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Sample records for relatif aux prescriptions

  1. OPTICS (Operational Threat Integrated Corrective Spectacles) Production and Initial Human Factors Testing (Lunettes Optics (Lunettes Correctrices Integrees a L’equipment de protection Contre les Menaces Operationnelles) - Production et Essais Initiaux Relatifs Aux Facteurs Humains)

    DTIC Science & Technology

    2006-06-01

    lentilles correctrices rapportées qui soient compatibles avec les lunettes de protection balistique et qui permettent l’utilisation à l’intérieur du...dispositif; le concept 0 a pris pour point de départ des lentilles rapportées de prescription commerciales courantes de type sportif, le concept 1 s’est...pouvant utiliser des lentilles de prescription intégrées à des lunettes de protection balistique et à un respirateur C4 a été bien reçu. Les participants

  2. LAnse Aux Meadows, Newfoundland

    NASA Image and Video Library

    2008-07-18

    LAnse aux Meadows is a site on the northernmost tip of the island of Newfoundland, located in the Province of Newfoundland and Labrador, Canada, where the remains of a Viking village were discovered in 1960. This image is from NASA Terra satellite.

  3. An Inventory of Human Rights Teaching Materials = Repertoire du Materiel Pedagogique Relatif aux Droits de la Personne.

    ERIC Educational Resources Information Center

    Manitoba Human Rights Commission, Winnipeg.

    This document is an inventory designed to help educators more efficiently locate resources for teaching about human rights in the classroom. The types of materials identified in this document include: teaching units and guides, reference books, multi-media kits, filmstrips, tapes, video cassettes, supplementary curricular materials, and other…

  4. An Inventory of Human Rights Teaching Materials = Repertoire du Materiel Pedagogique Relatif aux Droits de la Personne.

    ERIC Educational Resources Information Center

    Manitoba Human Rights Commission, Winnipeg.

    This document is an inventory designed to help educators more efficiently locate resources for teaching about human rights in the classroom. The types of materials identified in this document include: teaching units and guides, reference books, multi-media kits, filmstrips, tapes, video cassettes, supplementary curricular materials, and other…

  5. Exercise Prescription.

    ERIC Educational Resources Information Center

    Ribisl, Paul M.

    If exercise programs are to become effective in producing the desired results, then the correct exercise prescription must be applied. Four variables should be controlled in the prescription of exercise: (a) type of activity, (b) intensity, (c) duration, and (d) frequency. The long-term prescription of exercise involves the use of a (a) starter…

  6. Prescription Drugs

    MedlinePlus

    ... prescription drug misuse? Also known as: Opioids: Hillbilly Heroin, Oxy, OC, Oxycotton, Percs, Happy Pills, Vikes Depressants: ... opioid receptors—the same receptors that respond to heroin . These receptors are found on nerve cells in ...

  7. Prescriptive unitarity

    NASA Astrophysics Data System (ADS)

    Bourjaily, Jacob L.; Herrmann, Enrico; Trnka, Jaroslav

    2017-06-01

    We introduce a prescriptive approach to generalized unitarity, resulting in a strictly-diagonal basis of loop integrands with coefficients given by specifically-tailored residues in field theory. We illustrate the power of this strategy in the case of planar, maximally supersymmetric Yang-Mills theory (SYM), where we construct closed-form representations of all ( n-point N k MHV) scattering amplitudes through three loops. The prescriptive approach contrasts with the ordinary description of unitarity-based methods by avoiding any need for linear algebra to determine integrand coefficients. We describe this approach in general terms as it should have applications to many quantum field theories, including those without planarity, supersymmetry, or massless spectra defined in any number of dimensions.

  8. Prescription Drug Abuse

    MedlinePlus

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, ...

  9. Prescription Drug Abuse

    ERIC Educational Resources Information Center

    Hamilton, Gloria J.

    2009-01-01

    This article presents current statistics on nonmedical use of both categories of prescription medications by high school and college students. The incidence of nonmedical use of prescription medications continues to increase among high school and college students. Two categories of drugs that are commonly used for reasons other than those for…

  10. Prescription Drug Abuse

    ERIC Educational Resources Information Center

    Hamilton, Gloria J.

    2009-01-01

    This article presents current statistics on nonmedical use of both categories of prescription medications by high school and college students. The incidence of nonmedical use of prescription medications continues to increase among high school and college students. Two categories of drugs that are commonly used for reasons other than those for…

  11. Prescription of medicated feedingstuffs.

    PubMed

    McDonald, Janis

    2012-08-11

    This article, by Janis McDonald of the Veterinary Medicines Directorate (VMD), sets out advice on best practice in using medicated feedingstuffs prescriptions. It has been produced by the VMD in the light of concerns that procedures for completing medicated feedingstuffs prescriptions may not always be being followed correctly.

  12. Substance use -- prescription drugs

    MedlinePlus

    ... high, they cause feelings of well-being, intense happiness, and excitement. As street drugs, depressants come in ... A.D.A.M. Editorial team. Related MedlinePlus Health Topics Prescription Drug Abuse Browse the Encyclopedia A. ...

  13. Opioid Basics: Prescription Opioids

    MedlinePlus

    ... relievers for acute pain, and high daily doses. Addiction and Overdose Anyone who takes prescription opioids can ... in a primary care setting struggles with opioid addiction. 4,5,6 Once addicted, it can be ...

  14. Getting a prescription filled

    MedlinePlus

    ... are located inside of a grocery or large "chain" store. It is best to fill all prescriptions ... be used for long-term medicines and medical supplies. The website should have clear directions for filling ...

  15. Prescriptions for ACME's Future.

    ERIC Educational Resources Information Center

    Felch, William Campbell

    1991-01-01

    Five prescriptions for the future agenda of the Alliance for Continuing Medical Education are (1) a core curriculum; (2) informatics; (3) remedial continuing medical education (CME); (4) focus on the individual learner; and (5) practice-oriented CME. (SK)

  16. Prescription Drug Assistance Programs

    MedlinePlus

    ... Treatment & Support Finding and Paying for Treatment Understanding Health Insurance If You Have Trouble Paying a Bill Prescription ... income and no drug coverage If you have health insurance If your income is low: Look into Medicaid ...

  17. L'Anse Aux Meadows, Newfoundland

    NASA Technical Reports Server (NTRS)

    2008-01-01

    L'Anse aux Meadows is a site on the northernmost tip of the island of Newfoundland, located in the Province of Newfoundland and Labrador, Canada, where the remains of a Viking village were discovered in 1960 by the Norwegians Helge and Anne Ingstad. The only authenticated Viking settlement in North America outside Greenland, it was the site of a multi-year archaeological dig that found dwellings, tools and implements that verified its time frame. The settlement, dating more than five hundred years before Christopher Columbus, contains the earliest European structures in North America. Named a World Heritage site by UNESCO, it is thought by many to be the semi-legendary 'Vinland' settlement of explorer Leif Ericson around AD 1000. The settlement at L'Anse aux Meadows consisted of at least eight buildings, including a forge and smelter, and a lumber yard that supported a shipyard. The largest house measured 28.8 by 15.6 m and consisted of several rooms. Sewing and knitting tools found at the site indicate women were present at L'Anse aux Meadows

    The image was acquired on September 14, 2007, covers an area of 14.2 x 14.6 km, and is located at 51.5 degrees north latitude, 55.6 degrees west longitude.

    The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate.

  18. Prescription drug misuse.

    PubMed

    Monheit, Benny

    2010-08-01

    Recognising and dealing with patients who seek drugs for nonmedical purposes can be a difficult problem in general practice. 'Prescription shoppers' and patients with chronic nonmalignant pain problems are the main people who constitute this small but problematic group. The main drugs they seek are benzodiazepines and opioids. To provide data on current trends in prescription drug abuse and to discuss different strategies on how to deal with this issue in the clinic setting. Misuse of prescription drugs can take the form of injecting oral drugs, selling them on the street, or simply overusing the prescribed amount so that patients run short before the due date and then request extra prescriptions from the doctor. Currently oxycontin and alprazolam are the most abused drugs in Australia. Adequate prescription monitoring mechanisms at the systems level are lacking so we need to rely on our clinical skills and the patient's behaviour pattern over time to detect problematic prescription drug misuse. Management strategies may include saying 'no' to patients, having a treatment plan, and adopting a universal precaution approach toward all patients prescribed drugs of addiction. Among patients with chronic nonmalignant pain, requests for increasing opioid doses need careful assessment to elucidate any nonmedical factors that may be at play.

  19. Substrate-dependent Aux cluster: A new insight into Aux/CeO2

    NASA Astrophysics Data System (ADS)

    Zhu, Kong-Jie; Yang, Yan-Ju; Lang, Jia-Jian; Teng, Bo-Tao; Wu, Feng-Min; Du, Shi-Yu; Wen, Xiao-Dong

    2016-11-01

    To theoretically study the structures of metal clusters on oxides is very important and becomes one of the most challenging works in computational heterogeneous catalysis since many factors affect their structures and lead to various possibilities. In this work, it is very interesting to find that the stable structures and stability evolution of Aux clusters on ceria are varied with different index surfaces of CeO2. The corresponding reasons in chemical, geometric and electronic properties are systematically explored. Aux (x = 1-4) clusters prefer to separately disperse at the O-O bridge sites on CeO2(100) due to the low coordination number of surface O; while aggregate due to the strong Au-Au attractions when x is larger than 4. Owing to the uniform distribution of O-O bridge sites on CeO2(111) and (100), the most stable configurations of Aux are 3D structures with bottom atoms more than top ones when x is larger than 4. However, 2D configurations of Aux/CeO2(110) (x < 10) are more stable than the corresponding 3D structures due to the particular O-O arrangement on CeO2(110). 3D Aux clusters across O-O-Y lines are suggested as the most stable configurations for Aux/CeO2(110) (x ≥ 10). The present work gives a detailed example for the theoretical study of metal clusters on oxide, and will shed light into the design for controllable synthesis of ceria-based catalysts with metal nanoparticles supported on CeO2.

  20. Abuse of prescription drugs.

    PubMed Central

    Wilford, B B

    1990-01-01

    An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801

  1. Collaborateurs aux lignes directrices en soins primaires

    PubMed Central

    Allan, G. Michael; Kraut, Roni; Crawshay, Aven; Korownyk, Christina; Vandermeer, Ben; Kolber, Michael R.

    2015-01-01

    Résumé Objectif Déterminer la profession des collaborateurs scientifiques aux lignes directrices, les variables associées aux différences de participation des collaborateurs et si oui ou non les lignes directrices en soins primaires fournissent un énoncé sur les conflits d’intérêts. Type d’étude Analyse rétrospective des lignes directrices en soins primaires affichées sur le site web de l’Association médicale canadienne. Deux extracteurs de données indépendants ont examiné les lignes directrices et ont extrait les données pertinentes. Contexte Canada Principaux paramètres à l’étude Commanditaires des lignes directrices, territoire (national ou provincial) visé par les lignes directrices, profession des collaborateurs scientifiques aux lignes directrices et énoncés de conflits d’intérêts rapportés dans les lignes directrices. Résultats Sur les 296 lignes directrices de pratique clinique trouvées dans la section de la médecine familiale de l’Infobanque AMC, 65 apparaissaient en double et 35 se rapportaient de façon limitée à la médecine familiale. Vingt ne fournissaient aucune information sur les collaborateurs scientifiques, ce qui laissait 176 lignes directrices propices à l’analyse. Au total, il y avait 2495 collaborateurs (auteurs et membres de comité) : 1343 (53,8 %) spécialistes autres que des médecins de famille, 423 (17,0 %) médecins de famille, 141 (5,7 %) infirmières, 75 (3,0 %) pharmaciens, 269 (10,8 %) autres cliniciens, 203 (8,1 %) scientifiques non cliniciens et 41 (1,6 %) collaborateurs de profession inconnue. La proportion des collaborateurs de ces professions différait significativement entre les lignes directrices nationales et provinciales, de même qu’entre les lignes directrices financées par l’industrie et celles qui ne l’étaient pas (p < 0,001 dans les 2 cas). Dans le cas des lignes directrices de pratique clinique provinciales, 30,8 % des collaborateurs étaient des médecins de

  2. Prescription Opioids during Pregnancy

    MedlinePlus

    ... brand names ConZip®, Ryzolt®, Ultram®) The street drug heroin also is an opioid. What problems can opioids ... to buy them illegally. People often start using heroin after becoming addicted to prescription opioids. Sometimes opioids ...

  3. Medicare Prescription Drug Coverage

    MedlinePlus

    ... people also have to pay an additional monthly cost. Private companies provide Medicare prescription drug coverage. You choose the drug plan you like best. Whether or not you should sign up depends on how good your current coverage is. You need to sign up as ...

  4. Leadership Prescription Paradigms

    ERIC Educational Resources Information Center

    Stech, Ernest L.

    2007-01-01

    The three most common paradigms used to develop leadership prescriptions are the empirical, biographical, and ideological. The empirical paradigm is subdivided into quantitative and qualitative versions. Similarly, there are two forms of the biographical paradigm: historical and autobiographical. The ideological paradigm involves an appeal to…

  5. Pharmacy experience with facsimile prescriptions.

    PubMed

    Huntzinger, Paul E

    2010-11-01

    The purpose of this mixed qualitative/quantitative study was to review the impact of a policy to accept facsimile (fax) prescriptions as standard operating procedure. Between February and April 2009 the pharmacy processed 4,792 new prescriptions of which 363 (7.6%) were received through fax. Of the fax prescriptions, 19 (5.2%) concerned clarification of information, which took approximately 30 minutes to resolve. The fax prescription process allowed the pharmacy to adjust the distribution of its workload, provided quicker service for new prescriptions, and allowed more time for medication consultation that resulted in a high level of customer satisfaction. It appeared the policy allowing fax prescriptions was a "win-win" situation for both the pharmacy and its customers. Military pharmacies should consider running trials of accepting fax prescriptions to see whether it improves their prescription filling process.

  6. [Anxiety level and addiction to first-time prescriptions of anxiolytics: a psychometric study].

    PubMed

    Barthelmé, Benoit; Poirot, Yves

    2008-11-01

    The anxiety epidemic and its corollary, the widespread prescription of anxiolytics, present a public health problem in view of the risk of addiction to these drugs. To assess the level of anxiety and addiction in the borderline population at risk of addiction. The study analyzed a series of patients in the third month of their first prescription for anxiolytics. It used two validated scales: the Hospital Anxiety and Depression scale (HAD), and a French scale measuring addiction (the "Echelle Cognitive d'Attachement aux Benzodiazepines" or ECAB). 83% of patients were still anxious at the third month of treatment. 23% had become addicted. There is a contradiction between the prolonged prescription and use of anxiolytics, which are associated with a risk of addiction, and professional guidelines that recommend short treatment for outpatients using these drugs for the first time.

  7. Deprescription: The prescription metabolism

    PubMed Central

    Sivagnanam, Gurusamy

    2016-01-01

    Deprescribing is a structured approach to drug discontinuation. An alternative suggested term is “prescription metabolism.” The major aim of deprescription is to purge the drug(s) considered unwanted in a given patient, especially in the elderly patients with multiple comorbidities or in those suffering from chronic disease. Like drug metabolism, prescription metabolism is a way of eliminating unwanted, troublesome, or cost-ineffective medications. The removal of such drugs has been found to decrease the incidence of adverse drug reactions and improves the rate of medication adherence, thereby reducing the economic burden on the patient as well as on the health care providers. Certain categories of drugs are to be tapered rather than abruptly stopped. Despite the availability of many tools to minimize drug therapy-related problems, there is little guidance for the process of deprescribing in general clinical practice. Various methods to reduce the risks of polypharmacy include patient education, physician education, and regulatory intervention. The suggested S and S approach (seek and screen, save and severe, sensitize and supervise) may be tried for deprescribing in general practice. More research on deprescribing is the need of the hour in almost all branches of clinical medicine which may pave the way for the betterment of health care. PMID:27651709

  8. Soins Aux Brules Apres Un Accident Nucleaire

    PubMed Central

    Bargues, L.; Donat, N.; Jault, P.; Leclerc, T.

    2010-01-01

    Summary Les lésions radiques sont dues le plus souvent à des radio-isotopes utilisés dans l’industrie. L’explosion d’un réacteur nucléaire, les armes nucléaires ou une attaque terroriste constituent un risque d’afflux massif de victimes brûlées. Les radiations ionisantes occasionnent des brûlures thermiques, des syndromes d’irradiation aiguë avec pancytopénie et des signes cutanés retardés. Après une période de latence, des symptômes cutanés apparaissent et leur profondeur est proportionnelle à la dose reçue. Les protocoles habituels de réanimation des brûlés s’appliquent ici. Les soins aux irradiés nécessitent aussi une mesure de l’irradiation et une décontamination par des personnels entraînés. En cas de catastrophe nucléaire, la priorité est d’optimiser les structures existantes et de préserver les moyens pour les patients ayant la plus forte probabilité de survie. Après un accident nucléaire isolé, les difficultés dans les centres de brûlés sont l’évaluation de la profondeur et les techniques chirurgicales de couverture cutanée. La préparation des moyens médicaux et des centres de brûlés est nécessaire pour faire face à la prise en charge de ces brûlures différentes et complexes. PMID:21991218

  9. Hubble Space Telescope prescription retrieval.

    PubMed

    Redding, D; Dumont, P; Yu, J

    1993-04-01

    Prescription retrieval is a technique for directly estimating optical prescription parameters from images. We apply it to estimate the value of the Hubble Space Telescope primary mirror conic constant. Our results agree with other studies that examined primary-mirror test fixtures and results. In addition they show that small aberrations exist on the planetary-camera repeater optics.

  10. Burning by prescription in chaparral

    Treesearch

    Lisle R. Green

    1981-01-01

    Prescribed burning is frequently suggested for reducing conflagration costs in chaparral. Preparation for a prescribed burn includes environmental impact reports, approval by higher levels of authority, and a burn plan. After objectives are stated, the prescription can be written. Elements of the burn prescription reflect fuel, weather, and other factors that determine...

  11. A prescription fraud detection model.

    PubMed

    Aral, Karca Duru; Güvenir, Halil Altay; Sabuncuoğlu, Ihsan; Akar, Ahmet Ruchan

    2012-04-01

    Prescription fraud is a main problem that causes substantial monetary loss in health care systems. We aimed to develop a model for detecting cases of prescription fraud and test it on real world data from a large multi-center medical prescription database. Conventionally, prescription fraud detection is conducted on random samples by human experts. However, the samples might be misleading and manual detection is costly. We propose a novel distance based on data-mining approach for assessing the fraudulent risk of prescriptions regarding cross-features. Final tests have been conducted on adult cardiac surgery database. The results obtained from experiments reveal that the proposed model works considerably well with a true positive rate of 77.4% and a false positive rate of 6% for the fraudulent medical prescriptions. The proposed model has the potential advantages including on-line risk prediction for prescription fraud, off-line analysis of high-risk prescriptions by human experts, and self-learning ability by regular updates of the integrative data sets. We conclude that incorporating such a system in health authorities, social security agencies and insurance companies would improve efficiency of internal review to ensure compliance with the law, and radically decrease human-expert auditing costs.

  12. Commentary on Causal Prescriptive Statements

    ERIC Educational Resources Information Center

    Graesser, Arthur C.; Hu, Xiangen

    2011-01-01

    Causal prescriptive statements are valued in the social sciences when there is the goal of helping people through interventions. The articles in this special issue cover different methods for testing causal prescriptive statements. This commentary identifies both virtues and liabilities of these different approaches. We argue that it is extremely…

  13. Qualitative Assertions as Prescriptive Statements

    ERIC Educational Resources Information Center

    Nolen, Amanda; Talbert, Tony

    2011-01-01

    The primary question regarding prescriptive appropriateness is a difficult one to answer for the qualitative researcher. While there are certainly qualitative researchers who have offered prescriptive protocols to better define and describe the terrain of qualitative research design and there are qualitative researchers who offer research…

  14. Adolescent Nonmedical Prescription Drug Use

    ERIC Educational Resources Information Center

    Ford, Jason A.; Watkins, William C.

    2012-01-01

    For many adolescents today, the most common form of substance use is nonmedical prescription drug use. Fittingly, many researchers, policy makers, and people who work with youth are concerned about the serious problems associated with nonmedical prescription drug use (NMPDU). In this article, authors Jason Ford and William Watkins provide an…

  15. Adolescent Nonmedical Prescription Drug Use

    ERIC Educational Resources Information Center

    Ford, Jason A.; Watkins, William C.

    2012-01-01

    For many adolescents today, the most common form of substance use is nonmedical prescription drug use. Fittingly, many researchers, policy makers, and people who work with youth are concerned about the serious problems associated with nonmedical prescription drug use (NMPDU). In this article, authors Jason Ford and William Watkins provide an…

  16. Commentary on Causal Prescriptive Statements

    ERIC Educational Resources Information Center

    Graesser, Arthur C.; Hu, Xiangen

    2011-01-01

    Causal prescriptive statements are valued in the social sciences when there is the goal of helping people through interventions. The articles in this special issue cover different methods for testing causal prescriptive statements. This commentary identifies both virtues and liabilities of these different approaches. We argue that it is extremely…

  17. Ginseng in Traditional Herbal Prescriptions

    PubMed Central

    Park, Ho Jae; Kim, Dong Hyun; Park, Se Jin; Kim, Jong Min; Ryu, Jong Hoon

    2012-01-01

    Panax ginseng Meyer has been widely used as a tonic in traditional Korean, Chinese, and Japanese herbal medicines and in Western herbal preparations for thousands of years. In the past, ginseng was very rare and was considered to have mysterious powers. Today, the efficacy of drugs must be tested through well-designed clinical trials or meta-analyses, and ginseng is no exception. In the present review, we discuss the functions of ginseng described in historical documents and describe how these functions are taken into account in herbal prescriptions. We also discuss the findings of experimental pharmacological research on the functions of ginseng in ginseng-containing prescriptions and how these prescriptions have been applied in modern therapeutic interventions. The present review on the functions of ginseng in traditional prescriptions helps to demystify ginseng and, as a result, may contribute to expanding the use of ginseng or ginseng-containing prescriptions. PMID:23717123

  18. 21 CFR 201.120 - Prescription chemicals and other prescription components.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Prescription chemicals and other prescription... Prescription chemicals and other prescription components. A drug prepared, packaged, and primarily sold as a prescription chemical or other component for use by registered pharmacists in compounding prescriptions or...

  19. 21 CFR 201.120 - Prescription chemicals and other prescription components.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Prescription chemicals and other prescription... Prescription chemicals and other prescription components. A drug prepared, packaged, and primarily sold as a prescription chemical or other component for use by registered pharmacists in compounding prescriptions or...

  20. Prescription Drugs and Cold Medicines

    MedlinePlus

    ... Trends and Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Prescription ... 60 3.00 4.00 Narcotics other than Heroin Past Year - - 4.80 Vicodin Past Year 0. ...

  1. The prescription drug abuse epidemic.

    PubMed

    Yu, Hoi-Ying Elsie

    2012-09-01

    In the United States, the nonmedical use of prescription drugs is the second most common illicit drug use, behind only marijuana. This article discusses the abuse issues with three of the most widely abused prescription drugs: opioids, central nervous system (CNS) depressants (eg, benzodiazepines), and stimulants (eg, amphetamine-dextroamphetamine and methylphenideate) in the United States. Efforts to deal with the problem are described as well.

  2. Methadone and prescription drug overdose.

    PubMed

    Hendrikson, Hollie; Hansen, Melissa

    2014-12-01

    (1) Methadone accounted for 2 percent of painkiller prescriptions and more than 30 percent of prescription painkiller deaths in 2009. (2) Data suggest that the rise in deaths from methadone overdose is not related to its use in treating drug abuse but, rather, to its use for pain management. (3) Preferred drug lists in most Medicaid programs identify methadone as a preferred drug for managing chronic pain, but most experts do no recommend it as a first choice.

  3. AUX: a scripting language for auditory signal processing and software packages for psychoacoustic experiments and education.

    PubMed

    Kwon, Bomjun J

    2012-06-01

    This article introduces AUX (AUditory syntaX), a scripting syntax specifically designed to describe auditory signals and processing, to the members of the behavioral research community. The syntax is based on descriptive function names and intuitive operators suitable for researchers and students without substantial training in programming, who wish to generate and examine sound signals using a written script. In this article, the essence of AUX is discussed and practical examples of AUX scripts specifying various signals are illustrated. Additionally, two accompanying Windows-based programs and development libraries are described. AUX Viewer is a program that generates, visualizes, and plays sounds specified in AUX. AUX Viewer can also be used for class demonstrations or presentations. Another program, Psycon, allows a wide range of sound signals to be used as stimuli in common psychophysical testing paradigms, such as the adaptive procedure, the method of constant stimuli, and the method of adjustment. AUX Library is also provided, so that researchers can develop their own programs utilizing AUX. The philosophical basis of AUX is to separate signal generation from the user interface needed for experiments. AUX scripts are portable and reusable; they can be shared by other researchers, regardless of differences in actual AUX-based programs, and reused for future experiments. In short, the use of AUX can be potentially beneficial to all members of the research community-both those with programming backgrounds and those without.

  4. Availability of Spanish prescription labels.

    PubMed

    Sharif, Iman; Lo, Sarah; Ozuah, Philip O

    2006-02-01

    The research team conducted a cross-sectional telephone survey of all pharmacies in the Bronx, New York (99.4% participation rate) to determine availability of Spanish prescription labels. One hundred twenty five pharmacies (78%) were small independent pharmacies; 36 (22%) were large-chain pharmacies. Overall, 111 (69%) stated that they could provide prescription labels in Spanish. Overall, for all the pharmacy ZIP codes, the mean proportion of the population that was Spanish-speaking was 46.8% (range 11% to 71.6%). Seventy-eight (48%) pharmacies were located in areas where more than 50% of the population were Spanish-speaking, 48 (30%) were located in areas with 25.1-50% Spanish-speakers, and 35 (22%) were in areas with up to 25% Spanish-speakers. Small independent pharmacies were more likely than large chain pharmacies to provide prescription labels in Spanish (71% vs. 61%, p=0.25). All the pharmacists commented that a patient must specifically request a Spanish prescription label in order to receive one. Pharmacies located in areas with the highest proportion of Spanish speakers were more likely to provide prescription labels in Spanish (82% vs. 62% vs. 49%; p=.001). Of the 111 pharmacies that could provide Spanish labels, 95 (86%) used a computer program to perform the translation and 16(14%) used a lay employee. Of pharmacies using a computer program, only one had a Spanish-speaking pharmacist who could check and correct the computer translations.

  5. Diagnostic Prescriptive Reading System (DPRS).

    ERIC Educational Resources Information Center

    Kuchinskas, Gloria

    The purpose of this diagnostic-prescriptive reading system (DPRS), proposed by Palm Beach County and the Florida Atlantic University and sponsored by the Florida Department of Education, was to provide classroom teachers with resources which would enable them to more effectively meet the individual reading needs of their students. This report…

  6. Prescriptive Exercise for Older Adults.

    ERIC Educational Resources Information Center

    Piscopo, John

    1985-01-01

    In addition to physical benefits, exercise also provides a natural way to sustain mental alertness in the aging individual by supplying oxygen to the brain. A table focuses on 10 specific health-fitness problems with suggested prescriptive exercises designed to ameliorate the condition. (MT)

  7. Prescription Tracking and Public Health

    PubMed Central

    2008-01-01

    INTRODUCTION Monitoring and modifying physicians’ prescribing behavior through prescription tracking is integral to pharmaceutical marketing. Health information organizations (HIOs) combine prescription information purchased from pharmacies with anonymized patient medical records purchased from health insurance companies to determine which drugs individual physicians prefer for specific diagnoses and patient populations. This information is used to tailor marketing strategies to individual physicians and to assess the effect of promotions on prescribing behavior. DISCUSSION The American Medical Association (AMA) created the Prescription Data Restriction Plan in an attempt to address both the privacy concerns of physicians and industry concerns that legislation could compromise the availability of prescribing data. However, the PDRP only prohibits sales representatives and their immediate supervisors from accessing the most detailed reports. Less than 2% of US physicians have registered for the PDRP, and those who have signed up are not the physicians who are targeted for marketing. CONCLUSION Although it has been argued that prescription tracking benefits public health, data gathered by HIOs is designed for marketing drugs. These data are sequestered by industry and are not generally available for genuine public health purposes. PMID:18473146

  8. Exercise Prescription for Physical Fitness.

    ERIC Educational Resources Information Center

    Pollock, Michael L.; And Others

    1995-01-01

    Examines current guidelines for physical fitness, noting issues that may influence the updating of the American College of Sports Medicine exercise statement. Differences between exercise prescription for fitness and physical activity for health are discussed, noting the importance of designing individualized programs with appropriate levels of…

  9. Exercise Prescription for Physical Fitness.

    ERIC Educational Resources Information Center

    Pollock, Michael L.; And Others

    1995-01-01

    Examines current guidelines for physical fitness, noting issues that may influence the updating of the American College of Sports Medicine exercise statement. Differences between exercise prescription for fitness and physical activity for health are discussed, noting the importance of designing individualized programs with appropriate levels of…

  10. Prescriptions vary in ponderosa regeneration

    Treesearch

    Dale O. Hall

    1969-01-01

    Nonproducing acres and unproductive years are both costly to timberland owners. These costs are reduced by restoring timber stocking with minimum delay. The proper prescription for regeneration can insure fast restocking. But the silviculturist prescribes slash disposal, site preparation, seeding, and planting only after he has carefully examined the site environment...

  11. Prescription Program Provides Significant Savings

    ERIC Educational Resources Information Center

    Rowan, James M.

    2010-01-01

    Most school districts today are looking for ways to save money without decreasing services to its staff. Retired pharmacist Tim Sylvester, a lifelong resident of Alpena Public Schools in Alpena, Michigan, presented the district with a pharmaceuticals plan that would save the district money without raising employee co-pays for prescriptions. The…

  12. Opioids: The Prescription Drug & Heroin Overdose Epidemic

    MedlinePlus

    ... Resources Law Enforcement Resources Opioids: The Prescription Drug & Heroin Overdose Epidemic Opioids are natural or synthetic chemicals ... in your brain or body. Common opioids include heroin and prescription drugs such as oxycodone, hydrocodone, and ...

  13. Prescription and Over-the-Counter Medications

    MedlinePlus

    ... use. Prescription Opioid Abuse: A First Step to Heroin Use? Prescription opioid pain medications such as Oxycontin ® and Vicodin ® can have effects similar to heroin when taken in doses or in ways other ...

  14. Prescription Pain Medicines - An Addictive Path?

    MedlinePlus

    ... more than the number of people abusing cocaine, heroin, hallucinogens, and inhalants, combined. "The abuse of prescription ... on the receptors in the brain affected by heroin, morphine, and prescription painkillers. The tablets relieve drug ...

  15. Prescription Drug Abuse and Youth. Information Brief.

    ERIC Educational Resources Information Center

    Department of Justice, Washington, DC. National Drug Intelligence Center.

    Prescription drugs, a category of psychotherapeutics that comprises prescription-type pain relievers, tranquilizers, stimulants, and sedatives, are among the substances most commonly abused by young people in the United States. Prescription drugs are readily available and can easily be obtained by teenagers who abuse these drugs to experience a…

  16. 76 FR 51310 - Branded Prescription Drug Fee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-18

    ... Internal Revenue Service 26 CFR Part 51 RIN 1545-BJ39 Branded Prescription Drug Fee AGENCY: Internal... issuing temporary regulations relating to the branded prescription drug fee imposed by the Affordable Care... certain branded prescription drugs. The text of the temporary regulations also serves as the text of the...

  17. 76 FR 51245 - Branded Prescription Drug Fee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-18

    ... Service 26 CFR Parts 51 and 602 RIN 1545-BK34 Branded Prescription Drug Fee AGENCY: Internal Revenue... manufacturing or importing branded prescription drugs. This fee was enacted by section 9008 of the Patient... certain branded prescription drugs. The text of the temporary regulations also serves as the text of the...

  18. Treatment Acceptability of Symptom Prescription Techniques.

    ERIC Educational Resources Information Center

    Hunsley, John

    1993-01-01

    In Study 1, 99 college students rated acceptability of compliance-based and defiance-based forms of symptom prescription strategies for student seeking counseling because of procrastination. In Study 2, 96 students rated acceptability of compliance-based prescription and behaviorally based intervention. Overall, symptom prescription was rated as…

  19. 21 CFR 1306.08 - Electronic prescriptions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Electronic prescriptions. 1306.08 Section 1306.08... § 1306.08 Electronic prescriptions. (a) An individual practitioner may sign and transmit electronic... an electronic prescription, a pharmacist must include all of the information that this part requires...

  20. 21 CFR 1306.08 - Electronic prescriptions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Electronic prescriptions. 1306.08 Section 1306.08... § 1306.08 Electronic prescriptions. (a) An individual practitioner may sign and transmit electronic... an electronic prescription, a pharmacist must include all of the information that this part requires...

  1. Sequence stratigraphy of the Aux Vases Sandstone: A major oil producer in the Illinois basin

    USGS Publications Warehouse

    Leetaru, H.E.

    2000-01-01

    The Aux Vases Sandstone (Mississippian) has contributed between 10 and 25% of all the oil produced in Illinois. The Aux Vases is not only an important oil reservoir but is also an important source of groundwater, quarrying stone, and fluorspar. Using sequence stratigraphy, a more accurate stratigraphic interpretation of this economically important formation can be discerned and thereby enable more effective exploration for the resources contained therein. Previous studies have assumed that the underlying Spar Mountain, Karnak, and Joppa formations interfingered with the Aux Vases, as did the overlying Renault Limestone. This study demonstrates that these formations instead are separated by sequence boundaries; therefore, they are not genetically related to each other. A result of this sequence stratigraphic approach is the identification of incised valleys, paleotopography, and potential new hydrocarbon reservoirs in the Spar Mountain and Aux Vases. In eastern Illinois, the Aux Vases is bounded by sequence boundaries with 20 ft (6 m) of relief. The Aux Vases oil reservoir facies was deposited as a tidally influenced siliciclastic wedge that prograded over underlying carbonate-rich sediments. The Aux Vases sedimentary succession consists of offshore sediment overlain by intertidal and supratidal sediments. Low-permeability shales and carbonates typically surround the Aux Vases reservoir sandstone and thereby form numerous bypassed compartments from which additional oil can be recovered. The potential for new significant oil fields within the Aux Vases is great, as is the potential for undrained reservoir compartments within existing Aux Vases fields.

  2. [Exercise prescription and nutrition therapy].

    PubMed

    Shiota, Masatoshi; Sone, Ryoko; Matsuo, Eriko; Matsubara, Shigeru; Suzuki, Masato

    2014-08-01

    In the report of World Health Organization, the leading global risks for mortality in the world are high blood pressure (12.8%), tobacco use (8.7%), high blood glucose (5.8%), physical inactivity (5.5%), and overweight and obesity (4.8%). Increased blood pressure levels cause the increased morbidity and mortality of chronic diseases, such as stroke, myocardial infarction, chronic kidney disease. Improving the high blood pressure is considered as common challenges around the world. Exercise prescription and nutrition therapy might be important non-pharmacologic therapies in the control of hypertension. Applying these therapies to the general population can help to prevent an increase in blood pressure and decrease elevated blood pressure levels for those with hypertension. Exercise prescription and nutrition therapy are discussed using the international guidelines.

