Trends in postgraduate year 2 pharmacy residencies.

PURPOSE: The purpose of this study was to quantify the growth and trends in postgraduate year 2 (PGY2) pharmacy residencies. METHODS: Summaries of the American Society of Health-System Pharmacists (ASHP) Resident Matching Program from 2008 to 2021 were obtained. Only standalone PGY2 residencies were included in the analysis. Descriptive analyses were completed for data related to the programs and positions. RESULTS: From 2008 to 2021, the total number of ASHP-accredited PGY2 programs increased from 282 to 1,131 (301%) and the overall number of unfilled positions decreased from 22% (77 of 351) to 2% (34 of 1,492). The percentage of positions filled early increased from 23% (81 of 351) to 40% (594 of 1,492) during this time. In 2021, programs with a clinical focus accounted for 91.6% of total positions. The Ambulatory Care category accounted for the largest percentage of all PGY2 residency positions, at 19.2% (287 of 1,492) in 2021 compared to 12.8% (45 of 351) in 2008. The total share of PGY2 residency positions in the Critical Care category decreased from 22.8% (80 of 351) in 2008 to 13.7% (205 of 1,492) in 2021; however, the share of PGY2 residency positions in the Emergency Medicine category increased from 1.4% (5 of 351) to 5.9% (88 of 1,492). CONCLUSION: From 2008 to 2021 the total number of PGY2 residencies increased; however, this growth was uneven, as the share of positions within individual residency categories changed. It is important for pharmacy stakeholders to review the current state of postgraduate training and ensure it reflects the goals for future practice.

Evaluation of pharmacists' awareness of illegal online pharmacies and perceived impact on safe access to medicines.

Background: An estimated 95% of all online pharmacies operate unlawfully. Illegal online pharmacies distribute substandard and falsified medical products that may result in patient harm and suboptimal treatment, leading to an overall mistrust of medications, healthcare providers, and health systems. As medication experts, pharmacists are trusted to guide patients in selection of safe and effective medication therapy. Objective: The objective of this study was to determine gaps in knowledge and recognition of the negative clinical and safety impacts associated with illegal Internet pharmacies by licensed pharmacists. Methods: A 37-question electronic survey was developed and distributed to pharmacists across the United States by email via a database from the American Pharmacists Association. Descriptive statistics was utilized to analyze data. Results: A total of 347 pharmacists from across the United States responded to at least one question in the survey. In all, 58% of pharmacists reported a lack of confidence in their ability to counsel patients on the identification of illegal pharmacy websites. Fewer than 60% of pharmacists were able to accurately identify the legitimacy of a webpage based on visual characteristics. In addition, 75% of pharmacists reported being unfamiliar with resources available to help consumers identify safe and legitimate online pharmacies. Conclusion: Integration of the topic into pharmacy education curricula, training on available resources, and additional research into the prevalence and impact of illegal pharmacy websites are necessary to ensure that pharmacists and other healthcare professionals are adequately prepared to protect their communities from the threat of illegal online pharmacies.

Impact of Proactive Integrated Care on Chronic Obstructive Pulmonary Disease.

BACKGROUND: Up to 50% of chronic obstructive pulmonary disease (COPD) patients do not receive recommended care for COPD. To address this issue, we developed Proactive Integrated Care (Proactive iCare), a health care delivery model that couples integrated care with remote monitoring. METHODS: We conducted a prospective, quasi-randomized clinical trial in 511 patients with advanced COPD or a recent COPD exacerbation, to test whether Proactive iCare impacts patient-centered outcomes and health care utilization. Patients were allocated to Proactive iCare (n=352) or Usual Care ( =159) and were examined for changes in quality of life using the St George's Respiratory Questionnaire (SGRQ), symptoms, guideline-based care, and health care utilization. FINDINGS: Proactive iCare improved total SGRQ by 7-9 units (p < 0.0001), symptom SGRQ by 9 units (p<0.0001), activity SGRQ by 6-7 units (p<0.001) and impact SGRQ by 7-11 units (p<0.0001) at 3, 6 and 9 months compared with Usual Care. Proactive iCare increased the 6-minute walk distance by 40 m (p<0.001), reduced annual COPD-related urgent office visits by 76 visits per 100 participants (p<0.0001), identified unreported exacerbations, and decreased smoking (p=0.01). Proactive iCare also improved symptoms, the body mass index-airway obstruction-dyspnea-exercise tolerance (BODE) index and oxygen titration (p<0.05). Mortality in the Proactive iCare group (1.1%) was not significantly different than mortality in the Usual Care group (3.8%; p=0.08). INTERPRETATION: Linking integrated care with remote monitoring improves the lives of people with advanced COPD, findings that may have been made more relevant by the coronavirus 2019 (COVID-19) pandemic.

