bluuebunny/crossref_metadata_2025 huggingface dataset:
Whiteheadian Creativity, the Tao, and the Thomistic Act of Being
Authors: Bracken Joseph A.
Published: July 2017

The notion of Creativity within the philosophy of Alfred North Whitehead offers a generalised structure of intelligibility. Creativity is not an entity, not even God as the Supreme Being or utterly transcendent entity, but an underlying activity which serves as the ontological ground for everything that exists. Comparisons can thus be made between the notion of the Tao within classical Chinese philosophy, the God-world relationship within the philosophy and theology of Thomas Aquinas, and the neo-classical process-oriented metaphysics of Whitehead. It is arguable that a transcendent activity underlies all the particular changes in this world.
Living in Two Worlds
Authors: McCaughey J. Davis
Published: July 2017

At the end of the twentieth century, in the course of which the world has seen such monstrous evils, the first and most urgent task of Christians, among others, is to remember — as writers such as Anna Akhmatova and Elie Wiesel have reminded us. It is uniquely the power of memory, which in turn becomes story, which brings hope to birth and so enables the human being to live between worlds without being torn part.
The Eulogies on Macrina and Gorgonia: Or, What Difference Did Christianity Make?
Authors: Sheather Mary
Published: July 2017

Macrina and Gorgonia were two prominent women of the Cappadocian church. The eulogies given at the time of their death offer a portrayal of the role of women in the Christian community in that period and show the ways in which being a Christian offered women an opportunity to do away with the traditional pagan way of life.
Catchments for God-Talk: Karl-Josef Kuschel and Theological Language
Authors: Godfrey Michael J. H.
Published: July 2017

In this article a case is made for greater use of the works of creative imagination, particularly literature, in the formation of theological language. Particular reference is made to the recent theology of Karl-Josef Kuschel and to the writings of R. S. Thomas, James K. Baxter, D. H. Lawrence, and Fyodor Dostoevsky.
When a Good Conscience Errs
Authors: Gleeson Gerald
Published: July 2017

Standard Roman Catholic theology emphases the truth of the moral law and typically regards an error of conscience as a matter of ignorance, for which a person may be more or less culpable. Those who in good faith do wrong are, at best, to be “excused” rather than blamed. This article goes beyond the categories of ignorance, mistake and excuse to offer a positive evaluation of the good, albeit erring, conscience. Newman's understanding of the twofold nature of conscience is compared with recent studies of the distinction between (moral) goodness and (ethical) rightness. A well-formed conscience is shown to be both upright and faithful, and open to continuing conversion.
Finding the Framework to Prepare for Dialogue with Aborigines
Authors: Fletcher Frank
Published: July 2017

It is simplistic to tell Euro-Australians that the condition of Aboriginal people is due solely to our (Euro-Australian) acts of injustice and ignorance. Christians cannot adequately prepare for dialogue with the Aborigines within such a framework. What is needed is a framework that reflects the truth within ourselves as well as about ourselves. The first framework proposed in this essay understands the Euro-Australian “soul” to be caught in a conflict between the modern historical and the primal: a conflict that lies behind much of our treatment of the Aborigines. However, this conflict carries within it a deeper conflict and suppression: facing that conflict brings us to the true transforming framework to dispose for dialogue.
From Eschatology to Trinity: Pannenberg's Doctrine of God
Authors: Mostert Christiaan
Published: July 2017

This article comprises three parts. The first part establishes some important landmarks in Pannenberg's theology as it has developed over a number of decades. In the second part Pannenberg's identification of God with the future is noted, with particular reference to an early essay. The final part shows how this theme is taken up into the explicitly trinitarian theology which is the hallmark of Pannenberg's theological magnum opus.
“Practical Theology”: A New Sensibility for Theological Education
Authors: Veling Terry A.
Published: July 2017

“Practical theology” is emerging as a key theme in recent literature concerned with the future of theological education. This essay explores this new orientation as a vital attempt to bring theological education into serious engagement with the socio-cultural, political, economic and ecclesial contexts shaping our lives. The final section of the essay seeks to evoke some resonances between “practical” and “postmodern” sensibilities.
Determining Catholic Orthodoxy: Monologue or Dialogue
Authors: Rush Ormond
Published: July 2017

This article examines the notion of orthodoxy and the appropriate process for its determination in the Catholic Church. After outlining extreme approaches to the question, the article proposes that any approach to the determination of orthodoxy must make clear its position on three areas of theological enquiry: the theology of religious language; theological epistemology; and theological hermeneutics. It is then proposed that the determination of orthodoxy is a dialogic process of reception within the church.
Eucharist, Theology and Discipleship
Authors: Hamilton Andrew
Published: July 2017

