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This article advances the prerequisite network as a means to visualize the hidden structure in an academic curriculum. Networks have been used to represent a variety of complex systems ranging from social systems to biochemical pathways and protein interactions. Here, I treat the academic curriculum as a complex system with nodes representing courses and links between nodes the course prerequisites as readily obtained from a course catalogue. I show that the catalogue data can be rendered as a directed acyclic graph, which has certain desirable analytical features. Using metrics developed in mathematical graph theory, I characterize the overall structure of the undergraduate curriculum of Benedictine University along with that of its Biochemistry and Molecular Biology program. The latter program is shown to contain hidden community structure that crosses disciplinary boundaries. The overall curriculum is seen as partitioned into numerous isolated course groupings, the size of the groups varying considerably. Individual courses serve different roles in the organization, such as information sources, hubs, and bridges. The curriculum prerequisite network represents the intrinsic, hard-wired constraints on the flow of information in a curriculum, and is the organizational context within which learning occurs. I explore some applications for advising and curriculum reform.

This article discusses incorporation of academic curriculum elements into movement units, synchronous movement as a teaching tool, the movement-cognition connection, and identification and use of rhythm and movement elements in the classroom. (IAH)

Background: Patients undergoing vaginal hysterectomy with native tissue pelvic reconstruction typically have low pain levels overall in the postoperative period. Notwithstanding, pain control immediately after surgery may be more challenging and a barrier to same-day discharge. Intrarectal diazepam has been used for acute and chronic pelvic pain and has a pharmacokinetic profile ideal for intermittent use. However, its use has not been investigated after the surgical intervention.Objective: This study aimed to evaluate the effect of diazepam rectal suppositories on early postoperative pain after hysterectomy and vaginal reconstruction for pelvic organ prolapse.Study Design: This was a double-blind, randomized, placebo-controlled trial comparing postoperative pain scores after vaginal hysterectomy with native tissue prolapse repairs. Patients were randomized to receive either an intrarectal 10-mg diazepam suppository or an identical placebo. Moreover, the participants completed the questionnaires at baseline, the morning of postoperative day 1, and 2 weeks after the operation. Surveys included visual analog scales for pain, a validated Surgical Satisfaction Questionnaire, and queries regarding medication side effects and postoperative recovery. The primary outcome was pain scores based on a visual analog scale approximately 3 hours after surgery. The secondary outcomes included total morphine equivalents after surgery, patient satisfaction with pain control, same-day discharge outcome, and overall satisfaction. The chi-square, Fisher exact, and Mann-Whitney tests were used. Based on a 10-mm difference in postoperative vaginal pain using the visual analog scale, sample size was calculated to be 55 patients in each arm to achieve 80% power with an alpha of.05.Results: From February 2020 to August 2021, 130 participants were randomized. Of those participants, 7 withdrew, and 123 were analyzed: 60 in the diazepam group and 63 in the placebo group. The median age was 65 years (interquartile range, 27-80), the median body mass index was 27.9 kg/m2 (interquartile range, 18.70-45.90), and 119 of 123 participants (96.7%) were White. There was no difference in the baseline characteristics, prolapse stage, or types of procedures performed between groups. Most participants had concurrent uterosacral ligament suspension with anterior and posterior repairs. Of note, 50 of 123 participants (41%) had midurethral slings. Moreover, 61 of 123 participants (50%) were discharged on the day of surgery. There was no difference in the primary outcome of vaginal pain 3.5 to 6.0 hours postoperatively (25 vs 21 mm; P=.285). In addition, the amount of rescue narcotics used in the immediate postoperative period (19.0 vs 17.0 MME; P=.202) did not differ between groups. At 2-weeks postoperatively, patients in the placebo group reported higher satisfaction with pain control in the hospital (31 vs 43 mm; P=.006) and pain control at home (31 vs 42 mm; P=.022). No difference was noted between same-day discharges and those who were admitted overnight.Conclusion: The placement of a 10-mg diazepam rectal suppository immediately after pelvic reconstructive surgery did not improve pain or narcotic usage in the early postoperative period. Although the placebo group reported slightly higher satisfaction with pain control 2 weeks after surgery, overall pain levels were low. Therefore, we do not believe that the addition of diazepam to the postoperative regimen is warranted. [ABSTRACT FROM AUTHOR]