bluuebunny/crossref_metadata_2025 huggingface dataset:
Bepridil: A New Long-Acting Calcium Channel Blocking Agent
Authors: Zeller Frederick P. , Spinier Sarah A.
Published: February 2017

Bepridil is an investigational calcium channel blocking agent with antianginal activity that has a distinct and complex pharmacologic profile. Bepridil produces significant coronary vasodilation and modest peripheral effects, in addition to negative inotropic and chronotropic effects. Bepridil favorably modifies both myocardial oxygen demand and supply, supporting its use as an antianginal drug. Electrophysiologically, bepridil exhibits classes I, III, and IV antiarrhythmic activity. Five U.S. trials evaluating the short-term antianginal efficacy of bepridil collectively reported that bepridil causes significant improvement in both subjective and objective parameters of efficacy without depressing left ventricular function. In addition, one U.S. trial reported continued antianginal effects of bepridil after long-term use. There are limited data comparing and/or combining bepridil with other antianginal drugs, but the available information is promising. Limited information also exists on the use of bepridil in acute myocardial infarction and arrhythmias. Tolerance to bepridil therapy has been excellent, with the most common adverse effects being diarrhea and dizziness. It is unclear whether bepridil will be used as a first-line agent in the treatment of chronic stable angina pectoris; however, its long half-life, which makes once daily dosing possible, is certainly a significant advantage.
Using a Hand-Held Spirometer as a Monitoring Tool in Chronic Theophylline Therapy
Authors: Mikhail May N. , Catania Patrick N.
Published: February 2017

This study evaluates the use of a hand-held spirometer (pocket spirometer, Buhl type) in monitoring pulmonary function as a part of a homebased pharmacokinetic service for patients with respiratory disease. To calibrate the spirometer and determine its accuracy, six healthy volunteers were trained in its use by the pharmacist. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were determined for each volunteer once a month for six months, The T test for the presence of outliers showed no statistical difference at p <0.05.

Seven patients on chronic therapy with theophylline derivatives for respiratory problems were randomly referred by their physicians to the pharmacokinetic service. The pharmacist counseled each patient and measured FVC and FEV1 once a month for six months. The ratio, (FEV1:FVC) x 100, was calculated for each patient before and after steady-state serum level determination and dosage adjustment. The mean value for this ratio was 45.1 before pharmacokinetic intervention and 57.5 after intervention. Using the Student's t-test, these results were significant (p < 0.05). The correlation coefficient was calculated to determine if a correlation existed between the increase in the ratio and the increase in serum theophylline levels. Serum levels were ordered before and after intervention for five of the seven patients receiving pharmacokinetic intervention. The change in serum levels vs. change in the ratio was associated with a correlation coefficient of 0.718.

Monitoring pulmonary function may be a useful adjunct for the pharmacist who provides pharmacokinetic counseling to patients with respiratory disease, but expanded studies are needed to judge the value of routine spirometric measurements on homebased patients.
Calcium Antagonists in the Management of Asthma: Breakthrough or Ballyhoo?
Authors: Massey Kenneth L. , Hendeles Leslie , Alexander Michael R , Conner Christopher S.
Published: February 2017

Research demonstrating the importance of intracellular calcium regulation in each of the pathophysiologic events of asthma has lead to speculation that calcium antagonists may be beneficial in the treatment of reactive airways disease. A plethora of data has been generated on the effects of verapamil, diltiazem, nifedipine, and several investigational agents on experimentally induced asthma, indicating that none of these agents significantly affects resting bronchomotor tone, and their efficacy in preventing bronchospasm is a function of the drug, dose, route of administration and method of bronchoprovocation. Most studies have demonstrated calcium antagonists have only modest and highly variable effects on airway smooth muscle contraction. Additional studies are needed to define the effects on the inflammatory component of airways obstruction, steroid requirements in steroid-dependent patients, and on the alteration of the pharmacodynamics of other agents used for the management of chronic asthma.
Drug use in an Ambulatory Elderly Population: A Five-Year Update
Authors: Hale William E. , May Franklin E. , Marks Ronald G. , Stewart Ronald B.
Published: February 2017

Drug usage was studied in an ambulatory elderly population in Dunedin, Florida. Prescription and nonprescription drug use in these 2834 participants was compared with use during a period five years earlier. The average number of medications increased from 3.2 in 1978–80 to 3.7 in 1983–85. The most commonly prescribed medications in this population were hydrochlorothiazide-triamterene (13.5 percent), digoxin (9.6 percent), and hydrochlorothiazide (8.4 percent). There was a large increase in the use of nutritional supplements in the past five years, with 18.0 percent of these subjects reporting the use of vitamin E and 15.7 percent taking vitamin C. The general philosophy in geriatrics is to use the fewest drugs possible; however, it appears that the elderly are, in fact, receiving an increasing number of medications.
Bismuth Subsalicylate in the Treatment and Prevention of Diarrheal Disease
Authors: Dupont Herbert L.
Published: February 2017

