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The proposed national PrEP program would serve people who are uninsured as well as those enrolled in Medicaid. In this article, the authors propose a set of recommendations for the proposed program’s implementers as well as state Medicaid agencies and Medicaid managed care organizations to ensure PrEP access for people enrolled in Medicaid, addressing gaps without undermining the important role of the Medicaid program in covering and promoting PrEP.

Health system disruption caused by the COVID-19 pandemic prompted public health professionals to reevaluate potential barriers and opportunities to community pharmacist provision of chronic disease management services and to identify opportunities for maximizing community pharmacists' impact. Researchers conducted semistructured interviews with representatives from chronic disease prevention and pharmacy practice and policy organizations to identify key themes across multiple interviews and novel responses of interest. Interviewees described a lack of payment models to support pharmacist-provided chronic disease management services but noted opportunities for community pharmacists to demonstrate their value in offering services they are uniquely positioned to provide and to implement better workflow solutions. Successfully demonstrating pharmacists' value and making the case for reimbursement from payors, as well as optimizing pharmacy workflow, are critical to maximizing pharmacists' impact in chronic disease prevention and management.

Photodynamic Therapy or PDT is a treatment that uses light-sensitive drugs known as photosensitizing agents or PSAs in conjunction with a light source to eradicate harmful cells. While there have been successful applications of PDT in treating many varieties of cancer, it is still considered highly experimental. However, PDT to treat skin afflictions including acne, psoriasis, and actinic keratosis has entered into the mainstream.

Qualitative understanding of the dynamics of epizootics of the nuclear polyhedrosis virus of gypsy moth has become complete enough to justify attempts to quantitatively predict the timing and intensity of epizootics within a season. In earlier work (Dwyer and Elkinton, 1993), we compared the predictions of a simple differential equation model derived from Anderson and May (1981) to time series of virus mortality in each of eight gypsy moth populations (Woods and Elkinton, 1987). The model's predictions were very accurate for high density populations, but seriously under-estimated virus mortality in low density populations. Here we compare the predictions of the simple model to those of the gypsy moth life system model (GMLSM, Sheehan, 1985; Colbert and Racin, 1991), a highly complex computer simulation of gypsy moth population dynamics and forest stand growth that incorporates much of the existing knowledge of the many factors influencing gypsy moth populations. In particular we looked at two different versions of the GMLSM that incorporate two different models of virus transmission. One was identical to that of the simple model (Anderson and May, 1981; Dwyer and Elkinton, 1993), in which the rate of transmission was a constant (the transmission coefficient) times the product of the densities of healthy larvae and the densities infectious virus particles on foliage. The other approach, developed by Valentine and Podgwaite (1982) was a detailed model of production and consumption of infective particles on foliage. The model took account of age-related changes in the amount of foliage consumed and the variation in susceptibility of larvae to virus (LD50). The Anderson and May version of the GMLSM performed about as well as the simple differential equation model, but only for values of the transmission coefficient about 250 times higher that those we had determined experimentally (Dwyer and Elkinton, 1993). The Valentine and Podgwaite (1982) version of the GMLSM gave a much better fit, but only for values of LD50 that were 100 times higher than those determined experimentally. Future research will focus on efforts to refine our understanding of virus transmission in order to explain and reduce the discrepancies between model predictions and observed mortality from virus in fieldpopulations.

Adult specimens of seven southern Pacific rattlesnakes (Crotalus viridis helleri), four northern black-tailed rattlesnakes (Crotalus molossus molossus), and six western diamondback rattlesnakes (Crotalus atrox) were housed under controlled light and temperature and milked of venom monthly for 20 months. Ambient conditions were modelled to simulate seasonal change. Weighed amounts of lyophilized venom from each snake were compared chronologically for variation in isoelectric focusing patterns, using natural and immobilized gradients. No variation in patterns was evident over this time period for any individual snake. However, intraspecific differences were obvious in the venom samples. The pattern seems indicative of a species, however, concentration of various protein constituents seems individual and genetically "fingerprinted'. Unlike other physiological functions that demonstrate cyclicity in response to temperature and photoperiod, concentration ratios of venom components appear to be constant regardless of external cues. These findings may further emphasize the medical importance of treating snakebite victims symptomatically as individuals. A variation exists in the components of venoms of any given species, as well as in the physiological sensitivities of humans to a venom.