bluuebunny/crossref_metadata_2025 huggingface dataset:
Constructing an Assistive Technology Toolkit for Young Children: Views from the Field
Authors: Judge Sharon
Published: June 2017

Assistive technology is guaranteed by law to be included when appropriate on individualized education plans (IEP) for young children with disabilities. Yet, the full potential of technology remains unfulfilled due to insufficient knowledge of options available, limited professional development, and a dearth of evidence on its effectiveness for particular daily routines and activities. This article describes a proactive strategy for meeting the needs of young children with disabilities through an assistive technology toolkit approach. Surveys were completed by 38 early childhood special education professionals to assess what assistive technology tools are most useful for working with young children with disabilities. Results indicated that communication and low-technology devices were considered most useful. Discussion focuses on the effectiveness of an assistive technology toolkit that supports the learning, language, and motor development of young children with disabilities.
Reading Rate and Comprehension as a Function of Computerized versus Traditional Presentation Mode: A Preliminary Study
Authors: Sorrell Christy A. , Bell Sherry Mee , McCallum R. Steve
Published: June 2017

Using a counterbalanced, randomized treatment design, 12 elementary school-aged children read under two conditions: (a) independent, silent reading; and (b) computer-assisted reading, via Kurzweil 3000. A repeated-measures multivariate analysis of variance (MANOVA) revealed no significant difference in the composite mean for comprehension and reading rate scores based on presentation strategy. Computerized text presentation (via auditory and visual means) proved no more effective than traditional reading instruction for teacher-nominated weak readers in improving reading rate and comprehension. However, a trend was noted for slower readers to show increased reading rate as a function of computer-assisted reading, with the opposite result for faster readers. Overall, results indicate that for students reading material at their instructional level, computer-assisted reading did not improve comprehension. Future research should continue to focus on the role of technology as an aid to reading instruction.
Electronic Performance Support Systems: An Assistive Technology Tool for Secondary Students with Mild Disabilities
Authors: Mitchem Katherine , Kight Jason , Fitzgerald Gail , Koury Kevin , Boonseng Thitinun
Published: June 2017

This article presents the results of a qualitative study investigating the usability and perceived effectiveness of StrategyTools™, an electronic performance system support designed for secondary students with mild disabilities to use independently in classroom and home situations. The StrategyTools software contains 39 computerized research-based strategy tools to support learning, behavior, and transition in high school and beyond. Two special education teachers each used the software with their high school students for one semester. Interviews were subsequently conducted with the two teachers and four students with behavior disorders who used the software. Interview responses were analyzed inductively for themes related to benefits, concerns, and usability. Design features of the software, the systems to support use of the software, and results of the qualitative analysis are reported. Recommendations for future research and suggestions for use of the StrategyTools software and support system are provided.
Technology at Home: Implications for Children with Disabilities
Authors: Bouck Emily C. , Okolo Cynthia M. , Courtad Carrie Anna
Published: June 2017

Given the prominence technology holds in today's schools and society, it seems crucial to explore its use and function in home environments for students with disabilities, particularly when considering everyday technology such as “smart” toys, computers, and communication devices. Unfortunately, little research or literature has been devoted to this issue. This paper reviews the literature on smart toys for children in general, and extrapolates what we have learned from smart toys and computer use in the home to children with disabilities. It suggests future directions for research, and proposes that the field of technology in the home for children with disabilities is wide open and clearly in need of study.
Does it Add Up? Calculators as Accommodations for Sixth Grade Students with Disabilities
Authors: Bouck Emily C. , Bouck Mary K.
Published: June 2017

This study explored the performance of sixth grade students with and without disabilities on a mathematics assessment aligned to state standards when provided a calculator as an accommodation. The study utilized a pre/posttest design. No student was given access to a calculator on the pretest, and approximately half of the students were randomly assigned to have access to a four-function calculator on the posttest. The results suggest that both students with disabilities and students without disabilities benefited from access to a calculator. The findings raise implications for calculators as a valid accommodation on assessments and suggest directions for future research.
Broadcasting Disability: An Exploration of the Educational Potential of a Video Sharing Web Site
Authors: Bromley Barbara E.
Published: June 2017

YouTube is an Internet phenomenon, a video sharing Web site where individuals can upload videos to be viewed by anyone visiting the site. The purpose of this study was to search for and categorize videos related to disability on YouTube and explore the educational potential of the site for the disability community. A seven-day time period in mid-July 2007 was chosen for the search. The 13 disability categories listed in the Individuals with Disabilities Education Act (IDEA) were used to create search terms. A total of 147 videos were found, the majority from the deaf and autism groups. Eight content categories were identified. YouTube videos have unique educational potential, offer a place for discussion of disability issues, and provide an outlet for creative expression.
Micro-Processor Based Visual Image Controlled (Vis-I-Con) Instruction Delivery System for Deaf and Hearing Impaired Persons
Authors: Fox Raymond G.
Published: June 2017