  3. Evaluation des prescriptions antibiotiques au service des urgences de l’Hôpital Militaire d’Instruction Mohammed V (HMIMV)

    PubMed Central

    Elbouti, Anass; Rafai, Mostafa; Chouaib, Naoufal; Jidane, Said; Belkouch, Ahmed; Bakkali, Hicham; Belyamani, Lahcen

    2016-01-01

    Cette étude à pour objectifs de décrire les pratiques des prescriptions, évaluer leur pertinence et leur conformité aux règles d’utilisations et étudier les facteurs susceptibles de les influencer. Il s’agit d’une étude transversale d’évaluation des prescriptions antibiotiques portant sur 105 patients réalisée au service des urgences médico-chirurgicales de l’H.M.I.Med V de Rabat sur une période d’un mois. Le recueil des données était fait à l’aide d’un questionnaire rapportant les données démographiques et anamnestiques, les antécédents, la notion d’allergie, les données spécifiques de l’examen clinique, les données para cliniques, la prescription détaillée de l’antibiotique. Les données récoltées ont été ensuite évaluées par un médecin référent, chargé d’indiquer les éventuelles erreurs de traitement. Parmi les infections ayant motivé la prescription des antibiotiques, les affections des systèmes respiratoires et urinaires étaient au premier rang, les familles d’antibiotiques les plus couramment employées sont les pénicillines, les quinolones et les céphalosporines. 74 prescriptions soit (70,5%) étaient à la fois pertinentes et conformes contre 9 prescriptions soit (8,6%) justifiées mais non pertinentes et 6 prescriptions soit (5,7%) étaient jugées injustifiées par le médecin référent par absence d’infection. Les évaluations des pratiques médicales sont rarement menées dans les établissements de santé; c’est dans ce cadre que nous avons voulu nous inscrire en produisant cette étude afin d’améliorer la pertinence de nos prescriptions antibiotiques et d’optimiser leur conformité aux différentes recommandations. PMID:28292124

  4. Psychotropic Prescription Medication in Vietnam

    DTIC Science & Technology

    1978-05-01

    the psychotropic drugs prescribed were perceived by the prescribing physicians as being quite efficacious. Perhaps the primary care physicians were...psychotropic drug prescription rate was 12.5 per cent. (2) Psychiatrists prescribed more psychotropic drugs per prescribing physician than did the... psychotropic drugs in heavier doses and for longer periods of time than did the primary care physicians. (9) Disallowing the highly frequent use of

  5. Identification and quantification of prescription errors.

    PubMed

    Mohan, Prafull; Sharma, A K; Panwar, S S

    2014-04-01

    Prescription errors are commonly encountered in health care settings. They can lead to inefficient delivery of health care thus jeopardizing patient care. Knowing the quantum and the possible causes of such errors is the first step in trying to prevent them. We conducted a random audit of prescriptions received in service dispensary of a tertiary care hospital and analyzed them for prescription errors. A total of 1000 prescriptions were randomly selected. These prescriptions were analyzed with the help of three qualified pharmacists and were stratified as per the errors encountered. Out of the total of 1000 prescriptions, 650 prescriptions (65%) were found to have a total of 1012 errors. Type B errors were found in 22.4% prescriptions, type C errors in 9.7% prescriptions and type D in 69.1% prescriptions. Prescription errors require proactive, continuous and meticulous monitoring so as to minimize them. It requires identification of preventable causes, increasing awareness and sensitizing the prescriber towards this important aspect of health care delivery.

  6. Prescription drug abuse: problem, policies, and implications.

    PubMed

    Phillips, Janice

    2013-01-01

    This article provides an overview on prescription drug abuse and highlights a number of related legislative bills introduced during the 112th Congress in response to this growing epidemic. Prescription drug abuse has emerged as the nation's fastest growing drug problem. Although prescription drugs have been used effectively and appropriately for decades, deaths from prescription pain medicine in particular have reached epidemic proportions. Bills related to prescription drug abuse introduced during the 112th Congress focus on strengthening provider and consumer education, tracking and monitoring prescription drug abuse, improving data collection on drug overdose fatalities, combating fraud and abuse in Medicare and Medicaid programs, reclassifying drugs to make them more difficult to prescribe and obtain, and enforcing stricter penalties for individuals who operate scam pain clinics and sell pain pills illegitimately. This article underscores the importance of a multifaceted approach to combating prescription drug abuse and concludes with implications for nursing. Copyright © 2013. Published by Mosby, Inc.

  7. Rational Prescription for a Dermatologist

    PubMed Central

    Prakash, Bhanu; Nadig, Prathiba; Nayak, Amitha

    2016-01-01

    The ultimate goal in dermatological therapy is to use the safest and least number of drugs in order to obtain the best possible effect in the shortest period and at reasonable cost. Rational drug use (RDU) is conventionally defined as the use of an appropriate, efficacious, safe and cost-effective drug given for the right indications in the right dose and formulation, at right time intervals. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly as prescribed by the doctor. The process of Rational prescription for a Dermatologist (RPD) involves a series of steps such as defining the patient's illness, specifying the treatment objectives, using the principle of P-treatment, starting the treatment, providing appropriate information and monitoring the treatment. Reasons for irrational prescription could be physician related, patient related, industry related, regulations related. Practicing medicine irrationally can lead to disastrous events like increased morbidity and mortality, drain of resources, drug resistance etc. Principles to enhance the RDU in our practice and minimize errors of prescription are discussed in detail in this article. PMID:26955092

  8. [Inappropriate prescription in elderly inpatients].

    PubMed

    Fajreldines, Ana V; Insua, Jorge T; Schnitzler, Eduardo

    2016-01-01

    One of the causes of preventable adverse drug events (EAM) in the older adult population is the inappropriate prescription (PIM), i.e. that prescription where risks outweigh clinical benefits. The aim of this study is to determine the incidence of PIM with Beers criteria and Screening Tool of older person's prescriptions (STOPP), Potentially Prescribing Omissions (PPO) with Screening Tool to alert doctors to Right Treatments (START), and the average costs of hospitalization. This is an incidence study on a sample of patients over 64 years hospitalized, from January to July 2014 at a university hospital. According to Beers criteria, PIM incidence was 61.4%, 65.4% with STOPP and 27.6% PPO with START. The EAM rate calculated was 15.2/100 admissions and 18.6 EAM / 1000 patient days. The OR of EAM with PIM according to Beers and STOPP was 1.49 (IC95% 1.68-4.66) and 1.17 (IC95% 0.62-2.24) respectively. The average cost of hospitalization in patients with EAM were higher than without EAM (p = 0.020). PIM results are in line with most of the studies cited, but slightly higher for Beers and STOPP and lower for START, and the rate of EAM is lower than the data found by Kanaan (18.7% vs. 15.2%). PIM contributes to the appearance of EAM. The costs of hospitalizations with EAM are higher than those without EAM, achieving level of significance.

  9. Laboratory testing for prescription opioids.

    PubMed

    Milone, Michael C

    2012-12-01

    Opioid analgesic misuse has risen significantly over the past two decades, and these drugs now represent the most commonly abused class of prescription medications. They are a major cause of poisoning deaths in the USA exceeding heroin and cocaine. Laboratory testing plays a role in the detection of opioid misuse and the evaluation of patients with opioid intoxication. Laboratories use both immunoassay and chromatographic methods (e.g., liquid chromatography with mass spectrometry detection), often in combination, to yield high detection sensitivity and drug specificity. Testing methods for opioids originated in the workplace-testing arena and focused on detection of illicit heroin use. Analysis for a wide range of opioids is now required in the context of the prescription opioid epidemic. Testing methods have also been primarily based upon urine screening; however, methods for analyzing alternative samples such as saliva, sweat, and hair are available. Application of testing to monitor prescription opioid drug therapy is an increasingly important use of drug testing, and this area of testing introduces new interpretative challenges. In particular, drug metabolism may transform one clinically available opioid into another. The sensitivity of testing methods also varies considerably across the spectrum of opioid drugs. An understanding of opioid metabolism and method sensitivity towards different opioid drugs is therefore essential to effective use of these tests. Improved testing algorithms and more research into the effective use of drug testing in the clinical setting, particularly in pain medicine and substance abuse, are needed.

  10. The prescription pickup lag, an automatic prescription refill program, and community pharmacy operations.

    PubMed

    Lester, Corey A; Chui, Michelle A

    2016-01-01

    To determine the effect of an automatic prescription refill program on the prescription pickup lag in community pharmacy. A post-only quasi-experimental design comparing automatic and manual refill prescription cohorts for each of the 3 Centers for Medicare and Medicaid medication adherence metrics. A 29-store community pharmacy chain in the Midwest. Community-dwelling patients over the age of 65 years receiving prescription medications included in the statin, renin-angiotensin-aldosterone system antagonist, or non-insulin diabetes adherence metrics. An automatic prescription refill program that initiated prescription refills on a standardized, recurrent basis, eliminating the need for patients to phone in or drop off prescription refills. The prescription pickup lag, defined as the number of days between a prescription being adjudicated in the pharmacy and the prescription being picked up by the patient. A total of 37,207 prescription fills were examined. There were 20.5%, 22.4%, and 23.3% of patients enrolled in the automatic prescription refill program for the statin, renin-angiotensin-aldosterone system antagonist, and diabetes adherence metrics, respectively. Prescriptions in the automatic prescription refill cohorts experienced a median pickup lag of 7 days compared with 1 day for the manual refill prescriptions. 35.2% of all manual refill prescriptions had a pickup lag of 0 days compared with 13% for automatic refills. However, 15.4% of automatic prescription refills had a pickup lag of greater than 14 days, compared with 4.8% of manual refills. Prescriptions in the automatic prescription refill programs were associated with a significantly longer amount of time in the pharmacy before being picked up by the patient. This increased pickup lag may contribute positively by smoothing out workload demands of pharmacy staff, but may contribute negatively owing to an increased amount of rework and greater inventory requirements. Copyright © 2016 American

  11. Prescription Drug Monitoring and Dispensing of Prescription Opioids

    PubMed Central

    Brady, Joanne E.; Wunsch, Hannah; DiMaggio, Charles; Lang, Barbara H.; Giglio, James

    2014-01-01

    Objective In the United States, per-capita opioid dispensing has increased concurrently with analgesic-related mortality and morbidity since the 1990s. To deter diversion and abuse of controlled substances, most states have implemented electronic prescription drug monitoring programs (PDMPs). We evaluated the impact of state PDMPs on opioid dispensing. Methods We acquired data on opioids dispensed in a given quarter of the year for each state and the District of Columbia from 1999 to 2008 from the Automation of Reports and Consolidated Orders System and converted them to morphine milligram equivalents (MMEs). We used multivariable linear regression modeling with generalized estimating equations to assess the effect of state PDMPs on per-capita dispensing of MMEs. Results The annual MMEs dispensed per capita increased progressively until 2007 before stabilizing. Adjusting for temporal trends and demographic characteristics, implementation of state PDMPs was associated with a 3% decrease in MMEs dispensed per capita (p=0.68). The impact of PDMPs on MMEs dispensed per capita varied markedly by state, from a 66% decrease in Colorado to a 61% increase in Connecticut. Conclusions Implementation of state PDMPs up to 2008 did not show a significant impact on per-capita opioids dispensed. To control the diversion and abuse of prescription drugs, state PDMPs may need to improve their usability, implement requirements for committee oversight of the PDMP, and increase data sharing with neighboring states. PMID:24587548

  12. Prescription drug monitoring and dispensing of prescription opioids.

    PubMed

    Brady, Joanne E; Wunsch, Hannah; DiMaggio, Charles; Lang, Barbara H; Giglio, James; Li, Guohua

    2014-01-01

    In the United States, per-capita opioid dispensing has increased concurrently with analgesic-related mortality and morbidity since the 1990s. To deter diversion and abuse of controlled substances, most states have implemented electronic prescription drug monitoring programs (PDMPs). We evaluated the impact of state PDMPs on opioid dispensing. We acquired data on opioids dispensed in a given quarter of the year for each state and the District of Columbia from 1999 to 2008 from the Automation of Reports and Consolidated Orders System and converted them to morphine milligram equivalents (MMEs). We used multivariable linear regression modeling with generalized estimating equations to assess the effect of state PDMPs on per-capita dispensing of MMEs. The annual MMEs dispensed per capita increased progressively until 2007 before stabilizing. Adjusting for temporal trends and demographic characteristics, implementation of state PDMPs was associated with a 3% decrease in MMEs dispensed per capita (p=0.68). The impact of PDMPs on MMEs dispensed per capita varied markedly by state, from a 66% decrease in Colorado to a 61% increase in Connecticut. Implementation of state PDMPs up to 2008 did not show a significant impact on per-capita opioids dispensed. To control the diversion and abuse of prescription drugs, state PDMPs may need to improve their usability, implement requirements for committee oversight of the PDMP, and increase data sharing with neighboring states.

  13. [Detectig errors in chemotherapy prescription].

    PubMed

    Aguirrezábal Arredondo, A; Alvarez Lavín, M; Yurrebaso Ibarreche, M J; Vilella Ciriza, M L; Elguézabal Ortúzar, I; Goikolea Ugarte, F J; Escobar Martínez, A

    2003-01-01

    To analyse errors detected in the prescription of cytostatic drugs. Prospective study (February 1st to April 15th, 2002). All medical orders containing cytostatic agents were checked and 13 variables were studied: identification, anthropometric data, diagnosis, protocol, number of cycles, cytostatic drug, length of treatment, dose, route of administration, volume of infusion and/or final concentration, infusion time, diluent, and doctor's signature. Several possible errors were identified for each variable. Information on whether it was the first cycle, prescribing service, and prescription format was also recorded. In all, 618 medical orders were reviewed for a total of 1178 lines of cytostatic agents and 2,171 doses. The possible number of errors was 12.101 and the total number of errors actually found was 2,706 (22,03%). Not all these errors had the same impact on patients. Errors by omission were 2,340 (87,77%). Those which nursing staff found difficult to check and/or administer stood at 281 (10,54%). Potentially serious errors numbered 60 (2.06%): wrong body area > 10%: 5; wrong body area 5-10%: 2; erroneus protocol: 2; incorrect volume: 16; wrong dosage: 23 (difference < 25%: 5; difference 10-25%: 14; difference < 10%: 4). Reductions indicated but not implemented: 9; Inappropiate diluent: 3. There were no incorrect or omitted medications. The description of such errors and their uantification is a useful method of quality asurance in order to establish appropiate corrective measures. The most common error was the omission of information and therefore this issue, along with the development of computerised prescriptions, should be addressed.

  14. Writing all prescriptions by computer

    PubMed Central

    Preece, J.F.; Ashford, J.R.; Hunt, R.G.

    1984-01-01

    The information needed for safe prescribing is voluminous, complex and subject to continuous change. The computer makes an ideal instrument on which to store, access, and update general practice prescribing information. By using a desktop computer to check and write all prescriptions, it is possible for the general practitioner to build up a medication data base which has the capacity to record response to treatment and to supply information which can be reported to a remote central drug authority on a regular basis. PMID:6512749

  15. Prescription pricing across Canada (Part II).

    PubMed

    Archer, F

    1984-09-01

    The first of a two part article entitled "Prescription Pricing Across Canada" appeared in the June issue of CPJ. The article was prompted by recent press reports of a prescription drug study commissioned by the Saskatchewan government, and the consequent attention-getting headlines. The first article dealt with the Western provinces. The second part discusses prescription pricing in Ontario, Québec, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland, and the Northwest Territories.

  16. Exercise Prescription: Principles and Current Limitations

    PubMed Central

    Shephard, Roy J.

    1983-01-01

    Exercise prescriptions must be both safe and effective, while maximizing patient compliance. Safety can be threatened by physical injury, cardiac emergencies and environmental hazards. Risk can be reduced by individualizing the prescription, although the stress ECG contributes little to the prevention of the exercise catastrophe. Effectiveness of a prescription must be gauged by development of aerobic power and muscular strength, reduction of obesity, improvement of flexibility and control of coronary risk factors. The variability of patient response limits the potential for accurate laboratory prescription of exercise; fine tuning must depend upon the patient's immediate reactions. PMID:21283273

  17. Exercise Prescriptions in Older Adults.

    PubMed

    Lee, Pearl Guozhu; Jackson, Elizabeth A; Richardson, Caroline R

    2017-04-01

    Regular physical activity and exercise are important for healthy aging and are beneficial for chronic disease management. Exercise prescriptions for older adults should account for the individual's health status and functional capacity. Any amount of exercise is better than being sedentary, even if health status prevents a person from achieving recommended goals. For most health outcomes, more benefits occur with physical activity performed at higher intensity, greater frequency, or longer duration. Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity and at least two days of muscle-strengthening activities per week. Key components of the prescription include setting achievable activity goals, identifying barriers and providing potential solutions, and providing specific recommendations on the type, frequency, and intensity of activities. Older adults will derive distinct benefits from aerobic exercise, strength or resistance training, flexibility or stretching exercises, and balance training. Many community resources are available to help older adults begin a more active lifestyle.

  18. Structure-Function Analysis of the Presumptive Arabidopsis Auxin Permease AUX1W⃞

    PubMed Central

    Swarup, Ranjan; Kargul, Joanna; Marchant, Alan; Zadik, Daniel; Rahman, Abidur; Mills, Rebecca; Yemm, Anthony; May, Sean; Williams, Lorraine; Millner, Paul; Tsurumi, Seiji; Moore, Ian; Napier, Richard; Kerr, Ian D.; Bennett, Malcolm J.

    2004-01-01

    We have investigated the subcellular localization, the domain topology, and the amino acid residues that are critical for the function of the presumptive Arabidopsis thaliana auxin influx carrier AUX1. Biochemical fractionation experiments and confocal studies using an N-terminal yellow fluorescent protein (YFP) fusion observed that AUX1 colocalized with plasma membrane (PM) markers. Because of its PM localization, we were able to take advantage of the steep pH gradient that exists across the plant cell PM to investigate AUX1 topology using YFP as a pH-sensitive probe. The YFP-coding sequence was inserted in selected AUX1 hydrophilic loops to orient surface domains on either apoplastic or cytoplasmic faces of the PM based on the absence or presence of YFP fluorescence, respectively. We were able to demonstrate in conjunction with helix prediction programs that AUX1 represents a polytopic membrane protein composed of 11 transmembrane spanning domains. In parallel, a large aux1 allelic series containing null, partial-loss-of-function, and conditional mutations was characterized to identify the functionally important domains and amino acid residues within the AUX1 polypeptide. Whereas almost all partial-loss-of-function and null alleles cluster in the core permease region, the sole conditional allele aux1-7 modifies the function of the external C-terminal domain. PMID:15486104

  19. 21 CFR 1306.12 - Refilling prescriptions; issuance of multiple prescriptions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Refilling prescriptions; issuance of multiple prescriptions. 1306.12 Section 1306.12 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE... on which a pharmacy may fill each prescription; (iii) The individual practitioner concludes that...

  20. 21 CFR 1306.12 - Refilling prescriptions; issuance of multiple prescriptions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Refilling prescriptions; issuance of multiple prescriptions. 1306.12 Section 1306.12 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE... on which a pharmacy may fill each prescription; (iii) The individual practitioner concludes that...

  1. 21 CFR 1306.12 - Refilling prescriptions; issuance of multiple prescriptions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Refilling prescriptions; issuance of multiple prescriptions. 1306.12 Section 1306.12 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE... on which a pharmacy may fill each prescription; (iii) The individual practitioner concludes that...

  2. Maladies reliées aux loisirs aquatiques

    PubMed Central

    Sanborn, Margaret; Takaro, Tim

    2013-01-01

    Résumé Objectif Passer en revue les facteurs de risque, la prise en charge et la prévention des maladies reliées aux loisirs aquatiques en pratique familiale. Sources des données Des articles originaux et de synthèse entre janvier 1998 et février 2012 ont été identifiés à l’aide de PubMed et des expressions de recherche en anglais water-related illness, recreational water illness et swimmer illness. Message principal Il y a un risque de 3 % à 8 % de maladies gastrointestinales (MGI) après la baignade. Les groupes à risque élevé de MGI sont les enfants de moins de 5 ans, surtout s’ils n’ont pas été vaccinés contre le rotavirus, les personnes âgées et les patients immunodéficients. Les enfants sont à plus grand risque parce qu’ils avalent plus d’eau quand ils nagent, restent dans l’eau plus longtemps et jouent dans l’eau peu profonde et le sable qui sont plus contaminés. Les adeptes des sports dans lesquels le contact avec l’eau est abondant comme le triathlon et le surf cerf-volant sont aussi à risque élevé et même ceux qui s’adonnent à des activités impliquant un contact partiel avec l’eau comme la navigation de plaisance et la pêche ont un risque de 40 % à 50 % fois plus grand de MGI par rapport à ceux qui ne pratiquent pas de sports aquatiques. Il y a lieu de faire une culture des selles quand on soupçonne une maladie reliée aux loisirs aquatiques et l’échelle clinique de la déshydratation est utile pour l’évaluation des besoins de traitement chez les enfants affectés. Conclusion Les maladies reliées aux loisirs aquatiques est la principale cause de MGI durant la saison des baignades. La reconnaissance que la baignade est une source importante de maladies peut aider à prévenir les cas récurrents et secondaires. On recommande fortement le vaccin contre le rotavirus chez les enfants qui se baignent souvent.

  3. Considerations for an exercise prescription

    NASA Technical Reports Server (NTRS)

    Convertino, Victor A.

    1989-01-01

    A number of past and most recent research findings that describe some of the physiological responses to exercise in man and their relationship with exposure to various gravitational environments are discussed. Most of the data pertain to adaptations of the cardiovascular and body fluid systems. It should be kept in mind that the data from studies on microgravity simulation in man include exposures of relatively short duration (5 hours to 14 days). However, it is argued that the results may provide important guidelines for the consideration of many variables which are pertinent to the development of exercise prescription for long-duration space flight. The following considerations for exercise prescriptions during long-duration space flight are noted: (1) Relatively high aerobic fitness and strength, especially of the upper body musculature, should be a criterion for selection of astronauts who will be involved in EVA, since endurance and strength appear to be predominant characteristics for work performance. (2) Some degree of upper body strength will probably be required for effective performance of EVA. However, the endurance and strength required by the upper body for EVA can probably be obtained through preflight exercise prescription which involves swimming. (3) Although some degree of arm exercise may be required to maintain preflight endurance and strength, researchers propose that regular EVA will probably be sufficient to maintain the endurance and strength required to effectively perform work tasks during space flight. (4) A minimum of one maximal aerobic exercise every 7 to 10 days during space flight may be all that is necessary for maintenance of normal cardiovascular responsiveness and replacement of body fluids for reentry following prolonged space flight. (5) The possible reduction in the amount of exercise required for maintenance of cardiovascular system and body fluids in combination with the use of electromyostimulation (EMS) or methods other

  4. Application de la combustion catalytique aux turbines à gaz

    NASA Astrophysics Data System (ADS)

    Lebas, E.; Martin, G. H.

    2002-04-01

    La réduction des émissions d'oxydes d'azote sur turbines à gaz est obtenue par diminution de la température au sein de la chambre de combustion. Les techniques possibles comprennent l'injection d'eau ou de vapeur, la combustion pauvre et l'oxydation catalytique. Parmi celles-ci, la dernière est la plus prometteuse en terme de coûts et de performances, avec des émissions de NOx ramenées à un seul chiffre (typiquement inférieures à 3 ppm). L'IFP travaille depuis maintenant 10 ans sur l'adaptation de la combustion catalytique aux turbines à gaz. Les études ont été conduites au travers de projets européen tels que AGATA (Advance Gas Turbine for Automotive Application) et ULECAT (Ultra Low CATalytic combustor for dual fuel gas turbine). Le premier projet était destiné au développement de véhicules hybrides et le second à la combustion stationnaire de biogaz et de combustible Diesel. Les études en cours dans ce domaine portent sur le développement d'une unité de cogénération intégrant une microturbine à combustion catalytique. Les travaux menés à l'IFP concernent la mise au point de catalyseurs répondant aux exigences de la combustion catalytique en turbine à gaz et le développement de chambres de combustion permettant la mise en oeuvre de ces catalyseurs.

  5. Health Care Provider Physical Activity Prescription Intervention

    ERIC Educational Resources Information Center

    Josyula, Lakshmi; Lyle, Roseann

    2013-01-01

    Purpose: To examine the feasibility and impact of a health care provider’s (HCP) physical activity (PA) prescription on the PA of patients on preventive care visits. Methods: Consenting adult patients completed health and PA questionnaires and were sequentially assigned to intervention groups. HCPs prescribed PA using a written prescription only…

  6. Prescription of Physical Activity: A Paradigm Shift.

    ERIC Educational Resources Information Center

    Morgan, William P.

    2001-01-01

    Proposes a paradigm shift in physical activity prescription which involves: an idiographic approach; preferred exertion rather than a given percent of maximum in the prescription of exercise intensity; and purposeful physical activity. A summary of 10 cases is presented, revealing adherence figures ranging from 5 to 79 years. Adherence of 100…

  7. Exercise Prescription and the Kinesiological Imperative.

    ERIC Educational Resources Information Center

    Kelley, David L.

    1982-01-01

    Recent trends in physical education programs show a diverse spectrum of clients and an increasing amount of health-related litigation. These developments call for increased emphasis on exercise prescription. The sit-up is used in an example of a step-by-step guide to prescriptive technique. (JN)

  8. Health Care Provider Physical Activity Prescription Intervention

    ERIC Educational Resources Information Center

    Josyula, Lakshmi; Lyle, Roseann

    2013-01-01

    Purpose: To examine the feasibility and impact of a health care provider’s (HCP) physical activity (PA) prescription on the PA of patients on preventive care visits. Methods: Consenting adult patients completed health and PA questionnaires and were sequentially assigned to intervention groups. HCPs prescribed PA using a written prescription only…

  9. Exercise Prescription and the Kinesiological Imperative.

    ERIC Educational Resources Information Center

    Kelley, David L.

    1982-01-01

    Recent trends in physical education programs show a diverse spectrum of clients and an increasing amount of health-related litigation. These developments call for increased emphasis on exercise prescription. The sit-up is used in an example of a step-by-step guide to prescriptive technique. (JN)

  10. Prescription-Writing by Pediatric House Officers.

    ERIC Educational Resources Information Center

    Walson, Philip D.; And Others

    1981-01-01

    An examination to evaluate prescription writing was administered to a group of pediatric house officers and faculty at the University of Arizona. The data indicate that prescription writing should be taught to house officers, and that the therapeutic knowledge of beginning pediatric interns cannot be assumed to be adequate. (Author/MLW)

  11. Prescriptive Authority and Psychology: A Status Report

    ERIC Educational Resources Information Center

    Fox, Ronald E.; DeLeon, Patrick H.; Newman, Russ; Sammons, Morgan T.; Dunivin, Debra L.; Baker, Deborah C.

    2009-01-01

    The progress of psychology toward the acquisition of prescriptive authority is critically reviewed. Advances made by other nonphysician health care professions toward expanding their scopes of practice to include prescriptive authority are compared with gains made by professional psychology. Societal trends affecting attitudes toward the use of…

  12. Revisiting "the origins of compulsory drug prescriptions".

    PubMed Central

    Marks, H M

    1995-01-01

    It has been argued that today's prescription drug market originated in the arbitrary acts of the US Food and Drug Administration (FDA), which in 1938 issued regulations creating a class of drugs that could be sold by prescription only. On the basis of the FDA's administrative records, I argue that the 1938 regulations on prescription drug labeling were initiated by industry and then agreed to by the FDA; that contemporaries understood and accepted the reasons for restricting the use of certain drugs; and that the subsequent evolution of these regulations is best understood as an FDA effort to limit industry abuses of the prescription labeling system. This decade-long war of position ended when drug manufacturers persuaded the US Congress to enshrine their version of prescription labeling in law in a highly politicized struggle over government's role in the economy. Images FIGURE 1 PMID:7832245

  13. AUX/LAX family of auxin influx carriers—an overview

    PubMed Central

    Swarup, Ranjan; Péret, Benjamin

    2012-01-01

    Auxin regulates several aspects of plant growth and development. Auxin is unique among plant hormones for exhibiting polar transport. Indole-3-acetic acid (IAA), the major form of auxin in higher plants, is a weak acid and its intercellular movement is facilitated by auxin influx and efflux carriers. Polarity of auxin movement is provided by asymmetric localization of auxin carriers (mainly PIN efflux carriers). PIN-FORMED (PIN) and P-GLYCOPROTEIN (PGP) family of proteins are major auxin efflux carriers whereas AUXIN1/LIKE-AUX1 (AUX/LAX) are major auxin influx carriers. Genetic and biochemical evidence show that each member of the AUX/LAX family is a functional auxin influx carrier and mediate auxin related developmental programmes in different organs and tissues. Of the four AUX/LAX genes, AUX1 regulates root gravitropism, root hair development and leaf phyllotaxy whereas LAX2 regulates vascular development in cotyledons. Both AUX1 and LAX3 have been implicated in lateral root (LR) development as well as apical hook formation whereas both AUX1 and LAX1 and possibly LAX2 are required for leaf phyllotactic patterning. PMID:23087694

  14. OsAUX1 controls lateral root initiation in rice (Oryza sativa L.).

    PubMed

    Zhao, Heming; Ma, Tengfei; Wang, Xin; Deng, Yingtian; Ma, Haoli; Zhang, Rongsheng; Zhao, Jie

    2015-11-01

    Polar auxin transport, mediated by influx and efflux transporters, controls many aspects of plant growth and development. The auxin influx carriers in Arabidopsis have been shown to control lateral root development and gravitropism, but little is known about these proteins in rice. This paper reports on the functional characterization of OsAUX1. Three OsAUX1 T-DNA insertion mutants and RNAi knockdown transgenic plants reduced lateral root initiation compared with wild-type (WT) plants. OsAUX1 overexpression plants exhibited increased lateral root initiation and OsAUX1 was highly expressed in lateral roots and lateral root primordia. Similarly, the auxin reporter, DR5-GUS, was expressed at lower levels in osaux1 than in the WT plants, which indicated that the auxin levels in the mutant roots had decreased. Exogenous 1-naphthylacetic acid (NAA) treatment rescued the defective phenotype in osaux1-1 plants, whereas indole-3-acetic acid (IAA) and 2,4-D could not, which suggested that OsAUX1 was a putative auxin influx carrier. The transcript levels of several auxin signalling genes and cell cycle genes significantly declined in osaux1, hinting that the regulatory role of OsAUX1 may be mediated by auxin signalling and cell cycle genes. Overall, our results indicated that OsAUX1 was involved in polar auxin transport and functioned to control auxin-mediated lateral root initiation in rice.

  15. Evaluation des indicateurs d’alerte précoce de la résistance du VIH aux ARV en Côte d’Ivoire en 2011

    PubMed Central

    Yao, Kouadio Jean; Damey, Néto Florence; Konan, Diby Jean Paul; Aka, Joseph; Aka-Konan, Sandrine; Ani, Alex; Bonle, Marguerite Te; Kouassi, Dinard

    2016-01-01

    Introduction En 2001, l'Organisation des Nations Unies recommandait de rendre disponible les médicaments antirétroviraux dans les pays à ressources limitées. Cependant, l'utilisation de ces médicaments à grande échelle s'accompagne du développement de résistance du virus. En Côte d'Ivoire, plusieurs sites prescrivent les antirétroviraux. Cette étude avait pour objectif d'évaluer les facteurs programmatiques associés à un risque élevé d'émergence de résistance du VIH aux antirétroviraux. Méthodes Il s'agit d'une cohorte rétrospective sur 20 sites de prise en charge des personnes vivant avec le VIH. La population d'étude était constituée des personnes ayant initié leur traitement antirétroviral sur les sites en 2008-2009. L'estimation de la taille de l'échantillon a été faite à partir de la stratégie d'échantillonnage de l'OMS. Résultats Sur 20 sites, 98% des prescriptions initiales étaient conformes aux directives nationales et 20% des sites avaient 100% de prescriptions conformes. Au total, 33% des patients étaient perdus de vue au cours des 12 premiers mois de traitement antirétroviral et 20% des sites avaient moins de 20% de perdus de vue. A 12 mois, 51% des patients demeuraient sous traitement de première intention approprié et 11% des sites ont atteint le seuil d'au moins 70% de patients sous traitement de première intention approprié. Un seul site n'a pas connu de rupture d'antirétroviraux sur les 12 mois. Conclusion Des insuffisances relevées dans la prise en charge des personnes vivant avec le VIH traduisent l'existence d'un risque important de résistance du virus aux antirétroviraux en 2008-2009. Pour minimiser ce risque les pratiques de prescription devraient être améliorées, un système de recherche des absents aux rendez-vous devrait être mis en place et la disponibilité constante des antirétroviraux devraient être assurée. PMID:28250876

  16. Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists

    PubMed Central

    Rasubala, Linda; Pernapati, Lavanya; Velasquez, Ximena; Burk, James; Ren, Yan-Fang

    2015-01-01

    Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%), 190 (14.1%), and 140 (9.6%) received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (p<0.05). Total numbers of prescribed opioid pills in a 3-month period decreased from 5096 to 1120, signifying a 78% reduction in absolute quantity. Prescriptions for non-opioid analgesics acetaminophen increased during the same periods (p<0.05). We conclude that the mandatory PDMP significantly affected the prescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain. PMID:26274819

  17. Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists.

    PubMed

    Rasubala, Linda; Pernapati, Lavanya; Velasquez, Ximena; Burk, James; Ren, Yan-Fang

    2015-01-01

    Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%), 190 (14.1%), and 140 (9.6%) received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (p<0.05). Total numbers of prescribed opioid pills in a 3-month period decreased from 5096 to 1120, signifying a 78% reduction in absolute quantity. Prescriptions for non-opioid analgesics acetaminophen increased during the same periods (p<0.05). We conclude that the mandatory PDMP significantly affected the prescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain.

  18. Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines

    PubMed Central

    Dormuth, Colin R.; Miller, Tarita A.; Huang, Anjie; Mamdani, Muhammad M.; Juurlink, David N.

    2012-01-01

    Background: Opioid analgesics and benzodiazepines are often misused in clinical practice. We determined whether implementation of a centralized prescription network offering real-time access to patient-level data on filled prescriptions (PharmaNet) reduced the number of potentially inappropriate prescriptions for opioids and benzodiazepines. Methods: We conducted a time series analysis using prescription records between Jan. 1, 1993, and Dec. 31, 1997, for residents of the province of British Columbia who were receiving social assistance or were 65 years or older. We calculated monthly percentages of filled prescriptions for an opioid or a benzodiazepine that were deemed inappropriate (those issued by a different physician and dispensed at a different pharmacy within 7 days after a filled prescription of at least 30 tablets of the same drug). Results: Within 6 months after implementation of PharmaNet in July 1995, we observed a relative reduction in inappropriate filled prescriptions for opioids of 32.8% (95% confidence interval [CI] 31.0%–34.7%) among patients receiving social assistance; inappropriate filled prescriptions for benzodiazepines decreased by 48.6% (95% CI 43.2%–53.1%). Similar and statistically significant reductions were observed among residents 65 years or older. Interpretation: The implementation of a centralized prescription network was associated with a dramatic reduction in inappropriate filled prescriptions for opioids and benzodiazepines. PMID:22949563

  19. Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines.

    PubMed

    Dormuth, Colin R; Miller, Tarita A; Huang, Anjie; Mamdani, Muhammad M; Juurlink, David N

    2012-11-06

    Opioid analgesics and benzodiazepines are often misused in clinical practice. We determined whether implementation of a centralized prescription network offering real-time access to patient-level data on filled prescriptions (PharmaNet) reduced the number of potentially inappropriate prescriptions for opioids and benzodiazepines. We conducted a time series analysis using prescription records between Jan. 1, 1993, and Dec. 31, 1997, for residents of the province of British Columbia who were receiving social assistance or were 65 years or older. We calculated monthly percentages of filled prescriptions for an opioid or a benzodiazepine that were deemed inappropriate (those issued by a different physician and dispensed at a different pharmacy within 7 days after a filled prescription of at least 30 tablets of the same drug). Within 6 months after implementation of PharmaNet in July 1995, we observed a relative reduction in inappropriate filled prescriptions for opioids of 32.8% (95% confidence interval [CI] 31.0%-34.7%) among patients receiving social assistance; inappropriate filled prescriptions for benzodiazepines decreased by 48.6% (95% CI 43.2%-53.1%). Similar and statistically significant reductions were observed among residents 65 years or older. The implementation of a centralized prescription network was associated with a dramatic reduction in inappropriate filled prescriptions for opioids and benzodiazepines.