Bismuth subsalicylate (BSS) has been used for more than 80 years to treat gastrointestinal symptoms although little clinical evidence was available until recently to substantiate its value and possible mechanisms of action. BSS 4.2 g given over 3 1/2 hours was shown to reduce the number of stools passed and favorably alter subjective symptoms in patients with traveler's diarrhea. BSS has also been shown to have beneficial effects on chronic infantile diarrhea. A small but discernible effect has been shown on selected symptoms associated with Norwalk virus-induced gastroenteritis. A liquid preparation, in a dose of 60 ml qid (4.2 g/d), was 62 percent effective in preventing traveler's diarrhea during a three-week period of risk and a tablet formulation (BSS 600 mg qid) was 76 percent effective in preventing experimentally induced enterotoxigenic Escherichia coli diarrhea in volunteers. A tablet formulation (2.1 g/d) was recently shown to be 65 percent effective in preventing traveler's diarrhea during a three-week clinical trial in Mexico. Preliminary evidence suggests that the salicylate moiety exerts antisecretory effects in patients with diarrhea and the bismuth and intestinal hydrolysis products of BSS have direct antimicrobial effects.
Infectious Diseases in Day-Care Centers: Transmission and Approaches to Prevention
Authors: Carson Deborah Stier
Published: February 2017

Child day care is used increasingly by both single-parent and two-parent families. With the growth in numbers of children receiving day care outside the home comes a greater awareness of the potential for disease transmission. Epidemiologic patterns of spread of such diseases as Hemophilus influenzae type b, hepatitis A, diarrheal diseases, and cytomegalovirus are changing with respect to attendance at a day-care center. Not only is this a problem for the staff and children who attend a center, but it also may be a public health concern as these diseases could spread to households and the community at large. This review will identify those transmissible infectious agents frequently found in children who attend day-care centers with an emphasis on approaches to prevention and methods for decreasing secondary spread.
Cardiopulmonary Arrest following Barium Enema Examination with Glucagon
Authors: Harrington Rosemarie A. , Kaul Alan F.
Published: February 2017

This is a case report of a patient who presented to the hospital's ambulatory radiology suites for a barium enema to evaluate guaiac-positive stools. The patient, after receiving glucagon 0.5 mg iv and a small amount of rectally administered barium sulfate, experienced an “itchy tingling” feeling, vomited, became diaphoretic, and had a cardiopulmonary arrest. Despite a prompt response by the cardiac arrest team, the patient could not be resuscitated. This case demonstrates the potential for serious reactions during this procedure.
Effects of Renal Insufficiency on the Pharmacokinetics and Pharmacodynamics of Opioid Analgesics
Authors: Chan Gary L.C. , Matzke Gary R.
Published: February 2017

The disposition and pharmacologic activities of morphine, meperidine, methadone, propoxyphene, dihydrocodeine, and codeine are reviewed. Dose-related toxicities of these opioid analgesics include mental obtundation, respiratory depression, and hypotension. Furthermore, convulsions have been associated with normeperidine and cardiac toxicities with norpropoxyphene. Hepatic metabolism is the primary route of elimination, except for methadone, for which there is also significant renal excretion. Although the pharmacokinetics of morphine are unchanged in renal insufficiency, accumulation of active metabolites may lead to narcosis. Similar accumulation of normeperidine and norpropoxyphene, metabolites of meperidine and propoxyphene, respectively, as well as propoxyphene itself, and dihydrocodeine and codeine may explain reports of adverse reactions in patients with impaired renal function. A high index of suspicion of opioid-induced toxicities should be maintained in patients who have renal dysfunction and receive opioids.
Effect of Cimetidine on Herpes Zoster Infection
Authors: Bense László , Marcusson Jan A. , Ramsten Thomas
Published: February 2017

Cimetidine was administered to two patients for herpes zoster infection. An acute pain-relieving effect was observed. The patients were followed for 11 and 14 months without developing postherpetic neuralgia. Possible mechanisms for prevention of postherpetic neuralgia by cimetidine are discussed.
Compatibility and Stability of Clindamycin Phosphate-Aminoglycoside Combinations Within Polypropylene Syringes
Authors: Zbrozek Arthur S. , Marble Dwight A. , Bosso John A. , Bair Jan N. , Townsend Raymond J.
Published: February 2017

The stability and compatibility of clindamycin phosphate admixed separately with gentamicin sulfate, tobramycin sulfate, and amikacin sulfate in polypropylene syringes under specific storage conditions were studied.

In duplicate syringes, clindamycin phosphate 900 mg was admixed with sterile NaCl 0.9% 1 ml and with either gentamicin sulfate 120 mg, tobramycin sulfate 120 mg, or amikacin sulfate 750 mg. In duplicate polypropylene syringes, control solutions of clindamycin phosphate and each aminoglycoside were prepared separately and stored under the same conditions. The clindamycin control consisted of clindamycin phosphate 900 mg in 6 ml. The gentamicin and tobramycin controls consisted of gentamicin sulfate and tobramycin sulfate 120 mg in 3 ml plus 1 ml of sterile NaCl 0.9%. The amikacin control consisted of amikacin sulfate 750 mg in 3 ml plus 1 ml of sterile NaCl 0.9%.

