bluuebunny/crossref_metadata_2025 huggingface dataset:
Government–Business Partnerships for Radical Eco-Innovation
Authors: Lin Haiying
Published: December 2017

This study assessed whether and how government–business partnerships (GBPs) offer a unique platform that targets profound environmental impacts via the promotion of radical eco-innovation. It applied transactional cost and complementary logics to explain the rationale of GBP formation for radical eco-innovation, and further assessed the operation of GBPs from governance, learning, and rulemaking aspects. This study applied propensity score matching technique to empirically test these theoretical associations using 225 observations representing 166 U.S. firms’ participation in 192 environmental alliances between 1985 and 2013. The study results confirmed GBPs’ role in channeling public and private efforts in pursuing transformative environmental change via the adoption of radical eco-innovation goals. Results highlight four critical elements of GBP operation—effective governance, exploration learning, cognitive learning, and rulemaking—that enable participants to embrace these radical environmental solutions.
Psychosocial Screening Among Youth Seeking Weight Management Treatment
Authors: Ratcliff Megan B. , Catlin Perry A. , Peugh James L. , Siegel Robert M. , Kirk Shelley , Tamm Leanne
Published: December 2017

The objectives of this study were to identify rates of, and factors associated with, “at-risk” scores on a brief psychosocial screener among overweight/obese youth seeking weight management treatment, as well as concordance between youth and caregiver reports. A retrospective chart review of 1443 consecutive patients ages 4 to 18 years and their caregivers was conducted. Almost 1 in 4 youth with overweight/obesity presented with psychosocial symptoms in the at-risk range for significant mental health issues based on caregiver report on the Pediatric Symptom Checklist (PSC) and 1 in 6 based on youth self-report on the Youth Pediatric Symptom Checklist (Y-PSC). Concordance between caregiver and youth was fair (agreement 24% to 40%). Higher scores were associated with male sex and older age on the PSC and with indication of depressive disorder in the electronic medical record on the Y-PSC. Conducting a brief psychosocial screen in comprehensive weight management programs is feasible and clinically indicated.
Theorizing the social foundations of exceptional security politics: Rights, emotions and community
Authors: Norman Ludvig
Published: December 2017

This article theorizes the social processes through which purportedly liberal democratic states compromise fundamental rights in times of perceived security crises. It has become increasingly common to suggest that a general culture of fear serves both as the motor and the outcome of exceptional security politics. This article suggests instead that the transgression of fundamental rights in the name of security is intimately connected to collective feelings of humiliation and the reassertion of self-worth through efforts to re-establish the integrity of imagined communities. To demonstrate this, the article highlights the dual character of rights, having both a formal and a symbolic function, associated with collective emotions. By theorizing the connections between rights, emotions and belonging the article offers the building blocks for a more nuanced and possibly more accurate understanding of why exceptional security politics tend to elicit such broad public support in spite of its often-glaring contradictions to fundamental principles of liberal democracy.
The Role of Trait Anger in the Relation Between Juvenile Delinquency and Intimate Partner Violence in Adulthood
Authors: Armenti Nicholas A. , Snead Alexandra L. , Babcock Julia C.
Published: December 2017

Research has documented a connection between juvenile delinquency and criminality in adulthood. However, research examining why some individuals engage in criminal behavior only as juveniles, whereas others continue to perpetrate crime into adulthood, is still needed. This study examined trait anger as a mediator of relations between a history of juvenile detention and perpetration of three subtypes of intimate partner violence (IPV) in adulthood. Results suggested that trait anger significantly mediated relations between a history of juvenile detention and (a) physical assault and (b) psychological aggression, but not sexual coercion. Addressing anger in juvenile delinquents may be useful in intervention approaches designed to reduce IPV. Further investigations are encouraged to longitudinally explore other explanatory variables in the link between juvenile delinquency and IPV.
State- and Individual-Level Predictors of Mexican Death Penalty Support
Authors: Updegrove Alexander H. , Orrick Erin A.
Published: December 2017