  20. Combating the prescription painkiller epidemic: a national prescription drug reporting program.

    PubMed

    Shepherd, Joanna

    2014-01-01

    Prescription painkiller abuse is the fastest growing drug problem in the United States. In the past year, approximately one out of twenty Americans reported misuse or abuse of prescription painkillers. Several factors contribute to the prescription painkiller epidemic. Drug abusers use various methods--such as doctor shopping, paying with cash, and filling prescriptions in different states--to avoid detection and obtain prescription painkillers for illegitimate uses. A few rogue physicians and pharmacists, lured by substantial profits, enable drug abusers by illegally prescribing or supplying controlled substances. Even ethical physicians rarely have adequate training to recognize and address prescription drug abuse, and as a result, prescribe painkillers to patients who are not using them for legitimate medical purposes. Similarly, although the majority of pharmacies have taken steps to combat drug abuse and reduce prescription painkiller dispensing, under current reporting systems, pharmacists lack visibility into several important indicators of drug abuse. As a result, even the most vigilant pharmacists find it extremely difficult to identify and detect drug abuse with certainty. While state governments have established prescription drug monitoring programs (PDMPs) to crack down on prescription drug abuse, these programs have proven to be inadequate. The programs currently suffer from inadequate data collection, ineffective utilization of data, insufficient interstate data sharing, and constraints on sharing data with law enforcement and state agencies. By contrast, third-party prescription payment systems run by pharmacy benefit managers (PBMs) or health insurers have been effective in detecting prescription drug abuse. This paper suggests that a national prescription drug reporting program building on existing PBM networks could be significantly more effective than existing state PDMPs in detecting prescription drug abuse.

  1. The identification and characterization of specific ARF-Aux/IAA regulatory modules in plant growth and development.

    PubMed

    Krogan, Naden T; Berleth, Thomas

    2015-01-01

    The current model of auxin-inducible transcription describes numerous regulatory interactions between AUXIN RESPONSE FACTORs (ARFs) and Aux/IAAs. However, specific relationships between individual members of these families in planta remain largely uncharacterized. Using a systems biology approach, the entire suite of Aux/IAA genes directly regulated by the developmentally pivotal ARF MONOPTEROS (MP) was recently determined for multiple Arabidopsis tissue types. This study showed that MP directly targets distinct subclades of Aux/IAAs, revealing potential regulatory modules of redundantly acting Aux/IAAs involved in MP-dependent processes. Further, functional analyses indicated that the protein products of these targeted Aux/IAAs negatively feedback on MP. Thus, comprehensive identification of Aux/IAAs targeted by individual ARFs will generate biologically meaningful networks of ARF-Aux/IAA regulatory modules controlling distinct plant pathways.

  2. Filled Prescriptions for Opioids After Vaginal Delivery.

    PubMed

    Jarlenski, Marian; Bodnar, Lisa M; Kim, Joo Yeon; Donohue, Julie; Krans, Elizabeth E; Bogen, Debra L

    2017-03-01

    To estimate the prevalence of filled opioid prescriptions after vaginal delivery. We conducted a retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania who delivered a liveborn neonate vaginally from 2008 to 2013, excluding women who used opioids during pregnancy or who had an opioid use disorder. We assessed overall filled prescriptions as well as filled prescriptions in the presence or absence of the following pain-inducing conditions: bilateral tubal ligation, perineal laceration, or episiotomy. Outcomes included a binary measure of whether a woman had any opioid prescription fill 5 days or less after delivery and, among those women, a second opioid prescription fill 6-60 days after delivery. Among women with no coded pain-inducing conditions at delivery, we used multivariable logistic regression with standard errors clustered to account for within-hospital correlation to assess the association between patient characteristics and odds of a filled opioid prescription. Twelve percent of women (n=18,131) filled an outpatient opioid prescription 5 days or less after vaginal delivery; among those women, 14% (n=2,592, or 1.6% of the total) filled a second opioid prescription 6-60 days after delivery. Of the former, 5,110 (28.2%) had one or more pain-inducing conditions. Predictors of filled opioid prescriptions with no observed pain-inducing condition at delivery included tobacco use (adjusted odds ratio [OR] 1.3, 95% confidence interval [CI] 1.2-1.4) and a mental health condition (adjusted OR 1.3, 95% CI 1.2-1.4). Having a diagnosis of substance use disorder other than opioid use disorder was not associated with filling an opioid prescription 5 days or less after delivery, but was associated with having a second opioid prescription 6-60 days after delivery (adjusted OR 1.4, 95% CI 1.2-1.6). More than 1 in 10 Medicaid-enrolled women fill an outpatient opioid prescription after vaginal delivery. National opioid-prescribing recommendations for

  3. Monitoring physicians' prescription patterns on electronic health record: the prescription pattern around clinical event (PACE) algorithm.

    PubMed

    Yoon, Dukyong; Park, Inwhee; Park, Man Young; Hong, Seung Kwon; Park, Rae Woong

    2013-01-01

    Electronic health records (EHRs) have gained attention as a valuable data source for medical research, as its adoption rate continues to rise. However, no method for the monitoring of physicians' prescription patterns has been established. Since EHR maintain all prescription data as well as clinical events that occur during the care of patients, we hypothesized that a physician's prescription pattern can be monitored from EHR. In this study, we developed a novel algorithm named PACE, Prescription pattern Around Clinical Event. This algorithm analyzes distribution of the prescription of specific drugs around the time of a clinical event. In the proof of concept study, prescription changes with regard to hyperkalemia were well represented by the algorithm, and the observed patterns well correlated with the physician's knowledge on hyperkalemia (Cohen's kappa, 0.457-0.653). We expect that this algorithm can be used to monitor the guideline adherence of physicians.

  4. Teens Mix Prescription Opioids with Other Substances

    MedlinePlus

    ... Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Prescription Drugs & Cold ... least one other substance in the past year. Marijuana and alcohol were the most common (58.5% ...

  5. CDC Vital Signs: Prescription Painkiller Overdoses (Opioids)

    MedlinePlus

    ... for responsible prescribing, including screening and monitoring for substance abuse and mental health problems. Use prescription drug monitoring ... Working to improve access to mental health and substance abuse treatment through implementation of the Affordable Care Act. ...

  6. How Can Prescription Drug Addiction Be Treated?

    MedlinePlus

    ... Trends and Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Prescription ... same brain targets as other opioids such as heroin, morphine, and opioid pain medications. It has been ...

  7. Closing the Prescription Drug Coverage Gap

    MedlinePlus

    ... coverage gap discount work for brand-name drugs? Companies that make brand-name prescription drugs must sign ... Coverage Gap Discount Program. This program requires the companies to offer discounts on brand-name drugs to ...

  8. Are You Shopping Smart for Prescription Drugs?

    MedlinePlus

    ... best known for its ratings of cars, appliances, computers, and TVs, recently launched Consumer Reports Best Buy Drugs . The project compares prescription drugs based on their effectiveness, safety, side effects, and cost. The results are offered free at ...

  9. Prescription Nonsteroidal Anti-Inflammatory Medicines

    MedlinePlus

    ... is called a drug-drug interaction. Vitamins and herbal supplements can affect the way your body processes drugs, ... over-the-counter and prescription medicines, vitamins and herbal supplements that you are taking. Also, talk to your ...

  10. Prescription drug abuse in the elderly.

    PubMed

    Martin, Caren McHenry

    2008-12-01

    The increased use of prescription drugs has brought pain relief too many and often improved the quality of life of elderly patients. But the increase in use and availability of prescription medications-especially controlled substances-brings with it an increased potential for abuse. Studies have shown that intentional abuse of prescription drugs is increasing among all age groups. As the number of persons 65 years of age and older skyrockets with the aging of the baby boomers, experts predict that prescription drug abuse among the elderly also will rise significantly. Efforts to increase awareness of drug abuse among elderly patients, caregivers, and health care practitioners, as well as research into how best to prevent and treat the elderly drug abuser, will be necessary to thwart what could become a significant public health problem.

  11. Safety precautions in the rehabilitation medicine prescription.

    PubMed

    Brathwaite, Deborah; Aziz, Frederick; Eakins, Chauncy; Charles, Andrea Jno; Cristian, Adrian

    2012-05-01

    The rehabilitation medicine prescription is a communication tool between the referring physician and the rehabilitation team in both the inpatient and outpatient settings. This instrument is critical in both directing a course of treatment as well as minimizing risk to the patient during the treatment sessions. The goal of this article is to provide an overview of the rehabilitation prescription with an emphasis on safety. Copyright © 2012. Published by Elsevier Inc.

  12. Prescription drug misuse among antisocial youths.

    PubMed

    Hall, Martin T; Howard, Matthew O; McCabe, Sean Esteban

    2010-11-01

    The aim of this study was to describe the prevalence and correlates of nonmedical prescription drug misuse (PDM) in a state population of youths in residential care for antisocial behavior. Interviews assessing substance use, psychiatric symptoms, antisocial traits/behavior, and traumatic life experiences were conducted with 723 Missouri youths. Participants were predominantly male (87.0%), averaged 15.5 (SD = 1.2) years of age, and constituted 97.7% of the service population sampled. Overall, 314 youths (43.4%) reported lifetime PDM; 33.7%, 32.0%, and 11.2% had misused prescription opioids, tranquilizers, and barbiturates, respectively. Prescription drug misusers were significantly older, and larger proportions were girls, were White, and resided in small towns, compared with non-prescription drug misusers. Prescription drug misusers evidenced significantly more varied, frequent, and problematic psychoactive drug use; evidenced higher levels of distressing psychiatric symptoms; and were nearly twice as likely to have been diagnosed with a psychiatric disorder, compared with non-prescription drug misusers. Traumatic life events, experiences of criminal victimization, and suicidal ideation were significantly more prevalent in the histories of prescription drug misusers, compared with non-prescription drug misusers. In multiple logistic regression models, older age; White racial status; prior inhalant, marijuana, and LSD (lysergic acid diethylamide) use; residence in a small town; and impulsivity were associated with increased risk for PDM. Adolescents in residential care for antisocial behavior have high rates of PDM, as well as comorbid psychiatric and behavioral problems. Youths served in institutional settings should be routinely screened and treated for PDM and co-occurring disorders.

  13. Prescription Drug Misuse Among Antisocial Youths*

    PubMed Central

    Hall, Martin T.; Howard, Matthew O.; Mccabe, Sean Esteban

    2010-01-01

    Objective: The aim of this study was to describe the prevalence and correlates of nonmedical prescription drug misuse (PDM) in a state population of youths in residential care for antisocial behavior. Method: Interviews assessing substance use, psychiatric symptoms, antisocial traits/behavior, and traumatic life experiences were conducted with 723 Missouri youths. Participants were predominantly male (87.0%), averaged 15.5 (SD = 1.2) years of age, and constituted 97.7% of the service population sampled. Results: Overall, 314 youths (43.4%) reported lifetime PDM; 33.7%, 32.0%, and 11.2% had misused prescription opioids, tranquilizers, and barbiturates, respectively. Prescription drug misusers were significantly older, and larger proportions were girls, were White, and resided in small towns, compared with non-prescription drug misusers. Prescription drug misusers evidenced significantly more varied, frequent, and problematic psychoactive drug use; evidenced higher levels of distressing psychiatric symptoms; and were nearly twice as likely to have been diagnosed with a psychiatric disorder, compared with non-prescription drug misusers. Traumatic life events, experiences of criminal victimization, and suicidal ideation were significantly more prevalent in the histories of prescription drug misusers, compared with non-prescription drug misusers. In multiple logistic regression models, older age; White racial status; prior inhalant, marijuana, and LSD (lysergic acid diethylamide) use; residence in a small town; and impulsivity were associated with increased risk for PDM. Conclusions: Adolescents in residential care for antisocial behavior have high rates of PDM, as well as comorbid psychiatric and behavioral problems. Youths served in institutional settings should be routinely screened and treated for PDM and co-occurring disorders. PMID:20946750

  14. Descriptive study about congruence in wheelchair prescription.

    PubMed

    Cherubini, M; Melchiorri, G

    2012-06-01

    Wheelchair prescription is relevant in the prevention of muscular joint pathology, and to facilitate autonomy and the patient's social life. However, in order to reach this goal, respecting the standards with a client-centred approach is essential. Congruence between user ability and wheelchair characteristics by making wheelchairs more "user friendly" can improve patient independence, facilitate integration into society and improve the patient's quality of life. The purpose of this study was to analyse congruence of wheelchair use by our patients, through the consideration of specific recommendations related to each subject's individual clinical situation. The second aim of the paper was to improve wheelchair prescriptions, by identifying the most frequent mistakes in the prescription and construction of wheelchairs. Observational study, outpatient. One hundred-fifty wheelchair users (average age 46.7±17.3) were analysed and described at 16.2±8.5 years from the onset of their disability. The subjects were 80 males and 70 females. Sixty-eight percent of the wheelchairs were not suitable for the patients, while 32% were suitable. We reported the incidence of non-congruence with respect to each wheelchair part. After finding a correlation between the prescription sources and suitability, the authors suggested that wheelchair prescriptions should be carried out in specialized departments, or that physician competences, and collaboration between physicians and technicians must be improved. Our data indicates the necessity to pay more attention to wheelchair prescription while considering ergonomic fitting to the individual. Identifying the most frequent mistakes in the prescription and construction of wheelchairs in this paper could help to make more appropriate prescriptions.

  15. The Conundrum of Online Prescription Drug Promotion

    PubMed Central

    Wanasika, Isaac

    2016-01-01

    This commentary discusses pertinent issues from Hyosun Kim’s paper on online prescription drug promotion. The study is well-designed and the findings highlight some of the consequences of the Food and Drug Administration’s (FDA’s) decision to deregulate online advertising of prescription drugs. While Kim’s findings confirm some of the early concerns, they also provide a perspective of implementation challenges in the ever-changing technological environment. PMID:27285519

  16. Safe exercise prescription for children and adolescents

    PubMed Central

    Alleyne, Julia MK

    1998-01-01

    This article provides practical advice on healthy exercise prescription for children. There is growing scientific evidence about the abilities and limits of child athletes in both recreational and competitive environments. As exercise becomes essential for the prevention of illness and maintenance of health, the counselling for an exercise prescription requires enhanced knowledge. The latest recommendations on safe strength, resistance and weight training are presented in a concise format for office use. PMID:20401276

  17. [Good prescription practice for out-patients-quality requirements of prescriptions in Germany].

    PubMed

    Faller, Christine K; Seidling, Hanna M; Haefeli, Walter E

    2014-06-01

    Because the written prescription is a central communication medium between the prescribing physician and the dispensing pharmacist measures to improve the prescription quality are top priorities. While most primary care physicians in Germany use electronic systems, in outpatient clinics and nursing homes and on special occasions such as emergency services and home visits, many prescriptions are still handwritten. Incorrectly and illegibly issued prescriptions impair the physician-pharmacist-patient relationship and thus represent a risk factor in the context of medication safety. Well issued prescriptions expedite the dispensing and thus the continuity of treatment of the patients and spare human resources by avoiding queries and unnecessary steps in the care process. At the same time, legible and unequivocal prescriptions facilitate measures for quality assurance by the dispensing pharmacists and are essential preconditions needed for insurance reimbursement. Probably the most important step to high quality prescriptions is the consistent use of suitable electronic prescription software. This is only possible if physicians are willing to cooperate and understand the significance and benefits of an electronic prescription system.

  18. Should oral contraceptives be available without prescription?

    PubMed

    Trussell, J; Stewart, F; Potts, M; Guest, F; Ellertson, C

    1993-08-01

    In this paper, it is argued that oral contraceptives should be available without prescription. Prescription status entails heavy costs, including the dollar, time, and psychological costs of visiting a physician to obtain a prescription, the financial and human costs of unintended pregnancies that result from the obstacle to access caused by medicalization of oral contraceptives, and administrative costs to the health care system. After a review and evaluation of the reasons for strict medical control of oral contraceptives in the United States, safety concerns anticipated in response to the proposal discussed here are addressed. Also, concerns that prescription status is necessary for efficacious use are evaluated. It is concluded that neither safety nor efficacy considerations justify prescription status for oral contraceptives. Revised package design and patient labeling could allow women to screen themselves for contraindications, to educate themselves about danger signs, and to use oral contraceptives safely and successfully. Several alternatives to providing oral contraceptives by prescription with current package design and labeling and selling them over the counter are suggested; the proposals discussed would make these safe and effective contraceptives easier to obtain and to use.

  19. Should oral contraceptives be available without prescription?

    PubMed Central

    Trussell, J; Stewart, F; Potts, M; Guest, F; Ellertson, C

    1993-01-01

    In this paper, it is argued that oral contraceptives should be available without prescription. Prescription status entails heavy costs, including the dollar, time, and psychological costs of visiting a physician to obtain a prescription, the financial and human costs of unintended pregnancies that result from the obstacle to access caused by medicalization of oral contraceptives, and administrative costs to the health care system. After a review and evaluation of the reasons for strict medical control of oral contraceptives in the United States, safety concerns anticipated in response to the proposal discussed here are addressed. Also, concerns that prescription status is necessary for efficacious use are evaluated. It is concluded that neither safety nor efficacy considerations justify prescription status for oral contraceptives. Revised package design and patient labeling could allow women to screen themselves for contraindications, to educate themselves about danger signs, and to use oral contraceptives safely and successfully. Several alternatives to providing oral contraceptives by prescription with current package design and labeling and selling them over the counter are suggested; the proposals discussed would make these safe and effective contraceptives easier to obtain and to use. PMID:8342715

  20. [Drug prescriptions: Adherence and understanding in Madagascar].

    PubMed

    Raharinjatovo, L; Ralandison, S

    2015-01-01

    Frequently ignored or neglected, poor adherence is an important cause of treatment failure and a major public health problem. We assessed the factors involved in adherence in a hospital in Madagascar. This long-term study evaluated two groups of variables: patients' level of understanding of their disease and drug prescriptions, and the information on the prescription written by the doctor. We interviewed 93 in-patients (mean age: 50 years) and found that 16% were illiterate. Overall, 27% did not know the name of their illness, 34% were unaware of the treatment objectives, and 14% did not understand the drug prescription. On 20% of the prescriptions, the patients' name was not included, and the daily dose information and schedule was omitted from 16%. A day after receiving the prescription, only 64% had purchased the medication and only 53% of all patients had taken any. A correlation was observed between illiteracy, knowledge of the disease/treatment goals, and non-purchase of drugs. The poor quality of information contained in the prescriptions and patients' poor understanding of what they were supposed to do are obvious. Using pre-completed health forms and text messages might improve adherence.

  1. The Binding of Auxin to the Arabidopsis Auxin Influx Transporter AUX11[OA

    PubMed Central

    Carrier, David J.; Bakar, Norliza Tendot Abu; Swarup, Ranjan; Callaghan, Richard; Napier, Richard M.; Bennett, Malcolm J.; Kerr, Ian D.

    2008-01-01

    The cellular import of the hormone auxin is a fundamental requirement for the generation of auxin gradients that control a multitude of plant developmental processes. The AUX/LAX family of auxin importers, exemplified by AUX1 from Arabidopsis (Arabidopsis thaliana), has been shown to mediate auxin import when expressed heterologously. The quantitative nature of the interaction between AUX1 and its transport substrate indole-3-acetic acid (IAA) is incompletely understood, and we sought to address this in the present investigation. We expressed AUX1 to high levels in a baculovirus expression system and prepared membrane fragments from baculovirus-infected insect cells. These membranes proved suitable for determination of the binding of IAA to AUX1 and enabled us to determine a Kd of 2.6 μm, comparable with estimates for the Km for IAA transport. The efficacy of a number of auxin analogues and auxin transport inhibitors to displace IAA binding from AUX1 has also been determined and can be rationalized in terms of their physiological effects. Determination of the parameters describing the initial interaction between a plant transporter and its hormone ligand provides novel quantitative data for modeling auxin fluxes. PMID:18614710

  2. Protein-protein interaction and gene co-expression maps of ARFs and Aux/IAAs in Arabidopsis

    PubMed Central

    Piya, Sarbottam; Shrestha, Sandesh K.; Binder, Brad; Stewart, C. Neal; Hewezi, Tarek

    2014-01-01

    The phytohormone auxin regulates nearly all aspects of plant growth and development. Based on the current model in Arabidopsis thaliana, Auxin/indole-3-acetic acid (Aux/IAA) proteins repress auxin-inducible genes by inhibiting auxin response transcription factors (ARFs). Experimental evidence suggests that heterodimerization between Aux/IAA and ARF proteins are related to their unique biological functions. The objective of this study was to generate the Aux/IAA-ARF protein-protein interaction map using full length sequences and locate the interacting protein pairs to specific gene co-expression networks in order to define tissue-specific responses of the Aux/IAA-ARF interactome. Pairwise interactions between 19 ARFs and 29 Aux/IAAs resulted in the identification of 213 specific interactions of which 79 interactions were previously unknown. The incorporation of co-expression profiles with protein-protein interaction data revealed a strong correlation of gene co-expression for 70% of the ARF-Aux/IAA interacting pairs in at least one tissue/organ, indicative of the biological significance of these interactions. Importantly, ARF4-8 and 19, which were found to interact with almost all Aux-Aux/IAA showed broad co-expression relationships with Aux/IAA genes, thus, formed the central hubs of the co-expression network. Our analyses provide new insights into the biological significance of ARF-Aux/IAA associations in the morphogenesis and development of various plant tissues and organs. PMID:25566309

  3. Symetries et integrabilite des equations aux differences finies

    NASA Astrophysics Data System (ADS)

    Lafortune, Stephane

    2000-09-01

    La présente thèse porte sur l'étude des symétries et des propriétés d'intégrabilité des équations aux différences finies. Dans le chapitre 1, le groupe de symétrie ponctuelle d'un système couplé à deux équations différentielles aux différences est étudié. On montre que dans certains cas, la dimension du groupe peut être infinie. Les équations peuvent décrire l'interaction de deux longues chaînes moléculaires, chacune étant composée d'atomes d'un même type. Dans le chapitre 2, une classe de théories de champs avec interaction exponentielle est introduite. L'interaction dépend de deux matrices de ``couplage'' et est suffisamment générale pour inclure toutes les théories de champs de Toda existant dans la littérature. Les symétries de Lie ponctuelles sont obtenues pour les cas où l'on a un nombre fini, infini ou semi-infini de champs. Une attention spéciale est accordée à la présence de l'invariance conforme. Dans le chapitre 3, nous procédons à la classification et à l'étude d'équations linéarisables. Nous examinons tout d'abord l'équation de Gambier continue qui contient, comme réductions, toutes les équations de deuxième ordre intégrables par linéarisation. Nous introduisons par la suite la forme discrète de cette équation et obtenons les conditions d'intégrabilité à l'aide du confinement des singularités. Nous étudions aussi les différentes réductions du cas discret. De plus, nous obtenons des transformations de Schlesinger pour les équations de Gambier discrète et continue. Dans la dernière partie du chapitre, nous étudions une famille d'équations discrètes du deuxième ordre incluant des équations résolubles par linéarisation. Plusieurs cas intégrables sont obtenus. Dans le cas discret, l'étude de l'intégrabilité est faite à l'aide du confinement des singularités. Dans le chapitre 4, nous étudions un autre critère d'intégrabilité: l'entropie algébrique. Nous montrons que les r

  4. Réactions aux interfaces de bicristaux compatibles et incompatibles

    NASA Astrophysics Data System (ADS)

    Taisne, A.; Décamps, B.; Priester, L.

    2003-03-01

    La rupture intergranulaire peut apparaître suite à la non accommodation des contraintes au voisinage de l'interface. La transmission du glissement au travers d'une interface est un des modes de relaxation possible qui dépend des paramètres suivants : facteurs géométriques (caractéristiques de l'interface et systèmes de glissement activés), constantes élastiques de chacune des phases. Dans cette étude, la microscopie électronique à transmission (MET) est utilisée pour analyser les configurations de dislocations résultant d'une déformation par fatigue de bicristaux d'acier austénoferritique de désorientations contrôlées. Deux types de bicristaux sont étudiés, compatible et incompatible plastiquement. Pour chacun d'eux, la déformation est initiée soit dans la phase ferritique α soit dans la phase austénitique γ selon la localisation d'une entaille préalable à l'essai mécanique. Les résultats permettent de remonter aux mécanismes élémentaires qui régissent le transfert “direct” ou “indirect” des dislocations à travers l'interface. Une corrélation avec le comportement des bicristaux à l'échelle macroscopique est également tentée.

  5. [Induced drug prescription in oncology patients].

    PubMed

    Mas Arcas, C; Pascual Plá, F; Escrivá Muñz, J J; Boscas Mayans, R

    2004-01-01

    To study drug prescription generated by cancer patients treated at the Emergency Service (ES) of the Instituto Valenciano de Oncología (IVO) in their Primary Health Care Centre (PHCC). A descriptive prospective study has been carried out with patients treated and discharged from the ES of the IVO in November (n=207) and December (n=239) of 2001. 446 patients were treated and discharged; one out of five patients was contacted by telephone 48 hours after discharge to confirm drug prescriptions from the ES. In November, drug prescription was based on brand-name products, while, in December, generic drugs were prescribed. All patients were discharged with a detailed report that included: patient's medical records, consultation reason, physical exploration performed, diagnostic test results, discharge diagnosis and prescribed treatment. When a brand-name drug was prescribed, the majority of patients received the same product at the PHCC (92.5%), while the rest of them received the same active drug with a different brand name. When a generic drug was prescribed, patients received a prescription for the same active substance at the PHCC in 98% of cases (46% generic drug and 54% brand-name). As to length of treatment, 96% were short treatments (less than 2 weeks), while the rest of them were on-going. 80% needed one prescription; 15%, two, and 5% three or more prescriptions. In terms of therapeutic groups, the most commonly prescribed drugs were anti-infectious, analgesics, digestive-metabolism, respiratory, cardiovascular, neurological and miscellaneous. 1. There is a high level of induced drug prescription at PHCC in cancer patients, since primary care physicians usually maintain active substances prescribed by the ES of IVO, with few variations. 2. Promoting a good relationship between Hospital Care and Primary Health Care Centres helps control and reduce pharmaceutical costs. 3. A high correlation can be found between most frequently prescribed drugs in oncological

  6. Prescription Stimulants Are "A Okay": Applying Neutralization Theory to College Students' Nonmedical Prescription Stimulant Use

    ERIC Educational Resources Information Center

    Cutler, Kristin A.

    2014-01-01

    Objective: National college health data indicate that prescription stimulants are the most widely misused prescription drugs among college students, with 9% admitting to nonmedical use within the past year. Although motivations for the nonmedical use of these drugs have been explored, scant attention has been paid to justifications for nonmedical…

  7. Prescription Stimulants Are "A Okay": Applying Neutralization Theory to College Students' Nonmedical Prescription Stimulant Use

    ERIC Educational Resources Information Center

    Cutler, Kristin A.

    2014-01-01

    Objective: National college health data indicate that prescription stimulants are the most widely misused prescription drugs among college students, with 9% admitting to nonmedical use within the past year. Although motivations for the nonmedical use of these drugs have been explored, scant attention has been paid to justifications for nonmedical…

  8. 21 CFR 1306.12 - Refilling prescriptions; issuance of multiple prescriptions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... patient to receive a total of up to a 90-day supply of a Schedule II controlled substance provided the following conditions are met: (i) Each separate prescription is issued for a legitimate medical purpose by... providing the patient with multiple prescriptions in this manner does not create an undue risk of...

  9. Errors and omissions in hospital prescriptions: a survey of prescription writing in a hospital

    PubMed Central

    Calligaris, Laura; Panzera, Angela; Arnoldo, Luca; Londero, Carla; Quattrin, Rosanna; Troncon, Maria G; Brusaferro, Silvio

    2009-01-01

    Background The frequency of drug prescription errors is high. Excluding errors in decision making, the remaining are mainly due to order ambiguity, non standard nomenclature and writing illegibility. The aim of this study is to analyse, as a part of a continuous quality improvement program, the quality of prescriptions writing for antibiotics, in an Italian University Hospital as a risk factor for prescription errors. Methods The point prevalence survey, carried out in May 26–30 2008, involved 41 inpatient Units. Every parenteral or oral antibiotic prescription was analysed for legibility (generic or brand drug name, dose, frequency of administration) and completeness (generic or brand name, dose, frequency of administration, route of administration, date of prescription and signature of the prescriber). Eight doctors (residents in Hygiene and Preventive Medicine) and two pharmacists performed the survey by reviewing the clinical records of medical, surgical or intensive care section inpatients. The antibiotics drug category was chosen because its use is widespread in the setting considered. Results Out of 756 inpatients included in the study, 408 antibiotic prescriptions were found in 298 patients (mean prescriptions per patient 1.4; SD ± 0.6). Overall 92.7% (38/41) of the Units had at least one patient with antibiotic prescription. Legibility was in compliance with 78.9% of generic or brand names, 69.4% of doses, 80.1% of frequency of administration, whereas completeness was fulfilled for 95.6% of generic or brand names, 76.7% of doses, 83.6% of frequency of administration, 87% of routes of administration, 43.9% of dates of prescription and 33.3% of physician's signature. Overall 23.9% of prescriptions were illegible and 29.9% of prescriptions were incomplete. Legibility and completeness are higher in unusual drugs prescriptions. Conclusion The Intensive Care Section performed best as far as quality of prescription writing was concerned when compared with the

  10. Structural basis for the auxin-induced transcriptional regulation by Aux/IAA17.

    PubMed

    Han, Mookyoung; Park, Yangshin; Kim, Iktae; Kim, Eun-Hee; Yu, Tae-Kyung; Rhee, Sangkee; Suh, Jeong-Yong

    2014-12-30

    Auxin is the central hormone that regulates plant growth and organ development. Transcriptional regulation by auxin is mediated by the auxin response factor (ARF) and the repressor, AUX/IAA. Aux/IAA associates with ARF via domain III-IV for transcriptional repression that is reversed by auxin-induced Aux/IAA degradation. It has been known that Aux/IAA and ARF form homo- and hetero-oligomers for the transcriptional regulation, but what determines their association states is poorly understood. Here we report, to our knowledge, the first solution structure of domain III-IV of Aux/IAA17 (IAA17), and characterize molecular interactions underlying the homotypic and heterotypic oligomerization. The structure exhibits a compact β-grasp fold with a highly dynamic insert helix that is unique in Aux/IAA family proteins. IAA17 associates to form a heterogeneous ensemble of front-to-back oligomers in a concentration-dependent manner. IAA17 and ARF5 associate to form homo- or hetero-oligomers using a common scaffold and binding interfaces, but their affinities vary significantly. The equilibrium dissociation constants (KD) for homo-oligomerization are 6.6 μM and 0.87 μM for IAA17 and ARF5, respectively, whereas hetero-oligomerization reveals a ∼ 10- to ∼ 100-fold greater affinity (KD = 73 nM). Thus, individual homo-oligomers of IAA17 and ARF5 spontaneously exchange their subunits to form alternating hetero-oligomers for transcriptional repression. Oligomerization is mainly driven by electrostatic interactions, so that charge complementarity at the interface determines the binding affinity. Variable binding affinity by surface charge modulation may effectively regulate the complex interaction network between Aux/IAA and ARF family proteins required for the transcriptional control of auxin-response genes.

  11. Structural basis for the auxin-induced transcriptional regulation by Aux/IAA17

    PubMed Central

    Han, Mookyoung; Park, Yangshin; Kim, Iktae; Kim, Eun-Hee; Yu, Tae-Kyung; Rhee, Sangkee; Suh, Jeong-Yong

    2014-01-01

    Auxin is the central hormone that regulates plant growth and organ development. Transcriptional regulation by auxin is mediated by the auxin response factor (ARF) and the repressor, AUX/IAA. Aux/IAA associates with ARF via domain III−IV for transcriptional repression that is reversed by auxin-induced Aux/IAA degradation. It has been known that Aux/IAA and ARF form homo- and hetero-oligomers for the transcriptional regulation, but what determines their association states is poorly understood. Here we report, to our knowledge, the first solution structure of domain III−IV of Aux/IAA17 (IAA17), and characterize molecular interactions underlying the homotypic and heterotypic oligomerization. The structure exhibits a compact β-grasp fold with a highly dynamic insert helix that is unique in Aux/IAA family proteins. IAA17 associates to form a heterogeneous ensemble of front-to-back oligomers in a concentration-dependent manner. IAA17 and ARF5 associate to form homo- or hetero-oligomers using a common scaffold and binding interfaces, but their affinities vary significantly. The equilibrium dissociation constants (KD) for homo-oligomerization are 6.6 μM and 0.87 μM for IAA17 and ARF5, respectively, whereas hetero-oligomerization reveals a ∼10- to ∼100-fold greater affinity (KD = 73 nM). Thus, individual homo-oligomers of IAA17 and ARF5 spontaneously exchange their subunits to form alternating hetero-oligomers for transcriptional repression. Oligomerization is mainly driven by electrostatic interactions, so that charge complementarity at the interface determines the binding affinity. Variable binding affinity by surface charge modulation may effectively regulate the complex interaction network between Aux/IAA and ARF family proteins required for the transcriptional control of auxin-response genes. PMID:25512488

  12. Advancing Best Practices for Prescription Drug Labeling.

    PubMed

    Bailey, Stacy Cooper; Navaratnam, Prakash; Black, Heather; Russell, Allison L; Wolf, Michael S

    2015-11-01

    Problematic prescription drug labeling has been cited as a root cause of patient misunderstanding, medication errors, and nonadherence. Although numerous studies have recently been conducted to identify and test labeling best practices, the last systematic review on this topic was conducted a decade ago. The objective of this review was, therefore, to examine, summarize, and update best practices for conveying written prescription medication information and instructions to patients. English-language articles published from June 2005 to June 2015 were identified in MEDLINE and CINAHL by searching the following text words: 'medication OR prescription OR drug' AND 'label OR leaflet OR brochure OR pamphlet OR medication guide OR medication insert OR drug insert OR medication information OR drug information OR instructions' AND 'patient OR consumer.' Reference mining and secondary searches were also performed. A total of 31 articles providing evidence on how to improve written, prescription drug labeling for patient use were selected. Two reviewers independently screened articles, rated their quality, and abstracted data. Identified best practices included the use of plain language, improved formatting and organization, and more explicit instructions to improve patient comprehension. The use of icons had conflicting findings, and few studies tested whether practices improved knowledge or behaviors with patients' actual prescribed regimens. Future studies are needed to determine how specific modifications and improvements in drug labeling can enhance patient knowledge and behavior in actual use. Synthesizing best practices across all patient materials will create a more useful, coordinated system of prescription information. © The Author(s) 2015.

  13. [Acupoint combination and acupuncture-moxibustion prescription].

    PubMed

    Zhang, Guo-xue; Liu, Hao; Wang, Fu-chun

    2014-10-01

    The modern physicians have different views on acupoint combination and acupuncture-moxibustion prescription and confuse them in clinical practice. It is significant to clarify the conception, connotation and relationship between them so as to normalize the therapeutic program of acupuncture and moxibustion and promote the standardization of acupuncture and moxibustion. Through the collection of relevant literature and analysis on the differences in the understandings among physicians, the conception, connotation and relationship between acupoint combination and acupuncture-moxibustion prescription are summarized. It is viewed that the acupoint combination is based on TCM theory. Under the guide of acupoint selection, in combination of the characters of clinical practice and acupoint indications, two or more than two acupoints of the same function are combined to enhance the collaborative effects of acupoints so as to achieve specific efficacy and improve clinical efficacy. Regarding acupuncture-moxibustion prescription, on the basis of disorder and syndrome differentiation of patients, the concrete therapeutic program is put forward, including acupoint composition and therapeutic method. Acupoint combination is the basic element of acupuncture-moxibustion prescription. Acupuncture-moxibustion prescription is the specific application of acupoint combination.

