Prioritizing Pharmaceutical Activities

2012 ◽  
Vol 26 (4) ◽  
pp. 367-375 ◽  
Author(s):  
Sophie Renet ◽  
Cynthia Tanguay ◽  
Kevin Hall ◽  
Jean-François Bussières
Keyword(s):  
Health Outcomes ◽  
Hospital Pharmacy ◽  
Relative Weight ◽  
Primary Objective ◽  
Conclusive Evidence ◽  
Low Level ◽  
Simulated Environment ◽  
Core Set ◽  
Wide Range ◽  
Pharmacy Leaders

Objectives: The primary objective was to examine the consistency of prioritization decisions made by pharmacy residents in a simulated environment where the available resources are constrained. Secondary objectives were to rank the factors that influenced their prioritization and to compare the residents’ results with those of Canadian pharmacy leaders. Methods: We have developed a prioritization exercise that aims at evaluating how pharmaceutical activities are prioritized. The simulation was conducted with hospital pharmacy residents in 2 Quebec universities in 2011. Results: Residents covered a similar number of activities in the prioritization simulation (mean 27 of 32). Teams tended to favor a broad range of services delivered less comprehensively. Participants ranked “perception of the favorable impact of the activity on health outcomes” higher than “conclusive evidence available to support the decisions.” The relative weight attributed per domain was similar between pharmacy residents and pharmacy leaders, but their ranking of factors that influenced their decisions was different. Conclusions: Pharmacy residents opted to provide a wide range of services, but at a low level of comprehensiveness. The high variation between each team’s coverage per activity in this simulation supports the observation that pharmacy residents do not agree on a core set of pharmaceutical activities that should be prioritized.

scholarly journals Post-traumatic stress impact on health outcomes in Gulf War Illness

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Mary Jeffrey ◽  
Fanny Collado ◽  
Jeffrey Kibler ◽  
Christian DeLucia ◽  
Steven Messer ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Short Form ◽  
Gulf War ◽  
Ptsd Symptoms ◽  
Symptom Presentation ◽  
Trauma Symptoms ◽  
Post Traumatic Stress ◽  
Gulf War Illness ◽  
Cut Point ◽  
Wide Range

Abstract Background Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder affecting an estimated 25–32% of the returning military veterans of the 1990–1991 Persian Gulf War. GWI presents with a wide range of symptoms including fatigue, muscle pain, cognitive problems, insomnia, rashes and gastrointestinal issues and continues to be a poorly understood illness. This heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. Defining subgroups of the illness may help alleviate these complications. Our aim is to determine if GWI can be divided into distinct subgroups based on PTSD symptom presentation. Methods Veterans diagnosed with GWI (n = 47) and healthy sedentary veteran controls (n = 52) were recruited through the Miami Affairs (VA) Medical Health Center. Symptoms were assessed via the RAND short form health survey (36), the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson Trauma Scale value and performing heteroscedastic t-tests across all measures. Results Overall analyses returned two symptom-based subgroups differing significantly across all health and trauma symptoms. These subgroups supported PTSD symptomatology as a means to subgroup veterans. Hierarchical models showed that GWI and levels of PTSD symptoms both impact measures of physical, social, and emotional consequences of poor health (ΔR2 = 0.055–0.316). However, GWI appeared to contribute more to fatigue measures. Cut-point analysis retained worse health outcomes across all measures for GWI with PTSD symptoms compared to those without PTSD symptoms, and healthy controls. Significant differences were observed in mental and emotional measures. Conclusions Therefore, this research supports the idea that comorbid GWI and PTSD symptoms lead to worse health outcomes, while demonstrating how GWI and PTSD symptoms may uniquely contribute to clinical presentation.

scholarly journals Determinants of vitamin D status in Kenyan calves

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Rebecca Callaby ◽  
Emma Hurst ◽  
Ian Handel ◽  
Phil Toye ◽  
Barend M. de C. Bronsvoort ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Vitamin D ◽  
Health Outcomes ◽  
Critical Role ◽  
Subsequent Development ◽  
Vitamin D Metabolites ◽  
Vitamin D Status ◽  
Skeletal Health ◽  
A Genome ◽  
Wide Range