Mexico exerts a unique influence on Texas through immigration. As immigrants bring perspectives from their country of origin when they immigrate, studying attitudes toward capital punishment in Mexico may provide insight into ways Mexican immigrants could affect its future practice in Texas. Multilevel modeling is used to examine individual- and state-level predictors of death penalty support among a nationally representative sample of Mexicans. Results indicate age and Catholic affiliation are associated with death penalty support, although not in the expected directions, whereas states bordering the United States are less likely to support capital punishment, despite experiencing less overall peace and a higher average homicide rate. Findings suggest the need for researchers to use culture-specific factors to predict death penalty support.
The Impact of Structural Disadvantage on the Gender-Gap and Sex-Specific Rates of Nonlethal Violent Victimization
Authors: Powers Ráchael A. , Chamberlain Alyssa W. , Boggess Lyndsay N.
Published: December 2017

This study examined the gendered impact of structural disadvantage and economic inequality on two forms of nonlethal victimization (assault and robbery). Compared with research on the gendered impact of structural disadvantage on perpetration, few studies have examined the differential susceptibility of men and women’s risk of victimization. We use data from the City of Los Angeles (2001-2007) to examine the relative influence of neighborhood characteristics on both the gender gap in victimization as well as sex-specific measures of assault and robbery victimization. In general, we largely find that neighborhood disadvantage and economic inequality do little to explain the gender gap in victimization; however, structure plays a more significant role in understanding sex-specific victimization rates, but the relationship varies by crime type.
Health Behaviors and Juvenile Delinquency
Authors: Semenza Daniel C.
Published: December 2017

This study draws upon Kaplan’s theory of self-attitude and deviant response to examine the relationship between health behavior and juvenile delinquency. The analysis, examining data from the Monitoring the Future 2013 study, shows that health behavior is associated with multiple forms of delinquency even after accounting for illness, as well as pertinent demographic and individual factors. The findings support the position that health behaviors have a distinct theoretical relationship with delinquency related to self-attitude, separate from the effects of illness. The article builds upon prior work regarding physical health and delinquency, demonstrating that a healthy lifestyle may decrease the likelihood of delinquency through an improvement in self-attitude.
Recognizing our hybridity and interconnectedness: Implications for social and environmental justice
Authors: McIntyre-Mills Janet
Published: December 2017

A core capability for sociologists who wish to respond to the complex interconnected social, cultural, political and economic challenges will be the ability to transcend disciplinary boundaries and to work with diverse perspectives. Thus those who inform the argument for this article include De Waal and Dawkins (primatology and philosophy), Kymlicka and Donaldson (animal rights and shared habitat), Hirschman and Hannah Arendt (on economics and politics), Amartya Sen (on economics and morality), Stuart Hall (on identity) and Martha Nussbaum (on social justice). The work of Stiglitz on wellbeing stocks is extended through drawing on Vandana Shiva (on the intersections spanning economics, politics and the environment) and a recognition of our interconnectedness as part of a living system. This provides the basis for intersectional policy approaches to address violence against the planet and violence against those without a voice. This capability is important if we are to inform praxis on governing the Anthropocene, in order to protect both human and animal rights along with their shared and separate habitats.
School as Community, Community as School: Examining Principal Leadership for Urban School Reform and Community Development
Authors: Green Terrance L.
Published: December 2017

For decades, reform has been a persistent issue in urban schools. Research suggests that urban school reforms that are connected to equitable community development efforts are more sustainable, and that principals play a pivot role in leading such efforts. Yet, limited research has explored how urban school principals connect school reform with community improvement. This study examines principal leadership at a high school in the Southeastern United States where school reform was linked to improving community conditions. Using the case study method, this study draws on interviews and document data. Concepts from social capital theory are used to guide the analysis. Findings indicate that the principal’s actions to support urban school reform and community improvement included the following: positioned the school as a social broker in the community, linked school culture to community revitalization projects, and connected instruction to community realities. The study concludes with implications for practice and future research.
Gender Stereotypes and the Role of Women in Higher Education (Azerbaijan Case Study)
Authors: Mollaeva Elza Alipasha
Published: December 2017

Gender stereotypes are common among students of both sexes and among the teachers and students’ family environment. In addition to communication processes, they are manifested in the phenomenon of gender-based division of learning and the hidden curriculum. In developing countries, the problem of access to higher education is also unsolved, not only because of socioeconomic reasons but also because of psychological reasons—devaluation of education and professional potential of women. These factors have a negative influence on social and economic processes in general. The study of gender stereotypes is the foundation for strategies’ development to overcome gender inequality and implementing a model of gender parity (egalitarian model). This model assumes that the change must take place on both sides: the impact on people’s behavior by laws prohibiting discrimination, providing financial support and openings for women students; and changes in belief prevailing in the society by initiating discussions in media, educational institutions, and community organizations with a reasoned positioning of gender equality importance.
A Comparison of Methods for Estimating Relationships in the Change Between Two Time Points for Latent Variables
Authors: Finch W. Holmes , Shim Sungok Serena
Published: December 2017

