bluuebunny/crossref_metadata_2025 huggingface dataset:
Paricalcitol Injection and Ribavirin/Interferon Alfa-2b
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary® receive print and electronic versions of at least six monographs reviewing new drug entities or related drugs within a category. Some reviews take a second look at currently available drugs, whereas other preliminarily evaluate agents about to be released–just in time for use with your Pharmacy and Therapeutics Committee or for counter detailing. The monographs are prepared by clinical and drug-information pharmacists and are reviewed by expert pharmacists and physicians. Through the cooperation of The Formulary, Hospital Pharmacy has arranged to publish selected reviews in this column. If you would like more information about The Formulary or its related electronic bulletin board, known as the F.I.X.® (Formulary Information Exchange, write to: The Formulary, 33971 Selva Road, Suite 250, Dana Point CA 92629; or call 1-800-322-4349.
Pharmaceutical Manufacturers' Web Sites
Authors: Flory Stefanie M. , Seamon Matthew J.
Published: January 2018

This bimonthly column will keep readers up-to-date on the Internet as a source of drug information. Examples of using the Internet to answer inquiries and prepare for committee meetings will be taken from the authors' experiences at a drug information center. A list of reliable web sites–as well as some examples of sites that have not been useful–will be included in each column.
Preventable Methotrexate Toxicity ADRs Related to Ophthalmic Agents; Ophthalmic Adverse Effects Caused by Systemic Drugs ADRs with Antiretroviral Prophylaxis ADRS with Antimalarial Prophylaxis
Authors: Shuster Joel
Published: January 2018

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program (1-800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
Name Confusion with New COX-2 Inhibitor Ambiguous Abbreviation “EPO” Handwritten Ampersands Misread Avoiding Mix-ups with Hydroxyzine and Hydralazine
Authors: Cohen Michael R.
Published: January 2018

These medication errors have occurred in health care facilities at least once. They will happen again–perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program, which is presented in cooperation with the Institute of Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP tool-free, 24 hours a day, at 1-800-233-7767 (1-800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writer's names will be published if desired. ISMP may be contacted at the address shown below.
Physicians' and Nurses' Evaluation of a Pharmacist-Managed Heparin Protocol Service
Authors: Brown Charles H.
Published: January 2018

A total of 60 physicians and 90 nurses in a 300-bed, non-teaching, community-based hospital were surveyed to determine their attitudes and impressions of pharmacists' management of an inpatient, intravenous, unfractionated heparin dosing and monitoring service. Written questionnaires were used to gather their opinions of: (1) the value of having pharmacists provide the heparin protocol service, (2) the effectiveness of having pharmacists provide therapeutic management of thromboembolic disorders, and (3) the effectiveness of communications with pharmacists. Survey response rates were 82% and 53% for nurses and physicians, respectively. For all three service aspects evaluated, responses from nurses were significantly higher (p < 0.05) than physicians. Data from this study strongly support pharmacist-provided therapeutic management of thromboembolic disorders and show that nurses and physicians place a high value on pharmaceutical care services.
Bedside Medications More on Medication Storage and Security Anesthesia Carts
Authors: Rich Darryl S.
Published: January 2018

This column addresses questions from readers about any issue, process, standard, or future direction of the Joint Commission, whether it relates to home care, the hospital, or other practice environment. The objective is to give you a better insight into the Joint Commission accreditation process in your own practice site. Any question is fair game.
Unusual Visual Disturbances with Nefazodone; QT Interval Lengthening and Fexofenadine; Cimetidine-Induced Hot Flashes in a Dialysis Patient; Adverse Events with Risperidone
Authors: Shuster Joel
Published: January 2018

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's MEDWATCH program (1-800-FDA- 1088). If you have reported an interesting preventable ADR to MEDWATCH, please consider sharing the account with our readers.
Teaching Mandatory Programs with Computerized Slide Shows
Authors: Shifrin Daniel I.
Published: January 2018

Our study shows that computerized teaching programs can be an effective method for teaching staff members. Using the Microsoft Excel and Powerpoint programs, we created slide presentations that put our educational information into an attractive visual package. The benefits of this approach included: (1) user-friendly preparation requiring few modifications, and (2) the ability to run the programs manually or automatically. Through the use of post-tests and evaluations, the data showed that 69% of staff members felt that they were able to retain more facts about the topics presented. In additon, 42% of staff members were willing to return at another time to view a different topic. Computerized presentation programs can educate staff members about routine tasks on any topic, and slide shows can be tailored to meet the needs of a either a broad audience or a few individuals.
Barrier Isolation Technology: A Labor-Efficient Alternative to Cleanrooms
Authors: Mosko Paul , Rahe Hank
Published: January 2018

