Preparing for Pregnancy: Nutrition Tips

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This month, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, offer expert insights on pregnancy and nutrition.

Pregnancy from conception to birth and beyond is a long journey. While most would describe it as an amazing experience, it is not free of few challenges along the way. This article is the first of a six-part series on nutrition and exercise recommendations for the cycle of pregnancy and its focus is on nutritionally preparing for pregnancy.

The pregnancy journey begins prior to conception. Women that are contemplating pregnancy should focus on a few key goals including achieving a healthy weight, proper vitamin and mineral intake, exercise, reducing stress, and eliminating harmful substances.

Achieving a Healthy Weight

Attaining a healthy weight is one of the most important factors affecting fertility (for females and males), conception, and overall health. Research has shown that being overweight or underweight can affect hormone levels and alter ovulation, which make it harder to conceive. For those that are overweight, even a 5% decrease in body weight has shown significant improvement in conception rates. For those that are underweight, achieving a Body Mass Index (BMI) of 19-24 (normal range) improves the rate of conception. Achieving a healthy weight, though, should be done gradually and safely as drastic weight changes can be harmful. Seeking guidance and support from a Registered Dietitian can be very helpful in this process.

Body Mass Index (BMI) = weight (kg)/height (m)2

BMI range:

  • Underweight: < 18.5
  • Normal weight: 18.5 – 24.9
  • Overweight: 26.0-29.9
  • Obese: > 30

Vitamins and Minerals

Woman of childbearing age should consume a variety of foods to provide the vitamins and minerals necessary for a healthy pregnancy. The most important being folic acid, iron, zinc, vitamin B-12, calcium, choline, vitamin D, and omega-3 fatty acids (DHA and EPA). These vitamins and minerals are plentiful in a varied diet, but supplementation may be necessary in some cases and should be discussed with your Physician and/or Registered Dietitian.

The following foods are rich in the vitamins and minerals necessary for a healthy pregnancy:

Folic acid: legumes, green leafy vegetables, whole wheat bread, citrus fruits and juices, enriched cereals and pastas

Iron: dried fruits, iron-fortified cereals, lean red meat, fish, poultry

Zinc: whole grains, fortified cereals, yogurt, meat, shellfish, legumes

Vitamin B-12: fortified cereals, milk beverages, shellfish, organ meats, fish, poultry

Calcium: milk, cheese, yogurt, tofu, cottage cheese, calcium-fortified beverages such as orange juice and soymilk

Choline: eggs, legumes, low-fat milk, fish, beef, broccoli, cauliflower

Vitamin D: fatty fish, fortified dairy and soy products, fortified eggs, fortified cereals

Omega-3 Fatty Acids: fatty fish, fortified eggs, flaxseed, walnuts, canola oil, algae oil


Exercise plays a vital role in pregnancy. Current recommendations include 150 minutes per week of moderate-intensity aerobic exercise or 30 minutes most days of the week. Exercise modes and amounts may vary throughout pregnancy. This will be discussed in greater detail in future articles.

Stress Reduction

Stress reduction prior to pregnancy is beneficial as high stress levels can certainly affect conception, lead to unhealthy eating, and cause weight fluctuations. In addition, reducing stress levels prior most likely will lead to a more stress-free pregnancy. One of the most productive ways to reduce stress is through exercise and this will be discussed in more detail next month.

Eliminating Harmful Substances

It goes without saying that harmful substances such as alcohol, drugs, tobacco, etc. should be eliminated from the diet and/or daily routine. If you are having trouble eliminating these substances, discuss options with your health care provider.

Preparing nutritionally for pregnancy can increase the chances of conception and provide the foundation for a healthy pregnancy. For most, small changes can improve pregnancy outcomes and lead to a happier and healthier pregnancy.

The next six-blog articles discuss the current nutrition and exercise recommendations for women before, during, and after pregnancy. Pregnancy can certainly be a trying and confusing time and these articles are intended to provide answers to the most popular questions women (and often their providers) ask. information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC.