AbstractVitamin D plays a critical role in calcium homeostasis and in the maintenance and development of skeletal health. Vitamin D status has increasingly been linked to non-skeletal health outcomes such as all-cause mortality, infectious diseases and reproductive outcomes in both humans and veterinary species. We have previously demonstrated a relationship between vitamin D status, assessed by the measurement of serum concentrations of the major vitamin D metabolite 25 hydroxyvitamin D (25(OH)D), and a wide range of non-skeletal health outcomes in companion and wild animals. The aims of this study were to define the host and environmental factors associated with vitamin D status in a cohort of 527 calves from Western Kenya which were part of the Infectious Disease of East African Livestock (IDEAL) cohort. A secondary aim was to explore the relationship between serum 25(OH)D concentrations measured in 7-day old calves and subsequent health outcomes over the following 12 months. A genome wide association study demonstrated that both dietary and endogenously produced vitamin D metabolites were under polygenic control in African calves. In addition, we found that neonatal vitamin D status was not predictive of the subsequent development of an infectious disease event or mortality over the 12 month follow up period.

Effects of Weld Strength Mismatch on Estimation Procedures for J and CTOD Fracture Parameters Using SE(B) Specimens

2007 ◽  
Author(s):  
Gustavo H. B. Donato ◽  
Claudio Ruggieri
Keyword(s):  
Mouth Opening ◽  
Estimation Procedure ◽  
Primary Objective ◽  
Weld Strength ◽  
Crack Mouth Opening Displacement ◽  
Opening Displacement ◽  
Fracture Parameters ◽  
Wide Range ◽  
Estimation Procedures ◽  
Fracture Specimens

This work presents an exploratory development of J and CTOD estimation procedures for welded fracture specimens under bending based upon plastic eta factors and plastic rotation factors. The techniques considered include: i) estimating J and CTOD from plastic work and ii) estimating CTOD from the plastic rotational factor. The primary objective is to gain additional understanding on the effect of weld strength mismatch on estimation techniques to determine J and CTOD fracture parameters for a wide range of a/W-ratios and mismatch levels. Very detailed non-linear finite element analyses for plane-strain models of SE(B) fracture specimens with center cracked, square groove welds provide the evolution of load with increased load-line displacement and crack mouth opening displacement which are required for the estimation procedure. The results show that levels of weld strength mismatch within the range ±20% mismatch do not affect significantly J and CTOD estimation expressions applicable to homogeneous materials, particularly for deeply cracked fracture specimens. The present analyses, when taken together with previous studies, provide a fairly extensive body of results which serve to determine parameters J and CTOD for different materials using bend specimens with varying geometries and mismatch levels.

Large Eddy Simulations of Staggered Parallel-Plate Flows

2005 ◽  
Author(s):  
M. V. Pham ◽  
F. Plourde ◽  
S. K. Doan
Keyword(s):  
Heat Transfer ◽  
Numerical Simulations ◽  
Heat Transfer Enhancement ◽  
Parallel Plate ◽  
Large Scale ◽  
Primary Objective ◽  
Transfer Enhancement ◽  
Turbulent Structures ◽  
Wide Range ◽  
Large Eddy

Heat transfer enhancement is a subject of major concern in numerous fields of industry and research. Having received undivided attention over the years, it is still studied worldwide. Given the exponential growth of computing power, large-scale numerical simulations are growing steadily more realistic, and it is now possible to obtain accurate time-dependent solutions with far fewer preliminary assumptions about the problems. As a result, an increasingly wide range of physics is now open for exploration. More specifically, it is time to take full advantage of large eddy simulation technique so as to describe heat transfer in staggered parallel-plate flows. In fact, from simple theory through experimental results, it has been demonstrated that surface interruption enhances heat transfer. Staggered parallel-plate geometries are of great potential interest, and yet many numerical works dedicated to them have been tarnished by excessively simple assumptions. That is to say, numerical simulations have generally hypothesized lengthwise periodicity, even though flows are not periodic; moreover, the LES technique has not been employed with sufficient frequency. Actually, our primary objective is to analyze turbulent influence with regard to heat transfers in staggered parallel-plate fin geometries. In order to do so, we have developed a LES code, and numerical results are compared with regard to several grid mesh resolutions. We have focused mainly upon identification of turbulent structures and their role in heat transfer enhancement. Another key point involves the distinct roles of boundary restart and the vortex shedding mechanism on heat transfer and friction factor.

