...This article examines a multicenter double-blind placebo-controlled trial of cilostazol in preventing and reducing the risk of strokes. The results showed that cilostazol improved symptomatic regression by 2% in MRA scans and 4% in TCD tests. The effectiveness of cilostazol as a prevention for ischemic strokes was also compared against aspirin and reducing alcohol consumption. A background on ischemic strokes Ischemic strokes account for around 80% of all strokes, making them the most common type 1. The brain has a network of blood vessels that supply it with the oxygen and nutrients, importantly glucose, which it needs to work efficiently, as well as to remove waste such as carbon dioxide. A stroke is ischemic when the artery supplying...
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...CASE SCENARIO Leo R. is a 45-year-old patient with diabetes and is a widower with three young children. Two of Leo’s children suffer from chronic medical conditions. His oldest daughter, like Leo, has insulin-dependent diabetes. His only son suffers from grand mal epilepsy, which is poorly controlled by a plethora of medications. Leo works for a small printing business, a job he enjoys, but one that makes it difficult for him to make ends meet. With only six employees, the company’s owner cannot afford to offer health insurance. Leo’s annual salary of $30,000 allows him to purchase only the most basic of health plans, one that does not include coverage for prescription medications. Leo frequently must decide between medications and food, often opting for cheap junk food that is neither nutritious for his young family nor appropriate for a diabetic diet. Leo has recently applied for and been offered several other jobs, but at a lower salary and with no health insurance coverage. Recently, Leo’s diabetes has worsened. He has developed a serious infection that has led to lost wages and, far worse, the loss of his right leg below the knee. Leo is weighing his options. He has heard about a new clinical research trial open to insulin-dependent diabetics that pays $100 a week to research subjects. He has also been quite depressed and begun to wonder if his children might not be better off without him. He has several life insurance policies that would pay off generously if something...
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...------------------------------------------------- Clinical trial From Wikipedia, the free encyclopedia | This article may be too long to read and navigate comfortably. Please consider splitting content into sub-articles and using this article for a summary of the key points of the subject.(October 2010) | Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety (or more specifically, information about adverse drug reactions and adverse effects of other treatments) and efficacy data to be collected for health interventions (e.g., drugs, diagnostics, devices, therapy protocols). These trials can take place only after satisfactory information has been gathered on the quality of the non-clinical safety, and Health Authority/Ethics Committee approval is granted in the country where the trial is taking place. Depending on the type of product and the stage of its development, investigators enroll healthy volunteers and/or patients into small pilot studies initially, followed by larger scale studies in patients that often compare the new product with the currently prescribed treatment. As positive safety and efficacy data are gathered, the number of patients is typically increased. Clinical trials can vary in size from a single center in one country to multicenter trials in multiple countries. Due to the sizable cost a full series of clinical trials may incur, the burden of paying for all the necessary people and services...
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...Cultural Immersion: The Controversial Practice of Coining Ethan Norng West Coast University Abstract The medical practice of “coining” has been around for a very long time, yet it is still something that the West has not gotten used to. Originating in China and spreading to South East Asia, it has gained great popularity amongst the Asian community. It can easily be practiced in the comfort of your own home, all that is required is the right substances and tools. The practice is a controversial one mostly due to the fact that it leaves marks and bruises. Children who are admitted to the hospital with the marks that coining leaves behind, may be suspected victims of child abuse. Healthcare workers are very suspicious of this method....
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...is not natural to the participants of the study. There is an independent variable, which is purposefully manipulated by the researchers, and the dependent variable is measured, to see the effect of changing the IV on the DV. All other variables other than these are controlled to the best of the researchers’ ability, which are called extraneous variables, but sometimes other variables can affect the results – these are confounding variables. With laboratory experiments, cause and effect conclusions can be drawn * Careful controls mean they are replicable so can be tested for reliability – if carried out again and findings are similar, then it is likely to be reliable * Good controls mean there should be few confounding variables, so experiment is objective (e.g. there should be no subjectivity from the experimenter’s interventions and interpretations) and scientific * By isolating variables, the situation is not as in ‘real life’ so findings are not likely to be valid * Laboratory experiments usually lack validity of the task and therefore are not representative of true behaviour Milgram (1963) Study of Obedience Aim: To see whether people would obey and inflict harm on each another person using electric shocks, by following the orders of an authority figure. This was to see whether all individuals had the potential to cause harm like the Germans and the Nazi’s or if they were different. Procedure: A volunteer sample was recruited by placing an advert in...
