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Summarizes the clinical course of three fatal cases of Rocky mountain spotted fever (RMSF), a tickborne infection caused by Rickettsia rickettsii and characterized by a rash, in children and related illness in family during the summer of 2003. Information on the case of a female child aged 7 diagnosed with RMSF in Oklahoma; Overview of the laboratory tests of a male child with RMSF in Kentucky; Effective measures to reduce the risk of RMSF.

Reports on an outbreak of Rocky Mountain spotted fever (RMSF) in family clusters in Oklahoma, Kentucky, and Arizona during summer 2003. The Rickettsia rickettsii causing the infection that is characterized by a rash; Details of three fatal cases in children and related illness in family members; Importance of prompt diagnosis; CDC editorial note discussing the fatal tickborne illness RMSF.

Objective: This study examined the use of a medication therapy management (MTM) program by clinic-embedded pharmacists within a primary care clinic primarily by evaluating the impact on patient identification for pharmacy services. Secondary outcomes included characterizing intervention type, targeted drugs and disease states, and barriers to successful interventions, SETTING: Primary care clinic., Practice Description: CoxHealth Center Steeplechase is a primary care clinic of 13 providers with a clinic-embedded pharmacist, pharmacy residents, and student pharmacists providing chronic disease state management under collaborative practice agreements., Practice Innovation: Community pharmacists have an established history of providing services through MTM programs. Clinic-embedded pharmacists have the potential to participate in these programs as well, and many barriers to providing patient care services reported by community pharmacists can be overcome by clinic-embedded pharmacists, potentially allowing for greater success of MTM interventions., Evaluation: A 4-week pilot, in which clinic-embedded pharmacists dedicated 4 hours per week of effort to MTM services, examined the effectiveness of the program at identifying patients not otherwise receiving clinical pharmacy services, types of identified interventions, intervention success rates, barriers to intervention success, and revenue generation., Results: The clinical pharmacy team attempted 46 interventions in 34 unique patients in this 4-week pilot. Of the identified patients, 67.7% (n = 23) had no contact with the clinical pharmacy team in the previous year. Targeted interventions were more frequently attempted (targeted interventions n = 42; comprehensive reviews n = 4) and more successful than comprehensive medication reviews (88% vs. 25% success rate). Barriers to success included patient refusal of services, inability to contact the patient, and inapplicability of targeted interventions., Conclusion: Implementation of an MTM program in one clinic required coordinated interdepartmental efforts to implement, but it effectively expanded pharmacy services by identifying patients not otherwise referred to the clinical pharmacy team for chronic disease management., (Copyright © 2019 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Objective: To identify factors that predict quitting among adolescent smokers., Methods: Adolescent smokers aged 12-19 years (N = 633) from the national Teenage Attitudes and Practices Survey I (1989), were followed up in the Teenage Attitudes and Practices Survey II (1993). Multiple logistic regression was applied to identify the predictors of quitting., Results: A total of 15.6% of adolescent smokers had quit smoking at the follow-up survey four years later. There was no significant difference in the quit rate by age, gender, or ethnicity. Five baseline factors were identified in a multivariate analysis as significant predictors of quitting: frequency of smoking, length of past quit attempts, self-estimation of likelihood of continuing smoking, mother's smoking status, and depressive symptoms. The more risk factors the adolescents had, the less likely they would succeed in quitting., Conclusions: Quitting smoking by adolescents is influenced by multiple biological, behavioral, and psychosocial variables. Identifying these variables can help tailor cessation programs to more effectively help adolescents quit smoking.