Drug concentrations were determined at the time of preparation and 1, 4, 8, 12, 24, and 48 hours thereafter. Aminoglycosides were assayed by fluorescence polarization immunoassay and clindamycin was assayed by high performance liquid chromatography. Visual inspections and pH determinations of each combination and control solution were performed at each assay time. For the clindamycin, gentamicin, tobramycin, and amikacin control solutions, changes in concentration were within ten percent of the original concentration. Concentrations of clindamycin and gentamicin when admixed together also remained within ten percent of the original concentration. Similar results were found with concentrations of clindamycin and amikacin when admixed together. Tobramycin and clindamycin formed a lasting precipitate upon initial contact when admixed under the study conditions.
The Drug Approval Process and the Information it Provides
Authors: Myers Ann , Moore Steven R. , Hartzema Abraham G. , Porta Miquel S. , Tilson Hugh H.
Published: February 2017

By law, the commissioner of the Food and Drug Administration (FDA) is responsible for determining whether a new drug is safe and efficacious before it is approved for marketing in the U.S. and for monitoring its use after approval. This paper provides a brief overview of the approval process, in terms of responsibilities of the sponsor in submitting an application for review to the FDA and FDA's responsibilities and organizational procedures for reviewing and approving those applications. A brief history on the legislation regarding the FDA's responsibility in the drug approval area is discussed along with recent regulations, legislation, and FDA initiatives aimed at improving the drug approval process. Specific information that can be released to the public upon request is also discussed.

This paper is limited to the regulation of drugs; somewhat different regulations govern the review and regulation of biological products and abbreviated new drug applications.
Significance of Osmoticity in Antibiotic Small-Volume Parenterals
Authors: Crane Vicki S.
Published: February 2017

The most common cause of intravenous therapy morbidity is postinfusion phlebitis. It affects 25-70 percent of all hospitalized patients and can result in a prolonged stay. One potential contributing factor to postinfusion phlebitis is that most current intravenous antibiotic products and delivery systems do not consider osmolality. One important contribution hospital pharmacists can make to decreasing postinfusion phlebitis is to control final admixture osmoticity, thus ensuring that antibiotic small-volume parenterals are not causative factors. The purpose here is to discuss how changes in osmolality affect the development of postinfusion phlebitis and to provide hospital pharmacists with ideas for action to provide iso-osmotic formulations.
Recombinant Human Erythropoietin
Authors: Schwenk Michael H. , Halstenson Charles E.
Published: February 2017

Erythropoietin is produced mainly by the kidneys and stimulates erythropoiesis in the bone marrow. Chronic renal failure is characterized by anemia, which is principally caused by erythropoietin deficiency. Recombinant human erythropoietin (r-hEPO) corrects the anemia of chronic renal disease and improves patient well-being, exercise tolerance, and cognitive function. The clinical pharmacology, efficacy, safety, and tolerance of r-hEPO are presented. Four major studies attest to r-hEPO's efficacy in the treatment of anemia of chronic renal disease and document potential toxicities of hypertension, iron deficiency, thrombosis, and bone pain. Careful attention to the extent of correction of the hematocrit, increased heparinization during hemodialysis therapy, and compliance with dietary restrictions may minimize the incidence and severity of adverse reactions. Resistance to r-hEPO may be due to iron deficiency, aluminum toxicity, or inflammation, including infection. Potential future uses of r-hEPO include the treatment of various other anemias, such as those seen in sickle cell anemia, rheumatoid arthritis, and autologous blood donation. Controlled clinical studies in these areas have not been reported.
Meperidine Binding to Isolated Alpha1-Acid Glycoprotein and Albumin
Authors: Julius Hearee Chung , Levine Howard L. , Williams W. Donald
Published: February 2017

Interpatient variability in response to a given dose of meperidine, a synthetic opiate analgesic, may be partially explained by variability in plasma protein binding. Alpha1-acid glycoprotein (AAG), a plasma protein that primarily binds basic drugs, has been shown to increase in patients during stress such as trauma or surgery. The objective of this study was to determine the extent of meperidine binding to AAG and albumin as a function of both protein and meperidine concentrations. We performed a simple extraction procedure and a highly sensitive gas Chromatograph analytical procedure. The results indicated that meperidine binding did not vary significantly with meperidine concentration at a given AAG concentration. However, meperidine binding increased significantly (p<0.01) as AAG concentration increased. Conversely, meperidine binding to albumin appeared to be independent of concentration of either meperidine or albumin. In conclusion, alpha1-acid glycoprotein is a major plasma protein which binds meperidine in patients during stress. Further studies are suggested to elucidate the role of AAG on the pharmacologic effects of meperidine.
Thrombotic Microangiopathy Associated with Chemotherapy: Case Report and Review of the Literature
Authors: Fields Suzanne M. , Lindley Celeste M.
Published: February 2017

