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The response to COVID-19 created a need to evaluate options and develop innovative solutions to assure students progressed towards graduation. Creating both a Community Pharmacy APPE Test-Out Option and a Virtual Community Pharmacy APPE was a positive experience which provided a vital resource for students who were unable to complete the traditional Community Pharmacy APPE due to the pandemic. This solution provided a unique opportunity to utilize the combined expertise of faculty to tailor the Community Pharmacy APPE based on the individual student's previous experience and educational needs and meet both ACPE and graduation requirements. Further development of this option could prove useful as we move forward in these unprecedented times.

In response to the coronavirus (COVID-19) pandemic, there has been an increased need for personal and environmental decontamination to aid in curbing transmission of the SARS-CoV-2 virus. Products used for this purpose include sanitizers for hands and disinfectants for surfaces. The active chemical ingredients used in these products, termed antimicrobials, can enter waste streams after application and may be emerging as more prominent environmental contaminants. Even prior to COVID-19, there was recognized need to examine their implications for aquatic biota, which is now made more pressing due to their exaggerated use in response to the pandemic. Our objectives were to identify current antimicrobial active ingredients, quantify their increased use, and determine which may be candidates for further consideration as possible aquatic contaminants. By consulting multiple sources of publicly available information in Canada, we identified current-use antimicrobials from the lists of sanitizers and surface disinfectants approved for use against SARS-CoV-2 by Health Canada and the drug registration database. To estimate the use of sanitizers and disinfectants, we evaluated import quantities and grocery store retail sales of related compounds and products (Statistics Canada) and both lines of evidence supported increased use trends. The list of identified antimicrobials was refined to include only candidates with potential to reach aquatic ecosystems, and information on their environmental concentrations and toxicity to aquatic biota was reviewed. Candidate antimicrobials (n = 32) fell into four main categories: quaternary ammonium compounds (QACs), phenols, acids, and salts. Benzalkonium chloride, a QAC, was the most prominent active ingredient used in both nonalcohol-based hand sanitizers and surface disinfectants. Four QACs followed in prevalence and the next most used antimicrobial was triclosan (hand sanitizers only), an established and regulated environmental contaminant. Little information was found on environmental concentrations of other candidates, suggesting that the majority would fall into the category of emerging contaminants if they enter aquatic systems. Several were classified as acutely or chronically toxic to aquatic biota (Globally Harmonized System), and thus we recommend empirical research begin focusing on environmental monitoring of all candidate antimicrobials as a critical next step, with detection method development first where needed. Keywords: biocide, pharmaceutical and personal care products, PPCP, pandemic, SARS-CoV-2, Canada, COVID-19, antimicrobial En reponse a la pandemie de coronavirus (COVID-19), un besoin accru de decontamination personnelle et environnementale s'est manifeste pour aider a freiner la transmission du virus SRAS-CoV-2. Les produits utilises a cette fin comprennent des assainisseurs pour les mains et des desinfectants pour les surfaces. Les ingredients chimiques actifs utilises dans ces produits, appeles antimicrobiens, peuvent entrer dans les systemes des eaux usees apres leur application et peuvent devenir des contaminants environnementaux plus importants. Avant meme l'avenement de la COVID-19, on reconnaissait qu'il etait necessaire d'examiner leurs implications pour le biote aquatique, ce qui est aujourd'hui rendu plus urgent en raison de leur utilisation exageree en reponse a la pandemie. Nos objectifs consistaient a identifier les ingredients actifs antimicrobiens actuels, a quantifier leur utilisation accrue et a determiner ceux qui pourraient etre consideres comme des contaminants aquatiques potentiels. En consultant de multiples sources d'information publiquement accessibles au Canada, nous avons pu identifieer les antimicrobiens utilises actuellement a partir des listes d'assainisseurs et de desinfectants de surface dont l'utilisation contre le SRAS-CoV-2 a ete approuvee par Sante Canada, et de la base de donnees sur les produits pharmaceutiques. Pour estimer l'utilisation des assainisseurs et des desinfectants, nous avons evalue les quantites importees et les ventes au detail dans les epiceries de composes et de produits connexes (Statistique Canada) et les deux sources de donnees ont confirme les tendances a l'augmentation de l'utilisation. La liste des antimicrobiens identifies a ete affinee pour n'inclure que les candidats susceptibles d'atteindre les ecosystemes aquatiques, et les informations sur leurs concentrations environnementales et leur toxicite pour le biote aquatique ont ete examinees. Les antimicrobiens candidats (n = 32) se repartissent en quatre grandes categories: les composes d'ammonium quaternaire (CAQ), les phenols, les acides et les sels. Le chlorure de benzalkonium, un CAQ, etait l'ingredient actif le plus utilise dans les desinfectants non alcoolises pour les mains et les desinfectants de surface. Quatre CAQ suivaient en prevalence et l'antimicrobien le plus utilise ensuite etait le triclosan (uniquement dans les desinfectants pour les mains), un contaminant environnemental avere et reglemente. Peu d'informations sur les concentrations environnementales des autres candidats etaient accessibles, ce qui suggere que la majorite d'entre eux entreraient dans la categorie des contaminants emergents s'ils penetrent dans les systemes aquatiques. Plusieurs d'entre eux ont ete classes comme presentant une toxicite aigue ou chronique pour le biote aquatique (Systeme general harmonise de classification et d'etiquetage des produits chimiques, SGH). Les auteurs recommandent donc que la recherche empirique commence a se concentrer sur la surveillance environnementale de tous les candidats antimicrobiens comme prochaine etape critique, en commencant par le developpement de methodes de detection si necessaire. Le texte integral de l'article en francais est disponible parmi les documents supplementaires. Mots-cles : biocide, produits pharmaceutiques et de soins personnels, PPSP, pandemie, SRAS-CoV-2, Canada, COVID-19, antimicrobien, 1. Introduction The use of sanitizing and disinfecting products dramatically increased during the COVID-19 pandemic (da Silva et al. 2021; Dhama et al. 2021), and more information on the impacts [...]