A programmable micro-processor controlled interactive media based instruction delivery system using super-8 film cassettes and addressable audio tape messages has been developed in order to make available to deaf and hearing impaired learners delivery of a wide range of validated media-based instructional materials. This paper describes the prototype system, unique instructional materials authoring methods, makes comparisons with conventional computer assisted instruction (CAI) and computer managed instruction (CMI), and discusses the system use not only in instruction delivery, but in instructional materials development and validation for use in creating videodisc masters. It outlines current plans for implementing this technology in the near future.
Instructional Materials and Educational Programs for Severely Handicapped Students: Highlights of a Presentation by Lou Brown
Authors: Brown Lou
Published: June 2017

This paper addresses the critical relationship between instructional materials, educational programs, and the acquisition of chronological, age-appropriate and functional skills by severely handicapped students in natural environments.
A Switch for Education: Utilizing Simplified Microswitch Technology
Authors: Torner Ronald S.
Published: June 2017

Special opportunities for growth and development must be provided to enable students with disabilities to develop an increasing degree of control of the environment, including other people and themselves. Therefore, programming must be designed to gradually produce more complex behavior patterns that, in turn, increase a student's capacity to cope with the environment.

On the one hand, microswitches can quickly alter a student's involvement in the learning process from that of a passive recipient to that of an active participant. At the same time, microswitches can often enable these same students to experience the feelings of satisfaction and success that come from learning that their actions had some effect on their environments.

Therefore, both creativity and effective programming warrant attention to specific opportunities for development. The rate and direction of development, however, can sometimes be significantly modified by utilizing and controlling certain physical, psychological, and social aspects of the environment.
Designing a Management Information System for a Special Education Organization
Authors: Demchak Maryann
Published: June 2017

Effective and efficient management of a special education organization requires timely, accurate, and complete information. A management information system (MIS), a computer-based information processing system, can benefit the administrator in the management of the organization. This article discusses in detail several steps involved in the establishment of a MIS in a special education organization. These steps include (a) the study phase, (b) the gross design phase, (c) the detailed design phase, and (d) the implementation phase.
Touch Screen versus Keyboard: A Comparison of Task Performance of Young Children
Authors: Battenberg Janice K. , Merbler John B.
Published: June 2017

This study compared the effect of type of computer input device on the task performance of 40 developmental^ delayed and 40 non-delayed kindergarten children. Two input devices were evaluated, including a traditional computer keyboard and a touch-sensitive computer screen. Subjects completed an alphabet matching task and a spelling task under the counterbalanced treatment conditions. Results indicated that the touch-sensitive screen generally improved the performance of both groups. It was concluded that the more natural response associated with the touch screen enhanced subject performance through reducing preoccupation with the response device.
An Observational Coding Strategy for the Socially Reciprocal Interactions of Infants with Severe Disabilities and Their Caregivers
Authors: Spooner Fred , Calhoun Mary Lynne , Rose Terry L.
Published: June 2017

A discussion of the application of computer technology for the measurement and analysis of social reciprocity for young children with severe disabilities and their parents is presented. Four major areas are discussed: (a) social reciprocity, (b) behavior code development, (c) computer hardware and software requirements, and (d) observer training and reliability. The interface between computer technology and behavioral technology is stressed Practical application is delineated in light of potential data analyses.
Education TECH Points for Assistive Technology Planning
Authors: Bowser Gayl , Reed Penny
Published: June 2017

IDEA states that assistive technology must be a part of a student's special education, related services and/or supplementary aids and services if it is required for the student to benefit from the educational program. While the law is clear in this respect, school districts across the nation are struggling with questions regarding the best ways to determine the need for assistive technology and to ensure appropriate levels of service. This article describes the Education TECH Point system which can be used by school districts as a tool to develop effective assistive technology delivery systems for all students with disabilities.
An Economic Interpretation of The Diamond Sutra
Authors: Hsiung Bingyuang
Published: June 2017

When a person faces the various dishes on a buffet table, economics can help analyze how he makes choices among the dishes. But if the dishes are all the same to this person, then the issue of choice economics studies essentially disappears. The idea that the dishes are all the same, however, reflects metaphorically one of the central thoughts of The Diamond Sutra. By employing a set of analytical concepts of economics, this paper attempts to provide a logically consistent analysis of the central thoughts of the important Buddhist treatise and to explain their potential attractiveness as well as possible weaknesses.

JEL classification: A13, B40, P50.
Book Review: Western Europe. A systematic human geography
Authors: Blacksell Mark
Published: June 2017

Western Europe. A systematic human geography. 2nd edition. Brian W. Ilbery. Oxford University Press 0 19 823278 0 £22.50 hardback. 0 19 823277 2 £8.95 paperback.
Environment, Growth and Value
Authors: Mulberg Jon
Published: June 2017

The paper presents an impossibility theory, that micro-economics cannot consider environmental factors, and suggests that an analysis of the treatment of environment within economic theory reveals shortcomings in many areas of economics.

The essential element in the consideration of environment is the economic evaluation of environmental disruption. The development of new technology or of anti-pollution measures require that resources be correctly allocated. There are several reasons why this cannot be considered. The static nature of economic theory prohibits consideration of both technological and legal change. The ceteris paribus approach is inappropriate for dynamic analysis, and both the orthodox definition of economic rationality and the positivist philosophy are inapplicable to dynamic analysis.