The author begins by describing the qualities of Eucharistic celebration in functioning Australian Eucharistic communities. He then summarises the eucharistic theology of Josef Ratzinger, who provides a well-argued basis for criticising these qualities. Because discipleship is expressed in local situations, we should expect to find the life of the local communities taken into the celebration of the Eucharist. Within the acceptance of Apostolic proclamation and office, we should also expect to find a democratic and demotic spirit because these express the shape of discipleship in Australia, and so may not improperly be called the gift of Australia to the universal church.
The Two Magdalene Reports on the Risen Jesus in John 20
Authors: Crotty Robert
Published: July 2017

This article offers a review of previously suggested structures of John 20 and proposes an alternative structure based on both linguistic and thematic grounds. The theological message of the text delineated by this structure indicates the resurrection event as narrated in John 20 depicts the completion of Jesus' ministry and concludes the gospel message. Henceforward, the interpretation of Scripture, hê graphê, and the preaching of the word, legein, would replace the original event for subsequent potential and actual Christians. Mary Magdalene, as she exists in the Johannine narrative, provided the living link between original events and the subsequent interpretation and preaching of the Christian community.
Ministry, Disability and Brokenness: Orthodox Insights into the Authority of the Priesthood
Authors: Chryssavgis John
Published: July 2017

Christian ministers must learn to acknowledge the authenticity — and thereby the authority — of their own weakness and woundedness. From an Orthodox Christian spiritual perspective, the awareness of one's imperfection and brokenness can, paradoxically, become a source not only of personal blessing but also of ordained vocation. The idealisation of physical beauty and external wholeness, frequently at the exclusion of difference and brokenness, is more characteristic of classical Greek aesthetics than of Christian asceticism. The notion of prayerful waiting inroduces a third expression of our brokenness, the shattered world around us as we stand — or kneel — before the twenty-first century. The brokenness of creation reveals a further aspect of the role of the priest.
The Radical Irony of Tradition: Revis(ion)ing Antipodean Anglo-Catholicism
Authors: Hogan Trevor
Published: July 2017

This essay uses the recent revisionary histories of Australian Anglo-Catholicism by Colin Holden to revisit the antinomies of conservatism and radicalism in traditions (theological and political). In particular, it highlights the radical ironies contained within “retro-radicalism” of Anglo-Catholicism whereby the renewal of tradition requires both the recognition of its own plural and conflictual history and an active engagement with contemporary challenges. By developing a peripheral vision of the peculiar and contingent stories of provincial and regional traditions of one reform movement within Australian Anglicanism, Holden's histories offer a rich and complex vision of recurring global themes of centre and periphery: of empire and colony, imperialism and nationalism, race and culture, city and country, church and state. It is concluded that the future of Anglo-Catholicism, after the fact of its historic decline, must perforce lie in a rediscovery of its radical kernel: namely, of a sacramental connecting of ritual and art to the politics of socialism and associative democracy, and in both keys reaffirming a theology of the Trinitarian God.
Drug Testing in Police Agencies
Authors: Carper Gayle Tronvig , McCamey William
Published: July 2017

The recent United States Supreme Court decision regarding drug testing does not end the debate over acceptable procedures and justifications for obtaining a drug free police force. A government's desire to drug test its law enforcement officials may still be judged on a case by case basis. Drug testing programs must be carefully planned to properly balance government interests and individual rights. This article discussed the various approaches taken by state and federal courts faced with the competing concerns of government and the individual.
To Err is Human: Estimating Alcohol Content and Its Effects
Authors: Giacopassi David J. , Stein Preston M.
Published: July 2017

Questionnaires were given to 459 undergraduate stu dents to determine how accurately they could estimate the number of drinks (beer, light beer, wine, wine coolers, and whiskey) they would have to consume to become legally intoxicated. Using Widmark's formula, the projected number of drinks necessary to reach a blood alcohol level of .10 percent level of intoxication was calculated for each respondent. Results indicate that although responses differ by gender, respondents gener ally have a poor understanding of the number of drinks necessary to reach an intoxicated state and that respon dents tend to underestimate the intoxication power of wine coolers and overestimate the intoxication power of whiskey. The implications of these findings for crimino logical theory are discussed.
Prescribing of Drugs in a Nursing Home
Authors: Bergman H. David
Published: July 2017

Drug utilization review (DUR) is rapidly becoming a major component of the quality assurance programs of institutions involved in health care. Other DUR investigations and systems have substantiated the need for further DUR studies. DUR in the nursing home has received only limited attention; therefore, a study was conducted to review the prescribing of drugs by 23 physicians who care for patients on a monthly basis in a 106-bed nursing home.

The major objectives of the study were to review drugs prescribed by comparing their designated use with the FDA-approved use and with their efficacy and/or need in each case.

Only 31 (4.1 percent) of the 759 drugs prescribed were not prescribed for their FDA-approved use. However, 171 (22.6 percent) of 758 drugs prescribed were considered not effective and/or not needed by criteria used in this study.

The fact that the physician only reviews the patient's status monthly may motivate him to prescribe more drugs than needed in order to anticipate possible problems. This also requires the L.P.N. to make judgments concerning drug therapy that should be the role of other health professionals.