E-Cigarette marketing may influence e-cigarette use among youth. This study examined reported exposure to and perceptions of e-cigarette marketing among youth between 2017 and 2019 across countries with varying e-cigarette marketing restrictions. Cross-sectional online surveys were conducted with 35 490 youth aged 16-19 from England, Canada and the United States in 2017, 2018 and 2019. Weighted logistic regression models examined trends in the adjusted prevalence of self-reported exposure to e-cigarette marketing and the perceived appeal of e-cigarette ads between 2017 and 2019, by country and by smoking/vaping status. Reports of frequent exposure to e-cigarette marketing increased between 2017 and 2019 in all countries, but less so in England, where e-cigarette marketing is more restricted. Perceiving e-cigarette marketing as appealing increased from 2017 to 2019 in Canada and the United States, but not in England. In England, exposure to e-cigarette marketing did not increase in prohibited channels between 2017 and 2019. Between 2017 and 2019, never-users' reports increased for exposure to and appeal of e-cigarette marketing. The results suggest some effectiveness of e-cigarette marketing bans in England and receptivity to e-cigarette marketing among youth never users.

The current study examined the efficacy of health warnings on caffeinated energy drinks (CEDs). Participants aged 12-24 years (n = 2040) completed an online survey where they were asked to recall any existing warning statements on CED products and were randomized to one of 29 experimental warning conditions. Regression models were fitted to examine differences between conditions in product appeal, perceived safety and message recall. Overall, fewer than 30% of participants were able to accurately describe an existing CED product warning. Experimental findings indicated that exposure to CEDs with warning labels resulted in greater recall. Warnings on the back of CED cans featuring large font, a border, and a 'caution' heading resulted in significantly greater recall (P < 0.05 for all). Front-of-package 'High source of caffeine' labels resulted in greater recall than a quantitative description (P < 0.001); caffeine labels generally elicited lower product appeal (P < 0.001) and perceived safety (P = 0.002) ratings vs. no caffeine labels, and the qualitative caffeine statement elicited lower perceived safety ratings than the quantitative statement (P = 0.02). Existing warning statements in Canada have low levels of awareness. Warnings on CEDs could be enhanced to increase the salience of messages, with greater impact from clear, descriptive, front-of-package 'High source of caffeine' labels.

Introduction The current study sought to examine trends in indicators of dependence for youth vaping and smoking during a period of rapid evolution in the e-cigarette market. Aims and Methods Data are from repeat cross-sectional online surveys conducted between 2017 and 2022 among youth aged 16–19 in Canada, England, and the United States (US). Participants were 23 145 respondents who vaped and/or smoked in the past 30 days. Four dependence indicators were assessed for smoking and vaping (perceived addiction, frequent strong urges, time to first use after waking, days used in past month) and two for vaping only (use events per day, e-cigarette dependence scale). Regression models examined differences by survey wave and country, adjusting for sex, age, race, and exclusive/dual use. Results All six indicators of dependence increased between 2017 and 2022 among youth who vaped in the past 30 days (p  < .001 for all). For example, more youth reported strong urges to vape at least most days in 2022 than in 2017 (Canada: 26.5% to 53.4%; England: 25.5% to 45.4%; US: 31.6% to 50.3%). In 2017, indicators of vaping dependence were substantially lower than for smoking; however, by 2022, youth vaping was associated with a greater number of days used in the past month (Canada, US), shorter time to first use (all countries), and a higher likelihood of frequent strong urges (Canada, US) compared to youth smoking. Conclusions From 2017 to 2022, indicators of vaping dependence increased substantially. By 2022, vaping dependence indices were comparable to those of smoking. Implications Indicators of vaping dependence among youth have increased substantially since 2017 to levels that are comparable to cigarette dependence among youth who smoke. Future research should examine factors underlying the increase in dependence among youth who vape, including changes to the nicotine profile and design of e-cigarette products. [ABSTRACT FROM AUTHOR]

Gastric cancer remains one of the most fatal cancers, despite an intensive treatment regime of chemotherapy–surgery–chemotherapy. Peritoneal metastatic disease is commonly diagnosed post treatment regime and once established, patients are likely to die in 3–9 months. Systemic chemotherapy does not increase survival for these patients due to the poor vascularisation of this area. We are proposing the addition of pressurised intraperitoneal aerosol chemotherapy (PIPAC) to the treatment regime for curative patients as a preventive measure to reduce the risk of peritoneal metastases occurring.

