With the continuing evolution of pharmacy as a clinical profession, the need to prepare well‐trained clinicians beyond the knowledge gained from a doctor of pharmacy degree program is magnified. Such training is afforded by pharmacy residency programs, which have expanded from hospital sites to practice settings as diverse as managed care organizations and public health departments. Although the resident benefits from the intensive training program, the sponsoring institution also derives many benefits from hosting the residency. Fundamentally, residents are licensed pharmacists who provide several contributions to the organization at generally a much‐reduced direct cost. Federal funding for graduate medical education, often referred to as Medicare pass‐through funds, is a common source of support for the conduct of postgraduate year one residency programs in health system settings; other sources of funding may be found in organizational and academic outlets. Residents may be integral in expanding the revenue of an organization by serving as patient care providers, developing or enhancing services, and billing for services delivered. By virtue of the roles they can assume, residents can facilitate the redeployment of existing pharmacists to other areas, tasks, or projects, thus expanding the capabilities of the department. Increasing the capacity to conduct experiential education for pharmacy students, and the compensation for such activity, can be an additional benefit. Practice sites that conduct residency training often experience a greater degree of employee satisfaction and higher employee retention rates. Engaging in quality improvement and assessment activities, assisting in staff development, and supporting innovative approaches to care are additional activities that pharmacy residents can support. This primer from the American College of Clinical Pharmacy was developed to highlight the value an organization can realize by conducting pharmacy residency training.

Despite receiving a modified RHI infusion, critically ill trauma patients with renal failure are at greater risk for developing hypoglycemia and have more glycemic variability than patients without renal failure.

Clinical and laboratory abnormalities in critically injured patients with VAP do not resolve as quickly as suggested in the guidelines. Future studies should evaluate new methods to determine the response to antibiotic therapy in critically injured patients with VAP.

Limited Print and Electronic Distribution RightsThis document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.html.The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org For more information on this publication, visit www.rand.org/t/TL144z2Published by the RAND Corporation, Santa Monica, Calif. © Copyright 2018 RAND CorporationR® is a registered trademark.iii PrefaceIn December 2015, RAND Corporation researchers produced an online tool called the Motor Vehicle Prioritizing Interventions and Cost Calculator for States (MV PICCS) for the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC). The purpose of this tool, which is available to the public at www.cdc.gov/motorvehiclesafety/calculator/ (CDC, 2015), is to support states and local communities in making evidence-based resource allocation decisions relating to the implementation of effective evidence-based interventions for preventing motor vehicle-related injury.In 2017, the team completed an update to the tool as part of a project led by the National Governors Association, funded by CDC, to work with states and governors' offices to strengthen strategies to reduce highway and traffic injuries and fatalities. The work includes updates to some of the data used, updates to some of the assumptions and methods to derive the data, and a full redesign of the user interface of the tool. This report documents which data, assumptions, and methods we updated. The audience for this report is the users of the online tool, state and local health and safety officials seeking information on the effectiveness and costs of the 14 motor vehicle injury prevention interventions included in MV PICCS.The more complete documentation, which includes discussion of how we selected interventions for inclusion in the tool and how we programmed the tool, is available in Ringel et al., 2015. RAND researchers have also undertaken related work that used the data in the tool to conduct policy analyses of traffic safety spending. This work was sponsored by the Robert Wood Johnson Foundation. The main report is Ecola, Batorsky, and Ringel, 2015. Fou...

The response of ICU patients to continuously infused ketamine when it is used for analgesia and/or sedation remains poorly established. OBJECTIVES:To describe continuous infusion (CI) ketamine use in critically ill patients, including indications, dose and duration, adverse effects, patient outcomes, time in goal pain/sedation score range, exposure to analgesics/sedatives, and delirium. DESIGN, SETTING, AND PARTICIPANTS:Multicenter, retrospective, observational study from twenty-five diverse institutions in the United States. Patients receiving CI ketamine between January 2014 and December 2017. MAIN OUTCOMES AND MEASURES:Chart review evaluating institutional and patient demographics, ketamine indication, dose, administration, and adverse effects. Pain/sedation scores, cumulative doses of sedatives and analgesics, and delirium screenings in the 24 hours prior to ketamine were compared with those at 0-24 hours and 25-48 hours after. RESULTS:A total of 390 patients were included (median age, 54.5 yr; interquartile range, 39-65 yr; 61% males). Primary ICU types were medical (35.3%), surgical (23.3%), and trauma (17.7%). Most common indications were analgesia/sedation (n = 357, 91.5%). Starting doses were 0.2 mg/kg/hr (0.1-0.5 mg/kg/hr) and continued for 1.6 days (0.6-2.9 d). Hemodynamics in the first 4 hours after ketamine were variable (hypertension 24.0%, hypotension 23.5%, tachycardia 19.5%, bradycardia 2.3%); other adverse effects were minimal. Compared with 24 hours prior, there was a significant increase in proportion of time spent within goal pain score after ketamine initiation (24 hr prior:

The purpose of this project was to support states and local communities in making evidencebased resource allocation decisions relating to the implementation of effective evidence-based interventions for preventing motor vehicle-related injury. This report documents the data and assumptions that were used to develop the interactive online tool that states can use to assess state-specific costs and effectiveness of different interventions designed to prevent motor vehicle-related injuries. It also includes a user guide that describes how to use the tool. The tool should help states understand the trade-offs and prioritize the most cost-effective interventions to reduce motor vehicle-related injuries. The tool is available to the public at www.cdc.gov/motorvehiclesafety/calculator. The audience for this report is the users of the online tool, state and local health and safety officials seeking information on the effectiveness and costs of the various interventions. This work was sponsored by the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention. Reference to any specific commercial products, programs, or services by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation, or favoring by the U.S. government. The views and opinions of authors expressed herein do not necessarily state or reflect those of the U.S. government and shall not be used for advertising or product or program endorsement purposes. RAND researchers have undertaken related work that extended the online tool by including two additional interventions. This additional work is sponsored by the Robert Wood Johnson Foundation and is incorporated into this report. In addition, an accompanying report uses the data in the tool to conduct policy analyses of traffic safety spending, and four research briefs highlight those analyses:

In lieu of an abstract, here is the article\u27s first paragraph: \u22A global crisis of antibiotic resistance is ongoing, especially with resistant gram-negative pathogens including Pseudomonas spp, carbapenemase-producing Enterobacteriaceae, and extended-spectrum β-lactamase (ESBL)-producing organisms. The increasing rate of methicillin-resistant Staphylococcus aureus (MRSA) infections is also a concern.1 One newer intravenous cephalosporin (ceftaroline) was approved in 2010, and 2 new intravenous cephalosporin–β-lactamase inhibitor combinations (ceftolozane-tazobactam and ceftazidime-avibactam) have recently been approved to try to combat these resistant organisms in adult patients.\u2

HCl was effective for treating metabolic alkalosis, and no serious adverse events were seen. In this clinical setting, the baseline chloride ion deficit and SIDa were not useful for prediction of total HCl dose requirement, and serial monitoring of response is recommended.