Do you have a nutrition or exercise question? If so, submit them to . Questions will be answered on a monthly basis.

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5-Star Review for Introduction to Human Disease, Sixth Edition

Introduction to Human Disease: Pathophysiology for Health Professionals, Sixth EditionWonderful news– Introduction to Human Disease: Pathophysiology for Health Professionals, Sixth Edition by Agnes G. Loeffler and Michael N. Hart just received five stars and a perfect score of 100 from Doody’s Review Service.

Steven K Hamick, AAS, BIS, from William Beaumont Hospitals, writing for Doody’s Review Service, says that,

“The authors have done a masterful job of updating this book and it remains highly recommended for all nursing and allied health programs.”

Introduction to Human Disease: Pathophysiology for Health Professionals, Sixth Edition provides a broad overview of the most common and important human diseases for students pursuing careers in the health professions. Comprehensive yet accessible, it addresses the aspects of disease epidemiology, diagnosis, and treatment that are essential to clinical practice.

  • Thoroughly updated to cover the latest advances in medical knowledge and practice, especially with regard to mental health and nutritional disorders
  • Includes additional clinical information on treatments for diseases
  • Features new full-color photos and illustrations, learning objectives, and practice questions for review and assessment

Would you like to learn more? Preview a sample chapter now or visit our website.

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5-Star Review for Respiratory Care: Principles and Practice, Third Edition

Respiratory Care: Principles and Practice, Third EditionOutstanding news to share– Respiratory Care: Principles and Practice, Third Edition by Dean R. Hess, Neil R. MacIntyre, William F. Galvin, and Shelley C. Mishoe just received 5 stars and a perfect score of 100 from Doody’s Review Service. According to Steven K. Hamick, AAS, BIS, from William Beaumont Hospitals, writing for Doody’s Review Service,

“This is an outstanding book that continues to be a standard in respiratory care. [It is] intended primarily for respiratory therapy students, [but] it will [also] prove a useful and insightful reference for clinicians.”

With contributions from over 75 of the foremost experts in the field, the third edition of best-selling Respiratory Care: Principles and Practice represents the very best in clinical and academic expertise. Taught in leading respiratory care programs, it continues to be the top choice for instructors and students alike. The Third Edition includes numerous updates and revisions that provide the best foundational knowledge available.

What else makes the Third Edition special?

  • Five new chapters
  • More than 580 photos and illustrations
  • Each new print copy includes Navigate 2 Advantage Access that unlocks a comprehensive and interactive eBook, student practice activities and assessments, a full suite of instructor resources, and learning analytics reporting tools
  • Microsite with more information, including sample images, animations, a links to webinars

Would you like to learn more? Preview a sample chapter now or visit our website.

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Fad Diets: Too Good To Be True?

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This month, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, examine fad diets.

We are quickly approaching that time of year when we start to ponder our New Year’s resolutions. Most people have at least one goal that includes fitness, nutrition and/or weight loss thus leaving us vulnerable to the lure of fad diets.

Fad diets are weight-loss programs or supplements that promise to deliver quick weight loss with minimal effort. Fad diets are appealing to so many, as time is always a factor, but the negative implications in health and performance are not worth the risk. Fad diets are not supported with scientific research; therefore, the claims made regarding the products and/or ways of eating are not proven to be healthful or effective over the long term. The long-term use of fad diets has led to dangerous conditions that include dehydration, proteolysis (muscle protein loss), hypotension, and possible liver and kidney failure. Most fad diets are unmanageable, and the short-term weight loss is usually gained back once the person is no longer or is unable to follow the diet. Weight loss is usually water and glycogen loss, and is counterproductive to athletic performance as it can cause dehydration and early onset of fatigue. The best way to distinguish a fad diet from a healthful program is to recognize these important characteristics. Fad diets usually do the following:

  1. Recommend eliminating or limiting certain foods or food groups.
  2. Claim weight loss of greater than 1 or 2 pounds per week.
  3. Sounds too good to be true.
  4. Promise that you will not have to modify your diet at all, meaning that you can eat unhealthy foods and still lose weight.
  5. Have dramatic pictures, exaggerated statements and claims.
  6. Necessitate that you must buy the product in bulk, purchase meals or shakes, or attend seminars for the plan to be successful.
  7. Have studies that are not reviewed by other researchers.

