Children that are diagnosed with Idiopathic Toe walking (cITW) are characterized by persistent toe-to-toe contacts. The objective of this study was to explore whether typical foot contact dynamics during walking predisposes cITW to a higher risk of falling. Twenty cITW and age-matched controls performed typical and toe walking trials. The gait parameters related to foot contact dynamics, vertical force impulses during stance, slip, and trip risk were compared for both groups. We found that cITW manifest less stable gait and produced significantly higher force impulses during push-off. Additionally, we found that cITW had a higher slip-initiation risk that was associated with higher foot contact horizontal and vertical velocities in addition to lower transitional acceleration of center of mass. We found that cITW exhibited a higher trip risk with toe clearance being significantly lower when compared to healthy counterparts. This study allowed for a quantitative description of foot contact dynamics and delineated typical from toe walking among cITW. Overall, the results indicate that cITW are less stable during typical walking and are prone to a higher risk of slip and trip-like falls.

Closed-book summative assessment of student learning, common in pharmacy education, is challenging to administer in a remote setting due to the need for costly and intrusive monitoring technology. Therefore, open-book assessments without monitoring have been considered an alternative in remote settings. The present study investigated the effects of the transition from in-person closed-book to remote open-book format on the students’ scores in different assessment categories in a Pharmacokinetics course. The students’ performances in the transition cohort (Transition, n = 96) during the in-person and remote periods were compared with those of an in-person cohort (Control, n = 85) during the same periods. Assessments included take-home assignments, daily quizzes, and progress/final examinations. Whereas the take-home assignments were open-book for cohorts and periods, the quizzes and examinations were open-book only for the Transition cohort during the remote period. Only the quiz/examination questions that were identical for both cohorts were included in the analysis. Statistical analysis by a linear, mixed-effects model indicated that the transition did not have any significant impact on the scores of students in the assignments, which were open-book for both cohorts and both periods. However, there were significant increases in the Transition cohort’s scores (mean ± SE) during the remote open-book period in both quizzes (+8.4 ± 1.9%) and examination (+6.8 ± 1.5%) questions, compared with the Control cohort who had in-person closed-book assessments. These differences amounted to Cohen’s d-effect sizes of 0.61 and 0.59 for the quiz and examination questions, respectively. It is concluded that when the questions are similar, the students’ scores in pharmacokinetic assessments are higher (medium effect size) in a remote open-book format compared with the in-person closed-book format.

Background: During the COVID-19 pandemic, opioid-related overdose deaths increased. Although Medication-Assisted Treatment or Recovery (MAT or MAR) is available, initiation and retention rates vary. The goal of this study was to evaluate clinical, demographic, and Social Determinant of Health factors affecting MAR initiation, on-time initiation of medications, and successful retention in the program. The secondary goal was to evaluate the impact of a novel interprofessional practice model incorporating pharmacists. Methods: A retrospective analysis was conducted using electronic health record data from a pilot MAR Program initiated within a California Federally Qualified Healthcare Center. Results: From September 2019 to August 2020, 48 patients enrolled into the program. On-time initiation of medications occurred in 68% of patients and average program retention was 96.4 ± 95.8 days. Patients currently using opioids (p = 0.005) and those receiving supportive medications (p = 0.049) had lower odds of on-time MAR initiation. There were no statistically significant factors associated with successful retention in the program. The number of visits with members of the interprofessional team did not significantly affect on-time initiation or successful retention. Conclusions: Current opioid use and receipt of supportive medications were associated with lower on-time medication initiation. Further studies are warranted to explore additional factors which may affect initiation and retention.