  14. Subtypes of nonmedical prescription drug misuse

    PubMed Central

    McCabe, Sean Esteban; Boyd, Carol J.; Teter, Christian J.

    2010-01-01

    This study used three characteristics (i.e., motive, route of administration, and co-ingestion with alcohol) of nonmedical prescription drug misuse across four separate classes (i.e., pain, sedative/anxiety, sleeping and stimulant medications) to examine subtypes and drug related problems. A Web survey was self-administered by a randomly selected sample of 3,639 undergraduate students attending a large Midwestern 4-year U.S. university. Self-treatment subtypes were characterized by motives consistent with the prescription drug's pharmaceutical main indication, oral only routes of administration, and no co-ingestion with alcohol. Recreational subtypes were characterized by recreational motives, oral or non-oral routes, and co-ingestion. Mixed subtypes consisted of other combinations of motives, routes, and co-ingestion. Among those who reported nonmedical prescription drug misuse, approximately 13% were classified into the recreational subtype, while 39% were in the self-treatment subtype, and 48% were in the mixed subtype. There were significant differences in the subtypes in terms of gender, race and prescription drug class. Approximately 50% of those in subtypes other than self-treatment screened positive for drug abuse. The odds of substance use and abuse were generally lower among self-treatment subtypes than other subtypes. The findings indicate subtypes should be considered when examining nonmedical prescription drug misuse, especially for pain medication. PMID:19278795

  15. Variability in Pharmacy Interpretations of Physician Prescriptions

    PubMed Central

    Wolf, Michael S.; Shekelle, Paul; Choudhry, Niteesh K.; Agnew-Blais, Jessica; Parker, Ruth M.; Shrank, William H.

    2009-01-01

    Background: The clarity of prescription drug instructions is a health literacy and medication safety concern. Objective: To assess the variability of pharmacy interpretations of physician prescriptions. Design: Identically written prescriptions for 4 common medications (atorvastatin, alendronate, trimethoprim/sulfamethoxazole, ibuprofen) were filled in 6 pharmacies (2 largest chains, 2 grocery stores, 2 independents) in 4 cities (Boston, Chicago, Los Angeles, Austin). Measurement: Components of the instruction were coded as dose, frequency, administration route, timing, indication, and auxiliary instructions. Results: In all, 85 labels were evaluated. Dose frequency was omitted on 6% of instructions (“take 1 tablet for cholesterol”). Timing was explicitly stated on 2% of instructions (“in the morning”). All prescriptions included indications; pharmacies transcribed these onto 38% of labels. The prescription for alendronate stated not to lie down for at least 30 minutes after taking; this was transcribed with 50% of instructions. Reading difficulty was above recommended levels for 46% of instructions; with 14% greater than a high school level. Conclusions: Efforts are needed to ensure patients receive clear, consistent information supporting safe medication use. PMID:19194338

  16. Are Prescription Stimulants “Smart Pills”?

    PubMed Central

    Smith, M. Elizabeth; Farah, Martha J.

    2013-01-01

    Use of prescription stimulants by normal healthy individuals to enhance cognition is said to be on the rise. Who is using these medications for cognitive enhancement, and how prevalent is this practice? Do prescription stimulants in fact enhance cognition for normal healthy people? We review the epidemiological and cognitive neuroscience literatures in search of answers to these questions. Epidemiological issues addressed include the prevalence of nonmedical stimulant use, user demographics, methods by which users obtain prescription stimulants, and motivations for use. Cognitive neuroscience issues addressed include the effects of prescription stimulants on learning and executive function, as well as the task and individual variables associated with these effects. Little is known about the prevalence of prescription stimulant use for cognitive enhancement outside of student populations. Among college students, estimates of use vary widely but, taken together, suggest that the practice is commonplace. The cognitive effects of stimulants on normal healthy people cannot yet be characterized definitively, despite the volume of research that has been carried out on these issues. Published evidence suggests that declarative memory can be improved by stimulants, with some evidence consistent with enhanced consolidation of memories. Effects on the executive functions of working memory and cognitive control are less reliable but have been found for at least some individuals on some tasks. In closing, we enumerate the many outstanding questions that remain to be addressed by future research and also identify obstacles facing this research. PMID:21859174

  17. Prescription Monitoring Program Trends Among Individuals Arrested in Maine for Trafficking Prescription Drugs in 2014.

    PubMed

    McCall, Kenneth; Nichols, Stephanie D; Holt, Christina; Ochs, Leslie; Cattabriga, Gary; Tu, Chunhao

    2016-06-01

    To evaluate controlled substance prescribing trends available in the Maine Prescription Monitoring Program (PMP) among individuals arrested for prescription drug "trafficking." The demographic characteristics of the individuals who had matching prescription records in the PMP within 90 days of the arrest were identified. A population-based, retrospective cohort study using data from the Maine Diversion Alert Program (DAP) and the Maine PMP. The study population consisted of persons arrested for trafficking prescription drugs in Maine during the 2014 calendar year from January 1 to December 31. There were 594 trafficking arrests reported by the Maine DAP in 2014. The study population consisted of the 235 persons (40%) with arrests involving controlled prescription medications. The mean age of these persons was 33 years (range 18-77 yrs), and 156 (66%) were male. Arrests involved 154 prescription opioids (65%), seven stimulants (3%), seven benzodiazepines (3%), and 77 unspecified controlled prescription drugs (33%). A minority of individuals (n=57, 24%) had a prescription record in the PMP that matched the substance involved in the arrest. Only one person with matching PMP and arrest records utilized ≥ 5 prescribers, while none used ≥ 5 pharmacies within 90 days before the arrest. Payment methods for matching prescriptions were commercial insurance (n=28, 49%), Medicaid (n=19, 33%), Medicare (n=5, 9%), and cash (n=5, 9%). The majority (76%) of persons arrested for prescription drug trafficking did not have PMP records and did not directly obtain the diverted medication from a licensed pharmacy. Traditional red flags, like cash payment and using multiple prescribers or pharmacies, were uncommon. Therefore, arrest records for diversion and PMPs are distinct and complementary tools for identifying individuals at risk for substance misuse. © 2016 Pharmacotherapy Publications, Inc.

  18. Universal prescription drug coverage in Canada

    PubMed Central

    Boothe, Katherine

    2016-01-01

    Canada’s universal public healthcare system is unique among developed countries insofar as it does not include universal coverage of prescription drugs. Universal, public coverage of prescription drugs has been recommended by major national commissions in Canada dating back to the 1960s. It has not, however, been implemented. In this article, we extend research on the failure of early proposals for universal drug coverage in Canada to explain failures of calls for reform over the past 20 years. We describe the confluence of barriers to reform stemming from Canadian policy institutions, ideas held by federal policy-makers, and electoral incentives for necessary reforms. Though universal “pharmacare” is once again on the policy agenda in Canada, arguably at higher levels of policy discourse than ever before, the frequently recommended option of universal, public coverage of prescription drugs remains unlikely to be implemented without political leadership necessary to overcome these policy barriers. PMID:27744279

  19. Sale of prescription drugs over the Internet.

    PubMed

    Armstrong, K; Bloom, B S

    1999-01-01

    Online drugstores represent one of the hottest categories in electronic commerce. The Internet offers great promise in expanding access to prescription drugs for the disabled, the elderly, and people living in rural areas. But with this promise comes the danger of eliminating the safeguards that protect consumers from inappropriate use of medications and adverse drug events. This Issue Brief highlights two studies that investigate the availability of prescription drugs over the Internet, and focuses on the alarming ease with which consumers can obtain drugs without seeing a physician or a pharmacist.

  20. Prescription drug abuse: an epidemic dilemma.

    PubMed

    DuPont, Robert L

    2010-06-01

    The nonmedical use of prescribed controlled substances has become a major public health problem. This article reviews the extent of prescription drug abuse reflected in drug overdose deaths, youth drug use and drug-impaired driving. Efforts to reduce illegal, nonmedical use of prescribed controlled drugs must be balanced so as not to interfere with appropriate medical use of these medicines. Future policy options include identifying and expanding leadership in the research and medical communities, creation of a national public education campaign, development of abuse-resistant drug formulas, increasing prescription drug monitoring programs and enforcement efforts, establishing effective drugged driving laws, and improving substance abuse treatment.

  1. An evaluation of prescription device moisturizers.

    PubMed

    Draelos, Zoe Diana

    2009-03-01

    Moisturization of the skin is important for both medical and cosmetic purposes. The development of prescription device moisturizers, receiving 510K approval on the basis of the physical reduction in transepidermal water loss, provided a new dermatologic category. This investigator-blinded research utilized a split body model in 60 subjects to examine the effect of a traditional moisturizer as compared to a prescription device moisturizer in the treatment of mild to moderate symmetrical eczema of the arms or legs. This study demonstrated parity between the two moisturizers based on subject and investigator assessments.

  2. Purchasing prescription medication in Mexico without a prescription. The experience at the border.

    PubMed Central

    Casner, P. R.; Guerra, L. G.

    1992-01-01

    Prescription medication can often be purchased in Mexico without a physician's prescription. United States residents living along the border may have access to dangerous medications by crossing the border and purchasing them in Mexican pharmacies. We sought to determine the extent and frequency of this behavior in a sample of our ambulatory clinic population. Patients from the Texas Tech University Internal Medicine Clinic were surveyed to collect information about their use of medications, use of alternative sources of health care in Mexico, and purchasing of prescription medication in Juarez, Mexico. More than 80% of patients stated they had purchased prescription-type medication at a pharmacy without a physician's prescription. The most common reasons for buying prescription medication in Mexico were because it was less expensive or because a prescription was not necessary. These data indicate a potential for US residents along the border to take medications in an unregulated manner, a practice that could pose problems for health care providers on both sides of the border. Images PMID:1595276

  3. Factors Associated with Prescription of Opioids and Co-prescription of Sedating Medications in Individuals with HIV

    PubMed Central

    Merlin, Jessica; Tamhane, Ashutosh; Starrels, Joanna L.; Kertesz, Stefan; Saag, Michael; Cropsey, Karen

    2015-01-01

    Opioids are often prescribed for chronic pain, and opioid risks such as overdose and death are heightened when opioids are co-prescribed with other sedating medications. We investigated factors associated with chronic opioid prescription, alone and in combination with benzodiazepines and muscle relaxants, in a clinical cohort of individuals with HIV. We used multivariable logistic regression models to determine participant clinical and demographic characteristics that are associated with chronic prescription of opioids or chronic co-prescription of opioids with sedating medications. Among 1,474 participants, chronic prescription of opioids occurred in 253 individuals (17.2%), and chronic co-prescription occurred in 90 individuals (6.1%). Age >50, public insurance as compared to private insurance, and symptoms of depression and anxiety were significantly associated with chronic opioid prescription and chronic co-prescription. Our findings raise concern that opioid prescription and co-prescription of sedating medications occurs disproportionately in patients for whom use is riskier. PMID:26487298

  4. Ti1-xAux Alloys: Hard Biocompatible Metals and Their Possible Applications

    NASA Astrophysics Data System (ADS)

    Svanidze, Eteri; Besara, Tiglet; Ozaydin, M. Fevzi; Xin, Yan; Han, Ke; Liang, Hong; Siegrist, Theo; Morosan, Emilia

    2015-03-01

    The search for new hard materials is often challenging from both theoretical and experimental points of view. Furthermore, using materials for biomedical applications calls for alloys with high biocompatibility which are even more sparse. The Ti1-xAux (0 . 22 <= x <= 0 . 8) exhibit extreme hardness and strength values, elevated melting temperatures (compared to those of constituent elements), reduced density compared to Au, high malleability, bulk metallicity, high biocompatibility, low wear, reduced friction, potentially high radio opacity, as well as osseointegration. All these properties render the Ti1-xAux alloys particularly useful for orthopedic, dental, and prosthetic applications, where they could be used as both permanent and temporary components. Additionally, the ability of Ti1-xAux alloys to adhere to ceramic parts could reduce the weight and cost of these components. The work at Rice was supported by NSF DMR 0847681 (E.M. and E.S.).

  5. Evidence supporting an intentional Neandertal burial at La Chapelle-aux-Saints

    PubMed Central

    Rendu, William; Beauval, Cédric; Crevecoeur, Isabelle; Bayle, Priscilla; Balzeau, Antoine; Bismuth, Thierry; Bourguignon, Laurence; Delfour, Géraldine; Faivre, Jean-Philippe; Lacrampe-Cuyaubère, François; Tavormina, Carlotta; Todisco, Dominique; Turq, Alain; Maureille, Bruno

    2014-01-01

    The bouffia Bonneval at La Chapelle-aux-Saints is well known for the discovery of the first secure Neandertal burial in the early 20th century. However, the intentionality of the burial remains an issue of some debate. Here, we present the results of a 12-y fieldwork project, along with a taphonomic analysis of the human remains, designed to assess the funerary context of the La Chapelle-aux-Saints Neandertal. We have established the anthropogenic nature of the burial pit and underlined the taphonomic evidence of a rapid burial of the body. These multiple lines of evidence support the hypothesis of an intentional burial. Finally, the discovery of skeletal elements belonging to the original La Chapelle aux Saints 1 individual, two additional young individuals, and a second adult in the bouffia Bonneval highlights a more complex site-formation history than previously proposed. PMID:24344286

  6. Evidence supporting an intentional Neandertal burial at La Chapelle-aux-Saints.

    PubMed

    Rendu, William; Beauval, Cédric; Crevecoeur, Isabelle; Bayle, Priscilla; Balzeau, Antoine; Bismuth, Thierry; Bourguignon, Laurence; Delfour, Géraldine; Faivre, Jean-Philippe; Lacrampe-Cuyaubère, François; Tavormina, Carlotta; Todisco, Dominique; Turq, Alain; Maureille, Bruno

    2014-01-07

    The bouffia Bonneval at La Chapelle-aux-Saints is well known for the discovery of the first secure Neandertal burial in the early 20th century. However, the intentionality of the burial remains an issue of some debate. Here, we present the results of a 12-y fieldwork project, along with a taphonomic analysis of the human remains, designed to assess the funerary context of the La Chapelle-aux-Saints Neandertal. We have established the anthropogenic nature of the burial pit and underlined the taphonomic evidence of a rapid burial of the body. These multiple lines of evidence support the hypothesis of an intentional burial. Finally, the discovery of skeletal elements belonging to the original La Chapelle aux Saints 1 individual, two additional young individuals, and a second adult in the bouffia Bonneval highlights a more complex site-formation history than previously proposed.

  7. Sources of prescription opioids among diagnosed opioid abusers.

    PubMed

    Shei, Amie; Rice, J Bradford; Kirson, Noam Y; Bodnar, Katharine; Birnbaum, Howard G; Holly, Pamela; Ben-Joseph, Rami

    2015-04-01

    Diversion and abuse of prescription opioids are important public health concerns in the US. This study examined possible sources of prescription opioids among patients diagnosed with opioid abuse. Commercially insured patients aged 12-64 diagnosed with opioid abuse/dependence ('abuse') were identified in OptumHealth Reporting and Insights medical and pharmacy claims data, 2006-2012, and required to have continuous eligibility over an 18 month study period surrounding the first abuse diagnosis. We examined whether abusers had access to prescription opioids through their own prescriptions and/or to diverted prescription opioids through family members' prescriptions obtained prior to the abuser's first abuse diagnosis. For comparison, we examined access to prescription opioids of a reference population of non-abusers. Sensitivity analyses focused on patients initially diagnosed with opioid dependence and, separately, abusers not previously treated with buprenorphine. Of the 9291 abusers meeting the selection criteria, 79.9% had an opioid prescription prior to their first abuse diagnosis; 20.1% of abusers did not have an opioid prescription prior to their first abuse diagnosis, of whom approximately half (50.8%) had a family member who had an opioid prescription prior to the abuser's first abuse diagnosis (compared to 42.2% of non-abusers). Similar results were found among patients initially diagnosed with opioid dependence and among abusers not previously treated with buprenorphine. The study relied on the accuracy of claims data to identify abusers, but opioid abuse is often undiagnosed. In addition, only prescription claims that were reimbursed by a health plan were included in the analysis. While most abusers had access to prescription opioids through their own prescriptions, many abusers without their own opioid prescriptions had access to prescription opioids through family members and may have obtained prescription opioids that way. Given the study design and

  8. An Expert System for Designing Fire Prescriptions

    Treesearch

    Elizabeth Reinhardt

    1987-01-01

    Managers use prescribed fire to accomplish a variety of resource objectives. The knowledge needed to design successful prescriptions is both quantitative and qualitative. Some of it is available through publications and computer programs, but much of the knowledge of expert practitioners has never been collected or published. An expert system being developed at the,...

  9. 21 CFR 801.109 - Prescription devices.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Prescription devices. 801.109 Section 801.109 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... purpose for which it is intended, including all purposes for which it is advertised or represented...

  10. Aerobic Exercise Prescription for Rheumatoid Arthritics.

    ERIC Educational Resources Information Center

    Evans, Blanche W.; Williams, Hilda L.

    The use of exercise as a general treatment for rheumatoid arthritics (RA) has included range of motion, muscular strength, water exercise and rest therapy while virtually ignoring possible benefits of aerobic exercise. The purposes of this project were to examine the guidelines for exercise prescription in relation to this special population and…

  11. COLOR PRESCRIPTION FORM FOR COSMETIC GLOVES

    DTIC Science & Technology

    A technique is described for achieving more custom-like coloring of cosmetic gloves. The method involves the use of a color prescription form which...can be used to describe in greater detail the characteristics of those portions of the human hand of greater cosmetic significance.

  12. [Prescription drug abuse in elderly psychiatric patients].

    PubMed

    Wetterling, Tilman; Schneider, Barbara

    2012-08-01

    Due to demographic changes there will be a fraction of elderly patients with substance use disorders. However, only a few data have been published about elderly abusers of prescription drugs. Since substance abuse is frequently comorbid with psychiatric disorders, treatment in a psychiatric hospital is often needed. In this explorative study elderly people with prescription drug abuse who required psychiatric inpatient treatment should be characterized. This study was part of the gerontopsychiatry study Berlin (Gepsy-B), an investigation of the data of all older inpatients (≥ 65 years) admitted to a psychiatric hospital within a period of 3 years. Among 1266 documented admissions in 110 cases (8.7 %) (mean age: 75.7 ± 7.1 years) prescription drug abuse, mostly of benzodiazepines was diagnosed. Females showed benzodiazepine abuse more often than males. In only a small proportion of the cases the reason for admission was withdrawal of prescribed drugs. 85.5 % suffered from psychiatric comorbidity, mostly depression. As risk factors for abuse depressive symptoms (OR: 3.32) as well as concurrent nicotine (OR: 2.69) or alcohol abuse (OR: 2.14) were calculated. Psychiatric inpatient treatment was primarily not necessary because of prescription drug abuse but because of other psychopathological symptoms. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Prescriptions Guiding Prospective Teachers in Teaching Mathematics

    ERIC Educational Resources Information Center

    Zembat, Ismail Özgür; Aslan, Mustafa

    2016-01-01

    This study aims to investigate the nature of different mathematics teaching modes (prescriptions) that guide prospective teachers during their instruction. The participants were 24 junior prospective middle school mathematics teachers (19 females and 5 males) who were attending a mathematics methods course at a private university in central…

  14. Physician perceptions of prescription drug information.

    PubMed

    Evans, K R; Beltramini, R F

    1986-01-01

    This study reports the findings of an investigation designed to explore the importance of prescription drug information source characteristics among physicians. Differences were found to exist among the importance ratings both in aggregate, and between, categories of physician specialty and years in practice. Conclusions for pharmaceutical marketers and the implications for future research efforts are discussed.

  15. 21 CFR 801.109 - Prescription devices.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Prescription devices. 801.109 Section 801.109 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... article is a device for which directions, hazards, warnings, and other information are commonly known to...

  16. 21 CFR 801.109 - Prescription devices.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Prescription devices. 801.109 Section 801.109 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... article is a device for which directions, hazards, warnings, and other information are commonly known to...

  17. The Prescription Drug Marketing Act of 1987.

    PubMed

    Greenberg, R B

    1988-10-01

    The Prescription Drug Marketing Act of 1987 is described, and its implications for hospitals and other health-care entities are discussed. The act, which became effective on July 21, 1988, is intended to reduce public health risks from adulterated, misbranded, and counterfeit drug products that enter the marketplace through drug diversion. The law provides that prescription drug products manufactured in the United States and exported can no longer be reimported, except by the product's manufacturer. It also establishes restrictions on sales of prescription drug products and samples. Samples of prescription drug products may be distributed only if a licensed prescriber requests them. Other distribution channels for samples specified in the law are permissible, provided records are maintained. Under the law, wholesale distributors must be licensed by the state and meet uniform standards. Penalties for violations of the law are also identified. According to FDA's advisory guidelines on the statute, the law will permit hospitals to return drug products, provided the return is made to the manufacturer or wholesaler and provided written notice is secured that the goods were received (for manufacturers) or the goods were destroyed or returned to the manufacturer (for wholesalers). The final chapter on drug diversion must await issuance of final FDA regulations.

  18. Medication errors: prescribing faults and prescription errors

    PubMed Central

    Velo, Giampaolo P; Minuz, Pietro

    2009-01-01

    Medication errors are common in general practice and in hospitals. Both errors in the act of writing (prescription errors) and prescribing faults due to erroneous medical decisions can result in harm to patients. Any step in the prescribing process can generate errors. Slips, lapses, or mistakes are sources of errors, as in unintended omissions in the transcription of drugs. Faults in dose selection, omitted transcription, and poor handwriting are common. Inadequate knowledge or competence and incomplete information about clinical characteristics and previous treatment of individual patients can result in prescribing faults, including the use of potentially inappropriate medications. An unsafe working environment, complex or undefined procedures, and inadequate communication among health-care personnel, particularly between doctors and nurses, have been identified as important underlying factors that contribute to prescription errors and prescribing faults. Active interventions aimed at reducing prescription errors and prescribing faults are strongly recommended. These should be focused on the education and training of prescribers and the use of on-line aids. The complexity of the prescribing procedure should be reduced by introducing automated systems or uniform prescribing charts, in order to avoid transcription and omission errors. Feedback control systems and immediate review of prescriptions, which can be performed with the assistance of a hospital pharmacist, are also helpful. Audits should be performed periodically. PMID:19594530

  19. 21 CFR 1306.08 - Electronic prescriptions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... part 1311 of this chapter. (b) A pharmacy may fill an electronically transmitted prescription for a controlled substance provided the pharmacy complies with all other requirements for filling controlled... to be invalid and the pharmacy may not dispense the controlled substance. ...

  20. 21 CFR 1306.08 - Electronic prescriptions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... part 1311 of this chapter. (b) A pharmacy may fill an electronically transmitted prescription for a controlled substance provided the pharmacy complies with all other requirements for filling controlled... to be invalid and the pharmacy may not dispense the controlled substance. ...

  1. 21 CFR 1306.08 - Electronic prescriptions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... part 1311 of this chapter. (b) A pharmacy may fill an electronically transmitted prescription for a controlled substance provided the pharmacy complies with all other requirements for filling controlled... to be invalid and the pharmacy may not dispense the controlled substance. ...

  2. Whitebark Pine Guidelines for Planting Prescriptions

    Treesearch

    Glenda L. Scott; Ward W. McCaughey

    2006-01-01

    This paper reviews general literature, research studies, field observations, and standard Forest Service survival surveys of high-elevation whitebark pine plantations and presents a set of guidelines for outplanting prescriptions. When planting whitebark pine, the recommendations are: 1) reduce overstory competition; 2) reduce understory vegetation, especially grasses...

  3. [Gynecological theories and prescriptions for andriatric diseases].

    PubMed

    Sun, Yi-ming; Yu, Chang-fei

    2015-04-01

    Andrology and gynecology have a similar or the same theoretical basis in Traditional Chinese Medicine (TCM). Andrology has a history of less than 3 decades in China, while TCM gynecology has developed for over a thousand years. The development of andrology could be greatly promoted with the guidance of the theories and prescriptions of gynecology.

  4. Psychological Evaluation and Prescription Development Handbook.

    ERIC Educational Resources Information Center

    Vigo County School Corp., Terre Haute, IN.

    Developed to aid children with learning difficulties, from mental retardation or brain injury to maladjustment or physical or environmental handicaps, the joint school services program provides psychological evaluation and prescription development. The handbook reviews theories of child development and surveys behavior modification and…

  5. Prescriptions for Success in Heterogeneous Classrooms.

    ERIC Educational Resources Information Center

    Schurr, Sandra L.

    This handbook details 28 specific learning strategies for diverse groups of middle school students, each cast as a prescription applicable for students whose diagnosis reveals certain "conditions" such as particular learning styles or high or low reading skills. Reproducible pages accompany most of the strategies. Following are the activities: (1)…

  6. Effects of prescription adaptation by pharmacists

    PubMed Central

    2010-01-01

    Background Granting dispensing pharmacists the authority to prescribe has significant implications for pharmaceutical and health human resources policy, and quality of care. Despite the growing number of jurisdictions that have given pharmacists such privileges, there are few rigorous evaluations of these policy changes. This study will examine a January 2009 policy change in British Columbia (BC), Canada that allowed pharmacists to independently adapt and renew prescriptions. We hypothesize this policy increased drug utilization and drug costs, increased patient adherence to medication, and reduced total healthcare resource use. Methods/Design We will study a population-based cohort of approximately 4 million BC residents from 2004 through 2010. We will use data from BC PharmaNet on all of the prescriptions obtained by this cohort during the study period, and link it to administrative billings from physicians and hospital discharges. Using interrupted time series analysis, we will study longitudinal changes in drug utilization and costs, medication adherence, and short-term health care use. Further, using hierarchical modelling, we will examine the factors at the regional, pharmacy, patient, and prescription levels that are associated with prescription adaptations and renewals. Discussion In a recent survey of Canadian policymakers, many respondents ranked the issue of prescribing privileges as one of their most pressing policy questions. No matter the results of our study, they will be important for policymakers, as our data will make policy decisions surrounding pharmacist prescribing more evidence-based. PMID:21083922

  7. [Prescription for proton pump inhibitors in geriatrics].

    PubMed

    Schonheit, Claire; Le Petitcorps, Hélène; Pautas, Éric

    2015-01-01

    Proton pump inhibitors are widely prescribed, notably for the over 65s, despite there being significant side effects in the geriatric population. It is therefore important that doctors, caregivers and patients are fully aware of the recognised indications of PPIs and on the less well-known problems inherent to their prescription. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Role of diagnostic labeling in antibiotic prescription.

    PubMed Central

    Hutchinson, J. M.; Jelinski, S.; Hefferton, D.; Desaulniers, G.; Parfrey, P. S.

    2001-01-01

    OBJECTIVE: To evaluate the association between diagnostic labeling of respiratory tract infections (RTIs) and antibiotic prescription rates in family practice. DESIGN: Descriptive analysis of outpatient chart review supplemented by interviews with physicians. Charts of patients attending 73 general practitioners were reviewed between October 1997 and February 1998. Two days of practice were evaluated per physician. SETTING: Urban family practices in greater St John's, Nfld. PARTICIPANTS: Of 96 family physicians contacted, 73 (76%) agreed to participate. MAIN OUTCOME MEASURES: Rates of diagnoses and antibiotic prescriptions for acute infections. Physicians were divided into "low prescribers" and "high prescribers" based on overall rates of prescription to patients with infections. Low prescribers were compared with high prescribers with respect to physician characteristics, patient characteristics, and diagnoses assigned. RESULTS: Of all patients seen, 22% were seen for acute infections; RTIs accounted for 76% of diagnoses. Low prescribers and high prescribers were of similar ages and saw similar numbers of patients of similar ages with very similar presenting complaints. Both groups diagnosed urinary tract and skin and soft-tissue infections at similar rates, but differed markedly in their rates of diagnoses of RTIs. High prescribers diagnosed bacterial RTIs in 65.4% (147/225) of their patients; low prescribers diagnosed bacterial RTIs in 31.0% (66/213 (P < .001). CONCLUSION: Family doctors frequently prescribe antibiotics. The difference in rates of prescription between high prescribers and low prescribers is largely explained by assignment of diagnoses of RTIs. PMID:11421050

  9. Genome-Wide Analysis and Characterization of Aux/IAA Family Genes in Brassica rapa

    PubMed Central

    Rameneni, Jana Jeevan; Li, Xiaonan; Sivanandhan, Ganesan; Choi, Su Ryun; Pang, Wenxing; Im, Subin; Lim, Yong Pyo

    2016-01-01

    Auxins are the key players in plant growth development involving leaf formation, phototropism, root, fruit and embryo development. Auxin/Indole-3-Acetic Acid (Aux/IAA) are early auxin response genes noted as transcriptional repressors in plant auxin signaling. However, many studies focus on Aux/ARF gene families and much less is known about the Aux/IAA gene family in Brassica rapa (B. rapa). Here we performed a comprehensive genome-wide analysis and identified 55 Aux/IAA genes in B. rapa using four conserved motifs of Aux/IAA family (PF02309). Chromosomal mapping of the B. rapa Aux/IAA (BrIAA) genes facilitated understanding cluster rearrangement of the crucifer building blocks in the genome. Phylogenetic analysis of BrIAA with Arabidopsis thaliana, Oryza sativa and Zea mays identified 51 sister pairs including 15 same species (BrIAA—BrIAA) and 36 cross species (BrIAA—AtIAA) IAA genes. Among the 55 BrIAA genes, expression of 43 and 45 genes were verified using Genebank B. rapa ESTs and in home developed microarray data from mature leaves of Chiifu and RcBr lines. Despite their huge morphological difference, tissue specific expression analysis of BrIAA genes between the parental lines Chiifu and RcBr showed that the genes followed a similar pattern of expression during leaf development and a different pattern during bud, flower and siliqua development stages. The response of the BrIAA genes to abiotic and auxin stress at different time intervals revealed their involvement in stress response. Single Nucleotide Polymorphisms between IAA genes of reference genome Chiifu and RcBr were focused and identified. Our study examines the scope of conservation and divergence of Aux/IAA genes and their structures in B. rapa. Analyzing the expression and structural variation between two parental lines will significantly contribute to functional genomics of Brassica crops and we belive our study would provide a foundation in understanding the Aux/IAA genes in B. rapa. PMID

  10. Genome-Wide Analysis and Characterization of Aux/IAA Family Genes in Brassica rapa.

    PubMed

    Paul, Parameswari; Dhandapani, Vignesh; Rameneni, Jana Jeevan; Li, Xiaonan; Sivanandhan, Ganesan; Choi, Su Ryun; Pang, Wenxing; Im, Subin; Lim, Yong Pyo

    2016-01-01

    Auxins are the key players in plant growth development involving leaf formation, phototropism, root, fruit and embryo development. Auxin/Indole-3-Acetic Acid (Aux/IAA) are early auxin response genes noted as transcriptional repressors in plant auxin signaling. However, many studies focus on Aux/ARF gene families and much less is known about the Aux/IAA gene family in Brassica rapa (B. rapa). Here we performed a comprehensive genome-wide analysis and identified 55 Aux/IAA genes in B. rapa using four conserved motifs of Aux/IAA family (PF02309). Chromosomal mapping of the B. rapa Aux/IAA (BrIAA) genes facilitated understanding cluster rearrangement of the crucifer building blocks in the genome. Phylogenetic analysis of BrIAA with Arabidopsis thaliana, Oryza sativa and Zea mays identified 51 sister pairs including 15 same species (BrIAA-BrIAA) and 36 cross species (BrIAA-AtIAA) IAA genes. Among the 55 BrIAA genes, expression of 43 and 45 genes were verified using Genebank B. rapa ESTs and in home developed microarray data from mature leaves of Chiifu and RcBr lines. Despite their huge morphological difference, tissue specific expression analysis of BrIAA genes between the parental lines Chiifu and RcBr showed that the genes followed a similar pattern of expression during leaf development and a different pattern during bud, flower and siliqua development stages. The response of the BrIAA genes to abiotic and auxin stress at different time intervals revealed their involvement in stress response. Single Nucleotide Polymorphisms between IAA genes of reference genome Chiifu and RcBr were focused and identified. Our study examines the scope of conservation and divergence of Aux/IAA genes and their structures in B. rapa. Analyzing the expression and structural variation between two parental lines will significantly contribute to functional genomics of Brassica crops and we belive our study would provide a foundation in understanding the Aux/IAA genes in B. rapa.

  11. The Evolution of Minehunting in France (L’Evolution de la Chasse aux Mines en France),

    DTIC Science & Technology

    1983-07-13

    AD-A132 532 THE EVOLUTION OF MINEHUNTING IN FRANCE IL’EVOLUTION DE I/1 LA CHASSE AUX MINES EN FRANCE)(U) NAVAL INTELLIGENCE SUPPORT CENTER WASHINGTON...SEP 16 0 -wm- a/or.’- i.,it ______ D a " THE EVOLUTION OF MINEHUNTING IN FRANCE (de Drezigue, Cdr; L’Evolution de la Chasse aux Mines en France...than the minehunter could assure this mission? Evolution of Minehunting The guiding thought of this evolution is the following: to have a good

  12. 76 FR 26232 - EPAAR Prescription for Work Assignments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... Acquisition Regulation (EPAAR) to update policy, procedures, and contract clauses. The proposed rule provides revised language to the prescription for the work assignment clause, incorporating prescriptive language... INFORMATION CONTACT: Donna S. Blanding, Policy, Training, and Oversight Division, Office of Acquisition...

  13. 21 CFR 1306.05 - Manner of issuance of prescriptions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., who fills a prescription not prepared in the form prescribed by DEA regulations. (g) An individual... responsible in case the prescription does not conform in all essential respects to the law and regulations. A...

  14. 21 CFR 1306.05 - Manner of issuance of prescriptions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., who fills a prescription not prepared in the form prescribed by DEA regulations. (g) An individual... responsible in case the prescription does not conform in all essential respects to the law and regulations. A...

  15. 21 CFR 1306.05 - Manner of issuance of prescriptions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., who fills a prescription not prepared in the form prescribed by DEA regulations. (g) An individual... responsible in case the prescription does not conform in all essential respects to the law and regulations. A...

  16. 21 CFR 1306.22 - Refilling of prescriptions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... prescription record. If entered on another document, such as a medication record, or electronic prescription... trail for any specified strength and dosage form of any controlled substance (by either brand or generic...

  17. Abuse of Prescription Pain Medications Risks Heroin Use

    MedlinePlus

    ABUSE OF PRESCRIPTION PAIN MEDICATIONS RISKS HEROIN USE In 2010 almost 1 in 20 adolescents and adults - 12 million people - used prescription pain medication when it was not prescribed for them or only for the ...

  18. Non-Medical Prescription Opioid Use and Prescription Opioid Use Disorder: A Review

    PubMed Central

    Tetrault, Jeanette M.; Butner, Jenna L.

    2015-01-01

    Over the past few decades, there has been a rise in the non-medical use of prescription opioids, which has now reached epidemic proportions in the United States. In some cases, this non-medical use progresses to prescription opioid use disorder, heroin use, injection, and inhalation drug use, all of which may have further devastating consequences. The purpose of this review article is to discuss the epidemiology of the non-medical use of prescription opioids; discuss the potential progression to subsequent prescription opioid use disorder; review the state and national efforts in development to address addiction and diversion in the United States; discuss treatment options; and, lastly, to evaluate the impact of the related stigma to the development of opioid use disorder. Many unanswered questions remain, and we will explore future possibilities in how the medical community can play a role in curbing this epidemic. PMID:26339205

  19. Non-Medical Prescription Opioid Use and Prescription Opioid Use Disorder: A Review.

    PubMed

    Tetrault, Jeanette M; Butner, Jenna L

    2015-09-01

    Over the past few decades, there has been a rise in the non-medical use of prescription opioids, which has now reached epidemic proportions in the United States. In some cases, this non-medical use progresses to prescription opioid use disorder, heroin use, injection, and inhalation drug use, all of which may have further devastating consequences. The purpose of this review article is to discuss the epidemiology of the non-medical use of prescription opioids; discuss the potential progression to subsequent prescription opioid use disorder; review the state and national efforts in development to address addiction and diversion in the United States; discuss treatment options; and, lastly, to evaluate the impact of the related stigma to the development of opioid use disorder. Many unanswered questions remain, and we will explore future possibilities in how the medical community can play a role in curbing this epidemic.

