The Utah Pharmacy Summit: Collaborating to Optimize Patient Care

Pharmacy has evolved significantly over the past 20 years, despite advances in pharmacotherapy and the expanding scope of pharmacy practice, pharmacists have struggled to collaborate across disciplines to create improved processes that enable the best outcomes from these innovations. A lack of innovation at any part of the healthcare system could inhibit the progress of practice innovations thereby leading to suboptimal patient medication and health outcomes. The Utah Pharmacy Summit was held in late 2022 with the goal of promoting pharmacist collaboration and a unified pharmacist voice within the state. The success of the Summit leads us to encourage collaborative forums across the Globe.

The effects of degradable and undegradable intake protein on the performance of lactating first-calf heifers

Two 60-d experiments were conducted to evaluate the effects of supplementing degradable (DIP) and(or) undegradable (UIP) intake protein on the performance of lactating first-calf heifers. Diets were formulated to meet the requirements for either DIP, metabolizable protein (MP), or both when diets contained low-quality grass hay and an efficiency of microbial protein synthesis estimate of 10%. In Exp. 1, 32 individually fed first-calf heifers (avg 395 kg) were allotted to a 2 x 2 factorial arrangement of treatments (main effects of DIP, MP, and DIP x MP interaction) 1 d after calving. Cows consumed a basal diet of chopped crested wheat grass hay (4.3% CP, 67% DIP) ad libitum. Supplemental DIP and UIP were supplied by varying the ratios of soybean meal (75% DIP) and a heat-treated, protected soybean meal (70% UIP). Cow weight gain was better (P < 0.01) when adequate DIP was supplied than when DIP was deficient. However, calf weight gain was not increased by supplementing the cow with DIP. Supplemental UIP did not (P > 0.40) improve cow or calf weight gain. Blood urea N levels were higher (P < 0.01) for cows receiving supplemental DIP and UIP. However, milk production estimates were similar among treatments, as were digestibilities of OM and ADF. Nitrogen digestibility was greater when supplemental DIP was fed, but providing additional UIP did not (P = 0.15) change N digestibilities. Experiment 2 evaluated similar supplements using the same experimental design to determine changes in cow and calf weight gain, body condition score, and pregnancy rate. Seventy-two first-calf heifers (avg 441 kg) were allotted to supplement treatments 1 d after calving and were fed grass hay (5% CP, 53% DIP, 10% microbial efficiency) for ad libitum consumption for 60 d. Supplements were individually fed three times/week. Varying the ratios of soybean meal, heat-treated soybean meal, and corn gluten meal provided additional DIP and UIP. Unlike in Exp. 1, supplemental UIP improved (P < 0.05) cow weight gain. Calves from dams supplemented with DIP gained 5 kg more weight after 60 d than calves from dams deficient in DIP. Pregnancy rates in the fall were similar (P = 0.90) among treatments. These data suggest that DIP was more limiting in Exp. 1 than was UIP. Supplementing UIP in Exp. 2 improved cow weight gains but did not improve calf gains. Data suggest that the efficiency of microbial protein synthesis for this forage-based diet was probably less than 10%.