Women’s Healing Journey From Intimate Partner Violence: Establishing Positive Sexuality

2018 ◽  
Vol 29 (6) ◽  
pp. 779-795 ◽  
Author(s):  
Meredith E. Bagwell-Gray
Keyword(s):  
Intimate Partner Violence ◽  
Sexual Health ◽  
Health Outcomes ◽  
Partner Violence ◽  
Healing Process ◽  
Intimate Partner ◽  
Process Data ◽  
Transmitted Infection ◽  
Wide Range ◽  
Women's Healing

Survivors of intimate partner violence (IPV) have an elevated risk for negative sexual health outcomes, including HIV and sexually transmitted infection (STI). Given the unique risk contexts for survivors, there is a need for effective sexual health interventions that take into account the imbalances of power for women who are survivors of IPV. Toward the aim of informing contextually relevant intervention approaches, this article describes women’s strategies toward maintaining their sexual health in the context of violent, controlling relationships. Strategies are examined across women’s healing process. Data were collected through semi-structured, in-person interviews with women who had experienced IPV ( N = 28). Participants had a wide range of negative sexual health outcomes and commonly used an analogy of a journey to describe their healing. Throughout these journeys, women gained more confidence and ownership over their sexuality. Themes centered around enhanced self-acceptance, ownership of personal sexuality, and readiness for desirable sexual partnerships.

Appreciating Rapid Technology Integration in Creating Value in Enterprises

2014 ◽  
Vol 12 (1) ◽  
pp. 53-75 ◽  
Author(s):  
Mambo G. Mupepi ◽  
Sylvia C. Mupepi
Keyword(s):  
Knowledge Creation ◽  
Significant Proportion ◽  
Social Economy ◽  
Primary Objective ◽  
Social Enterprises ◽  
Use Of Technology ◽  
Wide Range ◽  
The World ◽  
Skilled Personnel ◽  
Increase Productivity

The primary objective of this paper is about innovation within specific social organization which compacts with the division of labor, knowledge creation, and the use of technology such as e-enterprise in social economy aimed at improving productivity. A significant proportion of the world's economy is organized to make profits not only for investors but to sustain the employment of many disadvantaged people throughout the world. It includes cooperative organizations, foundations and many other social enterprises that provide a wide range of products and services across the globe and generate sustainable employment. Productivity tends to increase when the job is divided into manageable portions and then performed by adequately skilled personnel. In order to succeed in an environment in which other businesses fiercely compete along with social enterprises it is imperative to take into account innovative systems such as e-enterprise to leverage competition and increase productivity.

scholarly journals Engineering and experimental testing of two-wavelength laser-assisted device for photocoagulation of eye tissue

2013 ◽  
Vol 6 (2) ◽  
pp. 10-15
Author(s):  
Yury Sergeevich Astakhov ◽  
Yevgeny Leonidovich Akopov ◽  
Aleksandr Anatolevich Ivanov ◽  
Mariya Alexeevna Smirnova ◽  
Leonid Nikolaevich Panteleev ◽  
...  
Keyword(s):  
High Efficiency ◽  
Experimental Testing ◽  
Wide Spectrum ◽  
Retinal Disease ◽  
Primary Objective ◽  
3D Analysis ◽  
Potential Candidate ◽  
Living Tissue ◽  
Wide Range ◽  
Retinal Photocoagulation