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..."Principles of Medical Ethics" and "Fundamental Elements of the Patient-Physician Relationship," reprinted with permission from the Code of Medical Ethics, American Medical Association, © 1994 and © 2000. AMA logo reprinted with the permission of the American Medical Association. © 2002 American Medical Association. Usage of the AMA logo does not imply an endorsement of the non-AMA material found in this book. Page 211: "Code of Ethics for Nurses with Interpretive Statements," reprinted with permission from the American Nurses Association, © 2001 American Nurses Publishing, American Nurses Foundation/American Nurses Association, Washington, D.C. Pages 212-15: "A Patient's Bill of Rights," reprinted with permission of the American Hospital Association, © 1992. Pages 216-17: "Pharmacy Patient's Bill of Rights," reprinted with permission of the National Association of Boards of Pharmacy. On the cover: The "triad of medical care" has been the basis for the ethical relationship between the pharmacist, the physician, and the patient for centuries. In the background, an early depiction of the triad from Book 7 of the encyclopedia On the Properties of Things by Bartholomew the Englishman, published in Westminster about 1495. In the foreground, a photograph of a contemporary triad (courtesy of the Department of Veterans Affairs). Cover design: Robert A. Buerki and Cynthia A. Gray © 1994 and 2002 by Robert A. Buerki and Louis D. Vottero First Edition, 1994 Reprinted...
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...CLINICAL PRACTICE GUIDELINES ON INTRAPARTUM AND IMMEDIATE POSTPARTUM CARE 2012 A collaboration of the Department of Health and the Philippine Obstetrical and Gynecological Society 1 The mention of specific product brands is not meant to suggest that they are endorsed or recommended by the Department of Health (DOH) and the Philippine Obstetrical and Gynecological Society (POGS) in preference to other products of a similar nature that are not mentioned. All reasonable precautions have been taken by DOH and POGS to ensure that the information contained in this publication is accurate. However, this guideline is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the guideline lies with the end user. In no event shall DOH and POGS be liable for damages arising from its use. 2 ii MESSAGE The primary aim of MDG 5 is to reduce by three quarters by between 1990 an 2015, the maternal mortality ratio,especially among less developed countries. The Philippines is among those with high maternal mortality rate (MMR). In 2006, our MMR was 162 deaths/100,000 live births, however, the Family Health Survey in 2011 showed that the MMR has increased to 221 deaths/100,000 live births. It is therefore important that we mobilize our efforts together to avert further deaths of our pregnant mothers. The Philippine Obstetrical and Gynecological Society (Foundation), Inc. (POGS) stood up to the challenge of World...
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...become more responsive to patient demand, which in turn will drive greater eciency in the delivery and funding of health care. However, whether enhanced patient choice will make hospital choice more responsive to quality is not well established, although the consequences of poor quality in health care can be dire. Patients' health can be severely compromised by poor quality care, including, as we show below, an increased risk of death. Thus there is a need to understand the responses of health care consumers when they are o ered more choice. This is exactly the issue we address here. To do this we exploit a reform which introduced patient choice and tie this to the estimation of a structural demand model that explicitly incorporates the institutional features of the reform. This enables us to identify the e ect of increasing choice on patient behavior. We use the model to quantify the gains from the reform in terms of patient welfare and survival and to analyze how the changes in patients' choices translate into changes in the competitive environment faced by hospitals. The reform we exploit is from the English National Health Service (NHS). In 2006, the UK government mandated that patients in the English NHS had to be o ered a choice of 5 hospitals when referred by their physician to a hospital for treatment. Prior to...
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...Geriatrics Geriatrics Jennifer P. Dugan, Pharm.D., BCPS Clinical Assistant Professor University of Colorado Colorado, Denver Updates in Therapeutics: The Pharmacotherapy Preparatory Review and Recertification Course 31 Geriatrics Learning Objectives: The following case pertains to questions 2 and 3. J.T. is an 82-year-old community-dwelling woman with a history of stage III Parkinson disease, hypertension, and urinary incontinence (UI). She is receiving carbidopa/levodopa, pramipexole, selegiline, tolterodine, diazepam, metoprolol, and hydrochlorothiazide. When she comes to your pharmacy to get her prescriptions, she walks slowly with a cane, and she is stooped over. 1. Identify age-related pharmacokinetic and pharmacodynamic changes in older people. 2. Evaluate the pharmacotherapy regimens of older people to support the maintenance of optimal physical and mental function. 3. Identify inappropriate medication prescribing in older people. 4. Recommend appropriate pharmacotherapy for patients with dementia. 5. Evaluate the risks and benefits of the use of antipsychotics (APs) (including atypical APs) in older patients with dementia. 6. Recommend appropriate interventions for patients suffering from behavioral symptoms related to dementia. 7. Identify the types of urinary incontinence and recommend appropriate treatments. 8. Given a patient’s American Urology Association Symptom Index for benign prostatic hyperplasia, recommend...