  20. Prescription, dispensation and marketing patterns of methylphenidate

    PubMed Central

    Perini, Edson; Junqueira, Daniela Rezende Garcia; Lana, Lorena Gomes Cunha; Luz, Tatiana Chama Borges

    2014-01-01

    OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales – psychoactive and others – subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines. PMID:26039389

  1. Literacy and misunderstanding prescription drug labels.

    PubMed

    Davis, Terry C; Wolf, Michael S; Bass, Pat F; Thompson, Jason A; Tilson, Hugh H; Neuberger, Marolee; Parker, Ruth M

    2006-12-19

    Health literacy has increasingly been viewed as a patient safety issue and may contribute to medication errors. To examine patients' abilities to understand and demonstrate instructions found on container labels of common prescription medications. Cross-sectional study using in-person, structured interviews. 3 primary care clinics serving mostly indigent populations in Shreveport, Louisiana; Jackson, Michigan; and Chicago, Illinois. 395 English-speaking adults waiting to see their providers. Correct understanding of instructions on 5 container labels; demonstration of 1 label's dosage instructions. Correct understanding of the 5 labels ranged from 67.1% to 91.1%. Patients reading at or below the sixth-grade level (low literacy) were less able to understand all 5 label instructions. Although 70.7% of patients with low literacy correctly stated the instructions, "Take two tablets by mouth twice daily," only 34.7% could demonstrate the number of pills to be taken daily. After potential confounding variables were controlled for, low (adjusted relative risk, 2.32 [95% CI, 1.26 to 4.28]) and marginal (adjusted relative risk, 1.94 [CI, 1.14 to 3.27]) literacy were significantly associated with misunderstanding. Taking a greater number of prescription medications was also statistically significantly associated with misunderstanding (adjusted relative risk, 2.98 [CI, 1.40 to 6.34] for > or =5 medications). The study sample was at high risk for poor health literacy and outcomes. Most participants were women, and all spoke English. The authors did not examine the association between misunderstanding and medication error or evaluate patients' actual prescription drug-taking behaviors. Lower literacy and a greater number of prescription medications were independently associated with misunderstanding the instructions on prescription medication labels.

  2. [Neonatal parenteral nutrition prescription practices in Portugal].

    PubMed

    Neves, A; Pereira-da-Silva, L; Fernandez-Llimos, F

    2014-02-01

    The use of guidelines for neonatal parenteral nutrition (PN) improves its clinical efficiency and the safety of prescription. To evaluate the practices of neonatal parenteral nutrition prescription in Portugal, and the adherence to the National Consensus on neonatal PN (2008). A questionnaire based on a multiple choice response on parenteral nutrition prescription was conducted, and sent to the coordinators of the 50 public and private Portuguese neonatal special care units, 25 being level III and 25 level II. Parenteral nutrition was prescribed in 32 neonatal units, 23 of which (71.9%) responded to the questionnaire. Of the respondents, 19 (82.6%) refer to follow the National Consensus, the remaining following local guidelines; 17 (73.9%) of units referred to using an electronic based system for prescription. In preterm neonates, most mentioned: administering judiciously the fluid intake during the first post-natal week; starting amino acids from the first post-natal day with 1.5-3g/kg/d, increasing up to 3-4g/kg/d; starting lipids from the first three post-natal days with 1g/kg/d, increasing up to 3g/kg/d; administering 40-70mg/kg/d of calcium and of phosphorus with the fixed calcium:phosphorus ratio of 1.7: 1 (mg:mg); and estimating the osmolality of the solutions, and weekly monitoring of serum triglycerides, blood urea, serum phosphorus and liver function. The high response rate is probably representative of the practice of PN prescription in Portugal. Most of the units used the National Consensus on neonatal PN as a reference, thus contributing to better nutritional support for neonates. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  3. Prescription, dispensation and marketing patterns of methylphenidate.

    PubMed

    Perini, Edson; Junqueira, Daniela Rezende Garcia; Lana, Lorena Gomes Cunha; Luz, Tatiana Chama Borges

    2014-12-01

    OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales - psychoactive and others - subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines.

  4. Genome-wide analysis of primary auxin-responsive Aux/IAA gene family in maize (Zea mays. L.).

    PubMed

    Wang, Yijun; Deng, Dexiang; Bian, Yunlong; Lv, Yanping; Xie, Qin

    2010-12-01

    The phytohormone auxin is important in various aspects of organism growth and development. Aux/IAA genes encoding short-lived nuclear proteins are responsive primarily to auxin induction. Despite their physiological importance, systematic analysis of Aux/IAA genes in maize have not yet been reported. In this paper, we presented the isolation and characterization of maize Aux/IAA genes in whole-genome scale. A total of 31 maize Aux/IAA genes (ZmIAA1 to ZmIAA31) were identified. ZmIAA genes are distributed in all the maize chromosomes except chromosome 2. Aux/IAA genes expand in the maize genome partly due to tandem and segmental duplication events. Multiple alignment and motif display results revealed major maize Aux/IAA proteins share all the four conserved domains. Phylogenetic analysis indicated Aux/IAA family can be divided into seven subfamilies. Putative cis-acting regulatory DNA elements involved in auxin response, light signaling transduction and abiotic stress adaption were observed in the promoters of ZmIAA genes. Expression data mining suggested maize Aux/IAA genes have temporal and spatial expression pattern. Collectively, these results will provide molecular insights into the auxin metabolism, transport and signaling research.

  5. Pharmacy communications with physician offices to clarify prescriptions.

    PubMed

    Smith, Marie; Sprecher, Bradley

    Our study was conducted to: (1) characterize the type and extent of prescription clarification communications between community pharmacies and physician offices, (2) describe the interventions made by community pharmacists, and (3) determine the time frame to clarify prescriptions prior to dispensing. A convenience sample and cross-sectional study. Five independent community pharmacies. Pharmacists and pharmacy technician staff members. Participating pharmacy staff members documented the type of interventions and length of time to resolve prescription clarifications. Number, type, and reason for pharmacist interventions to clarify prescriptions. Prescriptions that required clarification with physicians' offices were mostly new (n = 105; 74%) compared with refill prescriptions (n = 36; 26%). Electronic prescriptions (n = 51; 36%) required clarification more often than other types of prescription transmission. New prescriptions transmitted by e-prescribing required pharmacy-physician office communications 4-fold more frequently than faxed prescriptions and nearly 2-fold more frequently than written prescriptions. The most frequent reasons for pharmacy communications with the physician office were prior authorization approval (n = 45; 32%) and missing prescription information (n = 22; 16%). The most frequent resolutions involved dispensing a different dosage strength (n = 19; 11%) and different drug (n = 17; 10%). At the end of the study period, 30 (17%) prescription clarification cases were unresolved; most of the unresolved cases involved prior authorizations. Person-to-person telephone contacts had an 80% resolution rate compared with a 55% resolution rate for fax communications (P <0.001). The time frame to clarify prescriptions ranged from 6 minutes to more than 14 days. Person-to-person telephone contacts may be more efficient than fax communications for resolving prescription clarifications, especially for more complex information needs. This study

  6. Adolescent prescription ADHD medication abuse is rising along with prescriptions for these medications.

    PubMed

    Setlik, Jennifer; Bond, G Randall; Ho, Mona

    2009-09-01

    We sought to better understand the trend for prescription attention-deficit/hyperactivity disorder (ADHD) medication abuse by teenagers. We queried the American Association of Poison Control Center's National Poison Data System for the years of 1998-2005 for all cases involving people aged 13 to 19 years, for which the reason was intentional abuse or intentional misuse and the substance was a prescription medication used for ADHD treatment. For trend comparison, we sought data on the total number of exposures. In addition, we used teen and preteen ADHD medication sales data from IMS Health's National Disease and Therapeutic Index database to compare poison center call trends with likely availability. Calls related to teenaged victims of prescription ADHD medication abuse rose 76%, which is faster than calls for victims of substance abuse generally and teen substance abuse. The annual rate of total and teen exposures was unchanged. Over the 8 years, estimated prescriptions for teenagers and preteenagers increased 133% for amphetamine products, 52% for methylphenidate products, and 80% for both together. Reports of exposure to methylphenidate fell from 78% to 30%, whereas methylphenidate as a percentage of ADHD prescriptions decreased from 66% to 56%. Substance-related abuse calls per million adolescent prescriptions rose 140%. The sharp increase, out of proportion to other poison center calls, suggests a rising problem with teen ADHD stimulant medication abuse. Case severity increased over time. Sales data of ADHD medications suggest that the use and call-volume increase reflects availability, but the increase disproportionately involves amphetamines.

  7. Do Motives Matter?: Nonmedical Use of Prescription Medications among Adolescents

    ERIC Educational Resources Information Center

    McCabe, Sean Esteban; Boyd, Carol J.

    2012-01-01

    Adolescents' motives for engaging in nonmedical prescription drug use is somewhat different than their reasons for using other drugs, such as marijuana. For some youth, nonmedical prescription drug use is an attempt to self-treat a medical condition, for others it is an effort to get high, and some youth misuse prescription drugs for both reasons.…

  8. Resonant Messages to Prevent Prescription Drug Misuse by Teens

    ERIC Educational Resources Information Center

    Twombly, Eric C.; Holtz, Kristen D.; Agnew, Christine B.

    2011-01-01

    Prescription drug misuse is a major health problem, particularly among teens. A key step in curbing misuse is the development of effective prescription drug prevention messages. This paper explores the elements of prescription drug misuse prevention messages that resonate with teens using data from focus groups with seventh and eighth grade…

  9. Patterns of Prescription Medication Diversion among Drug Dealers

    ERIC Educational Resources Information Center

    Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

    2012-01-01

    This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South…

  10. 21 CFR 1306.04 - Purpose of issue of prescription.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Purpose of issue of prescription. 1306.04 Section 1306.04 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS General... a purported prescription, as well as the person issuing it, shall be subject to the...

  11. Patterns of Prescription Medication Diversion among Drug Dealers

    ERIC Educational Resources Information Center

    Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

    2012-01-01

    This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South…

  12. 77 FR 8174 - EPAAR Prescription for Work Assignments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... (EPA). ACTION: Final rule. SUMMARY: EPA will amend the EPA Acquisition Regulation (EPAAR) prescription for the work assignment clause. This final rule provides revised language to the prescription for the work assignment clause, incorporating prescriptive language that provides further instructions on the...

  13. The Philosophical Foundations of Prescriptive Statements and Statistical Inference

    ERIC Educational Resources Information Center

    Sun, Shuyan; Pan, Wei

    2011-01-01

    From the perspectives of the philosophy of science and statistical inference, we discuss the challenges of making prescriptive statements in quantitative research articles. We first consider the prescriptive nature of educational research and argue that prescriptive statements are a necessity in educational research. The logic of deduction,…

  14. Resonant Messages to Prevent Prescription Drug Misuse by Teens

    ERIC Educational Resources Information Center

    Twombly, Eric C.; Holtz, Kristen D.; Agnew, Christine B.

    2011-01-01

    Prescription drug misuse is a major health problem, particularly among teens. A key step in curbing misuse is the development of effective prescription drug prevention messages. This paper explores the elements of prescription drug misuse prevention messages that resonate with teens using data from focus groups with seventh and eighth grade…

  15. 76 FR 17137 - Pregnancy and Prescription Medication Use Symposium

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-28

    ... HUMAN SERVICES Food and Drug Administration Pregnancy and Prescription Medication Use Symposium AGENCY... announcing the following meeting: Pregnancy and Prescription Medication Use Symposium. The topic to be discussed is ``Prescription Drug Use in Pregnancy.'' Date and Time: The meeting will be held on May 17, 2011...

  16. 21 CFR 1306.09 - Prescription requirements for online pharmacies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Prescription requirements for online pharmacies... PRESCRIPTIONS General Information § 1306.09 Prescription requirements for online pharmacies. (a) No controlled... course of his professional practice and is acting on behalf of a pharmacy whose registration has...

  17. 21 CFR 1306.09 - Prescription requirements for online pharmacies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Prescription requirements for online pharmacies... PRESCRIPTIONS General Information § 1306.09 Prescription requirements for online pharmacies. (a) No controlled... course of his professional practice and is acting on behalf of a pharmacy whose registration has...

  18. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a)...

  19. 21 CFR 202.1 - Prescription-drug advertisements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (e) * * *...

  20. 21 CFR 202.1 - Prescription-drug advertisements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (e) * * *...

  1. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a)...

  2. 21 CFR 202.1 - Prescription-drug advertisements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (e) * * *...

  3. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions. For purposes of...

  4. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a)...

  5. 48 CFR 753.270 - Prescription of USAID forms.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Prescription of USAID... DEVELOPMENT CLAUSES AND FORMS FORMS Prescription of Forms 753.270 Prescription of USAID forms. The requirements for use of USAID forms are contained in parts 701 through 752 where the subject matter applicable...

  6. 48 CFR 753.270 - Prescription of USAID forms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Prescription of USAID... DEVELOPMENT CLAUSES AND FORMS FORMS Prescription of Forms 753.270 Prescription of USAID forms. The requirements for use of USAID forms are contained in parts 701 through 752 where the subject matter applicable...

  7. 48 CFR 753.270 - Prescription of USAID forms.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Prescription of USAID... DEVELOPMENT CLAUSES AND FORMS FORMS Prescription of Forms 753.270 Prescription of USAID forms. The requirements for use of USAID forms are contained in parts 701 through 752 where the subject matter applicable...

  8. 48 CFR 753.270 - Prescription of USAID forms.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Prescription of USAID... DEVELOPMENT CLAUSES AND FORMS FORMS Prescription of Forms 753.270 Prescription of USAID forms. The requirements for use of USAID forms are contained in parts 701 through 752 where the subject matter applicable...

  9. 48 CFR 753.270 - Prescription of USAID forms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Prescription of USAID... DEVELOPMENT CLAUSES AND FORMS FORMS Prescription of Forms 753.270 Prescription of USAID forms. The requirements for use of USAID forms are contained in parts 701 through 752 where the subject matter applicable...

  10. 21 CFR 1306.09 - Prescription requirements for online pharmacies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Prescription requirements for online pharmacies... PRESCRIPTIONS General Information § 1306.09 Prescription requirements for online pharmacies. (a) No controlled... course of his professional practice and is acting on behalf of a pharmacy whose registration has been...

  11. 21 CFR 1306.09 - Prescription requirements for online pharmacies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Prescription requirements for online pharmacies... PRESCRIPTIONS General Information § 1306.09 Prescription requirements for online pharmacies. (a) No controlled... course of his professional practice and is acting on behalf of a pharmacy whose registration has been...

  12. 21 CFR 1306.09 - Prescription requirements for online pharmacies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Prescription requirements for online pharmacies... PRESCRIPTIONS General Information § 1306.09 Prescription requirements for online pharmacies. (a) No controlled... course of his professional practice and is acting on behalf of a pharmacy whose registration has been...

  13. 21 CFR 202.1 - Prescription-drug advertisements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (a)(1) The...

  14. 21 CFR 202.1 - Prescription-drug advertisements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (a)(1) The...

  15. 76 FR 59897 - Branded Prescription Drug Fee; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... Internal Revenue Service 26 CFR Part 51 RIN 1545-BK34 Branded Prescription Drug Fee; Correction AGENCY... entities engaged in the business of manufacturing or importing branded prescription drugs. This fee was... September 28, 2011 and applies to any fee on branded prescription drug sales that is due on or after...

  16. 76 FR 59898 - Branded Prescription Drug Fee; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... Internal Revenue Service 26 CFR Part 51 RIN 1545-BJ39 Branded Prescription Drug Fee; Correction AGENCY... provides guidance relating to the branded prescription drug fee imposed by the Affordable Care Act. FOR... PART 51--BRANDED PRESCRIPTION DRUGS, the last line of the first paragraph, the language ``this issue of...

  17. Do Motives Matter?: Nonmedical Use of Prescription Medications among Adolescents

    ERIC Educational Resources Information Center

    McCabe, Sean Esteban; Boyd, Carol J.

    2012-01-01

    Adolescents' motives for engaging in nonmedical prescription drug use is somewhat different than their reasons for using other drugs, such as marijuana. For some youth, nonmedical prescription drug use is an attempt to self-treat a medical condition, for others it is an effort to get high, and some youth misuse prescription drugs for both reasons.…

  18. 76 FR 59897 - Branded Prescription Drug Fee; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... Internal Revenue Service 26 CFR Part 51 RIN 1545-BK34 Branded Prescription Drug Fee; Correction AGENCY... engaged in the business of manufacturing or importing branded prescription drugs. This fee was enacted by..., 2011 and applies to any fee on branded prescription drug sales that is due on or after September 30...

  19. 21 CFR 202.1 - Prescription-drug advertisements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (a)(1) The...

  20. The Philosophical Foundations of Prescriptive Statements and Statistical Inference

    ERIC Educational Resources Information Center

    Sun, Shuyan; Pan, Wei

    2011-01-01

    From the perspectives of the philosophy of science and statistical inference, we discuss the challenges of making prescriptive statements in quantitative research articles. We first consider the prescriptive nature of educational research and argue that prescriptive statements are a necessity in educational research. The logic of deduction,…

  1. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions. For purposes of this...

  2. Prevention of overlapping prescriptions of psychotropic drugs by community pharmacists.

    PubMed

    Shimane, Takuya; Matsumoto, Toshihiko; Wada, Kiyoshi

    2012-10-01

    The nonmedical use or abuse of prescription drugs, including psychotropic medicines, is a growing health problem in Japan. Patient access to psychotropic drugs, specifically from the oversupply of medications due to overlapping prescriptions, may increase the risk of drug abuse and dependence. However, very little is known about such overlapping prescriptions. Today, the dispensing of prescriptions is generally moving from inside to outside of hospitals, with psychotropic drugs mainly dispensed at community pharmacies. In this study, we used health insurance claims (i.e., receipts) for dispensing as the main source of information in an investigation of overlapping prescriptions of psychotropic drugs. A total of 119 patients were found to have received overlapping prescriptions, as identified by community pharmacists who were members of the Saitama Pharmaceutical Association, using patient medication records, followed by medication counseling and prescription notes for the patient. According to our findings, the most frequently overlapping medication was etizolam. Etizolam can be prescribed for more than 30 days since it is not regulated under Japanese law as a "psychotropic drug." Generally, when a drug can be prescribed for a greater number of days, it increases the likelihood of an overlapping prescription during the same period. As a result, the long-term prescription of etizolam increases the risk of overlapping prescriptions. We also found that the patients who received overlapping prescriptions of etizolam were mostly elderly and the most common pattern was prescription from both internal medicine and orthopedics physicians. Etizolam has wide range of indications that are covered by health insurance. Our results suggest that patients who received overlapping prescriptions of etizolam may receive prescriptions from different prescribers for different purposes. Therefore, it may be appropriate to regulate etizolam as a "psychotropic drug" under Japanese law

  3. Insight Into Quality of Prescription Writing - An Instituitional Study

    PubMed Central

    Dyasanoor, Sujatha

    2016-01-01

    Introduction Prescription writing is an important task performed by a doctor during patient management. Prescription refers to written instructions given to a patient regarding medications. Lack of attention during prescription writing can lead to prescription errors which in turn can adversely affect patients’ well-being. Thus, prescriptions are an important target area for improvement. Aim The purpose of the present study was to analyze the quality of prescriptions dispensed by the students of The Oxford Dental College and Hospital, Bangalore and to compare the prescription writing patterns amongst undergraduates, interns and postgraduates of this institution. Materials and Methods A cross-sectional study was conducted on 500 randomly selected prescriptions dispensed by the students of The Oxford Dental College and Hospital, Bangalore, India. All the prescriptions were analyzed for the presence of (a) Patient’s information: Out-Patient file number, name, age, gender, address and contact number (b) Doctors information: Full name, department name, qualification, contact details, date of prescription, superscription, and signature (c) Drug information: Name, strength, dosage form, dosage instructions, duration and total quantity. Each prescription was further categorized into groups A, B, C or D, depending on the scores obtained. Prescription quality was then compared between the undergraduates, interns and postgraduates. Results Analysis of prescriptions performed using Chi-square test showed that groups A, B, C and D had 12 (2%), 155 (31%), 333 (67%) and 0 (0%) students respectively. Association between the groups and qualifications showed statistically significant results (p<0.05). Undergraduate prescriptions were better written in comparison to interns and postgraduates. Conclusion Findings of the current study demonstrate the need for further improvement in the quality of prescription writing by students of The Oxford Dental College and Hospital, Bangalore

  4. High-Risk Obtainment of Prescription Drugs by Older Adults in New Jersey: The Role of Prescription Opioids.

    PubMed

    Gold, Sarah L; Powell, Kristen Gilmore; Eversman, Michael H; Peterson, N Andrew; Borys, Suzanne; Hallcom, Donald K

    2016-10-01

    To explore the high-risk ways in which older adults obtain prescription opioids and to identify predictors of obtaining prescription opioids from high-risk sources, such as obtaining the same drug from multiple doctors, sharing drugs, and stealing prescription pads. Logistic regression analyses of cross-sectional survey data from the New Jersey Older Adult Survey on Drug Use and Health, a representative random-sample survey. Adults aged 60 and older (N = 725). Items such as obtaining prescriptions for the same drug from more than one doctor and stealing prescription drugs were measured to determine high-risk obtainment of prescription opioids. Almost 15% of the sample used high-risk methods of obtaining prescription opioids. Adults who previously used a prescription opioid recreationally had three times the risk of high-risk obtainment of prescription opioids. These findings illustrate the importance of strengthening prescription drug monitoring programs to reduce high-risk use of prescription drugs in older adults by alerting doctors and pharmacists to potential prescription drug misuse and interactions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. The carrier AUXIN RESISTANT (AUX1) dominates auxin flux into Arabidopsis protoplasts.

    PubMed

    Rutschow, Heidi L; Baskin, Tobias I; Kramer, Eric M

    2014-11-01

    The ability of the plant hormone auxin to enter a cell is critical to auxin transport and signaling. Auxin can cross the cell membrane by diffusion or via auxin-specific influx carriers. There is little knowledge of the magnitudes of these fluxes in plants. Radiolabeled auxin uptake was measured in protoplasts isolated from roots of Arabidopsis thaliana. This was done for the wild-type, under treatments with additional unlabeled auxin to saturate the influx carriers, and for the influx carrier mutant auxin resistant 1 (aux1). We also used flow cytometry to quantify the relative abundance of cells expressing AUX1-YFP in the assayed population. At pH 5.7, the majority of auxin influx into protoplasts - 75% - was mediated by the influx carrier AUX1. An additional 20% was mediated by other saturable carriers. The diffusive influx of auxin was essentially negligible at pH 5.7. The influx of auxin mediated by AUX1, expressed as a membrane permeability, was 1.5 ± 0.3 μm s(-1) . This value is comparable in magnitude to estimates of efflux permeability. Thus, auxin-transporting tissues can sustain relatively high auxin efflux and yet not become depleted of auxin.

  6. Cloning and expression analysis of novel Aux/IAA family genes in Gossypium hirsutum

    USDA-ARS?s Scientific Manuscript database

    Members of the auxin/indole-3-acetic acid (Aux/IAA) gene family encode proteins to mediate the responses of auxin gene expression and to regulate various aspects of plant morphological development. In this paper, we report the identification of nine cDNAs that contain complete open reading frame (OR...

  7. [Drug design ideas and methods of Chinese herb prescriptions].

    PubMed

    Ren, Jun-guo; Liu, Jian-xun

    2015-09-01

    The new drug of Chinese herbal prescription, which is the best carrier for the syndrome differentiation and treatment of Chinese medicine and is the main form of the new drug research and development, plays a very important role in the new drug research and development. Although there are many sources of the prescriptions, whether it can become a new drug, the necessity, rationality and science of the prescriptions are the key to develop the new drug. In this article, aiming at the key issues in prescriptions design, the source, classification, composition design of new drug of Chinese herbal prescriptions are discussed, and provide a useful reference for research and development of new drugs.

  8. Prescription patterns of Chinese herbal products for menopausal syndrome: analysis of a nationwide prescription database.

    PubMed

    Chen, Hsing-Yu; Lin, Yi-Hsuan; Wu, Jau-Ching; Chen, Yu-Chun; Yang, Sien-Hung; Chen, Jiun-Liang; Chen, Tzeng-Ji

    2011-10-11

    ETHNO-PHARMACOLOGICAL RELEVANCE: Chinese herbal products (CHP) are commonly used for menopausal syndrome in traditional Chinese medicine (TCM). Because menopausal syndrome is a common issue among women worldwide, this study analyzed the prescription patterns and frequencies of CHP in relieving menopausal syndrome in Taiwan. Prescriptions of CHP for menopausal syndrome were obtained from the nationwide prescription database (National Health Insurance Research Database) of Taiwan. Every prescription with a leading diagnosis of menopausal syndrome made in the year 2002 for women out-patients aged 45-55 years was analyzed. Descriptive statistics and data mining method (association rule mining) were applied to the pattern of co-prescription. A total of 54456 prescriptions were made for 15486 subjects in clinical visits. Salvia miltiorrhiza and Dan-zhi-xiao-yao-san were the most commonly prescribed single herb (SH) and herbal formula (HF), respectively. For combinations of two CHP, Salvia miltiorrhiza with Dan-zhi-xiao-yao-san, Zhi-bai-di-huang-wan with Dan-zhi-xiao-yao-san, and Ligustrum lucidum with Eclipta prostrata were the most frequently co-prescribed CHP couplets as SH-HF, HF-HF, and SH-SH, respectively. The most commonly used combination of three CHP was Eclipta prostrata with Ligustrum lucidum and Dan-zhi-xiao-yao-san. The core formula for menopausal syndrome was Dan-zhi-xiao-yao-san. Combinations of CHP are widely used for menopausal syndrome. Data mining analysis demonstrates the core formula and the commonly combined CHP in prescriptions. Further studies are needed to evaluate their efficacy for menopausal syndrome. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. Variable Torque Prescription: State of Art.

    PubMed Central

    Lacarbonara, Mariano; Accivile, Ettore; Abed, Maria R.; Dinoi, Maria Teresa; Monaco, Annalisa; Marzo, Giuseppe; Capogreco, Mario

    2015-01-01

    The variable prescription is widely described under the clinical aspect: the clinics is the result of the evolution of the state-of-the-art, aspect that is less considered in the daily literature. The state-of-the-art is the key to understand not only how we reach where we are but also to learn how to manage propely the torque, focusing on the technical and biomechanical purpos-es that led to the change of the torque values over time. The aim of this study is to update the clinicians on the aspects that affect the torque under the biomechanical sight, helping them to understand how to managing it, following the “timeline changes” in the different techniques so that the Variable Prescription Orthodontic (VPO) would be a suitable tool in every clinical case. PMID:25674173

  10. Information prescriptions: A tool for veterinary practices

    PubMed Central

    Kogan, L.R.; Schoenfeld-Tacher, R.; Gould, L.; Hellyer, P.W.; Dowers, K.

    2014-01-01

    The Internet has become a major source of health information and has the potential to offer many benefits for both human and animal health. In order for impact to be positive, however, it is critical that users be able to access reliable, trustworthy information. Although more pet owners are using the Internet to research animal health information than ever before, there remains limited research surrounding their online activities or the ability to influence owners’ online search behaviors. The current study was designed to assess the online behaviors and perceptions of pet owners after receiving either general or topic-specific information prescriptions as part of their veterinary appointment. Results indicate that nearly 60% of clients accessed the suggested websites and nearly all of these clients reported positive feelings about this addition to their veterinary services. These results suggest that offering information prescriptions to clients can facilitate better online searches by clients and positively impact both animal health and client satisfaction. PMID:26623346

  11. Women who doctor shop for prescription drugs.

    PubMed

    Worley, Julie; Thomas, Sandra P

    2014-04-01

    Doctor shopping is a term used to describe a form of diversion of prescription drugs when patients visit numerous prescribers to obtain controlled drugs for illicit use. Gender differences exist in regard to prescription drug abuse and methods of diversion. The purpose of this phenomenological study guided by the existential philosophy of Merleau-Ponty was to understand the lived experience of female doctor shoppers. Interviews were conducted with 14 women, which were recorded, transcribed, and analyzed. Included in the findings are figural aspects of the participants' experience of doctor shopping related to the existential grounds of world, time, body, and others. Four themes emerged from the data: (a) feeding the addiction, (b) networking with addicts, (c) playing the system, and (d) baiting the doctors. The findings suggest several measures that nurses can take to reduce the incidence of doctor shopping and to provide better care for female doctor shoppers.

  12. Prescription opioid epidemic and infant outcomes.

    PubMed

    Patrick, Stephen W; Dudley, Judith; Martin, Peter R; Harrell, Frank E; Warren, Michael D; Hartmann, Katherine E; Ely, E Wesley; Grijalva, Carlos G; Cooper, William O

    2015-05-01

    Although opioid pain relievers are commonly prescribed in pregnancy, their association with neonatal outcomes is poorly described. Our objectives were to identify neonatal complications associated with antenatal opioid pain reliever exposure and to establish predictors of neonatal abstinence syndrome (NAS). We used prescription and administrative data linked to vital statistics for mothers and infants enrolled in the Tennessee Medicaid program between 2009 and 2011. A random sample of NAS cases was validated by medical record review. The association of antenatal exposures with NAS was evaluated by using multivariable logistic regression, controlling for maternal and infant characteristics. Of 112,029 pregnant women, 31,354 (28%) filled ≥ 1 opioid prescription. Women prescribed opioid pain relievers were more likely than those not prescribed opioids (P < .001) to have depression (5.3% vs 2.7%), anxiety disorder (4.3% vs 1.6%) and to smoke tobacco (41.8% vs 25.8%). Infants with NAS and opioid-exposed infants were more likely than unexposed infants to be born at a low birth weight (21.2% vs 11.8% vs 9.9%; P < .001). In a multivariable model, higher cumulative opioid exposure for short-acting preparations (P < .001), opioid type (P < .001), number of daily cigarettes smoked (P < .001), and selective serotonin reuptake inhibitor use (odds ratio: 2.08 [95% confidence interval: 1.67-2.60]) were associated with greater risk of developing NAS. Prescription opioid use in pregnancy is common and strongly associated with neonatal complications. Antenatal cumulative prescription opioid exposure, opioid type, tobacco use, and selective serotonin reuptake inhibitor use increase the risk of NAS. Copyright © 2015 by the American Academy of Pediatrics.

  13. Prescription Opioid Epidemic and Infant Outcomes

    PubMed Central

    Dudley, Judith; Martin, Peter R.; Harrell, Frank E.; Warren, Michael D.; Hartmann, Katherine E.; Ely, E. Wesley; Grijalva, Carlos G.; Cooper, William O.

    2015-01-01

    BACKGROUND AND OBJECTIVES: Although opioid pain relievers are commonly prescribed in pregnancy, their association with neonatal outcomes is poorly described. Our objectives were to identify neonatal complications associated with antenatal opioid pain reliever exposure and to establish predictors of neonatal abstinence syndrome (NAS). METHODS: We used prescription and administrative data linked to vital statistics for mothers and infants enrolled in the Tennessee Medicaid program between 2009 and 2011. A random sample of NAS cases was validated by medical record review. The association of antenatal exposures with NAS was evaluated by using multivariable logistic regression, controlling for maternal and infant characteristics. RESULTS: Of 112 029 pregnant women, 31 354 (28%) filled ≥1 opioid prescription. Women prescribed opioid pain relievers were more likely than those not prescribed opioids (P < .001) to have depression (5.3% vs 2.7%), anxiety disorder (4.3% vs 1.6%) and to smoke tobacco (41.8% vs 25.8%). Infants with NAS and opioid-exposed infants were more likely than unexposed infants to be born at a low birth weight (21.2% vs 11.8% vs 9.9%; P < .001). In a multivariable model, higher cumulative opioid exposure for short-acting preparations (P < .001), opioid type (P < .001), number of daily cigarettes smoked (P < .001), and selective serotonin reuptake inhibitor use (odds ratio: 2.08 [95% confidence interval: 1.67–2.60]) were associated with greater risk of developing NAS. CONCLUSIONS: Prescription opioid use in pregnancy is common and strongly associated with neonatal complications. Antenatal cumulative prescription opioid exposure, opioid type, tobacco use, and selective serotonin reuptake inhibitor use increase the risk of NAS. PMID:25869370

  14. In Pursuit of Leadership: The Prescriptive Approach.

    DTIC Science & Technology

    1987-03-16

    men." Henri Peyre V1 viii I PREFACE One enters the study of leadership with a great sense of challenge -- and some trepidation. It is a topic of...Prescriptive Approach K AUTHOR: Dale 0. Condit, Colonel, USAF L- ’ Most of the current literature on leadership is "descriptive," detailing what leaders are...into the young through the schools, but also through the family, the intellectual atmosphere, the literature , the history, the ethical teaching of

  15. The Diversion of Prescription Opioid Analgesics

    PubMed Central

    Inciardi, James A.; Surratt, Hilary L.; Lugo, Yamilka; Cicero, Theodore J.