Thrombotic microangiopathy (TMA) is a serious toxicity associated with a small number of antineoplastic agents. A case report of a patient with probable cisplatin and bleomycin-induced TMA is presented. The basic triad of symptoms that occurs in the TMA syndrome include microangiopathic hemolytic anemia, thrombocytopenia, and renal impairment. Cardiovascular, pulmonary, and neurologic complications also occur frequently. The pathogenesis of chemotherapy-associated thrombotic microangiopathy (C-TMA) has not been established. Proposed mechanisms include von Willebrand Factor abnormalities, decreased prostacyclin production, and immune complex formation. Treatment modalities have been unsuccessful and the majority of patients reported have died. Immunoperfusion with staphylococcal protein A is the most effective treatment available and this new technique appears promising. This article reviews the results of all cases of C-TMA reported to date in the English literature and discusses the theories of pathogenesis, clinical features, treatment, and treatment-related complications of the syndrome.
Cross-Sectional Study of the Ethics of Pharmacy Students
Authors: Boyce Eric G. , Montagne Michael , Reinsmith William A. , Hennessy Sean , Knowlton Calvin H.
Published: February 2017

The importance of ethics in pharmacy education and practice has recently received increased attention. Previous studies have addressed occupational orientation and personality traits as well as the nature of attitudes and values. Many unanswered questions remain. This cross-sectional study was designed to compare the attitudes and value priorities of pharmacy students in preprofessional and professional years of study and to evaluate a modified questionnaire. The 495 students who completed the questionnaire were representative of the 835 pharmacy students enrolled in this “0/5” undergraduate pharmacy program. The survey results indicated that honesty and full disclosure are preferences held by preprofessional students, whereas what may be described as professional judgment predominates in students during their final two professional years. Most students felt they had an idealistic or humanistic orientation. The differences among the classes may be due to any of a number of factors including curricula, normal maturation, or chance differences in the students within each class.
Beclomethasone Dipropionate in Chronic Asthma
Authors: Hart Linda L. , Middleton Robert K. , Cox Jennifer M. , Mowers Robert M.
Published: February 2017

THE DIAS ROUNDS is a discussion of requests for information received by various drug information centers and is edited by the Drug Information Analysis Service at the University of California, San Francisco. This issue features five requests: Beclomethasone Dipropionate in Chronic Asthma, Treatment of Psychosis in Pregnancy, Bromocriptine in Treatment of Depression, Nonoxynol 9 in Herpes, and IV Lidocaine as an Analgesic.
Developmental Pharmacology: Relationship to Drug Use
Authors: Reed Michael D.
Published: February 2017

The pharmacodynamics of drugs in children have been poorly understood, and only recently have technological advances permitted the issue to be studied. Factors that affect drug use in infants include absorption, distribution, protein binding, metabolism, renal elimination, and volume of distribution. Selection of antibiotics in this patient population should reflect commonly isolated organisms, such as staphylococci, group B streptococci, Escherichia coli, and gram-negative bacteria. An antibiotic must also have good penetration into the central nervous system. Displacement of bilirubin from its albumin-binding sites by drugs or endogenous substrates can lead to kernicterus, or bilirubin encephalopathy. The free bilirubin, rather than total concentration, appears to be only partly responsible for the development of kernicterus.
Protein Binding: What Does it Mean?
Authors: Scheife Richard T.
Published: February 2017

Protein binding can enhance or detract from a drug's performance. As a general rule, agents that are minimally protein bound penetrate tissue better than those that are highly bound, but they are excreted much faster. Among drugs that are less than 80–85 percent protein bound, differences appear to be of slight clinical importance. Agents that are highly protein bound may, however, differ markedly from those that are minimally bound in terms of tissue penetration and half-life. Drugs may bind to a wide variety of plasma proteins, including albumin. If the percentage of protein-bound drug is greater when measured in human blood than in a simple albumin solution, the clinician should suspect that the agent may be bound in vivo to one of these “minority” plasma proteins. The concentration of several plasma proteins can be altered by many factors, including stress, surgery, liver or kidney dysfunction, and pregnancy. In such circumstances, free drug concentrations are a more accurate index of clinical effect than are total concentrations. Formulary committees must grasp the clinical significance of qualitative and quantitative differences in protein binding when evaluating competing agents.
Achilles Tendon Rupture: Effect of Early Mobilization in Rehabilitation After Surgical Repair
Authors: Sorrenti Samiul J.
Published: February 2017

Background: Surgical and nonsurgical treatments of Achilles tendon ruptures are available. Nonsurgical treatment using immobilization does not have the varying degrees of infection as seen with surgical procedures, but it frequently is linked to muscle atrophy, weakness, and higher rates of rerupture than surgical treatment. This study reports the results of 64 patients with Achilles tendon ruptures treated surgically and with early mobilization. Methods: Surgery of the ruptured tendon involved dividing the proximal stump into two separate strands and the distal stump into a single strand. The repair was advanced to a V-Y formation, and nonabsorbable sutures were used for repair. After wound closure, an early mobilization rehabilitation program was initiated, which consisted of wearing a moveable ankle brace for 4 to 6 weeks in 0 to 15 degrees of dorsiflexion and 10 weeks of regular exercises. Results: All 64 patients resumed normal activities in an average of 3.3 months regardless of whether the rupture was acute or chronic. Tendons healed with no reruptures. There were 13 complications, all wound infections, which healed when treated with antibiotics. The infection rate dropped markedly when wounds were inspected and dressings changed 1 week postoperatively, instead of at 2 weeks. Conclusion: Surgery combined with early mobilization reduces range of motion loss, increases blood supply, and reduces the degree of muscle atrophy that typically occurs after Achilles tendon rupture, thereby decreasing the time to resumption of normal activities. Applying tension to the tendon also improved strength of the calf muscles and improved ankle movement. The main concern with early mobilization is rerupture, but this was lessened by patients carefully following the weightbearing and early mobilization protocols. The results of this study strengthen the argument to employ early mobilization rehabilitation after surgical repair.
The Distribution of the Superficial Peroneal Nerve on the Dorsum of the Foot and its Clinical Importance in Flap Surgery
Authors: Ikiz Z. Asli Aktan , Ucerler Hulya
Published: February 2017