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...Some of the most dangerous aspects associated with healthcare do not come from blood borne pathogens, chemical exposures or falls, but comes directly from people as evident in workplace violence(Fernandes, Bouthillette, Raboud, Bullock, Moore, Rae, Ouellet, Gillrie & Way, 1999). The effects of workplace violence is far-reaching and costly(Hoag-Apel, 1998). In fact according to the international council of nurses “ health care workers are more likely to be attacked at work than prison guards and police officers”(ICN, 2009). The aim of this essay is to critically appraise a systematic review of the literature based on workplace violence in the emergency department and to identify characteristics of interventional studies to guide best practice. This review will discuss current practices in reference to NSW health policy and guidelines, critique the systematic review by (Taylor & Rew, 2010) in terms of discussing methodology and provided a comprehensive overview of (Taylor & Rew, 2010) article(Hoag-Apel, 1998) (NSW Health, 2005). Finally, this review will attempt to recommend a change in practice in terms of the research question of what are the suggested interventions for workplace violence in the ED conducted by studies from 2004 ? Based on best evidence based practice and research(Hoag-Apel, 1998) . Although healthcare professionals and exclusively nurses are at higher risk of workplace violence, NSW legislation doesn’t reflect the increase risk associated or current international...
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...Standards for medicines management a We are the nursing and midwifery regulator for England, Wales, Scotland, Northern Ireland and the Islands. • We exist to safeguard the health and wellbeing of the public. • We set the standards of education, training and conduct that nurses and midwives need to deliver high quality healthcare consistently throughout their careers. • We ensure that nurses and midwives keep their skills and knowledge up to date and uphold the standards of their professional code. • We ensure that midwives are safe to practise by setting rules for their practice and supervision. • We have fair processes to investigate allegations made against nurses and midwives who may not have followed the code. b Standards for medicines management Introduction The Nursing and Midwifery Council (NMC) is the UK regulator for two professions: nursing and midwifery. The primary purpose of the NMC is protection of the public. It does this through maintaining a register of all nurses, midwives and specialist community public health nurses eligible to practise within the UK and by setting standards for their education, training and conduct. One of the most important ways of serving the public interest is through providing advice and guidance to registrants on professional issues. The purpose of this booklet is to set standards for safe practice in the management and administration of medicines by registered nurses, midwives and specialist community public health...
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...Health & Clinical Psychology Healthy Living Stress Dysfunctional Behaviour Disorders [pic] [pic] [pic] Contents • Objectives for the Health and Clinical Psychology module 6 • What is Health Psychology? Careers in Health Psychology 7 • Unit G543: Health and Clinical Psychology 8 • Exemplar exam paper 9 PART A – INFORMATION TO HELP EVALUATE STUDIES • Evaluation sheet for the theories/studies of Health Psychology 10 • Guide for answering part A & part B exam questions 11 PART B – HEALTHY LIVING • Introduction to Healthy Living 14 • Theories of Health Belief 17 • Compliance with a Medical Regime for Asthma (Becker 1978) 18 • Internal versus External Locus of Control (Rotter 1966) 21 • Analysis of Self-Efficacy Theory of Behavioural Change (Bandura and Adams 1977) 23 • Summary of the health belief theories 26 • Comprehension questions for theories of health belief 27 • Part A exam question 28 • Part B exam question 29 • Evaluation sheet of health belief theories/studies 30 Introduction to Health Promotion 31 • Theories of Health Promotion • Chip pan fire prevention (Cowpe 1983) 32 • Legislation-Bicycle helmet laws and educational campaigns (Dannenberg et al. 1993) 34 • Effects of Fear arousal (Janis & Feshbeck 1953) 37 • Summary of the health...
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...REVIEW OF RELATED LITERATURES (RRL) Literature About the Malunggay Leaves Extract Against Staphylococcus Aureus Staphylococcus is a group of bacteria that can cause a number of diseases as a result of infection of various tissues of the body. Staphylococcus is more familiarly known as Staph (pronounced "staff"). Staph-related illness can range from mild and requiring no treatment to severe and potentially fatal. The name Staphylococcus comes from the Greek staphyle, meaning a bunch of grapes, andkokkos, meaning berry, and that is what Staph bacteria look like under the microscope, like a bunch of grapes or little round berries. (In technical terms, these are gram-positive, facultative anaerobic, usually unencapsulated cocci.) Over 30 different types of Staphylococci can infect humans, but most infections are caused byStaphylococcus aureus. Staphylococci can be found normally in the nose and on the skin (and less commonly in other locations) of 25%-30% of healthy adults. In the majority of cases, the bacteria do not cause disease. However, damage to the skin or other injury may allow the bacteria to overcome the natural protective mechanisms of the body, leading to infection. And one of the cures for staphylococcus aureus is vitamin c which is found in malunggay. Called "Malunggay" in the Philippines, "Sajina" in the Indian Subcontinent, and "Moringa" in English, it is a popular tree. Many Asians use the leaves of Malunggay (Sajina) like spinach and also the fruit...