There is no quick way to lose weight; weight loss is a gradual process that requires dietary and exercise modifications, consistency and patience in order to achieve long-term success. Although some fad diet are popular and may “work” for a short time, the risks far outweigh the temporary benefits.

For more information on preventing the pitfalls of fad diets, read our previous post 15 Tips to Avoid Gaining 15 by 2015. information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC.

Do you have a nutrition or exercise question? If so, submit them to . Questions will be answered on a monthly basis.


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The Syllabus: The Program Building Block

2014 Headshot_Short HairAs undergraduate and graduate healthcare management education programs move to a competency based framework for curricula, one of a program’s hurdles is assessment of student achievement of those competencies. The basis for this assessment begins in the very building block of our curricula, the syllabus, which many faculty (and some lawyers) call “our contract with the student.” To that end our syllabi should be specific to the course topic, but also address the rest of the program and how this particular course fits into the bigger picture of the competency framework.

While many readers may feel this is a fundamental area of academic freedom where the instructor is free to include or omit whatever he or she desires,  the fact of the matter is to be learner centered and equitable to all students, certain elements must be included. Many of these are considered boilerplate elements:

• The instructor’s name, contact information, and office hours;
• Meeting times and place;
• Course catalog description;
• Academic integrity policies and other academic policies (lateness, use of technology, class deportment, etc.);
• Evaluation methods and grading scales;
• Assignment details;
• Required and recommended textbooks or readings;
• A weekly calendar with topics covered;
• Assignments and due dates; and,
• Rubrics for evaluation of the assignments (or links to an online repository of rubrics).

In addition to these above noted elements, I suggest syllabi should include:
• Course objectives using Bloom’s taxonomy;
• Competency framework for the program (can be an appendix, or a link to an external source); and,
• Crosswalk (aka a matrix or grid) connecting the course objectives, competencies for the course, and assessments (assignments) of the competencies.

Course objectives are not tasks or activities, or even course competencies. Course objectives are the guideposts to the students and the instructor for course expectations. The educationally accepted approach for articulating these objectives utilizes Bloom’s taxonomy. The action verb at the start of each course objective enables the instructor to distinguish between Lower Order Thinking Skills (LOTS) and Higher Order Thinking Skills (HOTS). In a graduate program, with rare exception, the majority of the course objectives should be HOTS. In an undergraduate program, the upper level courses should, likewise, utilize HOTS. It is helpful to have colleagues and university curriculum committees review your course objectives to ensure they are consistent with the level of coursework. Here’s an example from our graduate course, HCM 669, Patient Advocacy for Healthcare Quality.

Course Objectives
1. Critique concepts and theories about patient advocacy in health care, utilizing case studies and real world applications;
2. Analyze qualitative and quantitative data to assist in formulating effective patient advocacy initiatives;
3. Design a process to evaluate the effectiveness of patient advocacy efforts in a healthcare organization;
4. Create an action plan to improve patient advocacy in a healthcare organization;
5. Construct an interdisciplinary, organization-wide strategy for evaluating the patient advocacy action plan;
6. Advocate for patient-centered care, patient safety systems, and patient involvement in healthcare organizations; and,
7. Demonstrate effective written, verbal, and interpersonal proficiencies in application of course materials.

Once you have you have decided on your competency framework, you can then crosswalk the course outcomes to the competencies and to the assessments/assignments. This table should be front and center in the syllabus, right after course objectives. By doing this, the instructor and the program remind the students of the high priority placed on the competencies and clearly links the course outcomes to the competencies and the assessments/assignments. If a student complains they don’t understand why they have to do a particular assignment, the instructor can remind him of this crosswalk and the explicit link. I like to tell students there are no assignments in this course, “Just because.” The rationale for each assignment is there from the first day of the class.  The following is how I applied this to our Patient Advocacy course. For the purpose of brevity, I have only provided one example of this alignment.