Retinal photocoagulation is believed to be one of most efficient methods to treat many retinal abnormalities. By now, a number of lasers operating at different wavelengths, irradiation intensities, and exposure times have been tested in search of optimal parameters for each type of retinal photocoagulation. Taking into consideration a wide range of such parameters, the primary objective of the present study was to develop a device that would combine the potentials of different lasers into a single universal laser-assisted coagulator (ULAC) equally suitable for a wide diversity of retinal disease. Important issue would be the creation of an experimental model allowing an operative evaluation of the coagulating effect induced by the ULAC. The sources of coherent irradiation to be combined were DPSS and diode lasers (532 and 810 nm, respectively). Through two individual fibers, irradiation generated by each of the lasers entered the optical blender to be further directed to the target, now via a single fiber. The target termed the “surrogate of living tissue” was a mixture of donor human blood and chicken egg white, which corresponded, respectively, to the chromophore and thermocoagulating agent, both sensitive to laser beams at 532 and 810 nm. As a result, irradiation of surrogate of living tissue by a laser under the trial caused the formation of a coagulate and its firm adhesion to the coverslip, after that the coagulate was separated from the unaffected surrogate of living tissue followed by its 3D-analysis. In conclusion, the whole procedure, while being relatively non-expensive and easy to perform, has proved to be simple enough for testing of a wide spectrum of coagulation-inducing parameters, whatever laser was used. Moreover, even the initial experiments have shown the high efficiency of the ULAC as a potential candidate for the application in ophthalmological practice.

scholarly journals Effect of Low Level Acute of Aflatoxin on Performance in Faw- Bro Broiler

2008 ◽  
Vol 5 (3) ◽  
pp. 357-361
Author(s):  
Baghdad Science Journal
Keyword(s):  
White Blood Cells ◽  
Relative Weight ◽  
Live Weight ◽  
Serum Biochemistry ◽  
Feed Conversion ◽  
Broiler Breeder ◽  
Volume Percentage ◽  
Low Level ◽  
Randomized Design ◽  
Long Time

This study was conducted in the Poultry farm of the animal during the Production department, Iraqi during the (Ministry of Science and Technology) period from 3-9-2001 to 8-4-2002. The objectives of this study were to evaluate the effect of low – level chronic aflatoxicosis on performance (body weight, feed conversion efficiency and mortality), Serum biochemistry and activity of some enzymes (GOT,GPT, ALKP, LDH). A total of 300 male chicks of broiler breeder (Faw–Bro) were used. Chicks at day 1 of age were fed diets contaminated with aflatoxine at levels of 0, 0.3, 0.6, 0.9, 1.2, and 1.5 the feeding period were extended to 8 weeks. The data were subjected to analysis of variance by the completely randomized design. The results showed the presence of a number of fungi especially the type of Aspergillus flavus genus that reaches 40%. All aflatoxine dose levels significantly (P < 0.05) decreased live weight, it was also noticed that there were higher significant decrease in feed conversion when aflatoxine level was elevated in the feed. Increasing mortality with each increasing in aflatoxine level, the low level of chronic aflatoxine in the diets caused increased in the relative weight of internal organs (Liver, Pancreases, spleen, heart, gizzard, fibresia gland) as a results of aflatoxine presence in the diet, the low level of chronic aflatoxicosis for long time decreased in packed cell volume percentage, heamoglbulin concentration and red blood cell cont., with increase in white blood cells and (neutrophil, Hetrophil, Lymphocyte). The aflatoxine increased the serum concentration of protein, albumin, Cholesterol, Phosphor the activity of LDH, GOT, GPT, AIKP.

Facts and transformations in European minority language media systems amid digitalization and economic crisis

2018 ◽  
Vol 81 (3) ◽  
pp. 235-258 ◽  
Author(s):  
Iñaki Zabaleta ◽  
Arantza Gutierrez ◽  
Carme Ferré-Pavia ◽  
Itxaso Fernandez ◽  
Nikolas Xamardo
Keyword(s):  
Economic Crisis ◽  
Relative Weight ◽  
Minority Language ◽  
Minority Languages ◽  
Full Time ◽  
Media Type ◽  
Wide Range ◽  
The Media ◽  
Media Systems ◽  
Comparative Nature