Further problems arise due to the inability of economic theory to consider social value: in particular socially scarce ‘positional’ goods cannot be accounted for. The environment is one such good, but the concept of distribution also involves social scarcity, and is inadequately dealt with by economic theory. An environmentally sound economics must develop a theory of distribution.
Book Review: The Romanian Economy in the Twentieth Century
Authors: Lewis Robert
Published: June 2017

The Romanian Economy in the Twentieth Century. David Turnock, Croom Helm, London & Sydney, 1986 (296pp).
Coupon Privatization and Investor Protection
Authors: Baláz Vladimír
Published: June 2017

Coupon scheme helped to privatize a major part of national assets in the Czech and Slovak republics. Investment privatization funds obtained significant part of coupon investment points and became major shareholders in these republics. This lobby has been dominated both by banks and managers of the funds. Funds compete with other lobbies in privatizing of another national assets, with no regard to small investors rights. State supervision failed and the state was not able to protect small investors. Gaps in legislation and undeveloped capital market enabled numerous violations of investors rights. New legislation is created in order to match European Community standards and to ensure a higher level of investor protection.
The Evaluation of Public Policy: Normative Economic Theories of Government Failure
Authors: Dollery Brian E. , Worthington Andrew C.
Published: June 2017

Conventional economic analysis of public policy has been traditionally conducted in the conceptual context of the theory of market failure. The resultant analytical framework enabled analysts to assess the economic efficiency of market outcomes, and prescribe appropriate government intervention where necessary. No corresponding theoretical structure existed to facilitate an equivalent investigation into the economic efficiency of nonmarket outcomes. However, quite distinct from public choice theory, a normative theory of government failure has emerged to form a conceptual analogue to the market failure paradigm. At present this embryonic theory of government failure has three strands: Wolf’s theory of nonmarket failure, Le Grand’s theory of government failure, and Vining and Weimer’s theory of government production failure. The present paper evaluates the extent to which this seminal literature can assist in the design of rational public policy processes.
A Scheme for Comparing Competing Claims in Economics
Authors: Marney J.P. , Tarbert Heather F.E.
Published: June 2017

The main purpose of this paper is to suggest a general scheme for the examination of claims to scientific authority. The formulation of a scheme within which rational discourse can take place, and comparisons between competing paradigms can be made, is argued to have particular urgency for the neoclassicists in the light of the emergence of increasingly vociferous dissenting schools in economics, who see themselves either as the opponents of neoclassicism, or not in full agreement with mainstream neoclassicism. No strong position is taken on the relative merits of either camp, as the primary purpose of the paper is to suggest a way of achieving meaningful dialogue through explicit recognition of the way in which research is done. It is argued that a functional descriptive mapping scheme for distinguishing between competing claims may be derived from the work of Ziman, Stewart and, to some extent, Kuhn. By way of example, the suggested framework is used to examine neoclassical claims in the area of growth theory.
Analysis of Lattice Single Layer Cylindrical Structures
Authors: HegedüS Istvan
Published: June 2017

A matrix method is presented for the calculation of bar forces in a single layer lattice cylinder composed of regular ring polygons and symmetrically arranged bracing bars. Substantial differences occur between the stress distribution in the lattice structure and that of the membrane cylinder under the same load. Therefore, a membrane cylinder cannot be considered as a replacement continuum for the lattice construction. The purpose of the paper is to draw attention to the danger in the utilisation, without due caution, of this analogy.
Computational Strategies for Tracing Post-Limit-Point Paths with Pure Iterative Methods
Authors: Papadrakakis Manolis
Published: June 2017

In this work alternative methodologies are proposed for following post-buckling paths without the need for a complete factorization of the stiffness matrix or any factorization at all. This is achieved with two different approaches. The first employs nonlinear versions of preconditioned conjugate-like methods and the so called conjugate and secant-Newton methods have been tested. The second approach is based on the classical Newton-Raphson or modified Newton-Raphson methods, while for the linearized problem in each iteration the preconditioned Lanczos method is employed. Both methodologies combine the convergence properties of Newton-like methods and the low storage requirements of pure iterative methods by varying the storage demands for the preconditioning matrix according to the available computer storage facilities.
Dynamic Elasto-Plastic Buckling Simulation System for Single Layer Reticular Domes with Semi-Rigid Connections under Multiple Loadings
Authors: Kato Shiro , Murata Masaru
Published: June 2017

Single layer reticular domes are structures which can effectively cover a large area without columns inside. However, it should be noticed that the dome structures are subjected to severe instabilities in both elastic and plastic behaviors. Thus the paper presents an efficient elasto-plastic formulation for single layer reticular domes with semi-rigid connections, and the buckling behavior of the domes is investigated under multiple loadings such as gravity loads and earthquake motions. Furthermore, a system for graphic presentation and analyses implemented in this study are briefly explained with a comment for a future work to be performed for further development.
Elastic-Plastic Dynamic Buckling Analysis of Reticular Domes Subjected to Earthquake Motion
Authors: Ishikawa Koichiro , Kato Shiro
Published: June 2017

Static and Dynamic characteristics of shell-like structures such as reticular domes vary depending on their configuration. There is, however, very little information available concerning dynamic buckling collapse or dynamic buckling analysis.