Barrier isolation technology has been recognized by the Food and Drug Administration for a number of years as a safe and effective way to process parenteral products aseptically. Pharmaceutical companies have shown that this method of processing increases the sterility assurance level of their products and reduces manufacturing costs. Hospital pharmacies in Europe have used this technology for more than 10 years as a means of product and personnel protection. In the United States, the technology is becoming accepted because of its capital cost effectiveness and because it increases safety during the preparation of cytotoxic compounds. Some pharmacists, however, have expressed concerns about the efficiency of such systems in the pharmacy setting. Using work measurement techniques, the authors tested a barrier isolator system at the University of Cincinnati Hospital. The results are presented here.
Medication Use in Patients with G6PD Deficiency
Authors: Walton Ted
Published: January 2018

Hospital Pharmacy welcomes contributions to this column. Articles originally published in pharmacy department newsletters are reprinted here. Material is selected because of its educational value to pharmacists or because it demonstrates the type of information of interest to newsletter readers. If you wish to have your newsletter material considered for publication in this column, mail a copy—along with a computer disk containing the document—to Neil M. Davis, Editor-in-Chief, Hospital Pharmacy, 1143 Wright Drive, Huntingdon Valley, PA 19006-2721.
Metronidazole and Darkened Urine: Is There a Causal Relationship?
Authors: Cobb Douglas B. , Wilson James P.
Published: January 2018

A case of an intentional metronidazole overdose is reported in which the patient was observed to have darkened urine, a somewhat unusual reaction. The authors reviewed the literature about the known side-effects of metronidazole to (1) ascertain the rate of occurrence of darkened urine, as well as other clinical conditions that may coincide with metronidazole exposure; and (2) determine if metronidazole actually caused the urine discoloration or if some other factor was involved. Case reports and clinical trials related to the use metronidazole are presented and discussed. The consensus in the literature is that an unknown pigment related to metronidazole metabolism is responsible for the discoloration and that the clinical significance, other than possible interference with laboratory analysis, is unknown. The authors concluded that this side-effect, though rare, is more prevalent than previously believed. Possible alternative causes for the urine discoloration are also presented.
New Drugs Approved by the FDA; New Dosage Forms and Indications; Agents Pending FDA Approval; Major Labeling Changes
Authors: Baker Danial E.
Published: January 2018

This monthly feature is designed to help readers keep current on new drugs, new indications and dosage forms, and safety-related changes in labeling or use. Each month, new information will be added to the table (shown as shaded areas) and older information will be removed. Efforts have been made to ensure the accuracy of the information; however, if there are any questions, please let us know at hospitalpharma-cy@drugfacts.com .
Poorly Conceived Preprinted Prescriptions
Authors: Dunn Eddie B. , Wolfe Jonathan J.
Published: January 2018

Hospital Pharmacy welcomes contributions to this column. Articles originally published in pharmacy department newsletters are reprinted here. Material is selected because of its educational value to pharmacists or because it demonstrates the type of information of interest to newsletter readers. If you wish to have your newsletter material considered for publication in this column, mail a copy—along with a computer disk containing the document—to Neil M. Davis, Editor-in-Chief, Hospital Pharmacy, 1143 Wright Drive, Huntingdon Valley, PA 19006-2721.
CAF (FAC) Regimen
Authors: Solimando Dominic A. , Waddell J. Aubrey
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column reviews various issues related to the preparation, dispensing, and administration of cancer chemotherapy, both commercially available and investigational.
Toward Increased Reporting of Adverse Drug Reactions
Authors: Colodny Lisa , Spillane Joseph
Published: January 2018

The determination of an adverse drug reaction (ADR) can be a subjective process complicated by lack of awareness and liability issues. Low ADR reporting is common in many health care facilities. In 1996, the North Broward Hospital District formed an ADR task force that implemented a specific definition of “adverse drug reaction” and new reporting policies. Upon completion of the program, reporting increased by 53%. Improvement occurred most notably in the medical/surgical departments, where reporting increased from 23% to 41%. This initiative shows that ADR reporting can be enhanced by education and that programs aimed at increasing the number of reported ADRS can be valuable tools for improving the medication administration process.
Antiretroviral Medication Administration and HIV-Positive Patients: A Practical Approach
Authors: Debellis Ronald J. , Romanelli Frank , Dischler Jill E.
Published: January 2018

HIV medication management has become increasingly difficult. The most effective therapies available are often not the most desirable regimens from a convenience, side effect, or quality of life perspective. We will briefly review treatment guidelines, effectiveness, compliance barriers, and role of the pharmacist in caring for HIV-positive patients. We will also provide information on the normal dosing of HIV medications, how medications should be administered with regard to meals, and common antiretroviral combinations. Case studies will illustrate the most common regimens used in the treatment of HIV disease as well as some typical variations from the norm.
CDTM and Smoking Cessation
Authors: Wong Edward
Published: January 2018

Collaborative drug therapy management (CDTM) is a method for developing a patient-centered practice in which the pharmacist's activities are integrated with those of other health care providers. The goals of this continuing feature are to refine the concept of CDTM and provide patient-care applications from the authors' experience in Washington state.
Evaluation of the PhaSeal Hazardous Drug Containment System
Authors: Sessink Paul J. M. , Rolf Mary-Ann E. , Rydèn N. Stefan
Published: January 2018