Background: The superficial peroneal nerve (SPN) and its branches are at risk during surgical exposures. Our study aimed to demonstrate the distribution of the SPN on the dorsum of the foot to aid in surgical procedures close to this nerve. Methods: The SPN was dissected in 30 cadaver lower limbs (13 male and two female). Results: The variations in the distribution of the nerve were classified into seven types. Conclusion: A detailed knowledge of the branching patterns of the SPN may help to decrease iatrogenic injury to this nerve.
Novel Cognitive Paradigms for the Detection of Memory Impairment in Preclinical Alzheimer’s Disease
Authors: Loewenstein David A. , Curiel Rosie E. , Duara Ranjan , Buschke Herman
Published: February 2017

In spite of advances in neuroimaging and other brain biomarkers to assess preclinical Alzheimer’s disease (AD), cognitive assessment has relied on traditional memory paradigms developed well over six decades ago. This has led to a growing concern about their effectiveness in the early diagnosis of AD which is essential to develop preventive and early targeted interventions before the occurrence of multisystem brain degeneration. We describe the development of novel tests that are more cognitively challenging, minimize variability in learning strategies, enhance initial acquisition and retrieval using cues, and exploit vulnerabilities in persons with incipient AD such as the susceptibility to proactive semantic interference, and failure to recover from proactive semantic interference. The advantages of various novel memory assessment paradigms are examined as well as how they compare with traditional neuropsychological assessments of memory. Finally, future directions for the development of more effective assessment paradigms are suggested.
Evaluation of the Potential for Drug Interactions With Patiromer in Healthy Volunteers
Authors: Lesko Lawrence J. , Offman Elliot , Brew Christine Taylor , Garza Dahlia , Benton Wade , Mayo Martha R. , Romero Alain , Du Mond Charles , Weir Matthew R.
Published: February 2017

Introduction:

Patiromer is a potassium-binding polymer that is not systemically absorbed; however, it may bind coadministered oral drugs in the gastrointestinal tract, potentially reducing their absorption.

Methods:

Twelve randomized, open-label, 3-period, 3-sequence crossover studies were conducted in healthy volunteers to evaluate the effect of patiromer (perpetrator drug) on absorption and single-dose pharmacokinetics (PK) of drugs (victims) that might be commonly used with patiromer. Subjects received victim drug alone, victim drug administered together with patiromer 25.2 g (highest approved dose), and victim drug administered 3 hours before patiromer 25.2 g. The primary PK endpoints were area under the curve (AUC), extrapolated to infinity (AUC0-∞), and maximum concentration ( Cmax). Results were reported as 90% confidence intervals (CIs) about the geometric mean AUC0-∞ and Cmax ratios with prespecified equivalence limits of 80% to 125%.

Results:

Overall, 370 subjects were enrolled, with 365 receiving ≥1 dose of patiromer; 351 subjects completed the studies and all required treatments. When coadministered with patiromer, the 90% CIs for AUC0-∞ remained within 80% to 125% for 9 drugs (amlodipine, cinacalcet, clopidogrel, furosemide, lithium, metoprolol, trimethoprim, verapamil, and warfarin). The AUC0-∞ point estimate ratios for levothyroxine and metformin with patiromer coadministration were ≥80%, with the lower bounds of the 90% CIs at 76.8% and 72.8%, respectively. For ciprofloxacin, the point estimate for AUC0-∞ was 71.5% (90% CI: 65.3-78.4). For 8 of 12 drugs, point estimates for Cmax were ≥80% with patiromer coadministration; for ciprofloxacin, clopidogrel, metformin, and metoprolol, the point estimates were <80%. When patiromer was administered 3 hours after each victim drug, the 90% CIs for AUC0-∞ and Cmax for each drug were within the prespecified 80% to 125% limits.