This paper presents a method for dynamic buckling analysis with emphasis on dynamic buckling behaviour subjected to vertical earthquake motion. The study focuses on the elastic-plastic buckling of the members of a large dome as well as on the global shell-like buckling of the dome. Through the analyses, the efficiency of the proposed analytical method is discussed while a method for estimating collapse accelerations is proposed.
International Project Workshops: Merging Education with Enterprise
Authors: Frear Carl R. , Metcalf Lynn E.
Published: June 2017

The increasing volume of world trade and the nature of business being transacted on a global basis mandates the need for pedagogical approaches which adequately equip marketing students to cope effectively with an increasingly complex marketing environment. This study suggests that the International Marketing Projects Workshop overcomes some of the limitations associated with alternative pedagogical approaches and, in addition, provides a more effective learning experience.
Services Concepts in Marketing Textbooks: A Consideration of Product and Distribution
Authors: Orsini Joseph L.
Published: June 2017

Despite the importance of services to marketers, and the substantial amount of services marketing literature, marketing principles textbooks still tend to reflect a goods orientation. Product and distribution concepts in texts are reviewed, relevant services literature cited, and textbook authors encouraged to consider services issues more precisely and in greater depth.
Isradipine in the Treatment of Peripheral Occlusive Vascular Disease of the Lower Limbs: A Pilot Study
Authors: Catalano M , Tomasini M , Scandale G , Galimberti P , Milani M , Perm T Di , Libretti A
Published: June 2017

The long-term effects of isradipine on peripheral occlusive vascular disease of the lower limbs were investigated in 23 normotensive patients with stable Fontaine stage IIa disease and with an absolute pain-free interval (treadmill speed 4 km/h, no incline) of 300 – 700 m, and Doppler ankle – arm arterial pressure index of less than 0.80 in at least one leg. Using a double-blind, parallel-group design, patients received either 2.5 mg isradipine twice daily or placebo for 12 months. Both isradipine ( n = 11) and placebo ( n = 12) increased the absolute pain-free interval mean values; the increases were not significantly different. Similar trends were observed in the mean values for relative pain-free interval and ankle – arm arterial pressure index. In a subgroup of patients with a baseline absolute pain-free interval of greater than 500 m, isradipine ( n = 6) significantly ( P < 0.001) increased both the absolute and the relative pain-free intervals and increased the ankle – arm arterial pressure index compared with placebo ( n = 7). The favourable effects of long-term isradipine treatment suggest that isradipine could positively interfere with factors involved in the progression of atherosclerotic lesions or improve collateral vessel flow.

Gli effetti a lungo termine dell'isradipina sulla arteriopatia vascolare periferica agli arti inferiori sono stati studiati in 23 pazienti normotesi affetti da “claudicatio intermittens” allo stadio IIa di Fontaine e con un intervallo libero assoluto (velocita al treadmil 4 km/h, senza inclinazione) di 300 – 700 m e di un indice pressorio valutato con metodica Doppler fra caviglia e braccio minore di 0.80 in almeno una delle gambe. Secondo uno studio in doppio cieco ed a gruppi paralleli ai pazienti sono stati somministrati 2.5 mg due volte al giorno di isradipina o del corrispondente placebo per una durata di 12 mesi. Sia l'isradipina ( n = 11) sia il placebo ( n = 12) hanno innalzato i valori medi dell'intervallo libero assoluto e gli aumenti non si sono dimostrati statisticamente differenti Un trend simile si è osservato anche per i valori medi dell'intervallo libero relativo e dell'indice caviglia/braccio. In un sottogruppo di pazienti aventi un intervallo libero assoluto al basale maggiore di 500 m, l'isradipina ( n = 6) ha innalzato significativamente ( P < 0.001) sia l'intervallo libero assoluto sia quello relativo ed ha aumentato anche l'indice pressorio caviglia braccio nei confronti del placebo ( n = 7). Gli effetti benefici di un trattamento a lungo termine con l'isradipina suggeriscono che questo farmaco può interferire in modo positivo con i fattori che favoriscono il progredire delle lesioni aterosclerotiche, e/o il migliorare il flusso ematico a livello del circolo collaterale.
Fatal Pulmonary Embolism in Hospitalized Patients: Evidence for a Winter Peak
Authors: Manfredini R , Gallerani M , Salmi R , Zamroni P , Fersini C
Published: June 2017

This study was intended to determine whether there are circa-annual variations in the incidence of fatal pulmonary embolism for hospitalized patients. Patients (152), admitted into both the medical and surgical departments of St. Anna Hospital of Ferrara, Italy, during an 8-year period (1983 – 1990) and who died in hospital as a result of pulmonary embolism, were considered. The day and month of death were registered, and analysed by inferential statistics (single cosinor). A circa-annual variation, with a statistically significant peak in late January ( P = 0.002), was found for the total sample. After stratification by sex, this winter peak was confirmed only for women ( P = 0.006).
Primary Polycythaemia Vera in Elderly
Authors: Abyad A , Kligman E
Published: June 2017