PhaSeal is a containment system designed to ensure the safe preparation and administration of cytostatic drugs and thus reduce environmental contamination to work areas and to medical and support staff. The PhaSeal system was tested in an outpatient setting in Sweden for 1 year during the preparation and administration of cyclophosphamide, fluorouracil, and similar cytostatic drugs. The study was designed to determine the effectiveness of PhaSeal in preventing the leakage of cytostatic drugs frequently reported in a number of studies. Cytostatic drugs were prepared and administered using standard safety procedures, except that a biological safety cabinet was not used. At the conclusion of the study period, environmental contamination was determined from wiping samples of objects and surfaces in the drug preparation room. Neither cyclophosphamide nor fluorouracil was found in any of these samples. Results show that use of the PhaSeal system alone is sufficient to prevent environmental contamination during the preparation of cytostatic drugs.
Epoetin Alfa for Dialysis Outpatients: Analysis of Administered versus Medicare-Reimbursed Units
Authors: Oinonen Michael J. , Chen Connie , Danekas Lynne H. , Matuszewski Karl A. , Vlasses Peter H.
Published: January 2018

This study audited the efficiency and accuracy of patient billing and reimbursement systems for epoetin alfa (Epo). The outpatient records of 604 chronic dialysis patients at eight academic health centers, from selected quarters during 1989 to 1993, were reviewed. The number of units administered or dispensed for home use was compared with Health Care Finance Administration (HCFA) reimbursement records. Overall, 18% (range 2% to 45% per institution) of the Epo administered or dispensed at the study sites was not represented in the HCFA reimbursement records. Institutions may be losing some entitled reimbursement for Epo and should evaluate their reporting/billing practices. The extent to which reimbursement for Epo, our test drug, reflects billing/reimbursement inefficiencies for other drugs deserves further evaluation.
La Quête De La Lumière Au Mois De Khoiak: Une Histoire D'Oies
Authors: Graindorge Catherine
Published: January 2018

In the second court of the temple of Ramesses III at Medinet Habu, the feast of Sokar, which occurs on the 26th of Khoiak, is represented on the south and south-east walls. The procession of the henu-barque is the main episode of the Sokarian feast, as in all other iconographie documents. However, at Medinet Habu, the divine barque of Sokar is also accompanied by five other ships which belong to the goddesses Hathor, Wadjet, Shesemtet, Bastet and Sekhmet. Behind these ships, a priest brings a chest containing five birds. In this article, the author tries to explain why five goddesses, daughters of Re, and five birds are exceptionally associated with the Sokarian ceremonies, and how they meet together on the 26th of Khoiak.
Newly Discovered Sites in the Eastern Desert
Authors: Sidebotham Steven E.
Published: January 2018

Preliminary report of a survey of the Eastern Desert between the ancient Abu Sha'ar–Nile road in the north and the modern Quseir–Nile highway in the south. A number of hitherto unknown ancient sites have been recorded including road segments, road stations on the Abu Sha'ar–Nile road, gold mines, and hard stone quarries. A Latin inscription at one of these, associated with quarrying activities in the region and naming Flavius Diadumenus and Flavius Fortunatus, is here published.
The Stela of Neferhotep from the Sanctuary of Heqaib on Elephantine Island
Authors: Jenkins Michael R.
Published: January 2018

Report of the discovery on Elephantine of a Thirteenth Dynasty limestone stela from the Sanctuary of Heqaib. The owner, the Elder of the Portal Neferhotep, born of Nubhertjen, is otherwise unknown.
A Note on Puntite Housing
Authors: Phillips Jacke
Published: January 2018

Interpretation of the huts shown in the Deir el-Bahri reliefs as raised structures with enclosed ground-floor spaces, of potentially significant use.
Wine of Egypt's Golden Age: An Archaeochemical Perspective
Authors: Mcgovern P. E.
Published: January 2018

Neutron Activation Analysis and selective organic contents analysis were carried out for a group of 50 Malkata wine, honey, ‘ale’, ben-oil, and meat ostraca, together with seven additional New Kingdom reference samples from Thebes. Most of the ostraca and all of the reference samples form a tight chemical group, indicating that they were most likely made of a Theban marl clay and thus produced locally, perhaps in a royal workshop. Although the contents of amphoras were generally stated to have been produced elsewhere, they were evidently imported, ‘rebottled’, and then sealed and registered at a central facility in Thebes. The uniform procedures that were followed and the fact that most vessels were used only once may reflect the special circumstances for which they were intended—the heb-sed. Organic analyses confirmed the presence of wine for the wine ostraca; a tree resin, either terebinth or myrrh, was also added as a preservative, besides masking any offensiveness.
Heron ‘Bearer of Philosophia’ and Hermione Grammatike
Authors: Montserrat Dominic
Published: January 2018

This note suggests a new reading of a Greek inscription on the wrappings of a Roman mummy excavated by Petrie in the necropolis at Hawara in 1910-11. This reading may be relevant for interpreting the inscription of the famous mummy of Hermione from the same cemetery, now in Girton College, Cambridge.
Predictors of practice placement and academic outcomes in master’s-level pre-registration occupational therapy students
Authors: Thew Miranda M , Harkness David
Published: January 2018

Introduction

Occupational therapy pre-registration programmes are increasing their academic entry criteria globally to positively impact on professional practice. However, there is a lack of evidence of how a range of variables influence student outcomes.