The results of this study demonstrate the need for DUR in the nursing home and emphasize an important role for the pharmacist in this area.
Physician Prescribing Patterns–
Authors: Knoben James E. , Wertheimer Albert I.
Published: July 2017

The purpose of this report is to delineate the different therapies prescribed in the outpatient setting for the various age groups in our population. The data were derived from a special tabulation of unpublished figures by the National Disease and Therapeutic Index, available from I.M.S. America, Ltd. The data provide a general introduction to the volume of drug use by age groups, and the appearance of drug products from the 100 most frequently prescribed list. Additionally, a more refined picture of differences among age groups by therapeutic category is presented.
Medication Taking Behavior of the Elderly
Authors: Lundin Dorothy V.
Published: July 2017

The results of structured interviews of fifty persons aged 65 years and older who were living independently in the community indicated that hazardous as well as wasteful practices were occurring in their medication taking behavior. Sixty-six percent of the medications used by this population were being taken without adequate instructions and twenty-five percent of the medications were not being taken as labeled. There is a need for a greatly improved coordination, improved education, and advocacy involving patients, nurses, pharmacists and physicians in medication use.
Oral Contraceptive Associated Liver Tumors
Authors: Waschek James A. , Helling Dennis K.
Published: July 2017

Over the past few years an association between oral contraceptive use and liver tumors has been suggested, and this is now being studied on an epidemiological basis. Large scale retrospective studies to date support a relationship between oral contraceptive use and benign liver tumors. These tumors carry a significant risk of spontaneous rupture. The possible relationship with malignant liver tumors is also discussed. Clinical aspects of these tumors are presented, as well as suspected oncogenic mechanisms.
pKa Values of Medicinal Compounds in Pharmacy Practice
Authors: Newton David W. , Kluza Ronald B.
Published: July 2017

A brief review of pKa values and their uses in pharmacy practice is presented. Tables of pKa values for 400 medicinal compounds, of pH values of 18 body fluid sites, and of electron-inducing chemical substituents are provided. Adequate literature sources are included to permit further reference to the more detailed aspects of conditions associated with pKa value determinations or uses.
Pharmacoeconomic Aspects and Formulary Considerations Related to Histamine2-Receptor Antagonists
Authors: Souney Paul F. , Stoukides Cheryl A.
Published: July 2017

Since the introduction of cimetidine in 1977, hospital expenditures for the histamine2-receptor antagonists have steadily increased, making them one of the most costly classes of therapeutic agents. As a result of cost considerations, we reviewed the available antiulcer agents in our hospital and evaluated the potential for therapeutic interchange within this group of agents. We found that by using famotidine as the principal agent in our hospital, drug cost savings of approximately $65 000 were realized. Additionally, avoiding the administration of approximately 13 000 parenteral doses with the selection of famotidine resulted in further reduction of drug administration costs. We conclude that the histamine2-receptor antagonists represent a cost-effective target for pharmacy cost-containment programs, without affecting patient therapeutic outcomes.
Nitrendipine: A New Dihydropyridine Calcium-Channel Antagonist for the Treatment of Hypertension
Authors: Santiago Tamara M. , Lopez Larry M.
Published: July 2017

Nitrendipine, an investigational dihydropyridine calcium-channel antagonist for the treatment of hypertension, is reviewed. Clinical trials report efficacy equal to that of hydralazine, diuretics, beta-blockers, and other calcium-channel blockers such as nifedipine, verapamil, and isradipine. Nitrendipine has a favorable pharmacokinetic profile in that it is well absorbed and has a half-life long enough to allow once-daily administration in some patients. However, considerable variation observed with some pharmacokinetic parameters has consequently delayed marketing approval by the Food and Drug Administration. Adverse effects are generally mild and transient, and result from nitrendipine's vasodilatory properties. Nitrendipine may increase digoxin plasma concentrations in some patients, but this may not be clinically significant. Other studies are required to ascertain which drugs interact with nitrendipine. In summary, nitrendipine is safe and effective for treatment of hypertension, and because of its longer duration of action as well as lack of metabolic side effects, may provide an alternative to the present antihypertensive armamentarium.
Self-Reported Neuroendocrine Effects of Antipsychotics in Women: A Pilot Study
Authors: Hartzema Abraham G. , Porta Miquel S. , Tilson Hugh H. , Zito Julie Magno , Sofair Jane B. , Jaeger Judith
Published: July 2017