Collection and analysis of longitudinal data is an important tool in understanding growth and development over time in a whole range of human endeavors. Ideally, researchers working in the longitudinal framework are able to collect data at more than two points in time, as this will provide them with the potential for a deeper understanding of the development processes under study and a much broader array of statistical modeling options. However, in some circumstances data collection is limited to only two time points, perhaps because of resource limitations, issues with the context in which the data are collected, or the nature of the trait under study. In such instances, researchers may still want to learn about complex relationships in the data, such as the correlation between changes in latent traits that are being measured. However, with only two data points, standard approaches for modeling such relationships, such as growth curve modeling, cannot be used. The current simulation study compares the performance of two methods for estimating the correlations among changes in latent variables between two points in time, the two-wave latent change score model and the latent difference factor model. Results of the simulation study showed that both methods yielded generally accurate estimates of the correlation between changes in a latent trait, with relatively small standard errors. Estimation bias and standard errors were lower with larger samples, larger factor loading magnitudes, and more indicators per factor. Further comparisons between the methods and implications of these results are discussed.
Recommendations on the Sample Sizes for Multilevel Latent Class Models
Authors: Park Jungkyu , Yu Hsiu-Ting
Published: December 2017

A multilevel latent class model (MLCM) is a useful tool for analyzing data arising from hierarchically nested structures. One important issue for MLCMs is determining the minimum sample sizes needed to obtain reliable and unbiased results. In this simulation study, the sample sizes required for MLCMs were investigated under various conditions. A series of design factors, including sample sizes at two levels, the distinctness and the complexity of the latent structure, and the number of indicators were manipulated. The results revealed that larger samples are required when the latent classes are less distinct and more complex with fewer indicators. This study also provides recommendations about the minimum required sample sizes that satisfied all four criteria—model selection accuracy, parameter estimation bias, standard error bias, and coverage rate—as well as rules of thumb for sample size requirements when applying MLCMs in data analysis.
Assessing the Quality and Appropriateness of Factor Solutions and Factor Score Estimates in Exploratory Item Factor Analysis
Authors: Ferrando Pere J. , Lorenzo-Seva Urbano
Published: December 2017

This article proposes a comprehensive approach for assessing the quality and appropriateness of exploratory factor analysis solutions intended for item calibration and individual scoring. Three groups of properties are assessed: (a) strength and replicability of the factorial solution, (b) determinacy and accuracy of the individual score estimates, and (c) closeness to unidimensionality in the case of multidimensional solutions. Within each group, indices are considered for two types of factor-analytic models: the linear model for continuous responses and the categorical-variable-methodology model that treats the item scores as ordered-categorical. All the indices proposed have been implemented in a noncommercial and widely known program for exploratory factor analysis. The usefulness of the proposal is illustrated with a real data example in the personality domain.
Cardiac Stents;DEA Registration of Physicians;Use of Volunteers for Drug Delivery;Transfer Order Requirements;Crash Cart Locks;Pharmacist Review of Dialysis Orders;Sample Drug Documentation;Informed Consent for Drugs;Ophthalmic Drugs as Floor Stock;Insulin as Floor Stock;Nursing Identification of Patients' Own Medications;Monitoring Room Temperature;Pharmacist Review of “Orderless” Drugs;New Medication Use Standards
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.
Academic Detailing of Meperidine at a Teaching Hospital
Authors: Boothby Lisa A , Wang Lih-Jen , Mayhew Susan , Chestnutt Lynn
Published: January 2018