The Stevenson University Healthcare and Management Program has adopted a Health Leadership Competency Model to guide the design of all courses in the curriculum. The following table delineates the relationship between Program Objectives, Course Objectives, Health Leadership Competencies, and Assessments/Evaluations of Competency Attainment.

Course Outcome #3

Design a process to evaluate the effectiveness of patient advocacy efforts in a healthcare organization.

Health Leadership Competencies

• Interpersonal Communication
• Writing Skills
• Personal and Professional Ethics
• Cultural Competency
• Health care Issues and Trends
• Standards & Regulations
• Health care Personnel
• Health Economics
• Organizational Dynamics and Governance
• Problem-solving and Decision-making
• Time Management
• Quantitative Skills
• Legal principles development, application and assessment
• Quality Improvement/Performance Improvement

Human Resources Patient Advocate Interview Questions and Big Case Study 2 & Reflective Assignment
Discussion Forum: Letter to a CEO

While the competencies we have assigned to this course may seem overwhelming, remember when a program is new, it is important to see what works and what doesn’t work in a course. We will be revisiting this matrix in the future, and based on student, faculty, and stakeholder feedback, we will make adjustments accordingly and document those revisions to the curriculum. After reading the above, if you feel you might want to make revisions to your syllabi, this might be a good time to review course sequencing and the levels of the competencies expected from the course and the program, overall. So how do we assess the students’ competencies? That complex and complicated subject will be the topic for my blog for next month.

Sharon Buchbinder is Professor and Program Coordinator for the MS in Healthcare Management at Stevenson University in the Graduate and Professional School and former chair of the Association of University Programs in Health Administration (AUPHA). She is also the author of three books from Jones & Bartlett: Introduction to Health Care Management, Cases in Health Care Management, and Career Opportunities in Health Care Management.

Here are some references if you are interested in this topic:
Armstrong, P. (2015). Bloom’s taxonomy. Retrieved from

Broom, K., Wood, S., & Sampson, C. (2013, Summer). Current trends in graduate-level healthcare management education: An examination of accreditation outcomes. The Journal of Health Administration Education, 30(3)159-179.

Buchbinder, S. (2015, June 12). MS in Healthcare Management Program Healthcare Leadership and Management Competencies. Owings Mills, MD: Stevenson University, Graduate and Professional Studies. Retrieved from

Buchbinder, S. (2015). HCM 669 Patient advocacy for healthcare quality [Syllabus]. Owings Mills, MD: Stevenson University, Graduate and Professional Studies.

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The Health Benefits of Regular Physical Activity

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This week, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, provide expert insights on the health benefits of regular physical activity.

People exercise for numerous reasons including weight loss, weight gain, to improve performance or to improve overall health and well- being. Regular physical activity is one of the most important things a person can do to improving health. The following are some of the more significant benefits associated with consistent exercise:

  • Weight control
  • Reduce the risk of cardiovascular disease
  • Reduce the risk for type II diabetes and metabolic syndrome
  • Reduce the risk of some cancers
  • Strengthen bones and muscles
  • Improve mental health and mood
  • Improve the capacity to do daily activities and prevent falls (older adults)
  • Increase longevity

Weight Control

Both diet and exercise play a critical role in controlling weight. Weight gain is the result of consuming more calories that you expend; conversely, weight loss is the result of burning more calories that you consume. Regular physical activity not only helps one burn more calories, but provides additional health benefits as well. When it comes to weight management, a person’s physical activity needs will vary greatly; not all individuals lose and maintain weight the same way. It is recommended to work your way up to 150 minutes of moderate-intensity aerobic activity each week (approximately 30 minutes per day 5 times per week). If you are in need of professional help to get started, it is advisable to seek the help of an exercise physiologist and/or registered dietitian.