At presentation the history of an 87-year-old woman included progressive memory loss, repeated transient ischaemic attack, increasing fatigue, dizziness, palpitations and frequent falls. Investigations revealed erythrocytosis, leukocytosis, thrombocytosis, normal arterial oxygen concentration and an increased red cell volume. Polycythaemia vera was diagnosed and was successfully managed by phlebotomy with half a unit twice a week and rechecks of her haematocrit, initially; she reported marked improvement after 2 weeks of treatment. The alternative treatments for polycythaemia vera are discussed; in addition to venesection, conventional treatments include bone-marrow depressive agents such as phosphorus-32 and chemotherapy with agents such as hydroxyurea. More recent developments include isovolumic erythrocytophoresis, α-interferon and ticlopidine. All of the treatments are associated with complications, or other disadvantages, thrombotic complications in the case of phlebotomy, malignancies in the case of most myelosuppressive treatments, and problems of compliance in others. The optimal treatment for polycythaemia vera is a judicious combination of the alternatives, depending on the phase of the disease, the age of the patient, and other prognostic factors.
Pan-European Survey of Patients' Attitudes to Antibiotics and Antibiotic Use
Authors: Branthwaite A , Pechère J-C
Published: June 2017

This study was carried out to determine patient perceptions of respiratory tract infections and attitudes to taking antibiotics, thus helping doctors to have a better understanding of their patients and their requirements. Telephone interviews were conducted in the UK, Belgium, France, Italy, Spain and Turkey using standardized questionnaires directed at patients who had taken an antibiotic or given one to their child for a respiratory tract infection within the previous 12 months. Approximately 200 working adults (≤ 55 years), 200 elderly adults (> 55 years) and 200 mothers of children (< 12 years) from each country were contacted; in total, 3610 subjects. Pressure on GPs to prescribe antibiotics was highlighted by over 50% of interviewees' believing that they should be prescribed for most respiratory tract infections. Although interviewees were positive about antibiotics, with over 75% judging them to be effective and to speed recovery, some ambivalence was shown. Most patients waited 2 – 3 days before consulting their doctor and over 80% of respondents expected symptoms to improve after 3 days' treatment. This provided a natural watershed for compliance, with most defaulters stopping after 3 days because they felt better. Second only to fewer side-effects, patients ranked shorter and more convenient dosage alongside efficacy as the improvements most sought in antibiotic therapy. In conclusion, patients regarded antibiotics as important in the treatment of respiratory tract infections, with interest shown in short-course, once-daily therapy. Doctors, however, need to reassure patients that short courses will eradicate infections and have minimal adverse effects on the immune system.
Endometrial Adenocarcinoma in a Cat
Authors: Preiser H.
Published: June 2017

Five cases of uterine carcinoma in cats are cited from the literature. To these is added a description of a metastasizing adenocarcinoma of the uterus in an 11 1/3 year old cat.

Abb. 3. Hochgradige Hyperplasie des Uterusepithels (linke Bildhälfte) sowie Meta- und Anaplasie (rechte Bildhälfte).

Abb. 4. Ausschnittsvergrösserung der rechten Bildhälfte von Abb. 3. Ausgeprägte Invasion von grossen, kubischen, gelegentlich vielkernigen eosinophilen Tumorzellen mit sekundärer Infiltration von Lymphozyten.
Histochemische Untersuchungen nach subkutaner bzw. intramuskulärer Applikation von hochmolekularen Eisenpolysaccharid-Präparaten bei Saugferkeln
Authors: Ueberschär S. , Bollwahn W.
Published: June 2017

Subcutaneous or intramuscular injections of high molecular weight iron polysaccharides (Myofer 100® and Pigdex 100®) in therapeutic doses were given to pigs. These are taken up in macrophages between 6 and 24 hours following injection. If the material is finely divided, there occurs extracellularly and also in every case intracellularly a quick transformation from trivalent iron hydroxide to bivalent iron compounds; this process is essentially complete two days following injection. The high molecular weight polysaccharide is split off intracellularly from the iron components and is subject to its own chemical changes in the body. Accompanying this, in connection with the intracellular deposition of iron, there occurs the formation of an organic residual agent which is composed of mucopolysaccharides, glycoproteins and a matrix of protein and lipid.
The Corrosion Behavior of New Titanium Based Metal Ceramic Composites in Corrosive I.C. Engine Fluids
Authors: Ahmad Zaki , Abdul Aleem B. J. , Al-Abbas Saleh , McNamara David , Langen Timothy
Published: June 2017