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...Table of Contents Rpt. 25810062 14-Apr-2015 SAREPTA THERAPEUTICS INC COWEN AND COMPANY - BARAL, RITU, ET AL 4-8 Rpt. 25767315 06-Apr-2015 SAREPTA THERAPEUTICS INC ROTH CAPITAL PARTNERS, LLC - CHATTOPADHYAY, DEBJIT, ET AL 9 - 21 Rpt. 25736145 01-Apr-2015 SAREPTA THERAPEUTICS INC CANACCORD GENUITY - RESEARCH DEPARTMENT 22 - 28 Rpt. 25736256 01-Apr-2015 SAREPTA THERAPEUTICS INC PIPER JAFFRAY - COMPANY REPORT - TENTHOFF, EDWARD, ET AL 29 - 32 Rpt. 25733910 01-Apr-2015 SAREPTA THERAPEUTICS INC COWEN AND COMPANY - BARAL, RITU, ET AL 33 - 37 Rpt. 25736405 01-Apr-2015 SAREPTA THERAPEUTICS INC CREDIT SUISSE - NORTH AMERICA - SHEPARD, JEREMIAH, ET AL 38 - 56 Rpt. 25732665 01-Apr-2015 SAREPTA THERAPEUTICS INC RBC CAPITAL MARKETS (CANADA) - SIMEONIDIS, SIMOS, ET AL 57 - 62 Rpt. 25732827 01-Apr-2015 SAREPTA THERAPEUTICS INC JMP SECURITIES LLC - COMPANY REPORTS - BAYKO, LIISA 63 - 67 Rpt. 25735100 01-Apr-2015 SAREPTA THERAPEUTICS INC OPPENHEIMER AND CO - RESEARCH DEPARTMENT 68 - 72 Rpt. 25736008 01-Apr-2015 SAREPTA THERAPEUTICS INC RBC CAPITAL MARKETS (CANADA) - SIMEONIDIS, SIMOS, ET AL 73 - 78 These reports were compiled using a product of Thomson Reuters www.thomsonreuters.com 1 Table of Contents Rpt. 25736195 01-Apr-2015 SAREPTA THERAPEUTICS INC WILLIAM BLAIR & COMPANY - LUGO, TIM, ET AL 79 - 83 Rpt. 25736196 01-Apr-2015 SAREPTA THERAPEUTICS INC LEERINK PARTNERS LLC - SCHWARTZ...
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...Toronto Public Health October 2003 Women’s Health Program Financial assistance by Health Canada Toronto Public Health Advisory Committee: Jan Fordham, Manager, Planning & Policy – Family Health Juanita Hogg-Devine, Family Health Manager Tobie Mathew, Health Promotion Consultant – Early Child Development Project Karen Wade, Clinical Nurse Specialist, Planning & Policy – Family Health Mary Lou Walker, Family Health Manager Karen Whitworth, Mental Health Manager Copyright: Copyright of this document is owned by University Health Network Women’s Health Program. The document has been reproduced for purposes of disseminating information to health and social service providers, as well as for teaching purposes. Citation: The following citation should be used when referring to the entire document. Specific chapter citations are noted at the beginning of each chapter. Stewart, D.E., Robertson, E., Dennis, C-L., Grace, S.L., & Wallington, T. (2003). Postpartum depression: Literature review of risk factors and interventions. POSTPARTUM DEPRESSION: LITERATURE REVIEW OF RISK FACTORS AND INTERVENTIONS Table of Contents EXECUTIVE SUMMARY 2 OVERALL METHODOLOGICAL FRAMEWORK 5 CHAPTER 1: RISK FACTORS FOR POSTPARTUM DEPRESSION 9 Emma Robertson PhD, Nalan Celasun PhD, Donna E. Stewart MD FRCPC CHAPTER 2: DETECTION, PREVENTION AND TREATMENT OF POSTPARTUM DEPRESSION 71 Cindy-Lee Dennis RN PhD CHAPTER 3: THE EFFECT OF POSTPARTUM DEPRESSION ON THE MOTHER-INFANT RELATIONSHIP AND CHILD GROWTH...
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