Reduce the Risk of Cardiovascular Disease

Heart disease and stroke are two of the leading causes of death in the United States. By following the guidelines of completing at least 150 minutes of moderate-intensity aerobic exercise, you can put yourself at a lower risk for these diseases. It is known that regular aerobic exercise lowers blood pressure and improves cholesterol levels.

Reduce the Risk for Type II Diabetes and Metabolic Syndrome

Diabetes is the inability to control glucose levels in the bloodstream.   Metabolic Syndrome consists of high blood pressure, excess weight (fat) around the waist, low HDL cholesterol, and high triglycerides. Research shows much lower rates for these conditions when moderate-intense aerobic activity is conducted between 120 and 150 minutes per week.

Reduce the Risk of Some Cancers

Research shows that physically active people have a lower risk for colon and breast cancer than non-physically active people. If you are a cancer survivor, exercise has been shown to offer a better quality of life and improve physical fitness.

Strengthen Bones and Muscles

Research shows that doing regular aerobic exercise at a moderately intense level can slow the loss of bone density, reduce hip fractures from falls, improve balance and coordination, and provide a higher level of functional capacity for everyday living. Strength training exercises can also help maintain muscle mass and strength, improve joint and tendon integrity, and decrease susceptibility to injury. The recommendation for strength training is 2 to 3 times per week.

Improve Mental Health and Mood

Regular physical activity can help keep your thinking, learning, and judgment skills sharp as you age. Exercise has been shown to reduce depression and may improve sleep. Research has shown that doing aerobic activity or a mix of aerobic and strength training 3 to 5 times per week for 30 to 60 minutes can provide these mental health benefits.

Improve the Capacity to do Daily Activities and Prevent Falls

Research has shown that physically active middle-aged or older adults have a lower risk of functional limitations (such as climbing stairs, lifting heavy objects, or doing work around the home) than inactive people. Independence can be maintained with regular aerobic and strength training activities.

Increase longevity

Science shows that physical activity can reduce the risk of dying early from the leading causes of death, like heart disease and some cancers. People who are physically active for approximately 7 hours per week have a 40% lower risk of dying prematurely than those who are active for less than 30 minutes a week. You don’t have to do high amounts of activity or vigorous-intensity activity to reduce your risk of premature death. Doing at least 150 minutes a week of moderate-intensity activity can provide substantial benefits and is a good first goal.

There are some individuals who are hesitant about becoming active due to the fear of being injured or concerns that exercise has to be hard in order to gain a benefit. The good news is that moderate-   intensity aerobic activity, like brisk walking, is both beneficial and safe for most people.

It is important to understand that all physical activity should initially be done slowly. Additional intensity and frequency can built up over time. Cardiac events, such as a heart attack are rare during physical activity. However, the risk can increase when one becomes much more active than usual, especially after long periods of inactivity. An example of risk could be shoveling snow when not aerobically conditioned to meet the demands of such an intense activity. That is why it is important to start slow and gradually increase the level of activity. If there is any doubt as to how to go about developing a safe and effective program, you should consider consulting with an exercise physiologist or a trainer that has certifications in strength and conditioning from the ACSM or NSCA.

If someone has a chronic health condition such as arthritis, diabetes, or heart disease, talk with your physician to determine if your condition limits, in any way, your ability to be active. It is important to remember, that any amount of physical activity is better than none. Working with a professional will help you find a program that fits your needs and provide an essential health benefit. information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC. Until 11/30/2015, save 25% plus free shipping when you order online. Use coupon code SportsNut at checkout to apply the discount. U.S. orders only.

Do you have a nutrition or exercise question? If so, submit them to . Questions will be answered on a monthly basis.

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October 25th-31st is Respiratory Care Week

Celebrate Respiratory Care Week October 25th-31st by recognizing respiratory care professionals and raise awareness for improving lung health around the world.

Download American Association for Respiratory Care’s Respiratory Care Week Planning Guide to help organize events for your universities and communities.