The corrosion performance of a new titanium-based metal ceramic composite (TiCAD) in HCl, HNO3, H2SO4 and in Neutral Chloride Solution, was evaluated to determine its suitability for internal combustion engines, pump valves and bodies. Silicon combines outstanding properties of both metallic and ceramic constituents in TiCAD composite, and allows its consideration as a perspective material for thermally stressed I.C. engine parts. New methods ofthermo-mechanical treatment need to be explored to improve the corrosion resistance of TiCAD composite to fully explore the advantages offered by its outstanding physical and mechanical properties.
Liposphere Based Lipoprotein-Mimetic Delivery System for 6-Mercaptopurine
Authors: Khopade A. J. , Shelly C. , K. Pandit N. , Banakar U. V.
Published: June 2017

Long-circulating lipospheres containing 6-mercaptopurine (6-MP) were prepared by solidification of warm microemulsion at low temperature. Palmitoyl PEG was incorporated in the system to confer stealth-type nature. The size of lipospheres was in the range of 60-70 nm and was inversely proportional to sonication time. The size range was attained after 8 h. of sonication. The entrapped 6-MP contained 0.12 mmol/mole of lipid. The coating efficiency of 63-71% was attained. The zeta potential substantially decreased after PEG coating, however, the lipospheres were stable due to steric repulsion and exhibited no aggregation. The release of 6-MP was found to be 18-25% of administered dose in 24 h. and followed a mixed profile for stealth lipospheres. The percent dose remaining in plasma was found to be high even after 24 h as compared to control, indicating an increase in circulation time of lipospheres. Tissue accumulation of drug correlated with the pharmacokinetic behavior of lipospheres. The system seems to be an ideal carrier for anticancer drug delivery.
Hematological Aspects of Biocompatibility-Review Article
Authors: Banerjee R. , Nageswari K. , Puniyani R. R.
Published: June 2017

The development and improvement of medical devices and artificial organs is critically dependent on the realisation of the importance of the interactions between materials and body tissues. In this regard, the evaluation of biocompatibility assumes paramount importance. This paper reviews the hematological aspects of biocompatibility—the responses evoked by the material as well as the methods for their detection. The paper also mentions a few methods of improvement of material compatibility.
Bereavement Groups for Inner-City Children
Authors: Schilling Robert F. , Koh Nina , Abramovitz Robert , Gilbert Louisa
Published: June 2017

Guided by theory, empirical research, and clinical experience, this demonstration tested a 12-session group intervention for 38 inner-city children who had lost a caregiver. The design of the group intervention was guided by the psychodynamic tradition of the sponsoring agency, themes from the bereavement literature, and findings from intervention research on bereaved children and adults. Attendance for the group intervention was high among those 29 children who completed posttests. The loss of the parent figure often had an impact on caregiving and living arrangements. Children rated themselves as significantly more depressed at pretest than their caregivers rated them, but at posttest this difference diminished. However, the majority of children remained depressed throughout the study. Pretest and posttest comparisons suggest that the treatment intervention may have enabled children to develop a more mature concept of death. Mixed outcomes and the methodological limitations of the study allow for multiple interpretations. Nevertheless, modest results reported here may encourage other clinical researchers to build on this early effort. Better understanding of how to treat bereaved children must await controlled, longitudinal research.
The Role of the Clinical Pharmacist on a Nursing Home Care Team
Authors: Devenport Jean Kuwahara , Kane Robert L.
Published: June 2017

Provision of adequate patient care services to nursing homes is a recognized problem. The most recent Federal Regulations for nursing homes stipulate basic patient care and services, including expanded clinical pharmacy functions, in an attempt to improve overall patient care. A broad spectrum of drug-related problems have been identified in nursing homes.

One method for providing integrated patient care and education to nursing homes is a primary care team composed of a nurse practitioner, a social worker, a physician, and a clinical pharmacist. The pharmacist's role includes drug utilization control, patient counseling, drug information, and in-service education. Through the team concept, drug-related problems and recommendations can be managed efficiently with minimal confusion to patient and staff.

The team concept also provides an excellent educational opportunity for pharmacy students. By assignment to the nursing home, students can observe patient and staff responses to orders and recommendations from the team. More importantly, students have direct contact with the team members for discussion of patient problems. This experience prepares students for their future responsibilities in nursing home consultation services.
Spironolactone Induced Gynecomastia
Authors: Greenlaw Cal
Published: June 2017

Drug induced gynecomastia has infrequently been reported in the medical literature, but is probably more common than is suspected. A case report illustrating spironolactone induced gynecomastia is presented and various aspects of the condition are discussed, including mechanism of action and treatment.
Government Regulation and the Believability of Prescription Drug Advertising
Authors: Larson Lon N. , Smith Mickey C. , Sharpe Thomas R. , Hy Ronn , Garner Dewey D.
Published: June 2017

An experimental study was undertaken to assess the impact of governmental regulation on the believability of prescription drug advertising. The specific variables investigated were symbolic impact and fair balance. Mock advertisements were developed for four tricyclic antidepressant drugs. Symbolic impact was operationalized by portraying the advertisements as originating from U.S. medical journals (i.e., regulated) or Mexican medical journals (i.e., unregulated). Fair balance was operationally defined as the inclusion of a brief summary in the advertisement. A nonrandom sample of twenty-four physicians saw four advertisements representing the four treatment combinations. On a self-administered questionnaire, they indicated their confidence in the information contained in the advertisement. A two-factor, repeated measures randomized block factorial design was employed in the analysis. The results indicated that the presence of fair balance was significantly associated with higher levels of believability; the symbolic impact factor was non-significantly associated with believability.
Phenytoin Crystallization in Intravenous Fluids
Authors: Bauman Jerry L. , Siepler John K. , Fitzloff John
Published: June 2017

Free phenytoin crystallization in various commercially available intravenous solutions was investigated. Phenytoin determinations were completed at various time periods, before and after filtration, by spectrophotometric analysis.

