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The formation of a task force led to the successful passage of a bill granting the Kansas Board of Pharmacy the authority to issue regulations regarding mandatory pharmacy technician certification.

Purpose The development and implementation of a team-based pharmacy practice model is described. Methods In January 2016 a transition from a staff-specialist to a team-based pharmacy practice model was implemented. The overall goal of the model change was to enhance the pharmacist’s clinical roles and further integrate pharmacists into the healthcare team. Before implementation of the new staffing model, a formalized metric evaluation process was created. The aim of this metric evaluation was to gauge model success, determine areas of model revision, and objectively communicate pharmacist impact. Objective metrics were evaluated before implementation and 1 year after implementation. In addition, surveys were distributed to pharmacists, physicians, nursing and hospital administration before and after model implementation. Results At 1-year postimplementation, the pharmacist:patient bed ratio decreased from 1:87 to 1:47, the number of rounds/huddles with pharmacist attendance increased by 63% to 80 per week, and the number of clinical interventions and new clinical consultations increased from 57 to 62 and from 12 to 16 per day, respectively. Nonformulary medication use also decreased from 1.77 to 0.623 per 1000 patient days, and compliance with therapeutic initiatives increased from 77%to 91%. Overall, 72% of pharmacist survey responses indicated satisfaction with the model change. Conclusion A team-based pharmacy practice model was designed and successfully implemented over a 3-year period. Data analysis revealed improvements in clinical and operational endpoints and enhanced pharmacist, physician, and nursing satisfaction.

This paper tells the personal story of a cancer survivor and her experience dealing with death. It analyzes Ernest Becker’s thesis, The Denial of Death, by examining the solutions, which he suggests humans use to cope with the fear of death by establishing a sense of purpose and control. The author identifies examples of Becker’s solutions by looking at the mechanisms she used to cope with the possibility of dying through out her journey with cancer. With a tendency toward secularization and a focus on psychology in present day, the solutions people use to deal with death are changing. The author looks at how self-help, in the form of mind-body medicine, is a new solution that is used to deal with the fear of death in the present day socio-cultural landscape. While providing control, this way of dealing with the fear of death can be isolating and lead to self-blame.             Keywords: Ernest Becker, Denial of Death, mind-body medicine, psychologize death, self-help.

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The use of combination antiretroviral therapy in patients with malignancies is associated with improved HIV and cancer-related outcomes. Combining antiretroviral and antineoplastic therapy is often complicated by significant drug-drug interactions, drug-disease state monitoring interactions and overlapping toxicities. Definitive pharmacokinetic studies evaluating drug interactions between antineoplastics and antiretrovirals are uncommon and clinical judgment must often be used to determine the potential for significant interactions. Adjusting antiretroviral therapy in response to significant drug interactions or overlapping toxicities is often more feasible than modifying antineoplastic protocols.

Background: Insulin glargine and insulin detemir are the most commonly prescribed basal insulins in the United States. While these analogs chemically differ, clinical trials have established no significant difference in efficacy. However, controversy remains as to whether the 2 agents are comparable with regard to unit equivalency. Objectives: To determine the ratio of glucose lowering between insulin detemir and insulin glargine. Methods: This institutional review board-approved, singlecenter, retrospective, case-crossover study was conducted in patients with diabetes mellitus with inpatient admissions between June 30, 2014, to July 1, 2015. Patients must have received both insulin detemir and insulin glargine on either the same or separate hospital visits. A blood glucose-lowering ratio for both insulin glargine and insulin detemir was calculated for each patient based off of up to 5 days of fasting blood glucose values and the total number of units of insulin administered. Results: Fifty-two patients were included in this study. No significant difference was found in the blood glucose-lowering ratio between insulin glargine (0.23 mg/dL/unit) as compared with insulin detemir (0.16 mg/dL/unit; P = .08). Conclusion: No difference was found in the blood glucose-lowering ratio between insulin glargine and insulin detemir. The results of this study suggest that conversion between insulin glargine and insulin detemir using a 1:1 ratio in an acute care setting may be appropriate.

This chapter reviews concepts regarding the safe and effective use of antineoplastic and antiretroviral therapy in people living with HIV and cancer. Drug interactions and medication toxicities are discussed as well as drug–disease interactions. The chapter concludes with an overview of strategies for clinical management of people with cancer and HIV.