Meperidine (Demerol) is an opiate analgesic that is not considered first-line therapy for most pain management indications because of concerns about its safety and efficacy. Inpatient data from a 417-bed community teaching hospital revealed high use of meperidine in oral, IM, and IV forms. A multifaceted academic detailing approach was employed to change prescribing behavior and decrease meperidine use. This approach included conducting two concurrent Medication Use Evaluations; Grand Rounds presentations for pharmacy staff, nurses, and medical residents; solicitation of opinion leaders; pocket and table-top cards; newsletter articles; and provision of pharmaceutical care. Comparing the number of meperidine doses dispensed per adjusted patient day before and after the intervention, use was reduced by 0.0966 doses per patient (P < 0.05: 95% CI, 0.0955 to 0.0977). The number of patients receiving meperidine was reduced by 2.43% (P < 0.05: 95% CI, 1.97 to 2.88). This translates into a relative reduction of 29.5% in patients receiving meperidine and a relative reduction of 31% in meperidine doses dispensed per patient after academic detailing initiatives vs before. Eighty-five percent of standard orders were changed to improve therapy; these changes included converting meperidine to morphine or hydromorphone, decreasing cumulative acetaminophen daily dosages, using controlled-release and immediate-release opioids for pain management when oral therapy was tolerated, and combining modalities with different mechanisms of action for synergy and to decrease potential adverse effects from larger dosages of single entities. Academic detailing of meperidine resulted in short-term changes in prescribing patterns and decreased meperidine use at this institution. Long-term implications for pain management have not yet been assessed.
Letrozole: Delayed Puberty in Males
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses

This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data-including, background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations-precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Finding, Downloading, and Installing Software
Authors: Fox Brent I. , Felkey Bill G.
Published: January 2018

As we move to an increasingly digital environment, more and more PDA software is becoming available only in electronic format. In this issue, we discuss how to locate, download, and install software from Internet sites.
Multicenter Evaluation of Risk Factors for Aspergillosis in Patients Treated with Lipid Amphotericin B Products: Outcomes, Drug Utilization Parameters, and Benchmarking
Authors: Sutton Shawn Scott , Gomez-Fein Eleanor , Papadopoulos John , Olyaei Ali , Cazes John , Hennenfent Joel , Ambegaonkar Ambarish J. , Lubowski Teresa J.
Published: January 2018

Purpose

To evaluate the use of lipid amphotericin B products in relation to risk factors for aspergillosis and candidemia at the time therapy was initiated.

Methods

A single-group, concurrent, observational, multicenter study in hospitalized patients receiving a lipid amphotericin B product (Abelcet or AmBisome) was undertaken. The severity of illness, duration of therapy, length of hospital stay, microbiology, all-cause mortality, physician specialty, and clinical characteristics of each patient was recorded. Risk factors for aspergillosis and candidemia and process markers that might identify patients as candidates for lipid amphotericin B therapy were collected.

Results

One hundred eighty-six patients were enrolled in six US medical centers. One hundred four patients had positive fungal cultures; the majority of positive cultures were for Candida albicans (n = 40) or yeast (n = 27). Sixteen patients had positive cultures for Aspergillus. All patients receiving a lipid amphotericin B product had an overall statistically significantly greater number of risk factors for Candida vs Aspergillus infection. The mean (± SD) number of risk factors for Aspergillus was 2.46 ± 1.97 (range 0–10) and for Candida was 7.77 ± 3.14 (range 1–16) (P < 0.05). Risk factor assessment by medical service showed a statistically significantly larger number of Aspergillus risk factors in the bone marrow transplant (BMT) service compared with all other services (P < 0.05).

Conclusions

There were fewer documented risk factors for aspergillosis than candidemia in patients receiving a lipid amphotericin B product. Establishing drug usage protocols that include culture analysis, risk factor identification, high-risk medical services, and incorporation of drug use evaluation measures can guide the practitioner in selecting the appropriate therapy for their patients.
Topiramate: Weight Loss (Antipsychotic-Agent-Induced Weight Gain or Obesity)
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses-This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data—including, background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Serious Abuse Potential
Authors: Boothby Lisa Anne , Doering Paul L. , Hatton Randy C.
Published: January 2018