Method

An observational, retrospective cohort design measured previous degree, age, ethnicity and gender, on final academic and practice placement outcomes of previous MSc Occupational Therapy (pre-registration) students ( n = 153). Pearson’s product-moment correlation and one-way ANOVA tests were performed on the data to assess any significant relationships between variables.

Results

There was a significant positive correlation between final academic percentage and practice placement outcome, r = .245, n = 121, p = .007. Previous degree significantly correlated with final academic outcome, r = .333, n = 153, p = .000, but not with higher practice placement performance. Gender, ethnicity and age did not correlate with student outcomes. Students with previous degrees in the arts performed slightly better than those with social sciences.

Conclusion

Prior academic ability significantly predicts academic but not necessarily practice placement outcomes on an MSc Occupational Therapy programme. Although more academically able students appear to develop skills for practice to a higher standard, other student values-based attributes should be measured prior to admission. Research exploring the best combination of academic and interpersonal skills for recruitment is required.
Adolescents' self-reported motor assessments may be more realistic than those of their parents
Authors: Timler Amanda , McIntyre Fleur , Hands Beth
Published: January 2018

Introduction

Adolescents' motor competence influences their physical, social and emotional development. Parent-reported assessments may not be truly representative of their adolescent's motor difficulties. This study examined the congruency between parent- and self-reported motor competence in 133 parent-adolescent dyads.

Method

The adolescent-reported Adolescent Motor Competence Questionnaire (AMCQ; ≤83) and the parent-reported Developmental Coordination Disorder Questionnaire 2007 (DCDQ-07; ≤57) cut scores classified 133 (Mage = 14.5 years) adolescents into high and low motor competence. Parents also completed the Swanson, Nolan and Pelham IV (SNAP-IV) for descriptive purposes.

Findings

A moderate correlation ( r = 0.56, P < 0.001) was found between the AMCQ and the DCDQ-07 scores. Overall, 42 low motor competence cases were identified by both measures (AMCQ and DCDQ-07). Parents identified more boys (11) than girls (9) with low motor competence, whereas more female adolescents (22) self-reported low motor competence than boys (18). A high proportion agreement (0.82) was seen, which was principally due to the 91 (68.4% of sample) high motor competence case agreements.

Conclusion

Parents identified fewer motor difficulties in their adolescent, especially for girls. Self-report motor assessments may be more realistic for adolescents as they are aware of their own capabilities. Such measures are also more likely to identify previously undiagnosed adolescents with low motor competence.
The ISCO-88 International Standard Classification of Occupations in Cross-National Survey Research
Authors: Wolf Christof
Published: January 2018

Cross-national research on social stratification has to be based on measures of social status that are comparable and interculturally valid. As most status measures are based on information about occupations, an internationally comparable taxonomy of occupations is of central importance. An especially useful classification in this respect is ISCO-88. the 1988 version of the International Standard Classification of Occupations. First, the conceptual framework of this classification is outlined and some basic differences between ISCO-88 and its predecessor. ISCO-68, are illuminated. Secondly, three versions, which depart from the original classification in one way or another, are presented. Finally, Ganzeboom's and Treiman's status scales based on the new classification of occupations are introduced and the performance of the new scales relative to the old ones is assessed empirically. Occupation, Classification, ISCO, Status, Comparative Research.
Beano's Ice Cream Shop
Authors: Finkle Todd A.
Published: January 2018

Terry Smith has spent the last six months preparing to purchase a Beano's Ice Cream franchise. Because his personal assets were limited, Smith needed a partner who could finance the purchase. After Smith found a prospective partner, Barney Harris, they negotiated a purchase price with Beano's. Then, Harris gave Smith a partnership proposal. As the case opens, Smith is evaluating the partnership proposal. His three choices are: to accept Barney Harris's partnership proposal, to make a counter proposal, or to try to find a new partner.
Entrepreneurial Attitudes and Knowledge of Black Youth
Authors: Walstad William B. , Kourilsky Marilyn L.
Published: January 2018