Although neuroendocrine adverse effects (NAEs) of antipsychotic agents in women have been widely reported, it has been generally assumed that either (1) tolerance to these effects develops with chronic use, (2) patients adjust to the effects, or (3) a trial of dopamine-agonist treatment is effective. We have begun to examine the prevalence of chronic adverse effects and their effect on compliance using a pilot study of self-reported NAEs, antipsychotic drugs, and compliance patterns in a naturalistic setting. Twenty chronic psychiatric outpatients who had been continuously prescribed antipsychotic agents for a minimum of six months were interviewed. The major finding is the greater antipsychotic dose exposure among those with self-reported NAEs compared with those without NAEs (781 ±606 chlorpromazine-equivalent mg/d vs. 125 ± 117, p<0.001). High-potency agents were prescribed for all of the patients reporting amenorrhea and/or galactorrhea, although the relationship between potency group (high vs. low) and total neuroendocrine effects was not significant. Self-reported compliance was not significantly related to neuroendocrine adverse effects. However, a trend toward the association of self-reported galactorrhea and noncompliance (p=0.08) is noted. The implications of these findings and a suggested approach for their replication in a more powerful statistical analysis is discussed.
Selecting Cost-Effective Antimicrobial Prophylaxis in Surgery: Are We Getting What We Pay for?
Authors: Roach Albert C. , Kernodle Douglas S. , Kaiser Allen B.
Published: July 2017

The acquisition, administration, and infection-related expenses associated with the use of cefazolin or cefamandole during a prospective randomized comparison of antimicrobial prophylaxis in cardiac surgery were compared. Although the acquisition cost and administration charges related to the use of cefamandole were in excess of those incurred with cefazolin, differences in the charges associated with treating the wound infections that failed prophylaxis with each regimen made cefamandole the more cost-effective prophylactic agent (mean total of $766 per cefazolin recipient vs. $315 per cefamandole recipient). Analysis of prophylactic antimicrobials should include the expenses associated with “prophylactic failures.” The agent that is least expensive for the pharmacy may not be the most cost-effective choice for the institution.
Stability of Famotidine in a 3-IN-1 Total Nutrient Admixture
Authors: Shea Brian F. , Souney Paul F.
Published: July 2017

The stability of famotidine in a 3-in-1 total nutrient admixture stored at room temperature (24°C) was evaluated over 24 hours. Famotidine injection was diluted to a theoretical concentration of 20 mg/L in a total nutrient admixture containing 5% amino acid injection, 25% dextrose injection, and 2.25% intravenous fat emulsion. Admixtures were prepared in 2-L ethylene-vinyl acetate bags using conventional techniques and stored at room temperature. At 0, 4, 8, 12, and 24 hours, the admixtures were visually inspected for color change, creaming, or phase separation, and samples were obtained for assay with a stability-indicating method of HPLC, using samples obtained at time zero as controls. Two-way analysis of variance was used for data evaluation. There was no evidence of color change, creaming, or phase separation before quantitative analysis was performed, nor was there significant change in observed famotidine concentration over 24 hours. Based upon our data, famotidine intravenous solution 20 mg/L in the solution tested is stable at room temperature for 24 hours.
Severe Hypomagnesemia Induced by Pentamidine
Authors: Burnett Richard J. , Reents Stan B.
Published: July 2017

The use of pentamidine for treating Pneumocystis carinii pneumonia in AIDS patients has increased the awareness of pentamidine-induced adverse reactions. We report a case of severe hypomagnesemia and concurrent hypocalcemia that occurred during therapy with intravenous pentamidine. Pentamidine therapy was subsequently changed to the nebulized route. Electrolyte imbalances were corrected after daily supplementation with high doses of magnesium and calcium. Clinicians should monitor for electrolyte imbalances which can be severe in patients receiving prolonged courses of pentamidine therapy.
Perphenazine-Induced Priapism
Authors: Chan John , Alldredge Brian K. , Baskin Laurence S.
Published: July 2017

A 29-year-old man experienced four episodes of prolonged painful erection while being treated with perphenazine for paranoid schizophrenia. Each episode of priapism lasted five hours or longer. On two occasions, aspiration of blood from the corpora cavernosa resulted in detumescence; the other episodes were successfully managed with operative shunting of blood from the congested cavernosa. Perphenazine was discontinued after the fourth episode of priapism and antipsychotic treatment with thiothixene was subsequently initiated. During 16 months of follow-up, the patient has reported normal erections without repeat episodes of priapism.
Clinical Pharmacokinetics of Daptomycin
Authors: Pryka Randy D. , Novak Richard M. , Wagner David K. , Rodvold Keith A.
Published: July 2017

Daptomycin is a new lipopeptide antibiotic for which preliminary pharmacokinetic data in adults have been limited to normal healthy volunteers and patients with renal insufficiency. We report the clinical pharmacokinetics of the first and fifth doses of iv daptomycin 150 mg (2 mg/kg) q24h in a 29-year-old man being treated for a gram-positive cellulitis and thrombophlebitis. Individual pharmacokinetic parameters yielded similar results during doses one and five. The pharmacokinetic profile observed in our patient did not markedly differ from data obtained from healthy volunteers.
Prophylaxis of Posttraumatic Seizures
Authors: Kuhl David A. , Boucher Bradley A. , Muhlbauer Michael S.
Published: July 2017