    2012-01-01

    Prescription drug diversion involves the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace, and can occur along all points in the drug delivery process -- from the original manufacturing site, to the wholesale distributor, the physician's office, the retail pharmacy, or the patient. Although a number of recent scientific papers have discussed the problems associated with diversion, empirical data on the scope and magnitude of diversion are limited in the literature. This paper presents findings from a national diversion survey being conducted as part of risk management initiatives supported by Denver Health and Hospital Authority, designed to monitor the abuse and diversion of a variety of prescription opioid analgesics. On a quarterly basis, diversion investigators in 300 jurisdictions distributed throughout the 50 states, the District of Columbia, and Puerto Rico are sent short questionnaires designed to elicit data on the extent of drug diversion in their areas. During the 20-quarter survey period reported in this paper, a total of 64,655 cases of prescription drug diversion were reported from all of the participating sites. The most widely diverted opioid was hydrocodone, in that it was mentioned in 38.2% of the cases, followed by oxycodone, mentioned in 24.3% of the cases. By contrast, the proportions of cases in which other opioids were mentioned were significantly smaller. The diversion of opioids appears in all 50 states, the District of Columbia, and Puerto Rico, with especially high concentrations in rural areas. How all of these prescription opioids are being diverted to the street, however, is not altogether clear, and in many ways, diversion is a “black box” requiring concentrated systematic study. PMID:25267926

  16. Arts on prescription: a qualitative outcomes study.

    PubMed

    Stickley, T; Eades, M

    2013-08-01

    In recent years, participatory community-based arts activities have become a recognized and regarded method for promoting mental health. In the UK, Arts on Prescription services have emerged as a prominent form of such social prescribing. This follow-up study reports on the findings from interviews conducted with participants in an Arts on Prescription programme two years after previous interviews to assess levels of 'distance travelled'. This follow-up study used a qualitative interview method amongst participants of an Arts on Prescription programme of work. Ten qualitative one-to-one interviews were conducted in community-based arts venues. Each participant was currently using or had used mental health services, and had been interviewed two years earlier. Interviews were digitally recorded, transcribed and analysed. For each of the 10 participants, a lengthy attendance of Arts on Prescription had acted as a catalyst for positive change. Participants reported increased self-confidence, improved social and communication skills, and increased motivation and aspiration. An analysis of each of the claims made by participants enabled them to be grouped according to emerging themes: education: practical and aspirational achievements; broadened horizons: accessing new worlds; assuming and sustaining new identities; and social and relational perceptions. Both hard and soft outcomes were identifiable, but most were soft outcomes. Follow-up data indicating progress varied between respondents. Whilst hard outcomes could be identified in individual cases, the unifying factors across the sample were found predominately in the realm of soft outcomes. These soft outcomes, such as raised confidence and self-esteem, facilitated the hard outcomes such as educational achievement and voluntary work. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. The street value of prescription drugs

    PubMed Central

    Sajan, A; Corneil, T; Grzybowski, S

    1998-01-01

    BACKGROUND: Although most physicians are aware of the potential for abuse and resale of prescribed medications, little has been done to document it. The purpose of this study was to determine which prescription drugs have street value, what that value is and why these drugs are used. METHODS: A descriptive cross-sectional survey using a semistructured interview technique was carried out on 2 weekdays (Mar. 10 and Apr. 1, 1997) in Vancouver's Downtown Eastside. A total of 58 users and dealers of prescription sedative/hypnotic and narcotic drugs were approached. Information collected included the demographic characteristics of those interviewed, the common street names of the drugs of interest, and their value and method of use. RESULTS: Thirty-two people agreed to participate in the study (participation rate 55%), 7 of whom were dealers. The range in price of sedative/hypnotic drugs was $0.10 to $2. For narcotic drugs the range was much greater, at $0.25 to $75. Descriptive analysis identified the minimum and maximum price and the mode of each preparation. Among the weak narcotic drugs the index drug (highest in demand on the street) was Tylenol No. 3 and among the more potent narcotics, MS Contin 30 mg. INTERPRETATION: A wide variety of prescription sedative/hypnotic and narcotic drugs are available on the street. The mark-up from pharmacy cost can be considerable. Factors influencing pricing include the relative inexperience of the buyer, the availability of illicit narcotics, the current street supply of prescription medications and the time of the month (before or after issue of social assistance cheques). PMID:9700324

  18. Adolescents' Motivations to Abuse Prescription Medications

    PubMed Central

    Boyd, Carol J.; McCabe, Sean Esteban; Cranford, James A.; Young, Amy

    2007-01-01

    OBJECTIVES Our goals were to (1) determine adolescents' motivations (reasons) for engaging in the nonmedical (illicit) use of 4 classes of prescription medications and (2) examine whether motivations were associated with a higher risk for substance abuse problems. RESPONDENTS The 2005 sample (N = 1086) was derived from one ethnically diverse school district in southeastern Michigan and included 7th- through 12th-grade students. METHODS Data were collected by using a self-administered, Web-based survey that included questions about drug use and the motivations to engage in nonmedical use of prescription medication. RESULTS Twelve percent of the respondents had engaged in nonmedical use of opioid pain medications in the past year: 3% for sleeping, 2% as a sedative and/or for anxiety, and 2% as stimulants. The reasons for engaging in the nonmedical use of prescription medications varied by drug classification. For opioid analgesics, when the number of motives increased, so too did the likelihood of a positive Drug Abuse Screening Test score. For every additional motive endorsed, the Drug Abuse Screening Test increased by a factor of 1.8. Two groups of students were compared (at-risk versus self-treatment); those who endorsed multiple motivations for nonmedical use of opioids (at-risk group) were significantly more likely to have elevated Drug Abuse Screening Test scores when compared with those who were in the self-treatment group. Those in the at-risk group also were significantly more likely to engage in marijuana and alcohol use. CONCLUSION The findings from this exploratory study warrant additional research because several motivations for the nonmedical use of prescription medications seem associated with a greater likelihood of substance abuse problems. PMID:17142533

  19. Prescription use disorders in older adults.

    PubMed

    Kalapatapu, Raj K; Sullivan, Maria A

    2010-01-01

    The number of older adults needing substance abuse treatment is projected to rise significantly in the next few decades. This paper will focus on the epidemic of prescription use disorders in older adults. Particular vulnerabilities of older adults to addiction will be considered. Specifically, the prevalence and patterns of use of opioids, stimulants, and benzodiazepines will be explored, including the effects of these substances on morbidity and mortality. Treatment intervention strategies will be briefly discussed, and areas for future research are suggested.

  20. Controlled prescription drug abuse at epidemic level.

    PubMed

    2006-01-01

    In July 2005, The National Center on Addiction and Substance Abuse (CASA) at Columbia University announced the results of a study indicating that the number of Americans who abuse controlled prescription drugs has nearly doubled from 7.8 million to 15.1 million from 1992 to 2003 and abuse among teens has more than tripled during that time. A summary of that study and information about the full report are presented.

  1. Care management: agreement between nursing prescriptions and patients' care needs

    PubMed Central

    Faeda, Marília Silveira; Perroca, Márcia Galan

    2016-01-01

    ABSTRACT Objectives: analyze agreement between nursing prescriptions recorded in medical files and patients' care needs; investigate the correlation between the nurses' professional background and agreement of prescriptions. Method: descriptive study with quantitative and documentary approach conducted in the medical clinic, surgical, and specialized units of a university hospital in the interior of São Paulo, Brazil. The new validated version of a Patient Classification Instrument was used and 380 nursing prescriptions written at the times of hospital admission and discharge were assessed. Results: 75% of the nursing prescriptions items were compatible with the patients' care needs. Only low correlation between nursing prescription agreement and professional background was found. Conclusion: the nursing prescriptions did not fully meet the care needs of patients. The care context and work process should be analyzed to enable more effective prescriptions, while strategies to assess the care needs of patients are recommended. PMID:27508902

  2. Reviewing prescription spending and accessory usage.

    PubMed

    Oxenham, Julie

    This article aims to explore the role of the stoma nurse specialist in the community and how recent initiatives within the NHS have impacted on the roles in stoma care to react to the rising prescription costs in the specialty. The article will explore how the stoma care nurse conducted her prescription reviews within her own clinical commissioning group (CCG). The findings of the reviews will be highlighted by a small case history and a mini audit that reveals that some stoma patients may be using their stoma care accessories inappropriately, which may contribute to the rise in stoma prescription spending. To prevent the incorrect use of stoma appliances it may necessitate an annual review of ostomates (individuals who have a stoma), as the author's reviews revealed that inappropriate usage was particularly commonplace when a patient may have not been reviewed by a stoma care specialist for some considerable amount of time. Initial education of the ostomate and ongoing education of how stoma products work is essential to prevent the misuse of stoma appliances, particularly accessories, as the reviews revealed that often patients were not always aware of how their products worked in practice.

  3. [Summary of Hui prescriptions for treating cough].

    PubMed

    Zhang, Wen-jin; Liu, Yue; Zhang, Xin-hui

    2015-02-01

    In this study, by using the method of literature research, 35 prescriptions related to asthma therapy has been screened out from Hui medicine through collecting the ancient and modern literature. A comparison of fragrant medicine between the name in Arab and Chinese herbal medicine is done. The countif function in Microsoft Excel 2007 is used to get the prescriptions of the drug on the frequency statistics, summarizing the common drugs of Hui medicine for asthma are Pinellia, almond, white sugar, walnut. According to the commonly used drugs, the pathogeny and treatment principle about Hui medicine for asthma is preliminarily inferred combining literature research and the related Hui medical theory. In this study, those prescriptions have been classified into 21 cases which are effective and can be used in medical therapy according to the relevant literatures with the development of the Hui people in their long process of formation of the unique diet culture, 14 useful and convenient Halal diet therapies are made up according to the indications, therapies, party name and composition. Halal diet and "medicine and food" herbs are preliminarily analyzed and summarized, which can be convenient for the people to reduce pains through the diet and improve health awareness.

  4. Utilization of the Arkansas Prescription Monitoring Program to combat prescription drug abuse

    PubMed Central

    Rittenhouse, Rebecca; Wei, Feifei; Robertson, Denise; Ryan, Kevin

    2015-01-01

    Objective The Arkansas Prescription Monitoring Program (AR PMP) was implemented in 2013 to combat prescription drug abuse. All enrollees were invited to participate in a user survey available in February 2014, to identify makeup of users, utilization of the program, and changes made to health care practices after implementation of the program. Methods Of the 3694 individual enrollees invited to participate, 1541 (41.7%) completed the survey. Data collected were analyzed to identify changes in health care practices by program frequency of use and user profession. Results Medical doctors, advanced practice nurses, and pharmacists are the professions who use the program most frequently. Daily AR PMP users are considerably more likely than infrequent users to be prompted to access the program by the involvement of a controlled substance (CS) prescription or by office/facility policy requirements. Increased frequency of use of the AR PMP results in positive impacts on CS prescribing and dispensing practices. Conclusion Compelling more users of the AR PMP to be prompted to access the program by the involvement of a CS prescription or by requirements per office/facility policy may increase frequency of use of the program and thereby changes in health care practices to combat prescription drug abuse. PMID:26191489

  5. Crowdsourcing Black Market Prices For Prescription Opioids

    PubMed Central

    Freifeld, Clark; Brownstein, John S; Menone, Christopher Mark; Surratt, Hilary L; Poppish, Luke; Green, Jody L; Lavonas, Eric J; Dart, Richard C

    2013-01-01

    Background Prescription opioid diversion and abuse are major public health issues in the United States and internationally. Street prices of diverted prescription opioids can provide an indicator of drug availability, demand, and abuse potential, but these data can be difficult to collect. Crowdsourcing is a rapid and cost-effective way to gather information about sales transactions. We sought to determine whether crowdsourcing can provide accurate measurements of the street price of diverted prescription opioid medications. Objective To assess the possibility of crowdsourcing black market drug price data by cross-validation with law enforcement officer reports. Methods Using a crowdsourcing research website (StreetRx), we solicited data about the price that site visitors paid for diverted prescription opioid analgesics during the first half of 2012. These results were compared with a survey of law enforcement officers in the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System, and actual transaction prices on a “dark Internet” marketplace (Silk Road). Geometric means and 95% confidence intervals were calculated for comparing prices per milligram of drug in US dollars. In a secondary analysis, we compared prices per milligram of morphine equivalent using standard equianalgesic dosing conversions. Results A total of 954 price reports were obtained from crowdsourcing, 737 from law enforcement, and 147 from the online marketplace. Correlations between the 3 data sources were highly linear, with Spearman rho of 0.93 (P<.001) between crowdsourced and law enforcement, and 0.98 (P<.001) between crowdsourced and online marketplace. On StreetRx, the mean prices per milligram were US$3.29 hydromorphone, US$2.13 buprenorphine, US$1.57 oxymorphone, US$0.97 oxycodone, US$0.96 methadone, US$0.81 hydrocodone, US$0.52 morphine, and US$0.05 tramadol. The only significant difference between data sources was morphine, with a Drug Diversion price of US

  6. A population-based study of antipsychotic prescription trends in children and adolescents in British Columbia, from 1996 to 2011.

    PubMed

    Ronsley, Rebecca; Scott, David; Warburton, William P; Hamdi, Ramsay D; Louie, Dianna Clare; Davidson, Jana; Panagiotopoulos, Constadina

    2013-06-01

    eu une hausse exponentielle des prescriptions d’ADG en C.-B., consécutive à une vaste utilisation non indiquée sur l’étiquette, non seulement par les psychiatres mais aussi les médecins de famille et les pédiatres. Les initiatives de transmission des connaissances qui prônent des pratiques de prescription et de surveillance fondées sur les données probantes et reliées au traitement par ADG doivent cibler les 3 groupes de prescripteurs et être adaptées aux sous-groupes d’âge.

  7. Prescription Drug Misuse and Sexual Behavior among Young Adults

    PubMed Central

    Wells, Brooke E.; Kelly, Brian C.; Rendina, H. Jonathon; Parsons, Jeffrey T.

    2015-01-01

    Though research indicates a complex link between substance use and sexual risk behavior, there is limited research on the association between sexual risk behavior and prescription drug misuse. In light of the alarming increases in prescription drug misuse and the role of demographic characteristics in sexual risk behavior and outcomes, the current study examines demographic differences (gender, sexual identity, age, relationship status, parental class background, and race/ethnicity) in sexual risk behavior, sexual behavior under the influence of prescription drugs, and sexual risk behavior under the influence of prescription drugs in a sample of 402 young adults (18–29) who misuse prescription drugs. Nearly half of the sexually active young adult prescription drug misusers in this sample reported recent sex under the influence of prescription drugs, more than three quarters reported recent sex without a condom, and more than one-third reported recent sex without a condom after using prescription drugs. Zero-inflated Poisson regression models indicated that white race, younger age, higher parental class, and being a heterosexual man were all associated with sexual risk behavior, sex under the influence of prescription drugs, and sexual risk under the influence of prescription drugs. Findings have implications for the targeting of prevention and intervention efforts. PMID:25569204

  8. Prescription drug abuse: from epidemiology to public policy.

    PubMed

    McHugh, R Kathryn; Nielsen, Suzanne; Weiss, Roger D

    2015-01-01

    Prescription drug abuse has reached an epidemic level in the United States. The prevalence of prescription drug abuse escalated rapidly beginning in the late 1990s, requiring a significant increase in research to better understand the nature and treatment of this problem. Since this time, a research literature has begun to develop and has provided important information about how prescription drug abuse is similar to, and different from the abuse of other substances. This introduction to a special issue of the Journal of Substance Abuse Treatment on prescription drug abuse provides an overview of the current status of the research literature in this area. The papers in this special issue include a sampling of the latest research on the epidemiology, clinical correlates, treatment, and public policy considerations of prescription drug abuse. Although much has been learned about prescription drug abuse in recent years, this research remains in early stages, particularly with respect to understanding effective treatments for this population. Future research priorities include studies on the interaction of prescription drugs with other licit and illicit substances, the impact of prescription drug abuse across the lifespan, the optimal treatment for prescription drug abuse and co-occurring conditions, and effective public policy initiatives for reducing prescription drug abuse.

  9. Prescription Drug Abuse: From Epidemiology to Public Policy

    PubMed Central

    McHugh, R. Kathryn; Nielsen, Suzanne; Weiss, Roger D.

    2014-01-01

    Prescription drug abuse has reached an epidemic level in the United States. The prevalence of prescription drug abuse escalated rapidly beginning in the late 1990s, requiring a significant increase in research to better understand the nature and treatment of this problem. Since this time, a research literature has begun to develop and has provided important information about how prescription drug abuse is similar to, and different from the abuse of other substances. This introduction to a special issue of the Journal of Substance Abuse Treatment on prescription drug abuse provides an overview of the current status of the research literature in this area. The papers in this special issue include a sampling of the latest research on the epidemiology, clinical correlates, treatment, and public policy considerations of prescription drug abuse. Although much has been learned about prescription drug abuse in recent years, this research remains in early stages, particularly with respect to understanding effective treatments for this population. Future research priorities include studies on the interaction of prescription drugs with other licit and illicit substances, the impact of prescription drug abuse across the lifespan, the optimal treatment for prescription drug abuse and co-occurring conditions, and effective public policy initiatives for reducing prescription drug abuse. PMID:25239857

  10. Prescription Drug Misuse and Sexual Behavior Among Young Adults.

    PubMed

    Wells, Brooke E; Kelly, Brian C; Rendina, H Jonathon; Parsons, Jeffrey T

    2015-01-01

    Though research indicates a complex link between substance use and sexual risk behavior, there is limited research on the association between sexual risk behavior and prescription drug misuse. In light of alarming increases in prescription drug misuse and the role of demographic characteristics in sexual risk behavior and outcomes, the current study examined demographic differences (gender, sexual identity, age, relationship status, parental class background, and race/ethnicity) in sexual risk behavior, sexual behavior under the influence of prescription drugs, and sexual risk behavior under the influence of prescription drugs in a sample of 402 young adults (ages 18 to 29) who misused prescription drugs. Nearly half of the sexually active young adult prescription drug misusers in this sample reported recent sex under the influence of prescription drugs; more than three-quarters reported recent sex without a condom; and more than one-third reported recent sex without a condom after using prescription drugs. Zero-inflated Poisson regression models indicated that White race, younger age, higher parental class, and being a heterosexual man were all associated with sexual risk behavior, sex under the influence of prescription drugs, and sexual risk under the influence of prescription drugs. Findings have implications for the targeting of prevention and intervention efforts.

  11. Patient co-payments and use of prescription medicines.

    PubMed

    Doran, Evan; Robertson, Jane; Rolfe, Isobel; Henry, David

    2004-02-01

    To investigate how prescription co-payments influence the medicine use of Australian patients. Two surveys and an in-depth interview study were conducted in the Newcastle/Hunter region of New South Wales (NSW). A community-based survey explored how often prescription cost posed a barrier to prescription use. A general practice patient survey investigated the impact of prescription cost on the timing of medical consultations and prescription collection. Quantitative data were summarised using descriptive statistics; associations between household characteristics and outcomes were explored using odds ratios and chi square analysis. In-depth interviews were conducted to explore the role of prescription cost in medicine use. The interview data were qualitatively analysed for relevant themes using 'grounded theory'. 420 of 950 households (44%) participated in the community survey: 110 (26%) reported delaying visiting a GP, 85 (20%) not buying all of their prescription medicines and 77 (18%) not refilling a prescription because of cost. Sixty-two (15%) households reported significant difficulties with prescription costs. Households with children had twice the odds of reporting significant difficulties than those without (OR= 2.0, 95% CI 1.2-3.5). Of the 442 (43%) GP patients who participated, 25 (6%) patients reported prescription cost as the reason for delaying their visit. Of the 291 patients who received a prescription, 26 (9%) patients reported cost as the reason for not collecting some or all of their prescriptions. Given the wide variation in patients' capacity to manage increased out-of-pocket costs, co-payments may add to patients' burden and place a potential barrier to safe and timely prescription use.

  12. AUX/LAX Genes Encode a Family of Auxin Influx Transporters That Perform Distinct Functions during Arabidopsis Development[C][W

    PubMed Central

    Péret, Benjamin; Swarup, Kamal; Ferguson, Alison; Seth, Malvika; Yang, Yaodong; Dhondt, Stijn; James, Nicholas; Casimiro, Ilda; Perry, Paula; Syed, Adnan; Yang, Haibing; Reemmer, Jesica; Venison, Edward; Howells, Caroline; Perez-Amador, Miguel A.; Yun, Jeonga; Alonso, Jose; Beemster, Gerrit T.S.; Laplaze, Laurent; Murphy, Angus; Bennett, Malcolm J.; Nielsen, Erik; Swarup, Ranjan

    2012-01-01

    Auxin transport, which is mediated by specialized influx and efflux carriers, plays a major role in many aspects of plant growth and development. AUXIN1 (AUX1) has been demonstrated to encode a high-affinity auxin influx carrier. In Arabidopsis thaliana, AUX1 belongs to a small multigene family comprising four highly conserved genes (i.e., AUX1 and LIKE AUX1 [LAX] genes LAX1, LAX2, and LAX3). We report that all four members of this AUX/LAX family display auxin uptake functions. Despite the conservation of their biochemical function, AUX1, LAX1, and LAX3 have been described to regulate distinct auxin-dependent developmental processes. Here, we report that LAX2 regulates vascular patterning in cotyledons. We also describe how regulatory and coding sequences of AUX/LAX genes have undergone subfunctionalization based on their distinct patterns of spatial expression and the inability of LAX sequences to rescue aux1 mutant phenotypes, respectively. Despite their high sequence similarity at the protein level, transgenic studies reveal that LAX proteins are not correctly targeted in the AUX1 expression domain. Domain swapping studies suggest that the N-terminal half of AUX1 is essential for correct LAX localization. We conclude that Arabidopsis AUX/LAX genes encode a family of auxin influx transporters that perform distinct developmental functions and have evolved distinct regulatory mechanisms. PMID:22773749

  13. Geriatric Prescription in a Nigerian Tertiary Hospital

    PubMed Central

    Osemeke, Nwani Paul; Hart, Onwukwe Chikezie; Cosmas, Nwosu Maduaburochukwu; Ohumagho, Isah Ambrose

    2016-01-01

    Objectives: To assess the medications prescribed for elderly inpatients on specific days during hospital admission with a view to detecting areas of irrational prescription. Methods: It was a prospective study of all patients aged 65 years and above admitted to the medical wards of a Nigerian tertiary hospital over a 12-month period. The World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) drug use indicators were used to assess drug prescriptions on various days of admission. Results: A total of 1513 patient encounters involving 345 patients aged between 65 and 92 years were assessed on hospital days 1, 3, 5, 7, 14, and 28. The average number of medicines per encounter ranged from 6.1 ± 2.5 on hospital day 1 to 7.8 ± 2.4 on hospital day 28. This difference was statistically significant (F = 14.42; P < 0.05). The percentage of encounters with an antibiotic prescribed ranged from 50.4% on hospital day 1 to 62.9% on hospital day 28 while the percentage of encounters with an injection prescribed decreased from 72.8% on hospital day 1 to 50.0% on day 28. Conclusions: This study suggests some degree of irrational prescribing as evident by the high average number of medicine per encounter and the high percentages of encounters with an antibiotic or injection prescribed. However, there is a need to develop standard values for the WHO/INRUD indicators based on the recently published national treatment guidelines for common elderly diseases which will serve as yardsticks to assess elderly inpatients prescriptions using WHO/INRUD core indicators in future studies. PMID:28104970

  14. Dose prescription in boron neutron capture therapy

    SciTech Connect

    Gupta, N.M.S.; Gahbauer, R.A. ); Blue, T.E. ); Wambersie, A. )

    1994-03-30

    The purpose of this paper is to address some aspects of the many considerations that need to go into a dose prescription in boron neutron capture therapy (BNCT) for brain tumors; and to describe some methods to incorporate knowledge from animal studies and other experiments into the process of dose prescription. Previously, an algorithm to estimate the normal tissue tolerance to mixed high and low linear energy transfer radiations in BNCT was proposed. The authors have developed mathematical formulations and computational methods to represent this algorithm. Generalized models to fit the central axis dose rate components for an epithermal neutron field were also developed. These formulations and beam fitting models were programmed into spreadsheets to simulate two treatment techniques which are expected to be used in BNCT: a two-field bilateral scheme and a single-field treatment scheme. Parameters in these spreadsheets can be varied to represent the fractionation scheme used, the [sup 10]B microdistribution in normal tissue, and the ratio of [sup 10]B in tumor to normal tissue. Most of these factors have to be determined for a given neutron field and [sup 10]B compound combination from large animal studies. The spreadsheets have been programmed to integrate all of the treatment-related information and calculate the location along the central axis where the normal tissue tolerance is exceeded first. This information is then used to compute the maximum treatment time allowable and the maximum tumor dose that may be delivered for a given BNCT treatment. The effect of different treatment variables on the treatment time and tumor dose has been shown to be very significant. It has also been shown that the location of D[sub max] shifts significantly, depending on some of the treatment variables-mainly the fractionation scheme used. These results further emphasize the fact that dose prescription in BNCT is very complicated and nonintuitive. 11 refs., 6 figs., 3 tabs.

  15. Prescription Use Disorders in Older Adults

    PubMed Central

    Sullivan, Maria A.

    2012-01-01

    The number of older adults needing substance abuse treatment is projected to rise significantly in the next few decades. This article will focus on the epidemic of prescription use disorders in older adults. Particular vulnerabilities of older adults to addiction will be considered. Specifically, the prevalence and patterns of use of opioids, stimulants, and benzodiazepines will be explored, including the effects of these substances on morbidity and mortality. Treatment intervention strategies will be briefly discussed, and areas for future research are suggested. PMID:20958847

  16. [Science of Acupuncture Prescription: an innovation teaching material].

    PubMed

    Chen, Ze-lin

    2007-03-01

    The author introduces the background of writing the innovation teaching material Science of Acupuncture Prescription in TCM university and colleges. The characteristics of this book were: (1) It establishes the train of thought on acupuncture prescriptions mainly based on the location of the acupoints. (2) It ascertains the relationship between prescriptions and science of prescription. (3) It highlights the scientific property of Science of Acupuncture Prescription by organic combination of inheritance and creativity. The publication of Science of Acupuncture Prescription serves as a bridge between Science of Meridians and Collaterals and Acupoints and Science of Acupuncture Therapy, perfects the course system of acupuncture and moxibustion and complements knowledge structure of acupuncture and tuinaology, and it also symbolizes the development of acupuncture and moxibustion.

  17. Genome-wide analysis of Aux/IAA and ARF gene families in Populus trichocarpa

    SciTech Connect

    Kalluri, Udaya C; DiFazio, Stephen P; Brunner, A.; Tuskan, Gerald A

    2007-01-01

    Auxin/Indole-3-Acetic Acid (Aux/IAA) and Auxin Response Factor (ARF) transcription factors are key regulators of auxin responses in plants. A total of 35 Aux/IAA and 39 ARF genes were identified in the Populus genome. Comparative phylogenetic analysis revealed that the subgroups PoptrARF2, 6, 9 and 16 and PoptrIAA3, 16, 27 and 29 have differentially expanded in Populus relative to Arabidopsis. Activator ARFs were found to be two fold-overrepresented in the Populus genome. PoptrIAA and PoptrARF gene families appear to have expanded due to high segmental and low tandem duplication events. Furthermore, expression studies showed that genes in the expanded PoptrIAA3 subgroup display differential expression. The gene-family analysis reported here will be useful in conducting future functional genomics studies to understand how the molecular roles of these large gene families translate into a diversity of biologically meaningful auxin effects.

  18. Candidate Elastic Quantum Critical Point in LaCu6-xAux

    DOE PAGES

    Poudel, Lekh; May, Andrew F.; Koehler, Michael R.; ...

    2016-11-30

    In this paper, the structural properties of LaCu6-xAux are studied using neutron diffraction, x-ray diffraction, and heat capacity measurements. The continuous orthorhombic-monoclinic structural phase transition in LaCu6 is suppressed linearly with Au substitution until a complete suppression of the structural phase transition occurs at the critical composition xc=0.3. Heat capacity measurements at low temperatures indicate residual structural instability at xc. The instability is ferroelastic in nature, with density functional theory calculations showing negligible coupling to electronic states near the Fermi level. Finally, the data and calculations presented here are consistent with the zero temperature termination of a continuous structural phasemore » transition suggesting that the LaCu6-xAux series hosts an elastic quantum critical point.« less

  19. Dodo remains from an in situ context from Mare aux Songes, Mauritius.

    PubMed

    Meijer, Hanneke J M; Gill, Arike; de Louw, Perry G B; Van Den Hoek Ostende, Lars W; Hume, Julian P; Rijsdijk, Kenneth F

    2012-03-01

    Since 2005, excavations at Mare aux Songes, Mauritius, have revealed the presence of a very rich, ∼4,200-year-old fossil bone bed including dodo (Raphus cucullatus) bones and bone fragments. The recently excavated dodo assemblage comprises at least 17 individuals and is characterised by the presence of small and fragile skeletal elements, a dominance of leg elements and an absence of juveniles. The hydrology of the area suggests that dodos, like many other species, were probably lured to Mare aux Songes by the presence of freshwater during times of drought. The most likely scenario for the origin of the fossil deposit is that animals became trapped in the sediment in repeated miring events, which would favour the conservation of hindlimbs. Such a scenario is fully in accordance with the taphonomic characteristics of the bone assemblage.

  20. Dodo remains from an in situ context from Mare aux Songes, Mauritius

    NASA Astrophysics Data System (ADS)

    Meijer, Hanneke J. M.; Gill, Arike; de Louw, Perry G. B.; van den Hoek Ostende, Lars W.; Hume, Julian P.; Rijsdijk, Kenneth F.

    2012-03-01

    Since 2005, excavations at Mare aux Songes, Mauritius, have revealed the presence of a very rich, ˜4,200-year-old fossil bone bed including dodo ( Raphus cucullatus) bones and bone fragments. The recently excavated dodo assemblage comprises at least 17 individuals and is characterised by the presence of small and fragile skeletal elements, a dominance of leg elements and an absence of juveniles. The hydrology of the area suggests that dodos, like many other species, were probably lured to Mare aux Songes by the presence of freshwater during times of drought. The most likely scenario for the origin of the fossil deposit is that animals became trapped in the sediment in repeated miring events, which would favour the conservation of hindlimbs. Such a scenario is fully in accordance with the taphonomic characteristics of the bone assemblage.

  1. The Aux/IAA, Sl-IAA17 regulates quality parameters over tomato fruit development

    PubMed Central

    Su, LY; Audran, C; Bouzayen, M; Roustan, JP; Chervin, C

    2015-01-01

    Auxin is known to be involved in all the stages of fruit development. Aux/IAAs are regulators of the auxin signaling at the transcription level. In a recent study, using RNAi strategy to limit the expression Sl-IAA17, it was shown that this tomato AuxIAA regulates fruit size mainly through altering the ploidy level of pericarp cells. Indeed, Sl-IAA17 down-regulated lines showed fruit with larger diameter, bigger volume and heavier weight than wild-type. The increase in fruit size was associated with thicker pericarp rather than larger locular spaces. The thicker pericarp was linked to larger cells harboring higher ploidy level, probably due to more active endoreduplication at the beginning of fruit development. The present report describes some additional phenotypes, not described in the initial article, among which are soluble solid content, juice pH, firmness, seed weight and fruit morphology. PMID:26317283

  2. Prescription opioid dispensing and prescription opioid poisoning: Population data from Victoria, Australia 2006 to 2013.

    PubMed

    Berecki-Gisolf, Janneke; Hassani-Mahmooei, Behrooz; Clapperton, Angela; McClure, Roderick

    2017-02-01

    To describe recent trends in opioid prescribing and prescription opioid poisoning resulting in hospitalisation or death in Victoria, Australia. This is a population-based ecological study of residents of Victoria, 2006 - 14. Australian Bureau of Statistics residential population data were combined with Pharmaceutical Benefits Scheme (PBS) opioid prescription data, Victorian Admitted Episodes Data (VAED) and cause of death data. Annual opioid dispensings increased by 78% in 2006 - 13, from 0.33 to 0.58 per population. Opioid use increased with age: in 2013, 14% of Victorian residents aged ≥65 years filled at least one oxycodone prescription. In 2006 - 14, prescription opioid related hospital admissions increased by 6.8% per year, from 107 to 187 /1,000,000 person-years; 56% were due to intentional self-poisoning. Annual deaths increased from 21 to 28 /1,000,000 persons, in 2007 - 11. Admissions and deaths peaked at 25-44 years. Although both opioid prescribing and poisoning have increased, there is discrepancy between the exposed group (dispensings increased with age) and those with adverse consequences (rates peaked at ages 25-44 years). A better understanding is needed of drivers of prescribing and adverse consequences. Together with monitoring of prescribing and poisoning, this will facilitate early detection and prevention of a public health problem. © 2016 The Authors.

  3. Correlates of Prescription Drug Market Involvement among Young Adults

    PubMed Central

    Vuolo, Mike; Kelly, Brian C.; Wells, Brooke E.; Parsons, Jeffrey T.

    2014-01-01

    Background While a significant minority of prescription drug misusers report purchasing prescription drugs, little is known about prescription drug selling. We build upon past research on illicit drug markets, which increasingly recognizes networks and nightlife as influential, by examining prescription drug market involvement. Methods We use data from 404 young adult prescription drug misusers sampled from nightlife scenes. Using logistic regression, we examine recent selling of and being approached to sell prescription drugs, predicted using demographics, misuse, prescription access, and nightlife scene involvement. Results Those from the wealthiest parental class and heterosexuals had higher odds (OR=6.8) of selling. Higher sedative and stimulant misuse (ORs=1.03), having a stimulant prescription (OR=4.14), and having sold other illegal drugs (OR=6.73) increased the odds of selling. College bar scene involvement increased the odds of selling (OR=2.73) and being approached to sell (OR=2.09). Males (OR=1.93), stimulant users (OR=1.03), and sedative prescription holders (OR=2.11) had higher odds of being approached. Discussion College bar scene involvement was the only site associated with selling and being approached; such participation may provide a network for prescription drug markets. There were also differences between actual selling and being approached. Males were more likely to be approached, but not more likely to sell than females, while the opposite held for those in the wealthiest parental class relative to lower socioeconomic statuses. Given that misuse and prescriptions of sedatives and stimulants were associated with prescription drug market involvement, painkiller misusers may be less likely to sell their drugs given the associated physiological dependence. PMID:25175544

  4. Correlates of prescription drug market involvement among young adults.

    PubMed

    Vuolo, Mike; Kelly, Brian C; Wells, Brooke E; Parsons, Jeffrey T

    2014-10-01

    While a significant minority of prescription drug misusers report purchasing prescription drugs, little is known about prescription drug selling. We build upon past research on illicit drug markets, which increasingly recognizes networks and nightlife as influential, by examining prescription drug market involvement. We use data from 404 young adult prescription drug misusers sampled from nightlife scenes. Using logistic regression, we examine recent selling of and being approached to sell prescription drugs, predicted using demographics, misuse, prescription access, and nightlife scene involvement. Those from the wealthiest parental class and heterosexuals had higher odds (OR=6.8) of selling. Higher sedative and stimulant misuse (OR=1.03), having a stimulant prescription (OR=4.14), and having sold other illegal drugs (OR=6.73) increased the odds of selling. College bar scene involvement increased the odds of selling (OR=2.73) and being approached to sell (OR=2.09). Males (OR=1.93), stimulant users (OR=1.03), and sedative prescription holders (OR=2.11) had higher odds of being approached. College bar scene involvement was the only site associated with selling and being approached; such participation may provide a network for prescription drug markets. There were also differences between actual selling and being approached. Males were more likely to be approached, but not more likely to sell than females, while the opposite held for those in the wealthiest parental class relative to lower socioeconomic statuses. Given that misuse and prescriptions of sedatives and stimulants were associated with prescription drug market involvement, painkiller misusers may be less likely to sell their drugs given the associated physiological dependence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Disruptions in AUX1-dependent auxin influx alter hypocotyl phototropism in Arabidopsis.

    PubMed

    Stone, Bethany B; Stowe-Evans, Emily L; Harper, Reneé M; Celaya, R Brandon; Ljung, Karin; Sandberg, Göran; Liscum, Emmanuel

    2008-01-01

    Phototropism represents a differential growth response by which plant organs can respond adaptively to changes in the direction of incident light to optimize leaf/stem positioning for photosynthetic light capture and root growth orientation for water/nutrient acquisition. Studies over the past few years have identified a number of components in the signaling pathway(s) leading to development of phototropic curvatures in hypocotyls. These include the phototropin photoreceptors (phot1 and phot2) that perceive directional blue-light (BL) cues and then stimulate signaling, leading to relocalization of the plant hormone auxin, as well as the auxin response factor NPH4/ARF7 that responds to changes in local auxin concentrations to directly mediate expression of genes likely encoding proteins necessary for development of phototropic curvatures. While null mutations in NPH4/ARF7 condition an aphototropic response to unidirectional BL, seedlings carrying the same mutations recover BL-dependent phototropic responsiveness if co-irradiated with red light (RL) or pre-treated with either ethylene. In the present study, we identify second-site enhancer mutations in the nph4 background that abrogate these recovery responses. One of these mutations--map1 (modifier of arf7 phenotypes 1)--was found to represent a missense allele of AUX1--a gene encoding a high-affinity auxin influx carrier previously associated with a number of root responses. Pharmacological studies and analyses of additional aux1 mutants confirmed that AUX1 functions as a modulator of hypocotyl phototropism. Moreover, we have found that the strength of dependence of hypocotyl phototropism on AUX1-mediated auxin influx is directly related to the auxin responsiveness of the seedling in question.