This study investigates the attitudes towards, education in, and knowledge of entrepreneurship of black youth using results from a national survey that was administered to a random sample of youth, ages 14 to 19. Survey responses reveal that black youth—more so than white youth—strongly desire to start businesses, want more entrepreneurship taught in their schools, and believe successful entrepreneurs have a responsibility to give back to the community. Limited access to role models, inadequate knowledge, and discomfort with some of the rationing mechanisms of competitive markets may limit the potential for black youth to realize their entrepreneurial aspirations. Implications of the survey results for black entrepreneurship are presented along with an educational initiative that models the potential impact of suitably designed and validated curricula.
Securing the Future of the Family Enterprise: A Model of Offspring Intentions to Join the Business
Authors: Stavrou Eleni T. , Swiercz Paul Michael
Published: January 2018

In this study, the authors have tested empirically a model that investigates intergenerational transitions in family firms. Through the model, the authors have explored the aspirations of 18 to 28-year-old university students in taking over the family business and the reasons for which they would join or not join the business.
Founding Family Control and Capital Structure: The Risk of Loss of Control and the Aversion to Debt
Authors: Mishra Chandra S. , Mcconaughy Daniel L.
Published: January 2018

This paper tests the hypothesis that Founding Family Controlled Firms (FFCFs) are more averse to control risk than similar non-FFCFs and therefore avoid debt. Higher levels of debt increase the likelihood of bankruptcy and the level of control risk. We show that FFCFs use less debt; their choice of debt is more sensitive to conditions associated with control risk; and that leverage is not significantly related to managerial ownership in non-FFCFs, indicating that founding family control, not managerial ownership, matters in determining leverage.
Linking Corporate Entrepreneurship to Financial Theory through Additional Value Creation
Authors: Vozikis George S. , Bruton Garry D. , Prasad Dev , Merikas A. A.
Published: January 2018

The study of corporate entrepreneurship (CE) has principally used accounting measures to gauge a firm's CE activities, even though it has increasingly been recognized in entrepreneurial research that more appropriate, theory-based measures are required to provide an accurate picture of a firm's CE performance. This study links corporate entrepreneurship to financial theory by advancing additional value creation (AVC) as a better measure of performance for corporate entrepreneurship activities and based on the output of the firm, rather than the usual accounting measures that are input based.
Attitudes towards drugs among school youths: An evaluation of the Swedish DARE programme
Authors: Lindström Peter , Svensson Robert
Published: January 2018

Illicit drug use among high school students is on the rise in Sweden as well as in other countries. This fact has put high demand on the police, who are not only expected to reduce the availability of drugs but also to take part in the effort to affect the students' demand for drugs. The aim of this study was to analyse what impact students' demand for and perceived availability of illicit drugs in the seventh grade have on their attitudes towards and experience with drugs in the eighth grade. Moreover, the purpose was to investigate to what extent a specific police-led school-based drug prevention programme, the project DARE (Drug Abuse Resistance Education), affects students' attitudes and experiences regarding drugs.

As a part in an ongoing evaluation of the Swedish DARE programme (called VÅGA) about 1,800 students in 22 Swedish junior high schools on three occasions anonymously answered questions about their attitudes towards and experiences with drugs. Contextual analysis was used to estimate the significance of various student-level risk-factors (such as family bonding, school involvement, and peer activity) and school aggregated contextual factors.

The results show that students' curiosity and perceived availability of illicit drugs at the school-level have statistically significant effects on drug-related attitudes and experiences at the individual-student level. The attitudes towards and experiences with drugs in the eighth grade of students who participated in the DARE programme in the seventh grade were not different from those students who did not participate in the programme. A brief discussion of what measures the police should conduct in order to block the availability of drugs and what their role in schools should be are finally presented.
The use and availability of legal and illegal drugs among Finnish 15-year-old students
Authors: Ahlström Salme , Haavisto Kari , Metso Leena , Tuovinen Eeva Liisa
Published: January 2018

The article presents some Finnish results from a comparative survey (ESPAD) conducted among 15- to 16-year-old students in 1995 in 26 European countries. The focus is on the prevalence of the use of alcohol and other drugs, and on the relation between availability and use. In addition, the differences between metropolitan Helsinki and Finland as a whole are analysed. The Finnish results are compared with those of the neighbouring countries and the United Kingdom, where the prevalence of alcohol and substance use was among the highest in all ESPAD countries.

The lifetime prevalence of drunkenness was very high (77 %). There were no differences between boys and girls. Metropolitan Helsinki students did not differ from students living elsewhere in their alcohol use. Boys re ported that they had consumed more alcohol on their last drinking occasion than girls. Mixing alcohol with pills was more common among girls than boys. A quarter of all girls had at least sometimes mixed alcohol and pills. The prevalence of illegal substance use was low (5 %). In metropolitan Helsinki there were markedly more girls who had used alcohol and pills together (32 %) and taken tranquillisers or sedatives (14 %) than in the whole of Finland (25 % and 6 %, respectively). The reported use of marijuana and hashish was more common in metropolitan Helsinki (14 %) than on average (5 %).

The respondents found it very easy to get alcohol. The availability of a beverage was easier the wider its distribution network and the lower the minimum age for buying it. Of the other substances, inhalants (48 %) were assessed as the easiest to obtain, followed by tranquillisers and sedatives (21 %) and then by marijuana and hashish (14 %).