Drench treatments for management of larval Japanese beetle (Coleoptera: Scarabaeidae) in field-grown balled and burlapped nursery plants.

Insecticide drenches were applied to postharvest field-grown nursery plants harvested as 60-cm-diameter balled and burlapped (B&B) root balls for controlling third instars of Japanese beetle, Popillia japonica Newman (Coleoptera: Scarabaeidae). Bifenthrin, chlorpyrifos, lambda-cyhalothrin, and thiamethoxam were drench-applied in fall and spring tests at volumes of runoff (1X; approximately equal 2.57 liters per drench per root ball) or twice runoff (2X). Tests also examined consecutive drenches (two, four, or six) and B&B rotation between drenches. Fall-applied drenches did not meet the Domestic Japanese Beetle Harmonization Plan (DJHP) standards of < or =1 grub and ranged from 0 to 90% control. However, most fall-applied drenches significantly reduced grub numbers relative to the untreated root balls. Spring-applied drenches were more effective than fall drenches: chlorpyrifos treatments gave 94-100% control, whereas other spring-applied treatments were less consistent, including thiamethoxam (83-100% control) and bifenthrin (61-100% control). Lambda-cyhalothrin was not effective. A higher drench volume (2X) did not significantly improve treatment efficacy; however, grub numbers decreased as the number of drenches increased for fall-applied chlorpyrifos and thiamethoxam and spring-applied bifenthrin. Rotation of root balls significantly reduced grub numbers compared with nonrotated treatments for fall-applied chlorpyrifos (six drenches) and bifenthrin (two or six drenches), but these treatments did not meet DJHP standards. The study indicates chlorpyrifos, bifenthrin, and thiamethoxam drenches can control Japanese beetle in the spring and may provide a new postharvest option to certify B&B plants for Japanese beetle.

Chlorpyrifos immersion to eliminate third instars of Japanese beetle (Coleoptera: Scarabaeidae) in balled and burlapped trees and subsequent treatment effects on red maple.

This study examined chlorpyrifos immersion of balled and burlapped (B&B) nursery trees for elimination of third instars of Japanese beetle, Popillia japonica Newman (Coleoptera: Scarabaeidae), and for phytotoxicity on red maple, Acer rubrum L. Trees were harvested as 45- and 60-cm-diameter B&B and immersed in chlorpyrifos at U.S. Domestic Japanese Beetle Harmonization Plan rate (0.24 kg active ingredient [AI/100 liters) or lower rates of 0.015, 0.03, 0.06, and 0.12 kg (AI)/100 liters. The 0.03, 0.06, and 0.24 kg (AI) rates provided 100% control of Japanese beetle grubs in both 45- and 60-cm B&B. The 0.015 and 0.12 kg (AI) chlorpyrifos rates were 100% effective in three tests. However, in another test, 0.015 and 0.12 kg (AI) chlorpyrifos treatments had four (93% control) and one (98% control) grubs recovered, respectively. Root ball soils consisted of loam, silt loam, or clay loam texture classifications. Trunk diameter and internode growth of red maple harvested as 45-cm B&B decreased linearly with increasing chlorpyrifos dip rate during the first year, but effects were unapparent in the second year. Chlorpyrifos rates had no measurable impact on growth of red maples harvested as 60-cm B&B. No visual phytotoxicity symptoms were detected for chlorpyrifos rate or root ball size treatments. In conclusion, results support lowering the U.S. Domestic Japanese Beetle Harmonization Plan chlorpyrifos dip rate for category 2 states to at least 0.03 kg (AI) for B&B diameters < or =60 cm. Chlorpyrifos rates < 0.24 kg (AI) will lower cost, reduce worker exposure, and lessen potential environmental contamination.

Mosquitoes infected with West Nile virus in the Florida Keys, Monroe County, Florida, USA.

More than 30,000 mosquitoes in 22 species or species groups were collected from the Florida Keys, Monroe County, FL, USA, in dry ice-baited light and gravid traps. Dry ice-baited traps collected more mosquitoes than did gravid traps. West Nile virus was detected in pools of Anopheles atropos Dyar & Knab, Deinocerites cancer Theobald, and Ochlerotatus taeniorhynchus (Wiedemann).