This article investigates the reality and variations of the European minority language media systems between 2009 and 2016, a period of serious economic crisis and accelerated digitalization process. To that aim, several parameters were measured: structure of the media systems and changes during that period along the variables of media type, ownership and reach; presence and relevance of major media in each of the communities; number and variation of full-time journalists; and the density or relative weight of the media systems with regard to the speaking population. The 10 minority languages under analysis (Basque, Catalan, Galician, Corsican, Breton, Frisian, Irish, Welsh, Scottish-Gaelic and Sámi) represent a wide range of communities. The relevance of the study lies in its direct comparative nature and in the fact that it thoroughly updates previous scholarly literature, measuring the changes which occurred within the 10 media systems.

Patterns of skills acquisition in anesthesiologists during simulated interscalene block training on the soft embalmed Thiel cadaver (Preprint)

2021 ◽  
Author(s):  
Graeme McLeod ◽  
Mel McKendrick ◽  
Tedis Tafili ◽  
Mateo Obregon ◽  
Ruth Neary ◽  
...  
Keyword(s):  
Eye Gaze ◽  
Mastery Learning ◽  
Primary Objective ◽  
Learning Curves ◽  
Interscalene Block ◽  
Major Surgery ◽  
Skills Acquisition ◽  
Gaze Tracking ◽  
Self Rating ◽  
Wide Range

BACKGROUND Demand for regional anesthesia for major surgery has increased considerably but only a small number of anesthesiologists can provide such care. Simulation may improve clinical performance, but opportunities to rehearse procedures are limited and not formalised. Clinical educational outcomes prescribed by the Royal College of Anesthesiologists training curriculum 2021 are difficult to attain. Educational paradigms such as mastery learning and dedicated practice are increasingly used to teach technical skills in order to enhance skills acquisition. Moreover, high fidelity resilient cadaver simulators are now available: the soft embalmed Thiel cadaver shows similar physical characteristics and functional alignment to patients. The elasticity of tissues results in resolution of perineural fluid injection and enables hundreds of repeated injections without damage. However, learning curves, and their intra- and inter-individual dynamics, have not hitherto been measured on the Thiel cadaver simulator using the mastery learning and dedicated practice educational paradigm coupled with validated, quantitative metrics, such as checklists, eye tracking metrics and self-rating scores. OBJECTIVE Our primary objective was to measure the times taken to complete the scanning and needling phases of interscalene block conducted repeatedly on the soft embalmed Thiel cadaver over a 3-hour period of training. The primary outcome was the best-fit linear slope of log-log transformed time to complete the scanning and needling phases of repetitive, simulated interscalene block. METHODS Thirty anesthesiologists, with a wide range of experience, conducted up to 60 ultrasound-guided interscalene blocks over 3h on the left side of two soft embalmed Thiel cadavers. The duration of scanning and needling phases was defined as the time taken to perform all steps correctly. Our secondary objectives were to: measure pre-procedural psychometrics; describe deviations from the learning slope; correlate scanning and needling phase data; characterize skills according to clinical grade; re-test a sub-group of participants 2 to 3 months after training; measure learning curves using objective eye gaze tracking and subjective self-rating measures; and use these to discriminate between levels of scanning and needling performance RESULTS The median (IQR (range]) log-log learning slopes were -0.47 (-0.62 - -0.32 [-0.96 - 0.30]) and -0.23 (-0.34 - -0.19 [-0.71 - 0.27]) during the scanning and needling phases respectively. Loess curves showed wide variability in within-participant performance. The learning slopes of the scanning and needling phases correlated; rho 0.55 (0.23 - 0.76), P<.001; and rho -0.72 (-0.46 - -0.87), P<.001 respectively. Eye gaze fixation count and glance count during scanning and needling phases best reflected block duration. Using clustering techniques, fixation count and glance identified four distinct patterns of learning behaviour. CONCLUSIONS We quantified the rate or slope of learning by log-log transformation of learning curves and identified intra- and inter-individual patterns of variability. CLINICALTRIAL N/A

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