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Objective To describe an ongoing pharmacist-managed tobacco cessation clinic and assess the long-term effectiveness of the program. Setting Veterans Health Administration (VHA) community-based outpatient clinic in Missoula, Montana. Participants Pharmacy professor/clinical pharmacy specialist, advanced pharmacy practice experience students, and tobacco cessation participants. Practice Description Ongoing, pharmacist-managed tobacco cessation program offered to veterans. Practice Innovation With use of the “Vets without Cigarettes” program developed by the Montana VHA and the most current strategies reported in the literature, the clinical pharmacy specialist and pharmacy students provide tobacco cessation services for Missoula Veterans Affairs Primary Care Center veterans. Activities include a three-session program using the Transtheoretical Model of Change, tobacco cessation pharmacotherapy, behavioral strategies, cognitive techniques, documentation, and follow-up survey. Main Outcome Measure Percentage of veterans contacted reporting tobacco abstinence. Results Follow-up survey results were obtained for 130 (87.8%) of 148 veterans attending one or more sessions of the tobacco cessation class between November 1999 and December 2003. Of the 130 veterans contacted, 54 (41.5%) continued to be tobacco free. Conclusion This program demonstrates that pharmacists are effective providers of tobacco cessation services. Furthermore, a comprehensive tobacco cessation program is provided that can serve as a model to guide pharmacists in assisting more patients to become tobacco free and live healthier lifestyles.

Purpose. To evaluate the impact of an optional thoracic dissection elective upon anatomy subject acquisition and determine whether peer-mediated teaching has a beneficial effect. Methodology. First year medical students’ results on thoracic anatomy laboratory examinations over a five-year period were obtained. All students were taught in the laboratory using prosected specimens as part of a standard curriculum. A subset of students from each class volunteered to participate in an optional thoracic dissection. A comparison of exam performance between the two groups was made, and the results were analyzed to see if incorporating peer teaching into the elective had an impact on the students’ performance on anatomy examinations. Results. With the exception of one year’s results, no significant statistical difference was found in student performance on anatomy examinations between the two groups. The addition of peer teaching did not result in superior performance. Conclusion. It is believed that prosected specimens are suitable for anatomy laboratory teaching in an undergraduate medical curriculum. Our study did not reveal that an opportunity for dissection offered any added benefit in terms of exam performance. In addition, peer teaching did not affect exam performance. This study strictly compared student exam results. It did not assess the possible impact of the dissection process to influence student attitudes towards death or the development of clinically relevant visuospatial abilities and procedural skills.

The principle underlying all methods of blood purification for the treatment of uremia is based on the assumption that most symptoms of uremia depend on the concentrations of dialysable substances which are the end products of metabolism normally eliminated by the kidney. Therefore, dialysis therapy can only be effective if the concentrations of these endogenous substances remain below toxic limits.