Finland, together with the United Kingdom and Denmark, belongs to those ESPAD countries where the prevalence of drunkenness is highest, whereas the prevalence of illegal drug use in Finland is very low. The prevalence of mixing alcohol and pills was on the same level in Finland, Sweden and the United Kingdom.
Tranquillizers and Hypnotics-Sedatives as a Social Problem in Finland and Sweden
Authors: Schönberg Antti
Published: January 2018

This paper documents debates over benzodiazepine-based tranquillizers and hypnotics-sedatives in Finland and Sweden during the period of 1981–1994. It looks at the emergence of benzodiazepine dependence as a social problem in medical journals, newspapers, magazines, and administrative documents. The paper analyses the role of the media, experts, authorities, the drug industry, and patient organizations in the claims-making process. It compares Finnish and Swedish cases and locates the position of patients as self-conscious actors in the debates.

In Sweden there was genuine debate where physicians, medical authorities, and patient organizations took part. The public media had an important role in defining the status of the problem. The Finnish discussion was composed of single articles or debate articles, but did not form an interactive debate. Finnish authorities did not debate publicly with physicians or other actors. In the Swedish debate patients took part as self-conscious actors, while patients were missing from the Finnish debate.

Finally, the author considers the change in actor relations in medicine, drug, and health politics, and concludes that it may be more and more difficult for the traditional actors to marginalize the patient.
Frequency of Nephrotoxicity with Vancomycin and Aminoglycoside Antibiotic Therapy
Authors: Hailemeskel Bisrat , Namanny Michael , Wutoh Anthony
Published: January 2018

Three hundred and thirty four patients receiving aminoglycosides and/or vancomycin therapy for at least 72 hours were retrospectively reviewed for the development of nephrotoxicity. The patients' vancomycin and aminoglycoside serum concentrations were monitored by our clinical pharmacokinetics service. The average age, weight, and serum creatinine of the patients were 67.8 years, 71.3 kg, and 1.03 mg/dL, respectively. Nephrotoxicity occurred in 30 patients, but only 8 of these cases of renal toxicity (2.4%) were attributed to the use of vancomycin and/or aminoglycosides. The remaining 22 patients had other factors known to contribute to renal failure. Nephrotoxicity with aminoglycosides was more frequent than with vancomycin (2.8% versus 1.1%, respectively). Alarmingly, the frequency of renal toxicity increased by about four-fold when vancomycin was administered concomitantly with an aminoglycoside. Although further analysis is needed, preexisting renal impairment seems to be the major contributing factor for nephrotoxicity in our study.
Disease State Organization Web Sites
Authors: Flory Stefanie M. , Seamon Matthew J.
Published: January 2018

This bimonthly column will keep readers up-to-date on the Internet as a source of drug information. Examples of using the Internet to answer inquiries and prepare for committee meetings will be taken from the authors' experiences at a drug information center. A list of reliable web sites—as well as some examples of sites that have not been useful—will be included in each column.
New Drugs Approved by the FDA New Dosage Forms and Indications Agents Pending FDA Approval Major Labeling Changes
Authors: Baker Danial E.
Published: January 2018

This monthly feature will help readers keep current on new drugs, new indications and dosage forms, and safety-related changes in labeling or use. Each month, new information will be added to the table (shown in bold type) and older information will be removed. Efforts have been made to ensure the accuracy of the information; however, if there are any questions, let us know at hospitalpharmacy@drugfacts.com
Visual saliency detection for RGB-D images under a Bayesian framework
Authors: Wang Songtao , Zhou Zhen , Jin Wei , Qu Hanbing
Published: January 2018

In this paper, we propose a saliency detection model for RGB-D images based on the deep features of RGB images and depth images within a Bayesian framework. By analysing 3D saliency in the case of RGB images and depth images, the class-conditional mutual information is computed for measuring the dependence of deep features extracted using a convolutional neural network; then, the posterior probability of the RGB-D saliency is formulated by applying Bayes’ theorem. By assuming that deep features are Gaussian distributions, a discriminative mixed-membership naive Bayes (DMNB) model is used to calculate the final saliency map. The Gaussian distribution parameters can be estimated in the DMNB model by using a variational inference-based expectation maximization algorithm. The experimental results on RGB-D images from the NLPR dataset and NJU-DS400 dataset show that the proposed model performs better than other existing models.
Use of participatory, action and research methods in enhancing awareness of mental disorders in Kariobangi, Kenya
Authors: Othieno Caleb J. , Kitazi Nelly , Mburu James , Obondo Anne , Mathai Muthoni A. , Loewenson Rene
Published: January 2018