Conclusion:

For 9 of the 12 drugs coadministered with patiromer, there were no clinically significant drug–drug interactions. For 3 drugs (ciprofloxacin, levothyroxine, and metformin), a 3-hour separation between patiromer and their administration resulted in no clinically significant drug–drug interactions.
How Did the Great Recession Affect Charitable Giving?
Authors: Brooks Arthur C.
Published: February 2017

A great deal of research has studied the effects of income and tax changes on charitable giving. However, little work has focused on how these relationships were affected by the Great Recession. This article estimates the tax and income effects using the 2009 Panel Study of Income Dynamics. The estimates are notably different than the typical findings from before the recession. Most importantly, tax effects are higher and income effects are lower. These unusual patterns are more pronounced for secular giving than for religious giving, and the effects are muted when only considering tax itemizers. The estimates are used to develop policy analytic results, considering the effects of the 2013 personal income tax rate increases and possible tax deduction limits currently under consideration. I find the tax increases to have a moderately stimulative impact on giving but predict a cap on charitable deductions would have a large negative impact.
Exudative Inflammatory Lesions in the Nasal Cavities of the 26-Week Tg.rasH2 Mice Oral Gavage Carcinogenicity Studies
Authors: Paranjpe Madhav G. , Belich Jessica L. , Richardson Dayauna R. , Vidmar Tom , Mann Peter C. , McKeon Marie E. , Elbekai Reem H. , Brown Caren
Published: February 2017

Three levels of nasal cavity sections (anterior, middle, and most posterior) are routinely examined as protocol required tissues in our 26-week carcinogenicity studies involving Tg.rasH2 mice. Exudative inflammation of the nasal cavity was noted in the most posterior section of both males and females that were administered vehicle and/or test article via oral gavage, particularly when the vehicle and/or test article had irritant properties, was in the form of a salt, had a low pH, and/or was viscous. The exudative inflammatory lesion was characterized by the presence of eosinophilic proteinaceous fluid, fibrin, mucin, sloughed cells, and degenerate neutrophils within the nasal cavities. In lesions of increased severity, there was often degeneration, necrosis, and erosion of the underlying mucosa. Often, there was hyperplasia as well as squamous metaplasia of the mucosa. Retrospective analysis of our data, involving thirty-two 26-week Tg.rasH2 carcinogenicity studies, revealed that despite the presence of these exudative inflammatory changes with degeneration, necrosis, and mucosal hyperplasia, progression to tumor formation in the nasal cavities was rare and the incidence of nasal tumors was comparable in animals with or without exudative inflammatory lesions.
Revisiting cognitive reserve and cognition in multiple sclerosis: A closer look at depression
Authors: Patel Viral P , Walker Lisa AS , Feinstein Anthony
Published: February 2017

Background:

The protective effect of cognitive reserve (CR) on cognition in people with multiple sclerosis (PwMS) has been well described.

Objective:

To explore the relationship between aspects of CR, namely, leisure pursuits and depression.

Methods:

In a cross-sectional study, a sample of 155 PwMS and 115 healthy controls (HC) underwent cognitive testing with the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) battery. Leisure activity was retrospectively recorded using the Leisure Activity Scale (LAS). Depression was assessed using the Hospital Anxiety and Depression Scale.

Results:

PwMS demonstrated greater decreases in leisure activity over time compared to the HC group, particularly in the past year ( p < 0.001). Here, depression accounted for 17% of the variance in determining the level of leisure activity ( p < 0.001). Premorbid IQ and leisure activity within the past year emerged as significant predictors of information processing speed, learning, memory and executive function. After controlling for depression, the influence of leisure activity on cognition was insignificant.

Conclusion:

Depression can cause significant changes in behaviour which can influence indices of CR, such as leisure pursuits. Successfully treating depression may lead to a more active lifestyle thereby offsetting in part the cognitive burden of disease.
Understanding body image in physical education
Authors: Kerner Charlotte , Haerens Leen , Kirk David
Published: February 2017

Body image disturbance in children and adolescents has negative implications for psychological and physical well-being. To positively impact well-being, it is important to explore factors that influence body image and to identify strategies that can be used to reduce body image disturbance. The school curriculum can play a significant role in shaping how children and adolescents experience their bodies. Within this school curriculum, physical education lessons represent one of the only school subjects in which the body is a focus of curricular outcomes. In physical education, the body is judged for physical ability but is also situated in a space that provides the potential for social comparisons and body judgements. Significant attention has been paid to the development of classroom-based interventions that aim at reducing body image disturbance, yet physical education has largely been ignored as a context in which one can effectively intervene. This paper reviews current knowledge on the relationship between physical education and body image disturbance by using the cognitive-behavioural model of body image developments as a guiding framework. It also considers the contribution that physical education could make to wider school-based interventions.
Impact of a telemedicine eICU cart on sepsis management in a community hospital emergency department
Authors: Machado Shana M , Wilson Erika H , Elliott John O , Jordan Kim
Published: February 2017

Introduction

Intensivist involvement for patients with sepsis is associated with decreased complications and mortality, and lower hospital resource utilization, but few studies have evaluated outcomes for patients exposed to electronic intensive care unit (eICU) telemedicine sepsis management in the emergency department (ED). In this study, we assess whether eICU cart exposure in the ED improved compliance with components of the 2010 Surviving Sepsis Campaign bundles, length of stay (LOS), disposition and hospital costs.

Methods

An institutional review board-approved, retrospective cohort study was completed on patients with confirmed sepsis who presented to our ED from July 2010 through February 2013.