  6. Decommissioning of the nuclear licensed facilities at the Fontenay aux Roses CEA center

    SciTech Connect

    Jeanjacques, Michel; Piketty, Laurence; Letuhaire, Nathalie; Mandard, Lionel; Meden, Igor; Estivie, David; Boissonneau, Jean Francois; Fouquereau, Alain; Pichereau, Eric; Binet, Cedric

    2007-07-01

    Available in abstract form only. Full text of publication follows: The French Atomic Energy Commission (CEA) center at Fontenay aux Roses (CEN-FAR) is the Commission's oldest center is located in the southern suburbs of Paris. It was opened on 26 March 1946 to host the first French nuclear reactor ZOE that went critical on 12 December 1946. The first laboratories were installed in existing buildings on the site. (authors)

  7. [Medicinal products for human use in veterinary prescription].

    PubMed

    Kolář, Jozef; Vargová, Lucia; Ambrus, Tünde

    2015-09-01

    The paper deals with the problem of prescription and use of the medicinal products for human use in veterinary medicine. Using partial model analysis describes volume and structure of the prescription of medicinal products for human use in the veterinary practice in the years 2007-2011. Prescriptions included to the study were dispensed in a community pharmacy located in a county town in the Slovak Republic. Data were obtained from the basic collection of 845 veterinary prescriptions that included 1178 prescribed items in a total of 2954 packages.

  8. Patterns of prescription drug misuse among young injection drug users.

    PubMed

    Lankenau, Stephen E; Teti, Michelle; Silva, Karol; Bloom, Jennifer Jackson; Harocopos, Alex; Treese, Meghan

    2012-12-01

    Misuse of prescription drugs and injection drug use has increased among young adults in the USA. Despite these upward trends, few studies have examined prescription drug misuse among young injection drug users (IDUs). A qualitative study was undertaken to describe current patterns of prescription drug misuse among young IDUs. Young IDUs aged 16-25 years who had misused a prescription drug, e.g., opioids, tranquilizers, or stimulants, at least three times in the past 3 months were recruited in 2008 and 2009 in Los Angeles (n = 25) and New York (n = 25). Informed by an ethno-epidemiological approach, descriptive data from a semi-structured interview guide were analyzed both quantitatively and qualitatively. Most IDUs sampled were both homeless and transient. Heroin, prescription opioids, and prescription tranquilizers were frequently misused in the past 30 days. Qualitative results indicated that young IDUs used prescription opioids and tranquilizers: as substitutes for heroin when it was unavailable; to boost a heroin high; to self-medicate for health conditions, including untreated pain and heroin withdrawal; to curb heroin use; and to reduce risks associated with injecting heroin. Polydrug use involving heroin and prescription drugs resulted in an overdose in multiple cases. Findings point to contrasting availability of heroin in North American cities while indicating broad availability of prescription opioids among street-based drug users. The results highlight a variety of unmet service needs among this sample of young IDUs, such as overdose prevention, drug treatment programs, primary care clinics, and mental health services.

  9. Analysis of subcellular localization of auxin carriers PIN, AUX/LAX and PGP in Sorghum bicolor

    PubMed Central

    Wang, SuiKang; Shen, ChenJia; Zhang, SaiNa; Xu, YanXia; Jiang, DeAn; Qi, YanHua

    2011-01-01

    Auxin transport at least correlates to the three gene families: efflux carriers PIN-formed (PIN), p-glycoprotein (PGP), and influx carrier auxin resistant 1/like aux1(AUX/LAX) in Arabidopsis thaliana. In monocotyledon Sorghum bicolor, the biological function of these genes retains unclear. Our previous study reported that the member analysis, organ-specific expression and expression profiles of the auxin transporter PIN, PGP and AUX/LAX gene families in Sorghum bicolor under IAA, brassinosteroid, polar auxin transport inhibitors and abiotic stresses. Here we further supply the prediction of subcellular localization of SbPIN, SbLAX and SbPGP proteins and discuss the potential relationship between the subcellular localization and stress response. The predicted results showed that the most of SbPIN, SbLAX and SbPGP proteins are localized to the plasma membrane, except few localized to vacuolar membrane and endoplasmic reticulum. This data set provides novel information for investigation of auxin transporters in Sorghum bicolor. PMID:22112459

  10. POPI (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions): development of a tool to identify inappropriate prescribing.

    PubMed

    Prot-Labarthe, Sonia; Weil, Thomas; Angoulvant, François; Boulkedid, Rym; Alberti, Corinne; Bourdon, Olivier

    2014-01-01

    Rational prescribing for children is an issue for all countries and has been inadequately studied. Inappropriate prescriptions, including drug omissions, are one of the main causes of medication errors in this population. Our aim is to develop a screening tool to identify omissions and inappropriate prescriptions in pediatrics based on French and international guidelines. A selection of diseases was included in the tool using data from social security and hospital statistics. A literature review was done to obtain criteria which could be included in the tool called POPI. A 2-round-Delphi consensus technique was used to establish the content validity of POPI; panelists were asked to rate their level of agreement with each proposition on a 9-point Likert scale and add suggestions if necessary. 108 explicit criteria (80 inappropriate prescriptions and 28 omissions) were obtained and submitted to a 16-member expert panel (8 pharmacists, 8 pediatricians hospital-based -50%- or working in community -50%-). Criteria were categorized according to the main physiological systems (gastroenterology, respiratory infections, pain, neurology, dermatology and miscellaneous). Each criterion was accompanied by a concise explanation as to why the practice is potentially inappropriate in pediatrics (including references). Two round of Delphi process were completed via an online questionnaire. 104 out of the 108 criteria submitted to experts were selected after 2 Delphi rounds (79 inappropriate prescriptions and 25 omissions). POPI is the first screening-tool develop to detect inappropriate prescriptions and omissions in pediatrics based on explicit criteria. Inter-user reliability study is necessary before using the tool, and prospective study to assess the effectiveness of POPI is also necessary.

  11. POPI (Pediatrics: Omission of Prescriptions and Inappropriate Prescriptions): Development of a Tool to Identify Inappropriate Prescribing

    PubMed Central

    Prot-Labarthe, Sonia; Weil, Thomas; Angoulvant, François; Boulkedid, Rym; Alberti, Corinne; Bourdon, Olivier

    2014-01-01

    Introduction Rational prescribing for children is an issue for all countries and has been inadequately studied. Inappropriate prescriptions, including drug omissions, are one of the main causes of medication errors in this population. Our aim is to develop a screening tool to identify omissions and inappropriate prescriptions in pediatrics based on French and international guidelines. Methods A selection of diseases was included in the tool using data from social security and hospital statistics. A literature review was done to obtain criteria which could be included in the tool called POPI. A 2-round-Delphi consensus technique was used to establish the content validity of POPI; panelists were asked to rate their level of agreement with each proposition on a 9-point Likert scale and add suggestions if necessary. Results 108 explicit criteria (80 inappropriate prescriptions and 28 omissions) were obtained and submitted to a 16-member expert panel (8 pharmacists, 8 pediatricians hospital-based −50%- or working in community −50%-). Criteria were categorized according to the main physiological systems (gastroenterology, respiratory infections, pain, neurology, dermatology and miscellaneous). Each criterion was accompanied by a concise explanation as to why the practice is potentially inappropriate in pediatrics (including references). Two round of Delphi process were completed via an online questionnaire. 104 out of the 108 criteria submitted to experts were selected after 2 Delphi rounds (79 inappropriate prescriptions and 25 omissions). Discussion Conclusion POPI is the first screening-tool develop to detect inappropriate prescriptions and omissions in pediatrics based on explicit criteria. Inter-user reliability study is necessary before using the tool, and prospective study to assess the effectiveness of POPI is also necessary. PMID:24978045

  12. Prescriptive scientific narratives for communicating usable science.

    PubMed

    Downs, Julie S

    2014-09-16

    In this paper I describe how a narrative approach to science communication may help audiences to more fully understand how science is relevant to their own lives and behaviors. The use of prescriptive scientific narrative can help to overcome challenges specific to scientific concepts, especially the need to reconsider long-held beliefs in the face of new empirical findings. Narrative can captivate the audience, driving anticipation for plot resolution, thus becoming a self-motivating vehicle for information delivery. This quality gives narrative considerable power to explain complex phenomena and causal processes, and to create and reinforce memory traces for better recall and application over time. Because of the inherent properties of narrative communication, their creators have a special responsibility to ensure even-handedness in selection and presentation of the scientific evidence. The recent transformation in communication and information technology has brought about new platforms for delivering content, particularly through interactivity, which can use structured self-tailoring to help individuals most efficiently get exactly the content that they need. As with all educational efforts, prescriptive scientific narratives must be evaluated systematically to determine whether they have the desired effects in improving understanding and changing behavior.

  13. Quantitative Information on Oncology Prescription Drug Websites.

    PubMed

    Sullivan, Helen W; Aikin, Kathryn J; Squiers, Linda B

    2016-09-02

    Our objective was to determine whether and how quantitative information about drug benefits and risks is presented to consumers and healthcare professionals on cancer-related prescription drug websites. We analyzed the content of 65 active cancer-related prescription drug websites. We assessed the inclusion and presentation of quantitative information for two audiences (consumers and healthcare professionals) and two types of information (drug benefits and risks). Websites were equally likely to present quantitative information for benefits (96.9 %) and risks (95.4 %). However, the amount of the information differed significantly: Both consumer-directed and healthcare-professional-directed webpages were more likely to have quantitative information for every benefit (consumer 38.5 %; healthcare professional 86.1 %) compared with every risk (consumer 3.1 %; healthcare professional 6.2 %). The numeric and graphic presentations also differed by audience and information type. Consumers have access to quantitative information about oncology drugs and, in particular, about the benefits of these drugs. Research has shown that using quantitative information to communicate treatment benefits and risks can increase patients' and physicians' understanding and can aid in treatment decision-making, although some numeric and graphic formats are more useful than others.

  14. Summary and recommendations for initial exercise prescription

    NASA Technical Reports Server (NTRS)

    Stewart, Donald F.; Harris, Bernard A., Jr.

    1989-01-01

    The recommendations summarized herein constitute a basis on which an initial exercise prescription can be formulated. It is noteworthy that any exercise program designed currently would be an approximation. Examination of the existing space-flight data reveals a scarcity of in-flight data on which to rigorously design an exercise program. The relevant experience within the U.S. space program (with regard to long-duration space flight) is limited to the Skylab Program. Lessons learned from Skylab are relevant to the design of a Space Station exercise program, especially with regard to the total length of exercise time required, cardiovascular (CV) deconditioning/reconditioning, and bone loss. Certain observations of the U.S.S.R. exercise activities can also contribute to the formulation of an exercise prescription of Space Station. Reportedly, the U.S.S.R. uses both a bicycle ergometer and a treadmill device on long-duration missions with some degree of success. Using the third crew of Salyut 6, which was a 175-day stay, as a representative mission, the typical time dedicated to exercise varies from 2 to 3 hours per day. In addition, the cosmonauts wear an elasticized suit, called a penquin suit, for time periods ranging from 12 to 16 hours per day. This device provides a load across the axial skeleton against which the wearer must exert himself. Despite these extensive countermeasures, the effects of adaptation are not totally prevented.

  15. Pharmaceutical promotion and GP prescription behaviour.

    PubMed

    Windmeijer, Frank; de Laat, Eric; Douven, Rudy; Mot, Esther

    2006-01-01

    The aim of this paper is to empirically analyse the responses by general practitioners to promotional activities for ethical drugs by pharmaceutical companies. Promotion can be beneficial as a means of providing information, but it can also be harmful in the sense that it lowers price sensitivity of doctors and it merely is a means of maintaining market share, even when cheaper, therapeutically equivalent drugs are available. A model is estimated that includes interactions of promotion expenditures and prices and that explicitly exploits the panel structure of the data, allowing for drug specific effects and dynamic adjustments, or habit persistence. The data used are aggregate monthly GP prescriptions per drug together with monthly outlays on drug promotion for the period 1994-1999 for 11 therapeutic markets, covering more than half of the total prescription drug market in the Netherlands. Identification of price effects is aided by the introduction of the Pharmaceutical Prices Act, which established that Dutch drugs prices became a weighted average of the prices in surrounding countries after June 1996. We conclude that GP drug price sensitivity is small, but adversely affected by promotion. Ltd. Copyright (c) 2005 John Wiley & Sons, Ltd.

  16. Exercise prescription--North American experience.

    PubMed Central

    Shephard, R. J.

    1978-01-01

    The principles of exercise prescription are reviewed with respect to North American experience. The required regimen must be safe, therapeutically effective, and ensure a high rate of compliance. Precautions to increase the safety of exercise are discussed. Cardiac emergencies are sufficiently rare events (less than 1 in 200,000 hours even in post-coronary classes) that the need for immediate medical supervision of a well-designed programme can be questioned. The prime determinant of the response to training is the intensity of effort relative to the individual's initial fitness. Post-coronary patients often have a great potential for training due to their previous inactivity, but this will not be realised if the prescribed exercise is of insufficient intensity. Exercise programmes are plagued by a high 'drop-out' rate; 50% of normal middle-aged volunteers are lost in 6 months, and even with post-coronary programmes losses can be 60--70% over 4 years. Simple suggestions are made for improving compliance with the required exercise prescription. PMID:444812

  17. Prescriptive scientific narratives for communicating usable science

    PubMed Central

    Downs, Julie S.

    2014-01-01

    In this paper I describe how a narrative approach to science communication may help audiences to more fully understand how science is relevant to their own lives and behaviors. The use of prescriptive scientific narrative can help to overcome challenges specific to scientific concepts, especially the need to reconsider long-held beliefs in the face of new empirical findings. Narrative can captivate the audience, driving anticipation for plot resolution, thus becoming a self-motivating vehicle for information delivery. This quality gives narrative considerable power to explain complex phenomena and causal processes, and to create and reinforce memory traces for better recall and application over time. Because of the inherent properties of narrative communication, their creators have a special responsibility to ensure even-handedness in selection and presentation of the scientific evidence. The recent transformation in communication and information technology has brought about new platforms for delivering content, particularly through interactivity, which can use structured self-tailoring to help individuals most efficiently get exactly the content that they need. As with all educational efforts, prescriptive scientific narratives must be evaluated systematically to determine whether they have the desired effects in improving understanding and changing behavior. PMID:25225369

  18. [Clinical practice guideline. Drug prescription in elderly].

    PubMed

    Peralta-Pedrero, María Luisa; Valdivia-Ibarra, Francisco Javier; Hernández-Manzano, Mario; Medina-Beltrán, Gustavo Rodrigo; Cordero-Guillén, Miguel Angel; Baca-Zúñiga, José; Cruz-Avelar, Agles; Aguilar-Salas, Ismael; Avalos-Mejía, Annia Marisol

    2013-01-01

    The process of prescribing a medication is complex and includes: deciding whether it is indicated, choosing the best option, determining the dose and the appropriate management scheme to the physiological condition of the patient, and monitoring effectiveness and toxicity. We have to inform patients about the expected side effects and indications for requesting a consultation. Specific clinical questions were designed based on the acronym PICOST. The search was made in the specific websites of clinical practice guidelines, was limited to the population of older adults, in English or Spanish. We used 10 related clinical practice guidelines, eight systematic reviews and five meta-analyses. Finally, we made a search of original articles or clinical reviews for specific topics. The development and validation of clinical practice guidelines for "rational drug prescriptions in the elderly" is intended to promote an improvement in the quality of prescription through the prevention and detection of inappropriate prescribing in the elderly and, as a result of this, a decrease in the adverse events by drugs, deterioration of health of patients and expenditure of resources.

  19. How prescriptive norms influence causal inferences.

    PubMed

    Samland, Jana; Waldmann, Michael R

    2016-11-01

    Recent experimental findings suggest that prescriptive norms influence causal inferences. The cognitive mechanism underlying this finding is still under debate. We compare three competing theories: The culpable control model of blame argues that reasoners tend to exaggerate the causal influence of norm-violating agents, which should lead to relatively higher causal strength estimates for these agents. By contrast, the counterfactual reasoning account of causal selection assumes that norms do not alter the representation of the causal model, but rather later causal selection stages. According to this view, reasoners tend to preferentially consider counterfactual states of abnormal rather than normal factors, which leads to the choice of the abnormal factor in a causal selection task. A third view, the accountability hypothesis, claims that the effects of prescriptive norms are generated by the ambiguity of the causal test question. Asking whether an agent is a cause can be understood as a request to assess her causal contribution but also her moral accountability. According to this theory norm effects on causal selection are mediated by accountability judgments that are not only sensitive to the abnormality of behavior but also to mitigating factors, such as intentionality and knowledge of norms. Five experiments are presented that favor the accountability account over the two alternative theories.

  20. [Off-label prescription: practice and problems].

    PubMed

    Carneiro, António Vaz; Costa, João

    2013-09-01

    Approval of a drug for clinical use requires production of data on efficacy and safety through submission of results from randomized controlled trials (RCTs), in which the new molecule is usually compared with placebo (or an active comparator) for a set of outcomes that will serve as the basis for the drug's indications. These indications are crucial, because drugs are approved on the basis of their net clinical benefit for specific and well-defined diseases and--importantly--only for these. Once the drug is available for use in tens or hundreds of thousands of patients, physicians may realize that some medications can be effective in diseases for which they were not approved, i.e., no studies have been presented to the regulatory authorities, and therefore they are not formally approved for those indications. Convinced of the benefits for their patients, some physicians prescribe them for unapproved indications--off-label prescription. In this paper we discuss the prevalence of off-label prescription, and its advantages and problems. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  1. Variability in home mechanical ventilation prescription.

    PubMed

    Escarrabill, Joan; Tebé, Cristian; Espallargues, Mireia; Torrente, Elena; Tresserras, Ricard; Argimón, J

    2015-10-01

    Few studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV). The aim of this study was to characterize the prevalence of HMV and variability in prescriptions from administrative data. Prescribing rates of HMV in the 37 healthcare sectors of the Catalan Health Service were compared from billing data from 2008 to 2011. Crude accumulated activity rates (per 100,000 population) were calculated using systematic component of variation (SCV) and empirical Bayes (EB) methods. Standardized activity ratios (SAR) were described using a map of healthcare sectors. A crude rate of 23 HMV prescriptions per 100,000 population was observed. Rates increase with age and have increased by 39%. Statistics measuring variation not due to chance show a high variation in women (CSV=0.20 and EB=0.30) and in men (CSV=0.21 and EB=0.40), and were constant over time. In a multilevel Poisson model, hospitals with a chest unit were associated with a greater number of cases (beta=0.68, P<.0001). High variability in prescribing HMV can be explained, in part, by the attitude of professionals towards treatment and accessibility to specialist centers with a chest unit. Analysis of administrative data and variability mapping help identify unexplained variations and, in the absence of systematic records, are a feasible way of tracking treatment. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  2. Prescription Writing Trends of Antihistamines at the University Health Centre

    PubMed Central

    Kumar, Anil; Beenta

    2009-01-01

    The aim of the present study was to establish antihistamines drug prescribing pattern in order to improve the rational prescribing of antihistamines by physicians at Panjab University Health Centre. The study was performed in between the months of November 2005 to April 2006. Five hundred out patients were monitored and data was collected on WHO-based prescription-auditing performa. Demographic analysis of this prospective study revealed that out of the 500 patients, 293 (58.6 %) were male and 207 (41.4 %) were female and maximum patients were in the age group of 21-40 (34.8 %). Chlorpheniramine maleate (235 prescriptions) was the highest prescribed among antihistamine prescriptions (36.89 %) followed by diphenhydramine hydrochloride (186 prescriptions, 29.19%), cetirizine (175 prescriptions, 27.47 %) and promethazine (41 prescriptions, 6.4%). In comparison to generic drugs (169 prescriptions, 26.54%), branded were more prescribed at PUHC. Majority of antihistamines were in form of tablets (414 prescriptions, 64.99%) followed by liquid formulations (195 prescriptions, 30.61%) and injections (28 prescriptions, 4.40%). The average cost of different antihistamine drugs prescribed was as follows: diphenhydramine hydrochloride Rs. 34.74 followed by promethzine Rs. 22.46, chlorpheniramine maleate Rs. 15.30, and cetirizine Rs. 13.50. Average numbers of drugs prescribed per prescription were 1.27. The average consulting and dispensing time was 4.82 and 3.56 min, respectively. Out of the 500 university patients, 258 (51.6%) had the knowledge regarding the medication prescribed and 242 (48.4%) were unaware of the medication prescribed. PMID:20490299

  3. Prescription writing trends of antihistamines at the university health centre.

    PubMed

    Kumar, Anil; Beenta

    2009-05-01

    The aim of the present study was to establish antihistamines drug prescribing pattern in order to improve the rational prescribing of antihistamines by physicians at Panjab University Health Centre. The study was performed in between the months of November 2005 to April 2006. Five hundred out patients were monitored and data was collected on WHO-based prescription-auditing performa. Demographic analysis of this prospective study revealed that out of the 500 patients, 293 (58.6 %) were male and 207 (41.4 %) were female and maximum patients were in the age group of 21-40 (34.8 %). Chlorpheniramine maleate (235 prescriptions) was the highest prescribed among antihistamine prescriptions (36.89 %) followed by diphenhydramine hydrochloride (186 prescriptions, 29.19%), cetirizine (175 prescriptions, 27.47 %) and promethazine (41 prescriptions, 6.4%). In comparison to generic drugs (169 prescriptions, 26.54%), branded were more prescribed at PUHC. Majority of antihistamines were in form of tablets (414 prescriptions, 64.99%) followed by liquid formulations (195 prescriptions, 30.61%) and injections (28 prescriptions, 4.40%). The average cost of different antihistamine drugs prescribed was as follows: diphenhydramine hydrochloride Rs. 34.74 followed by promethzine Rs. 22.46, chlorpheniramine maleate Rs. 15.30, and cetirizine Rs. 13.50. Average numbers of drugs prescribed per prescription were 1.27. The average consulting and dispensing time was 4.82 and 3.56 min, respectively. Out of the 500 university patients, 258 (51.6%) had the knowledge regarding the medication prescribed and 242 (48.4%) were unaware of the medication prescribed.

  4. [Physician prescription behaviour using the example of general practitioners and their prescriptions of pharmaceuticals in Austria].

    PubMed

    Müller, M; Meyer, H; Stummer, H

    2011-07-01

    In extramural setting, general practitioners serve as gatekeepers and therefore control the demand for medical treatment and pharmaceuticals. As a result prescription habits are of major interest. The aim of the present study is to identify sample characteristics in the prescription behaviour of the general practitioners that allow one to differentiate between the individual and the basic population. The prescription behaviour of 4 231 general practitioners was operationalised by means of the two variables "quantity" and "price". Outliers in those categories, that indicate a doctor prescribing too many or too expensive drugs, were identified using Chebyshev's inequality. We found a statistically significant linear relationship between the individual characteristics of the medical doctors and their prescription behaviour (0.54≤ r ≤0.89) as well as between the variables "quantity" and "price" (r=0.86). Particularly notable seems to be the correlation between the number of the consultations and the quantity of the prescribed drugs. The average prescription amounts to approximately 1.8 pharmaceuticals per consultation. The quantity of drugs prescribed correlates with the demand for the physician's service. Only a few general practitioners deviate from this coherence. The tendency to prescribe disproportionately expensive drugs (average costs amount to € 18.4 per drug) especially applies to those general practitioners who, in addition to their occupation as a physician, are allowed to dispense the pharmaceuticals directly to the patient within their privately owned pharmacies ("Hausapotheke"). In addition to this attribute, the variables "number of patients" and "number of consultations" intensify the effect. The risk to be identified as an outlier is 7 times higher within the group of general practitioners who own a "Hausapotheke" and account for an above average number of consultations as within the group that does not incorporate those characteristics. The

  5. 21 CFR 1306.22 - Refilling of prescriptions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... refill history for Schedule III or IV controlled substance prescription orders (those authorized for refill during the past six months.) This refill history shall include, but is not limited to, the name of... into the computer each time a pharmacist refills an original prescription order for a Schedule III or...

  6. 75 FR 16235 - Electronic Prescriptions for Controlled Substances

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ...The Drug Enforcement Administration (DEA) is revising its regulations to provide practitioners with the option of writing prescriptions for controlled substances electronically. The regulations will also permit pharmacies to receive, dispense, and archive these electronic prescriptions. These regulations are in addition to, not a replacement of, the existing rules. The regulations provide......

  7. Non-Medical Prescription Drug Use among University Students

    ERIC Educational Resources Information Center

    Vidourek, Rebecca A.; King, Keith A.; Knopf, Ellen E.

    2010-01-01

    Background: Non-medical prescription drug use is an increasing problem among university students. Purpose: The present study investigated university students' involvement in non-medical prescription drug (NMPD) use and associations between use and other risky behaviors. Methods: A sample of 363 university students completed a four page survey…

  8. Prescription Drug Abuse Information in D.A.R.E.

    ERIC Educational Resources Information Center

    Morris, Melissa C.; Cline, Rebecca J. Welch; Weiler, Robert M.; Broadway, S. Camille

    2006-01-01

    This investigation was designed to examine prescription drug-related content and learning objectives in Drug Abuse Resistance Education (D.A.R.E.) for upper elementary and middle schools. Specific prescription-drug topics and context associated with content and objectives were coded. The coding system for topics included 126 topics organized…

  9. 21 CFR 1311.120 - Electronic prescription application requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... automated and need not require human intervention to be conducted. (26) The electronic prescription... control entries. (5) The electronic prescription application must accept two-factor authentication that...-factor authentication, as specified in § 1311.140(a)(4), which will constitute the signing of the...

  10. 21 CFR 1311.120 - Electronic prescription application requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... automated and need not require human intervention to be conducted. (26) The electronic prescription... control entries. (5) The electronic prescription application must accept two-factor authentication that...-factor authentication, as specified in § 1311.140(a)(4), which will constitute the signing of the...

  11. 77 FR 20637 - Request for Information on Prescription Medication Adherence

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-05

    ... HUMAN SERVICES Request for Information on Prescription Medication Adherence AGENCY: Department of Health... potential solutions associated with the public health problem of prescription medication non-adherence in..., health care providers, and industry and private organizations in efforts to improve medication...

  12. Preventing Prescription Drug Abuse in Adolescence: A Collaborative Approach

    ERIC Educational Resources Information Center

    Jones, Beth A.; Fullwood, Harry; Hawthorn, Melissa

    2012-01-01

    With the growing awareness of adolescent prescription drug abuse, communities and schools are beginning to explore prevention and intervention strategies which are appropriate for their youth. This article provides a framework for developing a collaborative approach to prescription drug abuse prevention--called the Prevention Awareness Team--that…

  13. Preventing Prescription Drug Abuse in Adolescence: A Collaborative Approach

    ERIC Educational Resources Information Center

    Jones, Beth A.; Fullwood, Harry; Hawthorn, Melissa

    2012-01-01

    With the growing awareness of adolescent prescription drug abuse, communities and schools are beginning to explore prevention and intervention strategies which are appropriate for their youth. This article provides a framework for developing a collaborative approach to prescription drug abuse prevention--called the Prevention Awareness Team--that…

  14. Prescription Privileges, Psychopharmacology and School Psychology: An Overview.

    ERIC Educational Resources Information Center

    Carlson, Cindy; Kubiszyn, Tom

    1994-01-01

    Focuses on psychopharmacology and prescription privileges for psychologists. Summarizes nine major findings from Task Force on Psychopharmacology in the Schools, created to review literature on prescription privileges for psychologists; identify specific issues attendant to use of psychoactive medications with children; and clarify implications…

  15. 16 CFR 315.6 - Expiration of contact lens prescriptions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Expiration of contact lens prescriptions. 315.6 Section 315.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.6 Expiration of contact lens prescriptions. (a) In general. A contact...

  16. 16 CFR 315.6 - Expiration of contact lens prescriptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Expiration of contact lens prescriptions. 315.6 Section 315.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.6 Expiration of contact lens prescriptions. (a) In general. A contact...

  17. 16 CFR 315.6 - Expiration of contact lens prescriptions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Expiration of contact lens prescriptions. 315.6 Section 315.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.6 Expiration of contact lens prescriptions. (a) In general. A contact...

  18. 16 CFR 315.6 - Expiration of contact lens prescriptions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Expiration of contact lens prescriptions. 315.6 Section 315.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.6 Expiration of contact lens prescriptions. (a) In general. A contact...

  19. 16 CFR 315.6 - Expiration of contact lens prescriptions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Expiration of contact lens prescriptions. 315.6 Section 315.6 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CONTACT LENS RULE § 315.6 Expiration of contact lens prescriptions. (a) In general. A contact...

  20. 21 CFR 1306.05 - Manner of issuance of prescriptions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... treatment” must include the identification number issued by the Administrator under § 1301.28(d) of this... shall note on the face of the prescription the medical need of the patient for the prescription. (d) A... “Public Health Service”) and his service identification number, in lieu of the registration number of the...

  1. 21 CFR 1306.13 - Partial filling of prescriptions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of the quantity supplied on the face of the written prescription, written record of the emergency... authorized to be dispensed, and the identification of the dispensing pharmacist. The total quantity of... (display or printout) of the original prescription number, date of issue, identification of prescribing...

  2. Prescription Opioid Abuse and Dependence: Assessment Strategies for Counselors

    ERIC Educational Resources Information Center

    Weigel, Daniel J.; Donovan, Kimberly A.; Krug, Kevin S.; Dixon, Wayne A.

    2007-01-01

    The authors review the article "Prescription Drug Use and Abuse: Risk Factors, Red Flags, and Prevention Strategies" (J. H. Isaacson, J. A. Hopper, D. P. Alford, & T. Parran, 2005), which provides an overview of the recent increase in prescription opioid abuse and dependence from the physician's perspective. In the present article, the authors…

  3. Is it legitimate? Strategies for assessing questionable prescriptions.

    PubMed

    Seeger, Vickie B; Vivian, Jesse C

    2002-01-01

    Pharmacists are responsible to screen prescriptions for legitimacy. Pharmacists must be alert for forged or altered prescriptions. Pharmacists must strike a careful balance between diversion control and the medical needs of legitimate patients. Although regulatory scrutiny remains a concern for some practitioners, fear of investigation is not a valid reason to deny patients needed medication.

  4. 75 FR 12555 - Prescription Drug User Fee Act; Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-16

    ... HUMAN SERVICES Food and Drug Administration Prescription Drug User Fee Act; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public meeting. SUMMARY: The Food and Drug... FDA to continue collecting user fees for the prescription drug program. The Federal Food, Drug, and...

  5. Prescription Drug Abuse in Texas: Mortality and Its Economic Consequences.

    ERIC Educational Resources Information Center

    Harlow, Kirk; Swint, J. Michael

    1981-01-01

    Prescription drug overdose mortality is documented and its economic consequences estimated for Texas in 1978. Drug-related deaths (N=117 out of 397) were due to the use of barbiturates, tranquilizers, and anti-depressants; 85 to mixing drugs. The economic cost of mortality exceeded $43 million, 32 percent of prescription drug overdose. (Author)

  6. 45 CFR 156.122 - Prescription drug benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Prescription drug benefits. 156.122 Section 156... Essential Health Benefits Package § 156.122 Prescription drug benefits. (a) A health plan does not provide... at least the greater of: (i) One drug in every United States Pharmacopeia (USP) category and...

  7. 77 FR 48111 - Branded Prescription Drug Fee; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 RIN 1545-BJ39 Branded Prescription Drug Fee; Correction AGENCY... prescription drug fee imposed by the Affordable Care Act. FOR FURTHER INFORMATION CONTACT: Concerning...

  8. Nonmedical Prescription Drug Use among Midwestern Rural Adolescents

    ERIC Educational Resources Information Center

    Park, Nicholas K.; Melander, Lisa; Sanchez, Shanell

    2016-01-01

    Prescription drug misuse has been an increasing problem in the United States, yet few studies have examined the protective factors that reduce risk of prescription drug abuse among rural adolescents. Using social control theory as a theoretical framework, we test whether parent, school, and community attachment reduce the likelihood of lifetime…

  9. 45 CFR 156.122 - Prescription drug benefits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Prescription drug benefits. 156.122 Section 156... Essential Health Benefits Package § 156.122 Prescription drug benefits. (a) A health plan does not provide... at least the greater of: (i) One drug in every United States Pharmacopeia (USP) category and...

  10. 77 FR 46653 - Branded Prescription Drug Fee; Hearing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 RIN 1545-BJ39 Branded Prescription Drug Fee; Hearing AGENCY... proposed regulations relating to the branded prescription drug fee imposed by the Affordable Care...

  11. [Failure mode and effects analysis on computerized drug prescriptions].

    PubMed

    Paredes-Atenciano, J A; Roldán-Aviña, J P; González-García, Mercedes; Blanco-Sánchez, M C; Pinto-Melero, M A; Pérez-Ramírez, C; Calvo Rubio-Burgos, Miguel; Osuna-Navarro, F J; Jurado-Carmona, A M

    2015-01-01

    To identify and analyze errors in drug prescriptions of patients treated in a "high resolution" hospital by applying a Failure mode and effects analysis (FMEA).Material and methods A multidisciplinary group of medical specialties and nursing analyzed medical records where drug prescriptions were held in free text format. An FMEA was developed in which the risk priority index (RPI) was obtained from a cross-sectional observational study using an audit of the medical records, carried out in 2 phases: 1) Pre-intervention testing, and (2) evaluation of improvement actions after the first analysis. An audit sample size of 679 medical records from a total of 2,096 patients was calculated using stratified sampling and random selection of clinical events. Prescription errors decreased by 22.2% in the second phase. FMEA showed a greater RPI in "unspecified route of administration" and "dosage unspecified", with no significant decreases observed in the second phase, although it did detect, "incorrect dosing time", "contraindication due to drug allergy", "wrong patient" or "duplicate prescription", which resulted in the improvement of prescriptions. Drug prescription errors have been identified and analyzed by FMEA methodology, improving the clinical safety of these prescriptions. This tool allows updates of electronic prescribing to be monitored. To avoid such errors would require the mandatory completion of all sections of a prescription. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  12. Relationship between e-prescriptions and community pharmacy workflow.

    PubMed

    Odukoya, Olufunmilola K; Chui, Michelle A

    2012-01-01

    To understand how community pharmacists use electronic prescribing (e-prescribing) technology and to describe the workflow challenges pharmacy personnel encounter as a result of using e-prescribing technology. Cross-sectional qualitative study. Seven community pharmacies in Wisconsin from December 2010 to March 2011. 16 pharmacists and 14 pharmacy technicians (in three chain and four independent pharmacies). Think-aloud protocols and pharmacy group interviews. Pharmacy staff descriptions of their use of e-prescribing technology and challenges encountered in their daily workflow related to this technology. Two contributing factors were perceived to influence e-prescribing workflow: issues stemming from prescribing or transmitting software and issues from within the pharmacy. Pharmacies experienced both delayed and inaccurate e-prescriptions from physician offices. An overwhelming number of e-prescriptions with inaccurate or unclear information resulted in serious time delays for patients as pharmacists contacted physicians to clarify wrong information. In addition, lack of formal training and the disconnect between pharmacy procedures for verifying prescription accuracy and presentation of e-prescription information on the computer screen influenced the speed of processing an e-prescription. E-prescriptions processing can hinder pharmacy workflow. As the number of e-prescriptions transmitted to pharmacies increases because of legislative mandates, it is essential that the technology supporting e-prescriptions (both on the prescriber and pharmacy operating systems) be redesigned to facilitate pharmacy workflow processes and to prevent unintended increase in medication errors, user frustration, and stress.

  13. Controversy in Purchasing Prescription Drugs Online in China.

    PubMed

    Yuan, Peng; Qi, Lin; Wang, Long

    2016-08-01

    China's government is considering legalization of online prescription drugs to increase the pharmaceutical market and enhance access to necessary medicines. However, challenges such as a shortage of licensed pharmacists and drug quality issues have raised concerns and delayed consensus on the proposal. China's government must address the most pressing issues so it can render a decision on online prescription sales.