This review examines literature on the efficacy and abuse potential of carisoprodol, makes recommendations for use of this agent in the hospital setting, and outlines applicable federal and state regulations. A Medline search using key words and MeSH terms was conducted. In addition, International Pharmaceutical Abstracts (1970–2002), Current Contents (1996–2002), Cochrane Database of Systematic Reviews (1999–2002), and Psych Info (1872–2002) were searched for relevant literature. Articles cited in the bibliographies produced by these searches were included in the review. A Web of Science search was conducted for all citations found in all the searches. Pain is a common physical symptom in patients with musculoskeletal problems, and pharmacologic therapy is often combined with nonpharmacologic measures to treat the pain etiology and symptomatology. Skeletal muscle relaxants (SMRs) and nonsteroidal anti-inflammatory drugs (NSAIDs) represent the most common drug therapy choices in patients with mild-to-moderate somatic pain. Carisoprodol (Soma) is an SMR that has a poorly defined mechanism of action and a high potential for abuse. This literature review produced little evidence to support the use of carisoprodol in pain control. The research also showed that patients with a history of previous substance abuse are more likely to abuse this drug; thus carisoprodol does not meet safety and efficacy standards and should be removed from the market. At the very least, states should reschedule carisoprodol as a schedule IV controlled substance to minimize chronic misuse and abuse. If carisprodol is listed in hospital formularies, it should be handled as a controlled substance regardless of its federal status. Alternative sedatives (eg, phenobarbital) should be used to manage patients experiencing carisoprodol withdrawal symptoms.
Teriparatide
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. The monographs are published in printed form and on diskettes that allow customization. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800–322–4349. The May 2003 monograph topics are enfuvirtide, oxybutynin transdermal, gemifloxacin, efalizumab, and hyaluronidase ovine. The DUE is on enfurvirtide.
Drug Therapy for Hypertension: Does ALLHAT Alter our Approach?
Authors: Howard Patricia A.
Published: January 2018

This continuing feature will update readers on recent developments in cardiovascular pharmacotherapy. Cardiovascular disease remains the number one killer in the US, and more clinical outcome trials have been conducted in cardiology than in any other field of medicine. Given this rapidly expanding knowledge base, pharmacists can have a significant impact on prevention and treatment — if they keep current with developments in drug therapy.
Gabapentin: Neuropathy (Diabetic)
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses

This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data—including, background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Influenza Virus Vaccine, Live, Intranasal
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The September 2003 monograph topics are tositumomab, omalizumab, emtricitabine, testosterone buccal system mucoadhesive, and alfuzosin. The DUE is on omalizumab.
Impact of an Automatic Therapeutic Interchange Program on Discharge Medication Selection
Authors: D'Amore Michael , Masters Patricia , Maroun Carolyn
Published: January 2018

This brief report describes the effect of an automatic therapeutic interchange program on patients' discharge medications. Pharmacists at a medical center were authorized to convert various nonformulary medications to formulary equivalents. To determine which medications were prescribed to the patients upon hospital discharge, automatic interchanges during June 2001 to September 2001 were identified. Of those identified, 94 met study inclusion criteria. Complete information was obtained for 46 patients. Inpatient and outpatient pharmacy records were reviewed retrospectively for a 3-month period postdischarge. In the majority (67.4%) of cases, the patient's preadmission medication was continued on an outpatient basis. In 17.4% of the cases, the therapeutic interchange medication was continued on an outpatient basis. In 15.3% of the cases, patients were prescribed medications that were neither preadmission nor the interchanged medications. These results demonstrate that an automatic interchange program has the potential to influence outpatient therapy.
Pneumonitis with Antiandrogens Severe Hypersensitivity Pneumonitis with Anagrelide Adverse Reactions to a New Food Ingredient Psychiatric Adverse Events with Levetiracetam Levofloxacin-Induced Hemolytic Anemia Levofloxacin and Achilles Tendon Rupture
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 (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
The Allure of Generic Drugs
Authors: Teagarden J. Russell
Published: January 2018

Managed care pharmacists are involved formally with the interface between the delivery and financing of health care; their work thus entails an accountability for both elements. Interpreted broadly, managed care pharmacists are pharmacists working within the sphere of a health care system, health care purchaser, health insurer, managed care organization, or benefit administration agency. Patients, the pharmacy profession, and society are best served by this broad interpretation, because the interdependency of financing and delivery is inextricably linked to the achievement of good health outcomes. This continuing feature will explore contemporary issues facing managed care pharmacists.
Disease Management vs Drug Management: Directing Drotrecogin Alfa Therapy with Standing Orders for Severe Sepsis
Authors: Nazworthy Jennifer , Woods Mark
Published: January 2018