Results

Of 711 patient ED encounters, 314 cases met criteria for analysis (95 exposed and 219 non-exposed). Patient cohorts had similar demographics and comorbid International Classification of Diseases, Ninth Edition (ICD-9) diagnoses. The exposed cohort received antibiotics more quickly (122.3 minutes ±83.3 versus 163.4 minutes ±204.4, p = 0.043) and were more likely to have lactic acid levels drawn within six hours (98.9% vs. 90%, p = 0.019). The exposed cohort had a shortened ED LOS (in days) 0.08 ± 0.28 versus 0.16 ± 0.37, p = 0.036. Hospital LOS, disposition and death were similar in both cohorts. Total hospital costs for the exposed cohort were lower and less variable (US$19,713 ± 16,550 vs. US$24,364 ± 25068), but this was not significant ( p = 0.274).

Discussion

Our findings suggest that in individuals with confirmed sepsis, ED exposure to a telemedicine-based eICU cart impacted adherence to aspects of the Surviving Sepsis Campaign recommended bundle, but did not impact overall survival and medical costs.
Parent–youth informant disagreement: Implications for youth anxiety treatment
Authors: Becker-Haimes Emily M , Jensen-Doss Amanda , Birmaher Boris , Kendall Philip C , Ginsburg Golda S
Published: February 2017

Greater parent–youth disagreement on youth symptomatology is associated with a host of factors (e.g., parental psychopathology, family functioning) that might impede treatment. Parent–youth disagreement may represent an indicator of treatment prognosis. Using data from the Child/Adolescent Anxiety Multimodal Study, this study used polynomial regression and longitudinal growth modeling to examine whether parent–youth agreement prior to and throughout treatment predicted treatment outcomes (anxiety severity, youth functioning, responder status, and diagnostic remission, rated by an independent evaluator). When parents reported more symptoms than youth prior to treatment, youth were less likely to be diagnosis-free post-treatment; this was only true if the youth received cognitive-behavioral therapy (CBT) alone, not if youth received medication, combination, or placebo treatment. Increasing concordance between parents and youth over the course of treatment was associated with better treatment outcomes across all outcome measures ( ps < .001). How parents and youth “co-report” appears to be an indicator of CBT outcome. Clinical implications and future directions are discussed.
Physical activity intensity and subjective well-being in healthy adults
Authors: Panza Gregory A , Taylor Beth A , Thompson Paul D , White C Michael , Pescatello Linda S
Published: February 2017

The effect of physical activity intensity on subjective well-being has not been well established. We examined this relationship among 419 healthy adults using objective and subjective physical activity measurements (sample size varied among well-being assessments). For accelerometers, light-intensity physical activity positively associated with psychological well-being ( n = 150) and negatively associated with depression ( n = 99); moderate intensity negatively associated with pain severity ( n = 419) and positively associated with psychological well-being; sedentary behavior negatively associated with psychological well-being and positively associated with depression ( ps < .05). These findings were generally consistent with subjective measurements of physical activity (Question 8, Paffenbarger Questionnaire). Higher levels of sedentary behavior are associated with lower subjective well-being.
A case-control study of psychosocial factors and their relationship to impairment and functionality in multiple sclerosis
Authors: Briones-Buixassa Laia , Milà Raimon , Arrufat Francesc X , Aragonès Josep Mª , Bufill Enric , Luminet Olivier , Moss-Morris Rona
Published: February 2017

The stress effect on multiple sclerosis remains unclear. Moderating psychosocial factors may be involved. This study compares some of them in people with multiple sclerosis and healthy controls, and their association with disease parameters. Coping style, social support, anxiety, alexithymia and early-life stress were measured, along with impairment and functionality. People with multiple sclerosis scored significantly higher on anxiety, alexithymia, and avoidance and instinctive coping but lower in social support. No differences were found in early-life stress. Impairment was related to avoidance, and functionality to avoidance and anxiety. Psychotherapeutic approaches focused on these psychosocial factors may improve functionality, impairment and quality of life in people with multiple sclerosis.
Information support, illness perceptions, and distress in survivors of differentiated thyroid cancer
Authors: Wiener Chelsea H , Cassisi Jeffrey E , Paulson Daniel , Husson Olga , Gupta Rema A
Published: February 2017

Survivors of differentiated thyroid cancer report significant distress. This study examines illness perceptions as mediating the relationship between information support and distress among survivors of differentiated thyroid cancer. Data were obtained from the Patient Reported Outcomes Following Initial Treatment and Long-term Evaluation of Survivorship registry. Model results revealed that greater information support was associated with better illness perceptions, and that better illness perceptions were associated with less distress. Information support and distress were indirectly related via illness perceptions. Results highlight the importance of addressing illness perceptions in this population and suggest that informational interventions may help serve this function.
Fathoming the constellations: Ways of working with families in music therapy for people with advanced dementia
Authors: Freeman Adrienne
Published: February 2017