Phenytoin was found to produce a more stable solution in normal saline and lactated Ringer's solutions than in 5 percent dextrose in normal saline or 5 percent dextrose in water. The pH differences between commercial phenytoin sodium for injection and the various intravenous fluids were felt to be the major factor responsible for free phenytoin crystallization.

It was concluded that phenytoin sodium admixture to normal saline or lactated Ringer's solution can indeed be used clinically, with precautions. The variations in pH of available intravenous solutions make apparent the need for careful inspection of sodium phenytoin admixtures and for such infusions to be started immediately after admixture.
In the Community
Authors: Hendeles Leslie , Kagan Benjamin M.
Published: June 2017

Chemoprophylaxis for the prevention of meningococcal disease is indicated only for intimate contacts, such as those who eat and sleep in the same dwelling as the index case. Polysaccharide vaccines are effective in preventing infections due to serogroup A and C meningococci in high risk groups such as military recruits and during epidemics. Sulfadiazine remains the chemoprophylactic agent of choice if the index case is known to be serogroup B or Y or sulfonamide susceptible. Rifampin is recommended when the serogroup and antimicrobial susceptibility are unknown. Minocycline may be used as an alternative to rifampin if the dose does not exceed 100 mg/M2/day. Reversible minocycline-induced vestibular toxicity appears to be related to excessive serum concentrations.
Role of Milrinone in the Management of Congestive Heart Failure
Authors: Hilleman Daniel E. , Forbes William P.
Published: June 2017

Milrinone is a bipyridine derivative with positive inotropic and vasodilating properties. The intravenous form of the drug has been approved by the Food and Drug Administration (FDA) for short-term management of congestive heart failure (CHF). The FDA has requested additional mortality data prior to approval of the oral form. Milrinone produces positive inotropic and vasodilating effects through unknown mechanisms, and causes a dose-dependent increase in cardiac index and a decrease in systemic vascular resistance and pulmonary capillary wedge pressure. It is extensively absorbed following oral administration with an elimination half-life of approximately 1.5–2 hours and a corresponding duration of action of 3–6 hours. Its major route of elimination is renal (83 percent). The intravenous dose is 50 μg/kg given over ten minutes, followed by a maintenance infusion of 0.375–0.75 μg/kg/min titrated to the desired hemodynamic response. The average effective oral dosage is 7.5–10 mg four to six times daily. Milrinone is most effective in the short-term management of CHF where the majority (60–80 percent) of patients have symptomatic and hemodynamic improvement as well as increases in exercise duration. However, many patients do not derive long-term benefit from milrinone therapy. Available evidence suggests that milrinone does not arrest the natural progression of CHF, and some investigators feel it may actually worsen CHF and shorten patients' length of survival. Milrinone has been generally well tolerated with a low risk of major organ toxicity. The most common adverse reactions with intravenous milrinone include ventricular arrhythmias (12 percent) and supraventricular arrhythmias (4 percent). Oral milrinone may cause gastrointestinal disturbances (11 percent), cardiac arrhythmias (7 percent), headache (7 percent), dizziness (6 percent), palpitations (6 percent), fatigue (3 percent), tachycardia (2 percent), and increased hepatic enzymes (2 percent). Although not proven, the major concern with milrinone is its potential to be proarrhythmic, leading to a higher incidence of sudden death in patients treated over the long term. Experience with milrinone indicates that its usefulness may be limited to the short-term treatment of CHF. Until mortality evaluations are complete, the role of milrinone in the long-term management of CHF will remain undefined.
Disposition of 3-Hydroxyquinidine in Patients Receiving Initial Intravenous Quinidine Gluconate for Electrophysiology Testing of Ventricular Tachycardia
Authors: Ackerman Bruce H. , Olsen Keith M. , Kennedy Eleanor E. , Taylor E. Howard , Chen Bai H. , Jordan Exel , Ackerman Deborah J.
Published: June 2017

The formation rate constant and elimination rate constant for 3-hydroxyquinidine were determined in eight patients with ventricular tachycardia. These two parameters (mean ± SD) were found to be 0.784 ± 0.202 and 0.042 ± 0.058 h−1, respectively. Coefficients of determination for the computer-generated line of best fit for serum concentration-time data were 0.986 ± 0.008. Patients received two infusions of quinidine gluconate 5 mg/kg over 30 minutes separated by a 20–30 minute electrophysiologic testing period. Unbound and total 3-hydroxyquinidine concentrations were also determined. Among the eight patients, 3-hydroxyquinidine was 61.9 percent bound. Studies in healthy volunteers had shown 50 percent binding. Linear regression of unbound and total 3-hydroxyquinidine was described by the equation Y = 0.3814X–1.448, r = 0.813. Although half-lives of 3.5–12.4 hours had been reported in healthy volunteers, prolonged half-lives were observed in all but two of our arrhythmia patients.
Clinical Pharmacology of Propofol: An Intravenous Anesthetic Agent
Authors: Larijani Ghassem E. , Gratz Irwin , Afshar Mary , Jacobi Athole G.
Published: June 2017