The issue of routine anticonvulsant prophylaxis for early and late posttraumatic epilepsy (PTE) has received much attention in the medical literature. Such problems as lack of standard definitions for early and late PTE, the retrospective design of most studies, the wide variability of inclusion and exclusion criteria, and the varied duration of follow-up make this body of literature extremely difficult to evaluate. Severe head trauma appears to cause injured neurons to become hyperexcitable; this in turn brings about the formation of an epileptogenic focus during the time between trauma and seizure occurrence. Both military and civilian head injury populations have been used to evaluate the incidence of PTE. Early seizures (i.e., <7 days) occur in approximately 3–5 percent of the head injury patients in both the military and civilian groups. Factors increasing this incidence include intracranial hematoma, focal neurologic deficits, posttraumatic amnesia (PTA) lasting >24 hours, depressed skull fracture, and age <5 years. The incidence of late seizures is directly related to the extent of brain damage. The military population, composed primarily of cases with penetrating head injury, is associated with a late PTE incidence of approximately 30–50 percent. Closed head injuries in the military population involve a 5–15 percent seizure incidence. Late PTE incidence after head injuries in the civilian population is <5 percent. Risk factors associated with late PTE include loss of consciousness or PTA lasting >24 hours, dural lacerations, depressed skull fractures, and various computerized tomography deficits. These factors vary slightly between the military and civilian populations. Seizures typically present as focal or generalized, or as a mixed focal-generalized seizure that begins as a focal and progresses into a generalized seizure. Studies on the efficacy of prophylactic treatment have given equivocal results. Most studies to date have included insufficient numbers to show significance. Few well-controlled trials have been conducted. Based on these findings, prophylactic treatment of early seizures is recommended, especially if risk factors are present. Although the evidence supporting the use of anticonvulsants in late PTE is much weaker, treatment should be considered if risk factors exist. Duration of treatment will depend upon the severity of the injury and the number of risk factors present. There is need for a large cooperative trial to determine the usefulness of prophylactic therapy for the prevention of seizures in head trauma patients.
Effect of a Clinical Pharmacist Program on the Cost of Hypertension Treatment in an HMO Family Practice Clinic
Authors: Forstrom Margo J. , Ried L. Douglas , Stergachis Andy S. , Corliss Don A.
Published: July 2017

This study evaluated the impact of a clinical pharmacy service on the cost of antihypertensive drug therapy in an HMO family practice clinic. The service was provided to five family practice physicians. Pharmacists identified hypertensive patients prior to their regularly scheduled office visits from April through June 1986. Patient's medical records and computerized drug files were reviewed, and written recommendations for drug therapy changes were placed in patients' medical record by the pharmacists. When appropriate, pharmacists alerted prescribers to lower cost alternatives. A matched control group of physicians was selected. Hypertensive patients were identified retrospectively in the control group. We found that the cost of antihypertensive drug therapy was significantly higher for study physicians' patients when compared with control physicians' patients in the period prior to implementing the service. The difference between the two groups was not significant after six months. Clinical pharmacist intervention decreased the average cost of antihypertensive treatment from 33.4 to 27.2 cents per day.
In Vitro Evaluation of Bleomycin-Induced Cell Lethality from Plastic and Glass Containers
Authors: Stajich Gregory V. , Miyahara Randell K. , Alonso Kenneth
Published: July 2017

To optimize cancer chemotherapy, a considerable amount of research has been expended to study pharmacologic, pharmacokinetic, biochemical, and pharmaceutic properties of antineoplastic agents. However, published data on the stability and compatibility of these agents in various administration fluids and containers are few in number. Evidence of a significant decrease in stability as shown by high-performance liquid chromatography has been reported when bleomycin was infused in plastic containers for prolonged periods (over 24 hours) as compared with the same procedure with glass containers. Because administration of bleomycin is usually given as a continuous infusion, we undertook this study to determine whether the drug loss of stability that occurs in plastic containers results in a therapeutic loss of efficacy (cytotoxicity). By using a tumor stem-cell assay we compared the quantitative effects of bleomycin in plastic and glass containers on cell lethality. The results from our assay showed no significant difference in cell lethality by bleomycin from its aqueous solution stored in glass and plastic containers over the time periods observed. If these results had been statistically significant, the tumor stem-cell assay may have been shown to be a more sensitive means of determining the clinical significance of these stability studies.
Ranitidine—Theophylline Interaction—Fact or Fiction?
Authors: Hegman Greg W. , Gilbert Robert P.
Published: July 2017