Septic patients require complex treatment and supportive care measures. The purpose of this project was to design interventions to optimize treatment of these critically ill patients. A sepsis management order form was developed to assist physicians in ordering appropriate medications and laboratory tests. The order form focused on several key elements: antibiotic and vasopressor selection, fluid and electrolyte replacement, nutritional support, respiratory support and deep vein thrombosis prophylaxis, stress ulcer prophylaxis, and drotrecogin alpha therapy. Guidelines for the dosing and administration of drotrecogin were also developed and disseminated to providers. Providing a sepsis management order form and other educational support for sepsis management may help optimize the treatment of septic patients.
A Review of Clinical Pharmacy Interventions Prior to Implementation of a Personal Digital Assistant Intervention Program in a Community Hospital
Authors: Wilson Amy Friedman , Foral Pamela A. , Nystrom Kelly K. , Heineman Susan M. , Wargo Kurt A. , Wargo Nichole A.
Published: January 2018

Purpose

To evaluate pharmacist interventions and identify areas of improvement prior to decentralization and implementation of a personal digital assistant (PDA) program for documenting interventions.

Methods

Intervention data were collected from April 1999 to June 2001 using standardized intervention and activity forms. Following collection, data were analyzed to determine the most common medications requiring intervention, acceptance rates, total and estimated cost savings, interventions performed per care unit, and pharmacist time.

Results

A total of 3030 interventions were captured from April 1999 through June 2001. The most common interventions were dosage or frequency changes (80.6%). The total cost savings for the medication ingredients during the period reviewed was $43,733. The estimated cost savings/cost avoidance of interventions during the study period was $850,417. The most common care units involved in interventions were areas where clinical pharmacy faculty practiced: hematology/oncology, general medicine, and intensive care. From January 2001 to June 2001 a comparison of faculty to clinical pharmacists showed that faculty in three care areas (68 beds) documented 552 interventions, compared with 392 interventions by the clinical pharmacists responsible for the seven other care areas (200 beds) (P< 0.05).

Conclusions

This review reinforces the benefit of interventions on cost avoidance and patient care. Because a high percentage of interventions was lost due to follow up, implementation of a simplified, uniform approach to clinical intervention reporting through a PDA program and additional decentralization is expected to decrease lost interventions and increase estimated cost avoidance.
Drug Regimen Review Adverse Events in Ambulatory Older Adults
Authors: Tobias Dianne E.
Published: January 2018

This continuing feature focuses on the medication needs of the geriatric population, a group that is especially vulnerable to a variety of medication-related problems (including medication errors). The goals of this series are to increase awareness about the inherent risks and challenges of pharmacologic therapy in elderly patients and to promote optimal medication use in this high-risk population. Questions and comments are appreciated and should be directed to Dianne E. Tobias, PharmD, CGP at detobias@aol.com .
Assessment of the Impact of an Antibiotic Shortage: Patient Outcomes and Costs
Authors: Bosso John A. , Kokko Heather
Published: January 2018

During the piperacillin/tazobactam (P/T) shortage of 2002, alternative antibiotics were recommended and used at our institution. The purpose of this analysis was to identify which antibiotics were used as substitutes and the effect that this substitution had on antibiotic expenditures and patient outcomes. The study was conducted at a 600-bed tertiary care, teaching institution. To assess the effects of the shortage, P/T and alternative antibiotic use for P/T indications was quantified and normalized for hospital census over the period of the shortage (March 1 to August 30, 2002). Cost was determined from actual purchase prices. For the same time period, numbers of patients with diagnoses related to potential P/T use, their in-house mortality, and length of stay (LOS) were also quantified. Antibiotic use, cost, and patient outcomes were compared with the same time period during 2001. The shortage of P/T during 2002 was, for the most part, accommodated by increased use of cefepime (146% increase), ticarcillin/clavulanate, and antibiotics with antianaerobic activity. The number of cases and in-house morbidity for targeted ICD-9s were largely unchanged over the two comparative time periods (P > 0.05). However, cumulative LOS decreased by 1.7 days and, although overall drug use increased 4.9%, total antibiotic expenditures for P/T and its alternatives decreased by 11.7% during the shortage. Patient outcomes were not adversely affected during the P/T shortage of 2002 and the use of alternative agents was associated with decreased LOS and cost reductions for the institution.
Daptomycin
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The January 2004 monograph topics are risperidone long-acting injection; efalizumab; epinastine HCL ophthalmic solution; prussian blue; and bevacizumab. The DUE is on palonosetron.
Enoxapirin-Induced Thrombocytopenia in a Child; Warfarin-Induced Skin Necrosis and Gangrene during HIT; Possible Seizure Due to Fluoroquinolone; Amifostine-Induced Fever; Neuroleptic Malignant Syndrome with Paroxetine and Olanzapine
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 (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
EDAP Regimen for Multiple Myeloma
Authors: Terenzi Lawrence M. , Waddell J. Aubrey , Solimando Dominic A.
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column focuses on the commercially available and investigational agents used to treat malignant diseases and reviews issues related to the preparation, dispensing, and administration of cancer chemotherapy.
Rofecoxib: Children, Postoperative Pain Management
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses

This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data—including background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Blood Transfusions: Alternatives; Hypertension; Pharmacy Newsletters
Authors: Generali Joyce A.
Published: January 2018

To help readers monitor the most important developments in specialized areas of pharmacy practice in organized health systems, Hospital Pharmacy commissions Basic Bibliographies by guest editors, who have expertise in their respective fields. These guest editors survey the relevant literature and rank approximately 15 to 20 references that represent the most significant research and practice contributions in their areas. The more fundamental are listed first so that persons with limited time can select reading appropriate to their needs. A cumulative index to Basic Bibliography topics will be published semiannually in June and December.
Bevacizumab; Cetuximab
Authors: Feagler R. Jon , Sano Harold S. , Waddell J. Aubrey , Solimando Dominic A.
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column focuses on the commercially available and investigational agents used to treat malignant diseases and reviews issues related to the preparation, dispensing, and administration of cancer chemotherapy.
Olanzapine for Injection (Intramuscular)
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The August 2004 monograph topics are lansoprazole injection, trospium chloride, tinidazole, natalizumab, and rubitecan. The DUE is on injectable proton-pump inhibitors.
The Role of Aldosterone Antagonists in Systolic Heart Failure
Authors: Howard Patricia A.
Published: January 2018

This continuing feature will update readers on recent developments in cardiovascular pharmacotherapy. Cardiovascular disease remains the number one killer in the US, and more clinical outcome trials have been conducted in cardiology than in any other field of medicine. Given this rapidly expanding knowledge base, pharmacists can have a significant impact on prevention and treatment — if they keep current with developments in drug therapy.
Pentoxifylline: Aphthous Stomatitis
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses

This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data—including background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Confusion between Various Acetylcysteine Dosage Forms: New Formulation of Cytoxan: Three-Way Name Mix-Up: Error despite Robotics?: Diabetes or Alzheimer Disease?
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 for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers’ names will be published if desired. ISMP may be contacted at the address shown below.

The reports described in this column were received through the USP–ISMP Medication Errors Reporting Program (MERP). Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) Web sites or communicated directly to ISMP by calling 1-800-FAIL SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications.

In 2004, ISMP is celebrating the 10th anniversary of its incorporation as a nonprofit organization. The Institute represents more than 20 years of experience in helping health care practitioners keep patients safe and continues to lead efforts to improve the medication use process.
Politics and Professions: Interdisciplinary Team Models and Their Implications for Health Equity in Ontario
Authors: Haydt Susan Marie
Published: December 2017

Ontario’s efforts to reform primary care through interdisciplinary primary care teams are unprecedented in Canada. Since 2004, the provincial government has focused its reform efforts on three models: Family Health Teams (FHTs), Community Health Centres (CHCs), and Nurse Practitioner-led Clinics (NPLCs). These models vary by team structure, funding, and governance. I examine the strong preference for the FHT model by the government and medical profession, and the implications of this preference on health equity. The opportunity for teams to increase health equity in Ontario may be limited due to the preference for physician-centered FHTs over more egalitarian team models.
Professional identity and turnover intentions of social workers in Beijing, China: The roles of job satisfaction and agency type
Authors: Jiang Haiyan , Wang Yean , Chui Ernest , Xu Yuebin
Published: December 2017

In order to address the ascending turnover rate among social workers in China, this article presents the idea, based on social identity theory, that professional identity is an important factor influencing turnover rate. Employing structural equation modelling (SEM) techniques, the study found that professional identity was negatively associated with social workers’ turnover intentions, and that social workers’ job satisfaction mediated the relationship between professional identity and their turnover intentions. The findings suggest that more work needs to be done on social work education and public image construction in China.