Food deprivation can occur for different reasons. Fasting (1-day duration) occurs when there is intentional (hunger strike or treatment of a medical condition) or unintentional (anorexia nervosa, drought, epidemic famine, war, or natural disaster) food deprivation. A scoping review was undertaken using the PubMed database to explore 1805 abstracts and review 88 eligible full-text articles to explore the adaptive relationships that emerge between cortisol, insulin, glucagon, and thyroid hormones on the metabolic pathways of macronutrients in humans during fasting and starvation. The collected data indicate that fasting and starvation prime the human body to increase cortisol levels and decrease the insulin/glucagon ratio and triiodothyronine (T₃) levels. During fasting, increased levels of cortisol and a decreased insulin/glucagon ratio enhance glycogenolysis and reduce the peripheral uptake of glucose and glycogenesis, whereas decreased T₃ levels potentially reduce glycogenolysis. During starvation, increased levels of cortisol and a decreased insulin/glucagon ratio enhance lipolysis, proteolysis, fatty acid and amino acid oxidation, ketogenesis, and ureagenesis, and decreased T₃ levels reduce thermogenesis. We present a potential crosstalk between T₃ and the above hormones, including between T₃ and leptin, to extend their adaptive roles in the metabolism of endogenous macronutrients during food deprivation.

Objectives. To assess the impact of a program to integrate introductory pharmacy practice experiences with pharmaceutical science topics by promoting active learning, self-directed learning skills, and critical-thinking skills. Design. The Learning Bridge, a curriculum program, was created to better integrate the material first-year (P1) students learned in pharmaceutical science courses into their introductory pharmacy practice experiences. Four Learning Bridge assignments required students to interact with their preceptors and answer questions relating to the pharmaceutical science material concurrently covered in their didactic courses. Assessment. Surveys of students and preceptors were conducted to measure the effectiveness of the Learning Bridge process. Feedback indicated the Learning Bridge promoted students' interaction with their preceptors as well as development of active learning, self-directed learning, and critical-thinking skills. Students also indicated that the Learning Bridge assignments increased their learning, knowledge of drug information, and comprehension of relevant data in package inserts. Conclusion. The Learning Bridge process integrated the didactic and experiential components of the curriculum, enhancing student learning in both areas, and offered students educational opportunities to interact more with their preceptors.

Peer reviewed article authored by (Karimi R). Read article or submit your manuscript for publishing.

To evaluate whether a novel integrated longitudinal curricular activity to prepare graduating doctor of pharmacy (PharmD) students for 2 comprehensive examinations was successful, and to assess whether it engaged other pharmacy students in curricular discussion and learning. Thirty-eight of 91graduating third-year (P3) students in a PharmD program formed 11 teams to create and present pharmacotherapeutic posters to their peers. The impact of the novel activity on graduating students' performance on the North American Pharmacist Licensure Examination (NAPLEX) and a comprehensive commercial examination was assessed. All first-year (P1), second-year (P2), and P3 students reviewed and discussed the content of each poster. Participants in the integrated longitudinal curricular activity performed better than nonparticipants on the commercial examination (p=0.023) and NAPLEX (p=0.033). However, regardless of participation, commercial examination scores predicted a significant amount of variance (ie, 34%) in NAPLEX scores. The P3 participants (83%) believed the curricular activity assisted them in their NAPLEX preparation, while 75% of P1 students, 79% of P2 students, and 80% of P3 students agreed that poster review provided an effective summary of different disease states. Ninety percent of faculty poster evaluators reported that the posters were professional, and all evaluators agreed that participants effectively conveyed their message to the intended audience. The integrated longitudinal curricular activity provided a positive learning environment for all pharmacy students and may have better prepared graduating students' for the NAPLEX.

Objectives. To implement a Learning Bridge tool to improve educational outcomes for pharmacy students as well as for preceptors and faculty members. Design. Pharmacy faculty members collaborated to write 9 case-based assignments that first-year pharmacy (P1) students worked with preceptors to complete while at experiential sites. Assessment. Students, faculty members, and preceptors were surveyed about their perceptions of the Learning Bridge process. As in our pilot study,¹ the Learning Bridge process promoted student learning. Additionally, the Learning Bridge assignments familiarized preceptors with the school's P1 curriculum and its content. Faculty teamwork also was increased through collaborating on the assignments. Conclusions. The Learning Bridge assignments provided a compelling learning environment and benefited students, preceptors, and faculty members.