Worldwide, mental disorders affect 450 million people and account for 15% of the overall burden of diseases from all causes (World Health Organization, 2001). Two-thirds of those affected do not receive adequate care owing to stigma, discrimination, neglect and poverty. The World Health Organization (2001) found that only 1% of the total health expenditure went to mental health in most countries.
The Stree Arogya Shodh: investigating gynaecological morbidities and women's mental health in India
Authors: Patel Vikram
Published: January 2018

Gynaecological complaints have long been associated with poor mental health, in particular depression and anxiety, in higher-income countries. Lower abdominal pain (both menstrual and non-menstrual) and pelvic pain are considered the hallmark gynaecological symptoms associated with somatoform, stress-related and neurotic disorders (the ‘common mental disorders', CMDs). Cultural and social factors heavily influence the expression of somatic symptoms and metaphors for emotional distress, but little is known about gynaecological psychosomatic clinical syndromes in non-Western cultures, despite the enormous global health significance of gynaecological symptoms. This paper considers the specific example of the syndrome of abnormal vaginal discharge (AVD) in India.
A decade of mental health services in Timor-Leste
Authors: Hawkins Zoe
Published: January 2018

The Democratic Republic of Timor-Leste (East Timor) occupies the eastern half of the island of Timor, which lies north-west of Australia and within the eastern Indonesia archipelago. The population is approximately one million, of whom 45% are below the age of 15. Average life expectancy is 59.5 years and 50% of the population live below the national poverty line of US$0.88 per day. The official languages are Tetun and Portuguese, with Indonesian also used. The majority of the population are Catholic but also hold traditional animist beliefs.
Internet pharmacies
Authors: Ghodse Hamid
Published: January 2018

Shopping on the internet has become routine for many people and covers a wide range of products and services. It is therefore unsurprising that, in some countries, medical and pharmaceutical services can also be bought. This has clear advantages in countries such as Australia, where some communities are isolated by huge distances (or other geographical circumstances) but are able to access the internet. However, shopping for psychotropic substances is not quite the same as shopping for toothpaste or televisions. These drugs are subject to strict controls, including the requirement for prescription by a qualified medical practitioner. It is possible to implement systems so that internet shopping for and mail delivery of psychotropic substances conform to regulatory requirements; if this is done, internet pharmacies can be valuable in ensuring an adequate supply of medical provisions to all citizens, wherever they live (US General Accounting Office, 2000). However, these same sales opportunities can easily be exploited by unlicensed internet pharmacies and it is the problems caused by these illicit ‘cyber-pharmacies’ that are now the cause of grave concern.
Beyond numbers: the NHS International Fellowship Programme in Psychiatry
Authors: Khan Murad M.
Published: January 2018

The recent controversy surrounding the National Health Service (NHS) International Fellowship Programme (IFP) for consultant psychiatrists (Patel, 2003) has raised a number of important issues. In particular, the issue of recruiting in an under-resourced developing country, where skilled and trained professionals are in short supply but where demand is huge, has exposed the duplicity with which many developed countries interact with developing countries. Although countries such as the UK are forever talking about strengthening the research and training capacity of these countries, they have no qualms about taking trained professionals for their own needs (Goldberg, 2003). Holsgrove (2005) has defended the IFP and tried to counter many of the arguments raised by those opposing it (Patel, 2003; Khan, 2004; Ndeiti et al, 2004).
Psychiatry in Cambodia: the phoenix rises from the ashes
Authors: MacCabe James , Sunbaunat Ka , Bunthoeun Pauv
Published: January 2018

Cambodia is a low-income country in south-east Asia. It covers an area of 181 035 km2and has a population of 14.5 million, of whom 42% are less than 15 years old. Life expectancy is 56.8 years and 36% of the population live on less than US$0.50 per day. Cambodia experienced a brutal civil war and genocide in the 1970s under the Khmer Rouge regime, during which approximately 1.7 million Cambodians were killed (Chandler, 1999) and the social and medical infrastructure was almost completely destroyed. No mental health services existed throughout the conflict and subsequent Vietnamese occupation, despite the incalculable impact of the Khmer Rouge regime on Cambodians' mental health. The current political situation is more stable, although there remain concerns about human rights abuses (Khan, 2005).
Self-harm by poisoning in Mauritius
Authors: Naga Mridula S.
Published: January 2018

Suicide rates and rates of self-harm are high in Mauritius. This report concerns a comprehensive analysis of the incidence of self-poisoning on the island. The incidence of self-poisoning could be minimised if all the causative factors contributing to the practice were identified. Since this form of self-harm is influenced by demographic patterns, the social and economic environment, legal provisions and the healthcare system, a study specific to Mauritius will be of great relevance.
The role of ethnicity in psychopharmacology
Authors: Ruiz Pedro
Published: January 2018

The association between ethnicity and pharmacology has been reported in the medical literature for several decades. However, the relationship between ethnicity and psychopharmacology has become widely recognised only in the last two or three decades. The large-scale migration which started after the Second World War, at first to the USA and more recently to other higher-income countries, as a result of globalisation, has greatly contributed to the attention and focus given to these migrant groups. In this context, these migrant groups primarily comprise ethnic and racial minority groups. This article briefly reviews the relationship between ethnicity and psychopharmacological agents.
New research advances in ethno-psychopharmacology: an Asian perspective
Authors: Pi Edmond H. , Zhu Weiguo
Published: January 2018