Propofol is a 2,6-diisopropylphenol with sedative-hypnotic properties. Because of its slight solubility in water, the drug is formulated as an emulsion for clinical use. It is highly lipophilic and distributes extensively in the body. The blood concentration-time profile of propofol after an iv bolus injection follows a three-compartment model with half-lives of 2–4 min, 30–45 min, and 3–63 h, respectively. Propofol is extensively metabolized by the liver prior to its elimination by the kidney. Following an iv dose of 2–2.5 mg/kg, loss of consciousness occurs in less than one minute and lasts for approximately five minutes. Hypnosis can be maintained by propofol blood concentrations of 1.5–6 μg/mL in the presence of N2O/O2 (60:40 ratio) or other anesthetic agents. During induction, propofol decreases the systolic and diastolic blood pressure by approximately 20–30 percent with minimal change in heart rate; apnea is also common. The cardiovascular and respiratory effects of propofol, however, should not cause major concern in otherwise healthy patients. By virtue of its pharmacokinetic profile, the drug lends itself to continuous infusion for maintenance of anesthesia. When used as the main anesthetic agent, it produces satisfactory anesthesia with rapid recovery and without major adverse effects in healthy individuals. In continuous infusion propofol can be used as an alternative to inhalation anesthetics.
Seizure Activity with Imipenem Therapy: Incidence and Risk Factors
Authors: Job Martin L. , Dretler Robin Henry
Published: June 2017

Two elderly patients with a history of either cerebral vascular accident (CVA) or head trauma and no evidence of renal disease developed seizures while receiving maximum doses of imipenem/cilastatin. Neither patient had reported previous seizures or seizure-like activity nor was receiving anticonvulsant agents. All seizures were controlled with therapeutic doses of phenytoin. Both patients had received maximum doses of other beta-lactam antibiotics without evidence of seizure activity.

PRELIMINARY DATA on adverse clinical experiences with imipenem/cilastatin revealed a low frequency of drug-related seizures similar to that with beta-lactam antibiotics. These data included patients with predisposing factors such as a prior history of seizures, central nervous system neoplasms, recent head trauma, and stroke.1 Since the release of this antibiotic, several cases of imipenem-induced seizures have been reported.2–5 In some instances, the patients were elderly and had mild renal impairment. In other cases, the patients had no overt evidence of renal disease. We report two cases of seizures, both of which occurred in elderly patients who had no overt evidence of renal impairment but had a prior history of central nervous system injury.
Time-Motion Study of Intravenous Ranitidine Admixtures
Authors: Gonzalez Edgar R. , Hruska Barbara M. , Elswick R.K. , Wood Clifton F. , Pesko Larry J.
Published: June 2017

This study determined the total preparation time, cost, and contamination rate associated with preparing 50-mL admixtures of ranitidine 50 mg from each of the following commercial source vials: 50 mg/2 mL unit-dose vial (treatment A), 50 mg/2 mL 10 mL multidose vial (treatment B), and 50 mg/2 mL 40 mL multidose vial (treatment C). The study consisted of two separate phases: phase I extemporaneous compounding and phase II batch manufacturing. Twelve technicians prepared ten admixtures from each source vial during each phase. All admixtures were tested for sterility; bacterial contamination was not observed. Multidose vials saved approximately $197 per 200 admixtures. Drug and personnel costs were reduced when batch manufacturing with 40-mL multidose vials was compared with extemporaneous compounding with unit-dose vials. Our study showed that multidose vials decreased the total preparation time and cost for making ranitidine admixtures during both extemporaneous compounding and batch manufacturing by reducing setup time, preparation time, and drug procurement cost.
Treatment of Digitalis Intoxication with Emphasis on the Clinical Use of Digoxin Immune Fab
Authors: Allen Nancy M. , Dunham Gary D.
Published: June 2017

Many studies and cases of digitalis intoxication have been reported since the time of William Withering's first publication in 1785. Recognition and management of digitalis toxicity is challenging. Before digoxin immune Fab was commercially available, treatment consisted of managing the signs and symptoms of toxicity until the digitalis was eliminated. Digoxin immune Fab offers a safe, effective, and specific method of quickly reversing digitalis toxicity. Factors that must be considered with the clinical use of this agent include the dosage calculation, administration technique, postdose monitoring, pharmacokinetics, mechanism of action, interference with commercially available digoxin assays, partial neutralizing dosing, rebound of free digoxin, and indications for use. For severe, life-threatening toxicity, digoxin immune Fab is the treatment of choice.