pharmacy Education. Ana Maria Castejon, Nova Southeastern University, Dawn Dacosta, Nova Southeastern University, Jaroslav Toth, Comenius University in Bratislava, Jan Kyselovic. Objectives: Understanding the practice of pharmacy from a global perspective is not a traditional curricular outcome in most US pharmacy programs. The objective of this CoCurricular activity was to provide students with an understanding, and appreciation for pharmaceutical and medical practices outside the UnitedStates. A total of 35 student pharmacists participated in aTravel Study Program (TSP) to Slovakia during the summer of 2013 at Comenius University in Bratislava, Slovakia. Topics covered included pharmacognosy, molecular drug design, European pharmaceutical regulatory agencies and the practice of the profession in Slovakia and the European Union (EU). Live lectures, laboratory practices at the host institution together with multiple site visits to different professional practice settings were included in the TSP. Through reflective exercises we assessed the students’ ability to: 1. Compare the practice of pharmacy in the US versus Slovakia and the EU 2. Identify the professional benefits of attending a structured pharmacy TSP Method: The 35 students completed reflective academic assignments and cultural competency activities before and after the three-week visit to Bratislava. The students’ reflective exercises were analyzed using narrative and content analysis, allowing us to capture the multiple meanings and dimensions of the experiences. Results: The students’ narrations reflected a major impact on their professional growth, intercultural sensitivity and competencies. Participants identified major differences in legal and regulatory aspects of the profession. They highlighted the establishment of connections and international learning networks. Implications:We believe that these programs promote global citizenship, while fostering learning and cultural exchange within the pharmacy profession.

Evaluation of Changes in Teamwork Perceptions after Experiencing a Diverse Team

• Changes in U.S. population demographics characteristics require the preparation of culturally diverse competent healthcare providers who are capable of practicing in an increasingly diverse society.1 • Training in cultural diversity competence has been recognized as a pre-requisite to fostering the transformation of healthcare1 • As response, the accreditation agencies of health-related academic programs have included new requirements of implementing cultural diversity competence along the curriculum.2,3 • Although demonstration of students’ cultural diversity competence and multicultural communication skills are required in most of the accreditation standards for healthrelated programs, more evidence is needed to determine the best teaching and learning practices for achieving these competencies.A Program to Foster Global Citizenship in Pharmacy Education. Ana Maria Castejon, Nova Southeastern University, Dawn Dacosta, Nova Southeastern University, Jaroslav Toth, Comenius University in Bratislava, Jan Kyselovic. Objectives: Understanding the practice of pharmacy from a global perspective is not a traditional curricular outcome in most US pharmacy programs. The objective of this CoCurricular activity was to provide students with an understanding, and appreciation for pharmaceutical and medical practices outside the UnitedStates. A total of 35 student pharmacists participated in aTravel Study Program (TSP) to Slovakia during the summer of 2013 at Comenius University in Bratislava, Slovakia. Topics covered included pharmacognosy, molecular drug design, European pharmaceutical regulatory agencies and the practice of the profession in Slovakia and the European Union (EU). Live lectures, laboratory practices at the host institution together with multiple site visits to different professional practice settings were included in the TSP. Through reflective exercises we assessed the students’ ability to: 1. Compare the practice of pharmacy in the US versus Slovakia and the EU 2. Identify the professional benefits of attending a structured pharmacy TSP Method: The 35 students completed reflective academic assignments and cultural competency activities before and after the three-week visit to Bratislava. The students’ reflective exercises were analyzed using narrative and content analysis, allowing us to capture the multiple meanings and dimensions of the experiences. Results: The students’ narrations reflected a major impact on their professional growth, intercultural sensitivity and competencies. Participants identified major differences in legal and regulatory aspects of the profession. They highlighted the establishment of connections and international learning networks. Implications:We believe that these programs promote global citizenship, while fostering learning and cultural exchange within the pharmacy profession.