Visit us at booth # 814 November 7th-10th in Tampa, Florida for AARC’s Congress 2015.

Check out a few of our Respiratory Care titles that will be featured at out booth at AARC Congress 2015. Use coupon code RCWEEK to receive 25% off and free ground shipping through 11/10/15.







For more Respiratory Care titles visit our website at

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Celebrate National Pharmacy Technician Day

October 20th is National Pharmacy Technician Day. This day recognizes technicians for their support and contributions throughout the year.  This annual event is endorsed by the American Association of Pharmacy Technicians (AAPT) and the Pharmacy Technician Educators Council (PTEC).

Learn more about Pharmacy Technicians by checking out our Pharmacy texts!

Professional Skills for the Pharmacy Technician aids technicians in viewing themselves as professionals within the health system. This easy-to-read text addresses some of the skills that could facilitate getting along in the workplace, and increasing safety  and communication. This resource discusses topics dealing with interpersonal relationships, conflicts, training of new employees, management and supervision within the technician ranks, and the importance of the technician role within the healthcare system.

Use coupon code PHARMTEC25 for 25% off and free ground shipping through the end of the month. Learn more about our pharmacy technician texts by visiting our website.

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October is Physical Therapy Month

National Physical Therapy Month is hosted by APTA to recognize how physical therapists and physical therapists assistant help transform individual’s lives by improving motion.

APTA’s campaign this year is the #AgeWell Campaign. This campaign focuses on healthy aging and how physical therapists can help individuals overcome pain, and gain and maintain movement.

National Physical Therapy Month also celebrates Global PT Day of Service on October 17th. Join PTs, PTAs, students, and physical therapy staff to participate in a day of service. APTA is hosting a series of events at its headquarters for local members, staff, and their families.

To learn how you can make a difference, visit,

Want to learn more about Physical Therapy? Check out our new Physical Therapy Texts!

Manual Therapy of the Extremities presents manual therapy techniques for the upper and lower extremities from a variety of perspectives. The presentation multiple techniques for each joint restriction is a unique feature of this book that provides students with a comprehensive and well-rounded approach to mobilization. Available January 2016

Dreeben-Irimia’s Introduction to Physical Therapist Practice, Third Edition is written specifically for  PTA’s and will help instructors introduce students to information regarding professionalism, professional roles, interpersonal communication, physical therapist’s behavior and conduct, teaching and learning, and evidence-based practice. Available January 2016

Guide to Evidence-Based Physical Therapist Practice, Third Edition’s  reader-friendly style facilitates learning and presents the knowledge and skills essential for physical therapist students to develop a foundation in research methods and methodologies related to evidence-based medicine. Special Value Pricing Available

Visit our website to view all of our Physical Therapist and Physical Therapist Assitant titles.

Take 25% off with free ground shipping with coupon code PTMONTH to celebrate National Physical Therapy Month.






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October is American Pharmacists Month!

The goal of American Pharmacists Month (APhM) is to promote the pharmacy profession as medication experts. This event aims to educate the public and policy makers about the role pharmacists play in the reduction of overall health care costs and the safe and effective management of medications.

To Learn more about APhM visit,

New Pharmacy Texts:

Pharmacy Practice and the Law, Eighth Edition by Richard R. Abood:

Reviews federal law and policy as it applies to and affects the pharmacist’s practice. This comprehensive, accessible text provides background, history, and discussion of the law to enable students to learn the facts, and apply and critically evaluate the information.

Patient Communication for Pharmacy: A Case-Study Approach on Theory and Practice by Min Liu:

Uses the case studies approach to develop readers’ understanding of the unique communication dynamics between pharmacists and patients. This text offers a unique focus on skills acquisition and the practicality of real-life case studies on pharmacist-patient communication. Incorporate current theory on patient=provider communication by including behavioral change theories, focusing on skills acquisition, utilizing case studies developed from interview data with practicing pharmacists.

Use Coupon Code APHM25 for 25% off and free ground shipping through the end of the month.

To learn more visit our website,

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