Asians represent more than half the world's population but themselves consist of very diverse genetic, ethnic, cultural and linguistic groups. Understanding the role of ethnicity in an individual's response to psychotropic medications is of importance in treating psychiatric disorders among Asians. Recent research has supported the notion that Asians carry distinct genetic profiles that can influence both the pharmacokinetics and the pharmacodynamics of a given medication (Lin & Smith, 2000; Pi & Simpson, 2005). In this brief review, we summarise the research findings in the field, focusing on pharmacogenetic variations between Asians and other ethnic groups.
What factors are associated with the presence of mental health legislation? A cross-national study
Authors: Shah Ajit , Heginbotham Chris
Published: January 2018

The World Health Report 2001, dedicated to mental health, identified several important factors for improving mental health services (World Health Organization, 2001): the policy and legislative framework; community mental health services; provision of mental healthcare within primary care; human resources; public education; links with other sectors; and monitoring and research. Moreover, national mental health policies and national implementation programmes for these policies are vital for the improvement of mental health services (World Health Organization, 2004; Jacob et al, 2007).
Intellectual disability and Aboriginal Australians – training needs for psychiatrists
Authors: Roy Meera , Balaratnasingam Sivasankaran
Published: January 2018

Aboriginal Australians have relatively high rates of intellectual disability, a situation that is probably due mainly to poor health and social disadvantage. Populations with high rates of intellectual disability are more at risk of developmental disorders and mental ill health. We explore the training needs for psychiatrists working with indigenous people and how they can be met.
Challenges for psychiatry in the 21st century
Authors: Bhugra Dinesh
Published: January 2018

Psychiatrists manage ambiguity in diagnosis as well as management of patients with psychiatric disorders and contain anxiety experienced by patients and their families as well as that of the teams. The changes in societies and cultures in the past few decades have produced changes in their expectations of their doctors, including psychiatrists. In some high-income countries, patients are better informed about their conditions and treatments than they were before. This availability of knowledge has led to a levelling in the relationship between patient and doctor.
Mental health in post-genocide Rwanda
Authors: Palmer Ian , Firmin Nsanzumuhire
Published: January 2018

The children who experienced the genocide against the Tutsi in Rwanda are now in their mid to late 20s. It is almost impossible to comprehend the scale of the terror and destruction of Rwanda's societal infrastructure between 6 April and 16 July 1994. While the world remained inactive, Rwanda, a small impoverished central African state, experienced the murder of about 1 million of its citizens; it also saw the terrorising, humiliation and rape of countless thousands. Although women and children were directly targeted, some actively engaged in atrocities. About 300000 children were murdered, a significant number at the hands of other children. The level of terror differed across the country and escape was frequently by luck alone. A UNICEF (2004) study of 3000 children revealed that 80% had experienced death in the family, 70% had witnessed a killing or injury, 35% saw other children killing or injuring other children, 61% were threatened with being killed and 90% believed they would die (Human Rights Watch, 2003). Of the 250000 women raped, 30% were between 13 and 35 years of age, 67% developed HIV/AIDS and 20 000 births resulted (Donovan, 2002).
Principled mental health law?
Authors: Zigmond Tony
Published: January 2018

A set of principles which might underpin mental health law across the world is discussed, and one particular difficulty is highlighted.
An evaluation of training in brief cognitive–behavioural therapy in a non-English-speaking region: experience from India
Authors: Gupta A. K. , Aman H.
Published: January 2018

The authors wanted to learn whether it was possible to deliver cognitive-behavioural therapy (CBT) in a low-income country where English is neither the first nor the preferred spoken language and to evaluate the effectiveness of the training in terms of skills acquisition. Twenty participants attended a 3-day workshop on the technique. All had experience of communicating in Hindi with patients, although their medical training was in English. There is no manual for CBT in Hindi. Role-plays focused on basic CBT skills such as Socratic dialogue, the ‘five area’ approach, the use of the ‘downward arrow’, developing an automatic negative thought record and devising behavioural experiments, in Hindi. The findings suggested that it is feasible to train mental health professionals in CBT where English is not the first language.
Strategic vision for mental health and substance misuse in the Eastern Mediterranean Region
Authors: Saeed Khalid , Gater Richard
Published: January 2018

The Eastern Mediterranean Region of the World Health Organization has recently developed a comprehensive strategy and action plan to promote mental health and provide for the integrated prevention, treatment and rehabilitation of mental, neurological and substance use disorders. By strengthening national mental health policies, plans and legislation, scaling up integrated services, capacity-building, promoting human rights and prioritising vulnerable groups, the strategy aims to improve mental health and to help countries achieve their national development objectives.