We report a 63-year-old woman who developed theophylline toxicity on two separate occasions after the addition of ranitidine to her drug regimen. The first incident occurred during hospitalization, when the patient developed classical signs of theophylline toxicity (e.g., nausea, anxiousness, tremor, cardiac arrhythmias) within 48 hours after the addition of ranitidine to her drug regimen. Her theophylline concentration on the third day of overlap of these medications was 312.4 μmol/L while she was receiving sustained-release theophylline 300 mg q4h. A concentration obtained 14 days prior to admission was 115.5 μmol/L when she was receiving a comparable dosage of theophylline (300 mg five to six times a day, depending on the need for a nighttime dose). The second incident involved the unintentional rechallenge of the patient with oral ranitidine, on an outpatient basis, which again resulted in clinical theophylline toxicity with a rise in concentrations from 104.5 to 187.6 μmol/L. In both instances, the theophylline concentrations returned to expected values for this patient with the discontinuation of ranitidine. The rechallenge of this patient with ranitidine substantiated our initial suspicion that a ranitidine–theophylline drug interaction occurred in this patient. The possibility of such an interaction was further supported by other case reports in the literature. These case reports are contrary to controlled studies which show no evidence of a ranitidine–theophylline drug interaction. However, the number of subjects in such studies are small, and our case report and others suggest that this drug interaction may occur in select patients. Whereas this drug interaction appears to be rare, there does not exist justification to avoid this combination of medications. In light of these case studies, we believe it is prudent to closely monitor patients for signs of theophylline toxicity if ranitidine is added to a patient's drug regimen.
Selegiline: Initial or Adjunctive Therapy of Parkinson's Disease?
Authors: Fuller Matthew A. , Tolbert Sandra R.
Published: July 2017

Parkinson's disease (PD) is a progressive neurologic motor disorder. Currently, levodopa/carbidopa is the standard mode of therapy for PD; however, it does not prevent progression of the disease. Selegiline (also known as deprenyl), is a selective irreversible monoamine oxidase type B inhibitor virtually devoid of the tyramine reaction at the recommended dosage of 10 mg/d. It is approved by the Food and Drug Administration for the adjunctive use in the management of patients with PD who are receiving levodopa/carbidopa and exhibit a “wearing off' effect of levodopa. Numerous clinical trials have been conducted evaluating selegiline's role in the treatment of PD. Preliminary evidence from the DATATOP trial suggests that selegiline may slow the progression of PD when used as initial therapy. However, final results of this trial and additional long-term controlled trials comparing selegiline to levodopa and placebo groups are necessary to further clarify selegiline's role in the treatment of PD.
Foscarnet Sodium
Authors: Minor James R. , Baltz Julie K.
Published: July 2017

Cytomegalovirus (CMV), a major opportunistic viral pathogen frequently causing disease in immunocompromised patients such as organ transplant recipients and people with AIDS, may present as pneumonitis, gastrointestinal disease, or encephalitis. Its most common manifestation in patients with AIDS is retinitis which, if left untreated, invariably progresses to extensive retinal necrosis and ultimately to blindness. Ganciclovir sodium, currently the only licensed antiviral agent for the treatment of CMV retinitis, effectively controls this infection in a majority of AIDS patients, but significant granulocytopenia or thrombocytopenia related to ganciclovir therapy often limit its clinical application. Myelosuppression may be further exacerbated in AIDS patients by such other agents as zidovudine or trimethoprim/sulfamethoxazole, often necessitating dosage reductions or discontinuation of these agents in patients receiving ganciclovir. Foscarnet sodium, a pyrophosphate analog active against both cytomegalovirus and the human immunodeficiency virus type 1 (HIV), may be an effective alternative to ganciclovir in the management of CMV retinitis. Trials with intravenous foscarnet in CMV retinitis have reported favorable results using initial daily doses of 180–230 mg/kg/d given as intermittent infusions every eight hours, followed by maintenance regimens of 60–90 mg/kg/d given as single daily one- or two-hour infusions. Foscarnet therapy may result in renal impairment, and indefinite intravenous maintenance therapy may be required to prevent recurrence of CMV infection. Despite these drawbacks, foscarnet's lack of major myelosuppressive toxicity, and its activity in suppressing HIV replication, make this a potentially safe and effective alternative agent for the management of CMV infection, especially in AIDS patients.
Prescribing Patterns in Primary Healthcare in Saudi Arabia
Authors: Al-Nasser Abdulaziz N.
Published: July 2017

A systematic sampling of prescriptions from primary care centers in the Al-Baha region of Saudi Arabia was analyzed to determine the patterns of drug prescribing and the compliance of practicing physicians in these centers with the essential drug list issued by the Ministry of Health. The average number of drugs per prescription was 2.3 ± 0.7 of which 86.5 percent of the prescriptions contained two to three drugs. In 53.7 percent of the prescriptions no duration for treatment was specified and 96.5 percent of the prescriptions did not indicate drug strength. The study showed that analgesics and vitamins were the two most common classes of drug prescriptions in the centers and that 18.6 percent of prescribed drugs were not from the allowed list of drugs. The causes of polypharmacy and noncompliance with the limited list are discussed with emphasis on the essential drug list as a method of rationalizing prescribing in primary healthcare.
Gentamicin Pharmacokinetics in Postpartum Women with Endomyometritis
Authors: Munar Myrna Y. , Lawson Lisa A. , Samuels Philip , Gibson Gene A.
Published: July 2017