This article will focus on the role of music therapy for people with advanced dementia and their families as well as considering the resource that the family can be for the Music Therapist in informing their work. Information on meaningful themes in the life of the person with dementia can be provided by the constellation of significant people around them. The importance of personal history and identity will be explored. Family members can influence music therapy in numerous ways, both outside and within sessions. This article will explore ways in which a reciprocal relationship, or therapeutic alliance, can be developed with family members and their loved one, with an emphasis on finding a unique approach that fits the family concerned. Much pain is encountered in this work, requiring the Music Therapist to proceed with caution and sensitivity. Ways in which music therapy enables expression of intimacy, particularly between couples, will also be addressed. Clinical illustrations underpin themes of this article, demonstrating the value of alliances being made between the Music Therapist and family members.
Gastrointestinal dysfunctions as a risk factor for sleep disorders in children with idiopathic autism spectrum disorder: A retrospective cohort study
Authors: McCue Lena M , Flick Louise H , Twyman Kimberly A , Xian Hong
Published: February 2017

Sleep disorders often co-occur with autism spectrum disorder. They further exacerbate autism spectrum disorder symptoms and interfere with children’s and parental quality of life. This study examines whether gastrointestinal dysfunctions increase the odds of having sleep disorders in 610 children with idiopathic autism spectrum disorder, aged 2–18 years, from the Autism Genetic Resource Exchange research program. The adjusted odds ratio for sleep disorder among those with gastrointestinal dysfunctions compared to those without was 1.74 (95% confidence interval: 1.22–2.48). In addition, the odds of having multiple sleep disorder symptoms among children with gastrointestinal dysfunctions, adjusted for age, gender, behavioral problems, bed wetting, current and past supplements, and current and past medications for autism spectrum disorder symptoms were 1.75 (95% confidence interval: 1.10–2.79) compared to children without gastrointestinal dysfunctions. Early detection and treatment of gastrointestinal dysfunctions in autism spectrum disorder may be means to reduce prevalence and severity of sleep problems and improve quality of life and developmental outcomes in this population.
‘Suddenly the first fifty years of my life made sense’: Experiences of older people with autism
Authors: Hickey Aoife , Crabtree Jason , Stott Joshua
Published: February 2017

Research on the experience of growing older with autism is very limited. In this study, 13 people with autism aged over 50 years participated in semi-structured interviews about their experiences of diagnosis, social support and getting older. Interviews were analysed using thematic analysis. Three overarching themes were generated: difference, life review and longing for connection. Prior to diagnosis, individuals had awareness of their difficulties, attributed these to intrinsic difference and engaged in a deliberate process of reducing the visibility of this difference. Diagnosis prompted a process of life review and externalisation, whereby past negative experiences were reattributed to autism as opposed to the self. Loneliness, isolation and yearning for interpersonal connection were ubiquitous and longstanding. Autism support and social groups were highly valued, offering opportunities for belonging, acceptance and social comparison. Results highlight the similarity to younger age groups in terms of lived experience and need for greater support, particularly with respect to reducing isolation and improving access to diagnosis.
Are males and females with autism spectrum disorder more similar than we thought?
Authors: Mussey Joanna L , Ginn Nicole C , Klinger Laura G
Published: February 2017

Differences in behavioral and cognitive profiles have been suggested to potentially impact the presentation of social and communication symptoms in females with autism spectrum disorder. This study examined gender differences in age of diagnosis, cognitive profiles, social communication symptomatology, and autism spectrum disorder symptom severity in a community-based sample of 566 males and 113 females with autism spectrum disorder ranging in age from 1 year, 9 months to 56 years, 4 months. Results suggest either very small or no gender differences in age at diagnosis, intelligence quotient, cognitive profiles, or autism spectrum disorder symptom severity. This is a departure from clinical lore that females with autism spectrum disorder are more likely to have lower intelligence quotient and more severe impairments. There is a slight difference in symptom severity with females having higher average total Childhood Autism Rating Scale scores, but this difference is likely of minimal clinical significance. In contrast, on the Autism Diagnostic Observation Schedule–Generic, females were found to receive lower scores than males particularly on modules 2 and 3. Across males and females, individuals with stronger verbal problem-solving skills were found to receive lower Autism Diagnostic Observation Schedule–Generic module 3 scores. Given the language demands of this module, additional attention may be warranted when evaluating older children and adolescents for autism spectrum disorder.
Interruptions of time: The coverage of the missing Malaysian plane MH370 and the concept of ‘events’ in media research
Authors: Sonnevend Julia
Published: February 2017

The article makes a case for foregrounding ‘event’ as a key concept within journalism studies before, during, and after the digital age. The article’s first part presents an overview of the existing research on events in philosophy, sociology, historiography, and journalism studies, arguing that the concept of ‘event’ has not received sufficient attention in journalism studies. The article’s second part demonstrates the need to consider ‘event’ as an essential concept of journalism studies through an empirical case study: the news coverage of the disappeared Malaysian Airlines plane MH370 (8 March 2014) in four American news outlets, The New York Times, The Washington Post, The Wall Street Journal and CNN. This article argues that journalists employed two strategies in their coverage: (1) they created and/or covered what the article calls ‘substitute events’, defined as minor events in the present that journalists perceived as new happenings and that led to further reporting and (2) turned to the past and the future for events in their reporting, extending the scope of coverage from the relatively eventless present. Overall, the case study shows that journalists are limited in their narration by the power of events, and they are eager to construct and cover events, even when events are not readily available.