Aims Design Setting Participants Measurements Findings Conclusions To measure changes over time (between 2017 and 2023) in disposable e‐cigarette use and popular brands among youth in Canada, England and the United States (US) who vaped.Nine waves of repeat cross‐sectional data from the International Tobacco Control Policy Evaluation Project (ITC) Youth Tobacco and Vaping Survey.Online surveys conducted in Canada, England and the US between 2017 and 2023.Youth aged 16 to 19 years who had vaped in the past 30 days (n = 19 710).Usual type (disposable, cartridge/pod, tank) and brand of e‐cigarette used; covariates sex at birth, age, race/ethnicity, cigarette smoking status, vaping on ≥20 of the past 30 days.In 2017, the majority of youth who vaped in the past 30 days reported using refillable tank e‐cigarettes, whereas disposable e‐cigarettes were the least commonly used product type in Canada (10.0%), England (8.6%) and the US (14.4%). Cartridge/pods overtook tank devices in Canada and the US by 2020; however, by 2023, disposables were the leading type of e‐cigarette used by youth who vaped in all three countries (Canada = 58.5%; England = 83.2%; US = 67.3%). The shift to disposables occurred among all socio‐demographic groups, with few differences by vaping and smoking status. The percentage of youth who vaped that reported ‘no usual’ brand also decreased substantially from 2017 (29% to 42%) to 2023 (11% to 17%). The rise of disposable e‐cigarettes appeared to be driven primarily by individual brands in the US (Puff Bar in 2020/2021, Elf Bar in 2022/2023) and England (Elf Bar in 2022/2023).The e‐cigarette market has evolved rapidly with notable shifts in the types of e‐cigarettes used by youth who vape in Canada, England and the United States. Although the timing differed across countries, major shifts in device types appear to be driven by individual brands and were often accompanied by increases in vaping prevalence among youth. [ABSTRACT FROM AUTHOR]

Introduction: This study examined menthol cigarette use among youth who smoked, after menthol cigarette bans were implemented in England (May 2020) and Canada (October 2017). Aims and Methods: Cross-sectional data come from 2021 ITC Youth Tobacco and Vaping Survey respondents aged 16-19 who smoked in the past 30 d in England (N = 715) and Canada (N = 419). Adjusted logistic regression models, estimated separately for each country, examined sociodemographic correlates of usually smoking menthol cigarettes (reporting currently most often smoking menthol cigarettes) overall, and by past 30-d use of any menthol accessories (e.g., filters, capsules). Youth reported the cigarette variety they smoked most often, coded as menthol or nonmenthol. Results: Almost no youth who smoked in the past 30 d reported most often smoking a cigarette variety coded as menthol. However, 34.5% (95% CI: 30.4% to 38.9%) of youth who smoke in England and 30.9% (26.0%-36.3%) in Canada reported usually smoking menthol cigarettes, with greater odds of use among those identifying as black, or other race/ethnicity, respectively, compared to white in England (60.0%, aOR = 3.08, p = .001; 47.4%, aOR = 2.27, p = .011) and Canada (43.6%, aOR = 2.44, p = .046; 51.2%, aOR = 2.92, p = .001). Among those who reported usually smoking menthol cigarettes in England (N = 223) and Canada (N = 108), 71.7% (64.0%-78.2%) and 51.5% (41.1%-61.7%) reported using menthol accessories. Conclusions: After menthol cigarette bans in England and Canada, approximately one-third of youth who smoked reported usually smoking menthol cigarettes, with disproportionately higher use among those identifying as black and other race/ethnicity. Menthol accessories accounted for most menthol cigarette use. Closing regulatory loopholes is critical to advancing public health equity. Implications: Use of menthol cigarette accessories (eg, filters, cards, capsules) among youth who smoked was prevalent after implementation of menthol cigarette bans in England and Canada, and there was disproportionately higher use among those who identified as black and any other race/ethnicity. Efforts are therefore required to close regulatory loopholes of menthol cigarette bans. Findings further support countries, such as the United States, proposing menthol cigarette bans which extend coverage to accessories. More comprehensive menthol bans that also restrict accessories are likely to be more effective in reducing flavored tobacco use among young people and in advancing health equity. [ABSTRACT FROM AUTHOR]