The pharmacokinetics of gentamicin in postpartum women with endomyometritis were characterized and models for predicting patient pharmacokinetic parameters were developed using multiple regression analysis. Fifty-one women 13–34 years of age received gentamicin in combination with either ampicillin or clindamycin to treat endomyometritis. Forty-three women delivered by cesarean section and 8 women had vaginal deliveries. Gentamicin serum concentrations were determined at steady-state to compute the elimination rate constant (Ke), half-life (t1/2), apparent volume of distribution (Vd), and total body clearance (Cl). Gentamicin dosages were individualized using a one-compartment intermittent infusion model to achieve steady-state peak and trough concentrations of 6.5 and <2 μg/mL, respectively. The mean gentamicin t1/2 was 2.8 ± 0.9 h; the mean apparent Vd was 21 ± 8 L; and the mean total body Cl was 89.5 ± 31.7 mL/min. Multiple regression analysis revealed that total body weight (TBW) was the best predictor for the apparent Vd, described by the equation Vd = 0.146 TBW + 8.153 (r=0.56, p=0.00005). Total body weight and creatinine clearance (Clcr) were included as predictors for total body Cl, described by the equation Cl = 0.264 TBW + 0.337 Clcr + 3.416 (r=0.68, p=0.00005). Age and serum creatinine (SCr) were included in the models for the Ke, described by the equation Ke = −3.770 · 10−3 age — 0.115 SCr + 0.449 (r=0.42, p<0.004). Additional patient factors need to be identified to explain the variance in these pharmacokinetic parameters.
Ketoconazole Hepatotoxicity in a Patient Treated for Environmental Illness and Systemic Candidiasis
Authors: Brusko Cynthia S. , Marten Julianna T.
Published: July 2017

Environmental illness, a hypothesized disease caused by exposure to substances such as combustion products, pesticides, food additives, and Candida albicans, is discussed. The case of a patient with environmental illness and systemic candidiasis is presented. Following treatment of systemic candidiasis for six weeks with ketoconazole, liver enzyme concentrations increased. One month after discontinuation of ketoconazole, the liver enzyme concentrations decreased; however, over the next five months, liver enzymes and bilirubin increased. The patient developed encephalopathy and eventually was transferred to a medical center for possible liver transplant. A review of the literature pertaining to ketoconazole hepatotoxicity is also presented.
Oral Vancomycin-Induced Rash: Case Report and Review of the Literature
Authors: McCullough Jill M. , Dielman Debra G. , Peery Deborah
Published: July 2017

Disseminated rash and pruritus are described in an 82-year-old woman with chronic renal failure following administration of oral vancomycin hydrochloride 125 mg q6h for the treatment of Clostridium difficile colitis. Renal function was estimated to be 0.27 mL/s based on a serum creatinine of 177 μmol/L. After eight days of therapy, she developed a slightly raised maculopapular rash on her legs and torso, which spread to her abdomen and arms with continued treatment. Vancomycin was discontinued and the patient was treated symptomatically. The rash cleared and did not recur. Rechallenge with vancomycin was not initiated. No other changes in medications or initiations of new medications occurred during the time of treatment with vancomycin. The patient denied any previous immunologically mediated reactions to medications. Maculopapular rash is rare secondary to vancomycin administration, particularly after oral administration. Although clinically significant serum concentrations can be obtained in patients treated with oral vancomycin who have concomitant C. difficile colitis and renal failure, there has not been a clear correlation between these concentrations and any reported adverse sequelae. This case supports the possible occurrence of a true allergic reaction secondary to low-dose oral vancomycin administration.
Medical versus Pharmaceutical Continuing Education: Are Both Appropriate for the Pharmacist?
Authors: Gardner Stephanie F. , Stanek Eric J. , Munger Mark A.
Published: July 2017

Continuing education (CE) courses in pharmacy and medicine often overlap with regard to their informational content. At the present time, however, it is feasible that two pharmacists could attend the same national meeting that has continuing medical education (CME) approval status and only one of them would receive CE credit from his state board of pharmacy. Therefore, a survey of 51 state board of pharmacy policies regarding acceptance of CME was conducted. Forty-five of the 51 boards of pharmacy require CE for relicensure. Twenty percent of state boards requiring CE accept CME credit without review, 24 percent do not accept CME credit, and the remaining 56 percent review submitted requests for CME credit. A general lack of uniformity exists among state boards regarding policies pertaining to CE credit. If CME credit was universally accepted, pharmacists would benefit from the increased availability of CE, the building of collegial relationships with other healthcare professionals, and the cost savings of combining courses that mutually benefit both pharmacists and physicians.
Self-Determination among Transition-Age Youth with Autism or Intellectual Disability: Parent Perspectives
Authors: Carter Erik W. , Lane Kathleen Lynne , Cooney Molly , Weir Katherine , Moss Colleen K. , Machalicek Wendy
Published: July 2017

This study examined 68 parents' views of the self-determination skills and capacities of their young adult children with autism spectrum disorders and intellectual disability (ages 19–21 years). Results indicated parents placed a high value on the importance of all seven component skills (i.e., choice-making skills, decision-making skills, goal-setting skills, problem-solving skills, self-advocacy and leadership skills, self-awareness and self-knowledge, and self-management and self-regulation skills) associated with enhanced self-determination. Yet, parents indicated their young adult children did not often perform these skills well. Effect sizes suggested high-magnitude differences between parents' ratings of the importance and their child's performance for each self-determination skill evaluated. Furthermore, regression analyses indicated parents' perceptions of the severity of their child's disability accounted for a significant portion of the variance in the overall ratings of their child's performance of these seven skills (26%) and overall self-determination capacity (27%). Parents who described their children's disabilities as being less severe rated their children as having higher performance levels on both measures of self-determination. Educational implications are presented along with recommendations for future research.
Stress, Behavior, and Children and Youth Who are Deafblind
Authors: Nelson Catherine , Greenfield Robin G. , Hyte Holly A. , Shaffer Jason P.
Published: July 2017

Children and youth who are deafblind with multiple disabilities have several identified risk factors for experiencing toxic levels of stress, and such stress is known to impair physical, mental, and emotional health. This single-case multiple baseline study examined the frequency and duration of behaviors thought to indicate stress, the duration of active participation in class activities, and the effect of the stress hormone salivary cortisol to determine the extent to which participating students with deafblindness were experiencing stress and how it affected their behavior and participation in school activities. Examined were three groups of intervention strategies designed to decrease stress and its behavioral manifestations and, at the same time, increase active participation. The selected intervention strategies did significantly lower behaviors that had been thought to indicate stress and concomitantly increased active participation. However, sampled salivary cortisol demonstrated only one instance of actual toxic stress. This finding is discussed from the perspective of delineated protective factors against toxic stress.
“It's Not So Much a Job But a Relationship”: A Response to Romer and Walker
Authors: O'Brien John
Published: July 2017

Romer and Walker's “Appreciative Inquiry,” which obtained input from 16 capable personal assistants, challenges some influential assumptions about personal assistance and opens a way to think about the demanding work of developing capable and committed personal assistants. Attempts to depersonalize the relationship between people with severe disabilities and assistants and how they share daily life with them reflect social devaluation of disability and social anxiety about dependency. Good service organizations will invest in cultivating the relationship qualities identified through the inquiry—presence, authentic listening, negotiating, moving with, trust, and respect.
Exploring the Link between Job Quality and Employee Well-being: An Empirical Study
Authors: Sivapragasam P. , Raya R.P.
Published: July 2017

Working life is a strong determinant of an individual’s life satisfaction. However, what matters is not just having a job with a good pay, but also the kind of job. This study is based on a specific theory of how job quality affects employee well-being, and provides measures of ( a) job quality; ( b) individual states resulting such as well-being, perceived efficacy and engagement. This study reports data collection from a large sample of 626 employees working in the information technology sector. Reliability and validity statistics suggest that the proposed model has quite satisfactory psychometric characteristics. The results suggest that job quality as an important determinant for employee well-being and for the development of a healthy organisation; otherwise the goal of sustained performance will remain elusive. Implications are drawn from the results, and priorities are established for future research.
New Product Development and Performance in the Banking Industry
Authors: Fong Sook-Fun , Lo May-Chiun , Ramayah T.
Published: July 2017

In this competitive environment, the path to create and develop new products is a series of difficult trials. Considering the potential cascading effect that new product development could have on an organisation’s performance, previous researches may have under-estimated the impact of new product development on organisation performance. The main objective of this article is to hypothesise the impact of new product development on organisation performance. Two hundred and fifty banks’ customers voluntarily participated in this study. SmartPLS 2.0 (M3), also known as partial least squares (PLS), was applied to test the hypotheses that comprised of firm image, brand strength, market sensing capability, product innovativeness and new product quality on new product performance, and subsequently bootstrapping was conducted to investigate the standard error of the estimate and t-values. The findings revealed that four types of new product development factors, namely, firm image, brand strength, product innovativeness and new product quality were found to be positively related to new product performance. Potential limitations of the study and directions for future research are discussed further.
Overload Confusion Proneness: The Underlying Cognitive Vulnerabilities and Their Decision Moderations through Various Risk Reduction Strategies in High Involvement Personal Care Category
Authors: Sarabhai Samar , Singh Neerja
Published: July 2017

In today’s competitive environment, consumers are being increasingly exposed to a plethora of products and an enormous amount of marketing communications. Also, a lot of these products and communications exhibit a baffling amount of similarity. This increased clutter and similarity has resulted in the ever-increasing amount of consumer confusion in different markets. Through the present research, the problem of consumer confusion owing to the product similarity and clutter has been investigated in the Indian face wash market using a sample size of 150, with the emphasis on the risk reduction strategies utilised by the same when confused. For this purpose, a scale was developed and validated; following which it was utilised for the study of overload confusion proneness in the face wash market. Using the formulated hypotheses, the decision moderations in case of high perceived risk was studied and discussed in the Indian face wash market.