  14. Using Prescription Drug Monitoring Programs to Address Drug Abuse.

    PubMed

    Hansen, Melissa

    2015-03-01

    (1) Forty-nine states have established prescription drug monitoring programs (PDMPs) to address misuse and abuse of controlled substances. (2) Pilot programs have shown that connecting prescribers' PDMPs using health information technology results in improved patient care. (3) Legislators can access up-to-date information about their state PDMP at the Prescription Drug Monitoring Program Training and Technical Assistance Center.

  15. A Comparison of Computer and Teacher Prepared Individualized Reading Prescriptions.

    ERIC Educational Resources Information Center

    Fey, Thomas Frederick

    The purpose of this study was to compare the individualized reading prescriptions prepared by a digital computer, classroom teachers, and reading teachers with those prepared by a panel of experts. Selected fifth graders were administered three instruments: the Gilmore Oral Test; selected items from the McGraw-Hill Prescriptive Reading Inventory…

  16. 21 CFR 1306.06 - Persons entitled to fill prescriptions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Persons entitled to fill prescriptions. 1306.06 Section 1306.06 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS... either registered individually or employed in a registered pharmacy, a registered central fill pharmacy...

  17. 21 CFR 1306.06 - Persons entitled to fill prescriptions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Persons entitled to fill prescriptions. 1306.06 Section 1306.06 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS... either registered individually or employed in a registered pharmacy, a registered central fill pharmacy...

  18. 21 CFR 1306.06 - Persons entitled to fill prescriptions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Persons entitled to fill prescriptions. 1306.06 Section 1306.06 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS... either registered individually or employed in a registered pharmacy, a registered central fill pharmacy...

  19. 21 CFR 1306.06 - Persons entitled to fill prescriptions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Persons entitled to fill prescriptions. 1306.06 Section 1306.06 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS... either registered individually or employed in a registered pharmacy, a registered central fill pharmacy...

  20. 21 CFR 1306.06 - Persons entitled to fill prescriptions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Persons entitled to fill prescriptions. 1306.06 Section 1306.06 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS... either registered individually or employed in a registered pharmacy, a registered central fill pharmacy...

  1. Recognizing Signs of Prescription Drug Abuse and Addiction, Part I.

    PubMed

    Felicilda-Reynaldo, Faye D

    2014-01-01

    Prescription drug abuse/misuse is increasing. Nonmedical use of prescription medications, especially opioid analgesics, now is considered an epidemic in the United States. Medical-surgical nurses are in a strategic position to help address substance abuse problems in patients.

  2. 21 CFR 310.200 - Prescription-exemption procedure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... paragraph (b) or (e) of this section. (b) Prescription-exemption procedure for drugs limited by a new drug... supplement to an approved new drug application. (c) New drug status of drugs exempted from the prescription... section is a “new drug” within the meaning of section 201(p) of the act until it has been used to...

  3. Nonmedical Prescription Drug Use among Midwestern Rural Adolescents

    ERIC Educational Resources Information Center

    Park, Nicholas K.; Melander, Lisa; Sanchez, Shanell

    2016-01-01

    Prescription drug misuse has been an increasing problem in the United States, yet few studies have examined the protective factors that reduce risk of prescription drug abuse among rural adolescents. Using social control theory as a theoretical framework, we test whether parent, school, and community attachment reduce the likelihood of lifetime…

  4. 21 CFR 1306.04 - Purpose of issue of prescription.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual... provided for violations of the provisions of law relating to controlled substances. (b) A prescription may... the individual practitioner for the purpose of general dispensing to patients. (c) A prescription...

  5. Emergency department discharge prescription errors in an academic medical center

    PubMed Central

    Belanger, April; Devine, Lauren T.; Lane, Aaron; Condren, Michelle E.

    2017-01-01

    This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule. Descriptive statistics were used to address the study objective. Categories evaluated were patient age, provider type, drug class, and type and time of error. The discharge prescription error rate out of 1000 prescriptions was 13.4%, with “incomplete or inadequate prescription” being the most commonly detected error (58.2%). The adult and pediatric error rates were 11.7% and 22.7%, respectively. The antibiotics reviewed had the highest number of errors. The highest within-class error rates were with antianginal medications, antiparasitic medications, antacids, appetite stimulants, and probiotics. Emergency medicine residents wrote the highest percentage of prescriptions (46.7%) and had an error rate of 9.2%. Residents of other specialties wrote 340 prescriptions and had an error rate of 20.9%. Errors occurred most often between 10:00 am and 6:00 pm. PMID:28405061

  6. Prescription Privileges, Psychopharmacology and School Psychology: An Overview.

    ERIC Educational Resources Information Center

    Carlson, Cindy; Kubiszyn, Tom

    1994-01-01

    Focuses on psychopharmacology and prescription privileges for psychologists. Summarizes nine major findings from Task Force on Psychopharmacology in the Schools, created to review literature on prescription privileges for psychologists; identify specific issues attendant to use of psychoactive medications with children; and clarify implications…

  7. Prescription Opioid Abuse and Dependence: Assessment Strategies for Counselors

    ERIC Educational Resources Information Center

    Weigel, Daniel J.; Donovan, Kimberly A.; Krug, Kevin S.; Dixon, Wayne A.

    2007-01-01

    The authors review the article "Prescription Drug Use and Abuse: Risk Factors, Red Flags, and Prevention Strategies" (J. H. Isaacson, J. A. Hopper, D. P. Alford, & T. Parran, 2005), which provides an overview of the recent increase in prescription opioid abuse and dependence from the physician's perspective. In the present article, the authors…

  8. Adolescent use of prescription drugs to get high in Canada.

    PubMed

    Currie, Cheryl L; Wild, T Cameron

    2012-12-01

    To present epidemiologic information on adolescent use of prescription drugs to get high, and not for medical purposes, in Canada. Data were obtained from 44 344 adolescents in grades 7 to 12 living across Canada's 10 provinces who completed the Youth Smoking Survey in 2008/2009. Nationally, 5.9% of adolescents in grades 7 to 12 reported the use of prescription drugs to get high in the past 12 months in 2008/2009. Females were more likely to report use of pain relievers, sedatives, or tranquilizers to get high, while males were more likely to report the use of prescription stimulants for this purpose. The use of prescription drugs to get high was elevated among older youth, those living in British Columbia, and those who identified as First Nations, Métis, or Inuit. School connectedness was associated with a reduction in this form of prescription drug misuse for all adolescents; however, this protective effect was particularly strong for Aboriginal youth, and may be an important preventative factor for this population. Use of prescription drugs to get high was prevalent among adolescents in Canada in 2008/2009. Findings highlight the need for clinicians to include questions about prescription drugs when screening adolescents for substance abuse in Canada. Findings also highlight the need for evidence-informed strategies to reduce prescription drug misuse among Aboriginal youth living outside First Nations communities in Canada. The results of this study suggest school connectedness may be a particularly important target for these interventions.

  9. Opioid prescriptions before and after high-energy trauma.

    PubMed

    Zwisler, Stine T; Hallas, Jesper; Larsen, Morten S; Handberg, Gitte; Mikkelsen, Soeren; Enggaard, Thomas P

    2015-01-01

    To describe the legal use of opioids in adult patients before and after high-energy trauma. The study was a retrospective database study. Clinical care outside hospitals. All patients who suffered high-energy trauma and were brought to Odense University Hospital (OUH), Denmark, in 2007 and 2008 were retrieved from the trauma database. These patients were linked with data on opioid use from the regional prescription database. In all, 938 patients were included. Redemption of opioid prescription during the 6 months prior to a multitrauma or redemption of two or more prescriptions for opioids 6 months or later after a multitrauma. Of the 938 patients brought to OUH with severe trauma within the study period, 61 patients died (7 percent) and six of these had redeemed prescriptions for opioids within 6 months prior to the trauma (10 percent) compared to 65 patients of the 877 survivors (7 percent) (odds ratio 1.4, nonsignificant). In all, 62 patients (7 percent) redeemed opioid prescriptions later than 6 months after their trauma and in a multivariable analysis, severe injury itself and severe injuries of the lower extremities were associated with redemption of opioid prescription after the trauma. The authors did not find any correlation between death by trauma and redemption of opioid prescriptions within the 6 months before the trauma. More severe traumas and especially severe traumas to the lower extremities were associated with redemption of opioid prescriptions after multitrauma.

  10. Prescription drug abuse information in D.A.R.E.

    PubMed

    Morris, Melissa C; Cline, Rebecca J Welch; Weiler, Robert M; Broadway, S Camille

    2006-01-01

    This investigation was designed to examine prescription drug-related content and learning objectives in Drug Abuse Resistance Education (D.A.R.E.) for upper elementary and middle schools. Specific prescription-drug topics and context associated with content and objectives were coded. The coding system for topics included 126 topics organized within 14 categories. A two-dimensional coding system for context identified Use versus Abuse and Explicit versus Implicit references to prescription drugs. Results indicated that content and objectives found in D.A.R.E. represent a very narrow breadth of prescription drug topics. Moreover, all prescription-drug related content and objectives were presented in an Abuse-Implicit context. Although some educational material in D.A.R.E. modules potentially is related to prescription drugs, none of the content or objectives explicitly identify drugs discussed as prescription drugs. If elementary and middle schools rely on D.A.R.E. modules to teach students about drug abuse, students are likely to be underinformed about prescription drug risks.

  11. Controlling Communication: A Prescriptive Approach to Communication Studies.

    ERIC Educational Resources Information Center

    Garner, Mark; Johnson, Edward

    If the discussions of communication can be divided into those concerned with a description or theory and those concerned with prescription, then it must be understood that the former can never by itself improve communication. As a field, communication studies does not yet know enough about prescriptive language theory; that is, theory concerned…

  12. Women who abuse prescription opioids: findings from the Addiction Severity Index-Multimedia Version Connect prescription opioid database.

    PubMed

    Green, Traci C; Grimes Serrano, Jill M; Licari, Andrea; Budman, Simon H; Butler, Stephen F

    2009-07-01

    Evidence suggests gender differences in abuse of prescription opioids. This study aimed to describe characteristics of women who abuse prescription opioids in a treatment-seeking sample and to contrast gender differences among prescription opioid abusers. Data collected November 2005 to April 2008 derived from the Addiction Severity Index Multimedia Version Connect (ASI-MV Connect) database. Bivariate and multivariable logistic regression examined correlates of prescription opioid abuse stratified by gender. 29,906 assessments from 220 treatment centers were included, of which 12.8% (N=3821) reported past month prescription opioid abuse. Women were more likely than men to report use of any prescription opioid (29.8% females vs. 21.1% males, p<0.001) and abuse of any prescription opioid (15.4% females vs. 11.1% males, p<0.001) in the past month. Route of administration and source of prescription opioids displayed gender-specific tendencies. Women-specific correlates of recent prescription opioid abuse were problem drinking, age <54, inhalant use, residence outside of West US Census region, and history of drug overdose. Men-specific correlates were age <34, currently living with their children, residence in the South and Midwest, hallucinogen use, and recent depression. Women prescription opioid abusers were less likely to report a pain problem although they were more likely to report medical problems than women who abused other drugs. Gender-specific factors should be taken into account in efforts to screen and identify those at highest risk of prescription opioid abuse. Prevention and intervention efforts with a gender-specific approach are warranted.

  13. Prescription for choosing an interpolating function

    NASA Astrophysics Data System (ADS)

    Takimi, Tomohisa

    2016-02-01

    Interpolating functional method is a powerful tool for studying the behavior of a quantity in the intermediate region of the parameter space of interest by using its perturbative expansions at both ends. Recently several interpolating functional methods have been proposed, in addition to the well-known Padé approximant, namely, the "Fractional Power of Polynomial" and the "Fractional Power of Rational functions" methods. Since combinations of these methods also give interpolating functions, we may end up with multitudes of the possible approaches. So a criterion for choosing an appropriate interpolating function is very much needed. In this paper, we propose reference quantities which can be used for choosing a good interpolating function. In order to validate the prescription based on these quantities, we study the degree of correlation between "the reference quantities" and the "actual degree of deviation between the interpolating function and the true function" in examples where the true functions are known.

  14. Knowledge of drug prescription in dentistry students.

    PubMed

    Guzmán-Álvarez, R; Medeiros, M; Lagunes, Li Reyes; Campos-Sepúlveda, Ae

    2012-01-01

    Students in schools of dentistry attend to patients with illnesses, and often prescribe medication. Because students are still learning, they are influenced by a variety of factors: the different teaching approaches of the professors at the clinics and in the pharmacology course, fellow students, and even the information provided by the pharmaceutical industry. The aim of this pilot study was to assess the prescription knowledge and common mistakes in fourth-year students at the School of Dentistry at the Universidad Nacional Autónoma de México. In March 2010, a survey was conducted among 66 fourth-year students at the School of Dentistry, applying a previously validated questionnaire consisting of six open-ended questions The following factors were assessed: the most frequent illness requiring dental prescription; the most prescribed nonsteroidal anti-inflammatory drugs and antibiotics; the most frequent errors; sources of information used for prescribing drugs; and whether the students knew and followed the World Health Organization Guide to Good Prescribing. The most frequent response for each question was considered the most significant. The most common reason for prescribing medication was infection (n = 37, 56%), followed by pain (n = 24, 38%); the most used painkillers were ibuprofen and acetaminophen at equal levels (n = 25, 37.8%), followed by ketorolac (n = 7, 10.6%), naproxen (n = 6, 9.1%), diclofenac (n = 2, 3%), and aspirin (n = 1, 1.5%); the most widely prescribed antibiotics were amoxicillin (n = 52, 78.9%), ampicillin (n = 7, 10.6%), and penicillin V and clindamycin (n = 3, 4.5%). The most frequent errors reported by students were: lack of knowledge about drug posology (n = 49, 74.2%), improperly filled prescriptions (n = 7, 10.7%), not knowing the brand names and uncertainty about the correct drug indicated for each case (n = 3, 4.54%), not knowing the duration of treatment (n = 2, 3%), not asking the patient about possible allergies, and not

  15. ENHANCING PRESCRIPTION DRUG INNOVATION AND ADOPTION

    PubMed Central

    Alexander, G. Caleb; O’Connor, Alec B.; Stafford, Randall S.

    2014-01-01

    The adoption and use of a new drug would ideally be guided by its Innovation and cost-effectiveness. The adoption and use of a new drug would ideally be guided by its innovation and cost-effectiveness. However, information about the relative efficacy and safety of a drug is typically incomplete even well after market entry, and various other forces create a market place in which most new drugs are little better than their older counterparts. Five proposed mechanisms are considered for promoting innovation and reducing the use of therapies ultimately found to offer poor value or have unacceptable risks. These changes range from increasing the evidence required for U.S. Food and Drug Administration approval to modifying the structure of drug reimbursement. Despite the challenges of policy implementation, the United States has a long history of successfully improving the societal value and safe use of prescription medicines. PMID:21690598

  16. Comparison of fatal poisonings by prescription opioids.

    PubMed

    Häkkinen, Margareeta; Launiainen, Terhi; Vuori, Erkki; Ojanperä, Ilkka

    2012-10-10

    There is a rising trend of fatal poisonings due to medicinal opioids in several countries. The present study evaluates the drug and alcohol findings as well as the cause and manner of death in opioid-related post-mortem cases in Finland from 2000 to 2008. During this period, fatal poisonings by prescription opioids (buprenorphine, codeine, dextropropoxyphene, fentanyl, methadone, oxycodone, tramadol) increased as a share of all drug poisonings from 9.5% to 32.4%, being 22.3% over the whole period. A detailed study including the most prevalent opioids was carried out for the age group of 14-44 years, which is the most susceptible age for drug abuse in Finland. Poisonings by the weak opioids, codeine and tramadol, were found to be associated with large, often suicidal overdoses resulting in high drug concentrations in blood. Methadone poisonings were associated with accidental overdoses with the drug concentration in blood remaining within a therapeutic range. The manner of death was accidental in 43%, 55% and 94% of cases in codeine, tramadol and methadone poisonings, respectively. The median concentration of codeine and the median codeine/morphine concentration ratio were higher in codeine poisonings (1.4 and 22.5 mg/l, respectively) than in other causes of death (0.09 and 5.9 mg/l, respectively). The median concentrations of tramadol and O-desmethyltramadol were higher in tramadol poisonings (5.3 and 0.8 mg/l, respectively) than in other causes of death (0.6 and 0.2 mg/l, respectively). In methadone poisonings, the median concentration of methadone (0.35 mg/l) was not different from that in other causes of death (0.30 mg/l). Sedative drugs and/or alcohol were very frequently found in fatal poisonings involving these prescription opioids.

  17. Antipsychotic prescription amongst hospitalized patients with dementia.

    PubMed

    Gallagher, P; Curtin, D; de Siún, A; O'Shea, E; Kennelly, S; O'Neill, D; Timmons, S

    2016-09-01

    Antipsychotic drugs are used to treat behavioural and psychological symptoms of dementia, despite significant safety concerns regarding increased risk of stroke and mortality. The numbers of patients with dementia and related behavioural symptoms being treated in acute hospitals is increasing. (i) to determine pre-admission and in-hospital prevalence of antipsychotic use in a national sample of patients with dementia and acute illness; (ii) identify reasons for antipsychotic use; (iii) assess features of the ward environment which impact on patients with dementia; (iv) determine availability of dementia-specific policies, training, appraisal and mentorship programs which influence service delivery. Four-part standardized audit in 35 public acute hospitals comprising (i) retrospective healthcare record review (n = 660); (ii) prospective assessment of ward environment (n = 77); (iii) ward organization interview with clinical managers (n = 77); (iv) hospital organisation interview with senior managers (n = 35). Antipsychotic drugs were prescribed to 29% of patients with dementia before hospitalization and to 41% during hospitalization; one quarter received new or additional prescriptions. Assessments for delirium (45%), dementia symptoms (39%), mood (26%), mental state (64%) and distress-provoking factors (3%) were suboptimal. Drug indications were documented in 78%. Non-pharmacological interventions were not documented. Most wards lacked environmental cues to promote orientation. Dementia-specific care pathways existed in 2 of 35 hospitals. Staff support and training programmes were suboptimal. 12% of patients were discharged with new antipsychotic prescriptions. Antipsychotic medications are commonly prescribed for hospitalized patients with dementia in Ireland. Ward environments and dementia-related governance structures are suboptimal. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights

  18. Health Outcomes in Patients Using No-Prescription Online Pharmacies to Purchase Prescription Drugs

    PubMed Central

    2012-01-01

    Background Many prescription drugs are freely available for purchase on the Internet without a legitimate prescription from a physician. Objective This study focused on the motivations for using no-prescription online pharmacies (NPOPs) to purchase prescription drugs rather than using the traditional doctor-patient-pharmacy model. We also studied whether users of NPOP-purchased drugs had poorer health outcomes than those who obtain the same drug through legitimate health care channels. Methods We selected tramadol as a representative drug to address our objective because it is widely prescribed as an unscheduled opioid analgesic and can easily be purchased from NPOPs. Using search engine marketing (SEM), we placed advertisements on search result pages stemming from the keyword “tramadol” and related terms and phrases. Participants, who either used the traditional doctor-patient-pharmacy model to obtain tramadol (traditional users, n=349) or purchased it on the Web without a prescription from their local doctor (ie, nontraditional users, n=96), were then asked to complete an online survey. Results Respondents in both groups were primarily white, female, and in their mid-forties (nontraditional users) to upper forties (traditional users). Nearly all nontraditional users indicated that their tramadol use was motivated by a need to treat pain (95%, 91/96) that they perceived was not managed appropriately through legitimate health care channels. A majority of nontraditional users (55%, 41/75) indicated they used NPOPs because they did not have access to sufficient doses of tramadol to relieve pain. In addition, 29% (22/75) of nontraditional users indicated that the NPOPs were a far cheaper alternative than seeing a physician, paying for an office visit, and filling a prescription at a local pharmacy, which is often at noninsured rates for those who lack medical insurance (37%, 35/96, of NPOP users). The remainder of participants (16%, 12/96) cited other motivations

  19. A prescription analysis exercise in a pharmaceutical care laboratory course.

    PubMed

    Waitzman, Jennifer A; Dinkins, Melissa M

    2013-03-12

    To assess the impact of a new prescription analysis exercise in a second-year pharmaceutical care laboratory course. A new prescription analysis exercise was created and implemented that shifted the focus from strictly identifying errors and omissions to identifying and correcting them. Students used electronic label templates and mock prescription materials to correct various errors and omissions commonly seen in practice. Forty-one percent of students received full credit for the exercise using the new method compared to the previous method where 9.1% of students received full credit. Ninety-four percent of respondents preferred the new method versus the original method, with reasons given including the new method seemed more practical, applicable, and realistic. The new prescription analysis exercise addressed many inconsistencies noted with the original method. Students performed better on graded assessments using the new method and preferred it over the old method of prescription analysis.

  20. Store and prescription characteristics associated with primary medication nonadherence.

    PubMed

    Jackson, Tristen H; Bentley, John P; McCaffrey, David J; Pace, Pat; Holmes, Erin; West-Strum, Donna

    2014-08-01

    Primary medication nonadherence (PMN) is any instance whereby patients fail to initiate a pharmacotherapy regimen after receiving a prescription for new therapy. The Pharmacy Quality Alliance (PQA) has proposed a standardized definition for PMN and a quality measure to assess the rates of PMN in community pharmacies. To (a) measure PMN using the proposed PQA measure with data available from a pharmacy dispensing system and (b) identify the prescription-level (patient, prescriber, and medication) and store-level (store and neighborhood) characteristics associated with PMN. This study was approved by a southern university institutional review board, and a data use agreement was in place. A large national pharmacy grocery chain provided de-identified, transactional data for 2010 through January 2012, for 100 pharmacies (de-identified unique patient and store codes were available). The proposed PQA-PMN measure was used, and PMN rates were calculated. Investigators examined adult individuals with a new electronic prescription for any of the included medications during the measurement period and determined whether the medication or an appropriate alternative was claimed within 30 days. Multilevel logistic regression with a random intercept was used to evaluate prescription-level and store-level predictors of PMN. Prescription-level variables included prescriber type, PQA-defined drug class, patient gender and age, whether the prescription was accompanied by another prescription on the same day, payment source, and out-of-pocket costs. A daily average prescription volume variable was calculated for each pharmacy as a store-level variable. Additional store-level variables were derived from the 2007-2011 American Community Survey, available from the U.S. Census Bureau (median household income, educational level, percentage of minorities, and percentage aged 65 years and over in the census tracts where the pharmacies are located).  Of the e-prescriptions during the 1-year

  1. Delayed antibiotic prescriptions for respiratory infections.

    PubMed

    Spurling, Geoffrey Kp; Del Mar, Chris B; Dooley, Liz; Foxlee, Ruth; Farley, Rebecca

    2017-09-07

    Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections. For this 2017 update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, Issue 4, 2017), which includes the Cochrane Acute Respiratory Infection Group's Specialised Register; Ovid MEDLINE (2013 to 25 May 2017); Ovid Embase (2013 to 2017 Week 21); EBSCO CINAHL Plus (1984 to 25 May 2017); Web of Science (2013 to 25 May 2017); WHO International Clinical Trials Registry Platform (1 September 2017); and ClinicalTrials.gov (1 September 2017). Randomised controlled trials involving participants of all ages defined as having an RTI, where delayed antibiotics were compared to immediate antibiotics or no antibiotics. We defined a delayed antibiotic as advice to delay the filling of an antibiotic prescription by at least 48 hours. We considered all RTIs regardless of whether antibiotics were recommended or not. We used standard Cochrane methodological procedures. Three review authors independently extracted and collated data. We assessed the risk of bias of all included trials. We contacted trial authors to obtain missing information. For this 2017 update we added one new trial involving 405 participants with uncomplicated acute respiratory infection. Overall, this review included 11 studies with a total of 3555 participants. These 11 studies involved acute respiratory infections including acute otitis media (three studies

  2. How do Community Pharmacies Recover from E-prescription Errors?

    PubMed Central

    Odukoya, Olufunmilola K.; Stone, Jamie A.; Chui, Michelle A.

    2014-01-01

    Background The use of e-prescribing is increasing annually, with over 788 million e-prescriptions received in US pharmacies in 2012. Approximately 9% of e-prescriptions have medication errors. Objective To describe the process used by community pharmacy staff to detect, explain, and correct e-prescription errors. Methods The error recovery conceptual framework was employed for data collection and analysis. 13 pharmacists and 14 technicians from five community pharmacies in Wisconsin participated in the study. A combination of data collection methods were utilized, including direct observations, interviews, and focus groups. The transcription and content analysis of recordings were guided by the three-step error recovery model. Results Most of the e-prescription errors were detected during the entering of information into the pharmacy system. These errors were detected by both pharmacists and technicians using a variety of strategies which included: (1) performing double checks of e-prescription information; (2) printing the e-prescription to paper and confirming the information on the computer screen with information from the paper printout; and (3) using colored pens to highlight important information. Strategies used for explaining errors included: (1) careful review of patient’ medication history; (2) pharmacist consultation with patients; (3) consultation with another pharmacy team member; and (4) use of online resources. In order to correct e-prescription errors, participants made educated guesses of the prescriber’s intent or contacted the prescriber via telephone or fax. When e-prescription errors were encountered in the community pharmacies, the primary goal of participants was to get the order right for patients by verifying the prescriber’s intent. Conclusion Pharmacists and technicians play an important role in preventing e-prescription errors through the detection of errors and the verification of prescribers’ intent. Future studies are needed

  3. How do community pharmacies recover from e-prescription errors?

    PubMed

    Odukoya, Olufunmilola K; Stone, Jamie A; Chui, Michelle A

    2014-01-01

    The use of e-prescribing is increasing annually, with over 788 million e-prescriptions received in US pharmacies in 2012. Approximately 9% of e-prescriptions have medication errors. To describe the process used by community pharmacy staff to detect, explain, and correct e-prescription errors. The error recovery conceptual framework was employed for data collection and analysis. 13 pharmacists and 14 technicians from five community pharmacies in Wisconsin participated in the study. A combination of data collection methods were utilized, including direct observations, interviews, and focus groups. The transcription and content analysis of recordings were guided by the three-step error recovery model. Most of the e-prescription errors were detected during the entering of information into the pharmacy system. These errors were detected by both pharmacists and technicians using a variety of strategies which included: (1) performing double checks of e-prescription information; (2) printing the e-prescription to paper and confirming the information on the computer screen with information from the paper printout; and (3) using colored pens to highlight important information. Strategies used for explaining errors included: (1) careful review of patient's medication history; (2) pharmacist consultation with patients; (3) consultation with another pharmacy team member; and (4) use of online resources. In order to correct e-prescription errors, participants made educated guesses of the prescriber's intent or contacted the prescriber via telephone or fax. When e-prescription errors were encountered in the community pharmacies, the primary goal of participants was to get the order right for patients by verifying the prescriber's intent. Pharmacists and technicians play an important role in preventing e-prescription errors through the detection of errors and the verification of prescribers' intent. Future studies are needed to examine factors that facilitate or hinder recovery

  4. [Long-term prescription of benzodiazepines and non-benzodiazepines].

    PubMed

    Verthein, U; Martens, M S; Raschke, P; Holzbach, R

    2013-07-01

    The number of persons with a dependence on prescription drugs such as sedatives or tranquilizers in Germany is estimated at between 1.4 and 1.9 million. According to national addiction treatment documentations only very few of them seek help in specialised treatment services. The majority of prescription drug-dependent people use benzodiazepines. This medication is usually prescribed by physicians and according to German guidelines it should be prescribed only for limited, short periods and in low doses. This study aims to determine the extent of the problematic prescription of benzodiazepines and non-benzodiazepines. We used prescription data from the Northern Germany Computing Centre for Pharmacies registered between 2005 and 2007. For the German regions of Hamburg, Bremen and Schleswig-Holstein, benzodiazepine prescriptions during an individual prospective period of 12 months were analysed. From July 2005 to June 2006, 294 143 prescriptions of benzodiazepines and non-benzodiazepines were recorded for 78 456 citizens of Hamburg and billed at the expenses of the governmental health insurance funds. In the course of one observed patient year, 51.1% of benzodiazepine prescriptions were in accordance with the German guidelines. 15.6% of the patients were supplied on a long-term basis (0.5-1 DDD during at least 2 months). Prescriptions for women and persons older than 70 years were disproportionately high. Compared with the Federal states of Bremen and Schleswig-Holstein, Hamburg does not show an exceptional position. The prescription of benzodiazepines which is not in accordance with the relevant national guidelines is widespread and calls for discussion and education among physicians and pharmacists. Furthermore, professional addiction services should reconsider ways to help and attract prescription drug-dependent people to cover their needs, as their numbers will grow in an aging society. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Initiation into Prescription Opioid Misuse among Young Injection Drug Users

    PubMed Central

    Lankenau, Stephen E.; Teti, Michelle; Silva, Karol; Bloom, Jennifer Jackson; Harocopos, Alex; Treese, Meghan

    2011-01-01

    Background Prescription opioids are the most frequently misused class of prescription drugs among young adults. Initiation into prescription opioid misuse is an important public health concern since opioids are increasingly associated with drug dependence and fatal overdose. Descriptive data about initiation into prescription opioid misuse among young injection drug users (IDUs) are scarce. Methods An exploratory qualitative study was undertaken to describe patterns of initiation into prescription opioid misuse among IDUs aged 16 to 25 years. Those young IDUs who had misused a prescription drug at least three times in the past three months were recruited during 2008 and 2009 in Los Angeles (n=25) and New York (n=25). Informed by an ethno-epidemiological approach, descriptive data from a semi-structured interview guide were analysed both quantitatively and qualitatively. Results Initiation into prescription opioid misuse was facilitated by easy access to opioids via participant’s own prescription, family, or friends, and occurred earlier than misuse of other illicit drugs, such as heroin. Nearly all transitioned into sniffing opioids, most injected opioids, and many initiated injection drug use with an opioid. Motives for transitions to sniffing and injecting opioids included obtaining a more potent high and/or substituting for heroin; access to multiple sources of opioids was common among those who progressed to sniffing and injecting opioids. Conclusion Prescription opioid misuse was a key feature of trajectories into injection drug use and/or heroin use among this sample of young IDUs. A new pattern of drug use may be emerging whereby IDUs initiate prescription opioid misuse before using heroin. PMID:21689917

  6. Initiation into prescription opioid misuse amongst young injection drug users.

    PubMed

    Lankenau, Stephen E; Teti, Michelle; Silva, Karol; Jackson Bloom, Jennifer; Harocopos, Alex; Treese, Meghan

    2012-01-01

    Prescription opioids are the most frequently misused class of prescription drugs amongst young adults. Initiation into prescription opioid misuse is an important public health concern since opioids are increasingly associated with drug dependence and fatal overdose. Descriptive data about initiation into prescription opioid misuse amongst young injection drug users (IDUs) are scarce. An exploratory qualitative study was undertaken to describe patterns of initiation into prescription opioid misuse amongst IDUs aged 16-25 years. Those young IDUs who had misused a prescription drug at least three times in the past three months were recruited during 2008 and 2009 in Los Angeles (n=25) and New York (n=25). Informed by an ethno-epidemiological approach, descriptive data from a semi-structured interview guide were analysed both quantitatively and qualitatively. Initiation into prescription opioid misuse was facilitated by easy access to opioids via participant's own prescription, family, or friends, and occurred earlier than misuse of other illicit drugs, such as heroin. Nearly all transitioned into sniffing opioids, most injected opioids, and many initiated injection drug use with an opioid. Motives for transitions to sniffing and injecting opioids included obtaining a more potent high and/or substituting for heroin; access to multiple sources of opioids was common amongst those who progressed to sniffing and injecting opioids. Prescription opioid misuse was a key feature of trajectories into injection drug use and/or heroin use amongst this sample of young IDUs. A new pattern of drug use may be emerging whereby IDUs initiate prescription opioid misuse before using heroin. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. 75 FR 12756 - Agency Information Collection Activities: Proposed Collection; Comment Request; Prescription Drug...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-17

    ... Collection; Comment Request; Prescription Drug Advertisements AGENCY: Food and Drug Administration, HHS..., contained in FDA's regulations on prescription drug advertisements. DATES: Submit written or electronic... of information technology. Prescription Drug Advertisements--21 CFR 202.1 (OMB Control Number 0910...

  8. 78 FR 18364 - Electronic Prescriptions for Controlled Substances Notice of Approved Certification Process

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... Enforcement Administration Electronic Prescriptions for Controlled Substances Notice of Approved Certification... is announcing two new DEA-approved certification processes for providers of Electronic Prescriptions... scheme established by Congress. Electronic Prescriptions for Controlled Substances (EPCS)...

  9. Are Prescription Stimulants "Smart Pills"? The Epidemiology and Cognitive Neuroscience of Prescription Stimulant Use by Normal Healthy Individuals

    ERIC Educational Resources Information Center

    Smith, M. Elizabeth; Farah, Martha J.

    2011-01-01

    Use of prescription stimulants by normal healthy individuals to enhance cognition is said to be on the rise. Who is using these medications for cognitive enhancement, and how prevalent is this practice? Do prescription stimulants in fact enhance cognition for normal healthy people? We review the epidemiological and cognitive neuroscience…

  10. The ARF, AUX/IAA and GH3 gene families in citrus: genome-wide identification and expression analysis during fruitlet drop from abscission zone A.

    PubMed

    Xie, Rangjin; Pang, Shaoping; Ma, Yanyan; Deng, Lie; He, Shaolan; Yi, Shilai; Lv, Qiang; Zheng, Yongqiang

    2015-12-01

    Completion of the whole genome sequencing of citrus enabled us to perform genome-wide identification and functional analysis of the gene families involved in agronomic traits and morphological diversity of citrus. In this study, 22 CitARF, 11 CitGH3 and 26 CitAUX/IAA genes were identified in citrus, respectively. Phylogenetic analysis revealed that all the genes of each gene family could be subdivided into three groups and showed strong evolutionary conservation. The GH3 and AUX/IAA gene families shrank and ARF gene family was highly conserved in the citrus genome after speciation from Arabidopsis thaliana. Tissue-specific expression profiles revealed that 54 genes were expressed in at least one tissue while just 5 genes including CitARF07, CitARF20, CitGH3.04, CitAUX/IAA25 and CitAUX/IAA26 with very low expression level in all tissues tested, suggesting that the CitARF, CitGH3 and CitAUX/IAA gene families played important roles in the development of citrus organs. In addition, our data found that the expression of 2 CitARF, 4 CitGH3 and 4 AUX/IAA genes was affected by IAA treatment, and 7 genes including, CitGH3.04, CitGH3.07, CitAUX/IAA03, CitAUX/IAA04, CitAUX/IAA18, CitAUX/IAA19 and CitAUX/IAA23 were related to fruitlet abscission. This study provides a foundation for future studies on elucidating the precise role of citrus ARF, GH3 and AUX/IAA genes in early steps of auxin signal transduction and open up a new opportunity to uncover the molecular mechanism underlying citrus fruitlet abscission.

  11. Prescription errors and the impact of computerized prescription order entry system in a community-based hospital.

    PubMed

    Jayawardena, Suriya; Eisdorfer, Jacob; Indulkar, Shalaka; Pal, Sethi Ajith; Sooriabalan, Danushan; Cucco, Robert

    2007-01-01

    Adverse drug events occur often in hospitals. They can be prevented to a large extent by minimizing the human errors of prescription writing. To evaluate the efficacy of a computerized prescription order entry (CPOE) system with the help of ancillary support in minimizing prescription errors. Retrospective study carried out in a community-based urban teaching hospital in south Brooklyn, NY from January 2004 to January 2005. Errors were categorized into inappropriate dosage adjustment for creatinine clearance, duplication, incorrect orders, allergy verification, and incomplete orders. The pharmacists identified the type of error, the severity of error, the class of drug involved, and the department that made the error. A total of 466,311 prescriptions were entered in the period of 1 year. There were 3513 errors during this period (7.53 errors per 1000 prescriptions). More than half of these errors were made by the internal medicine specialty. In our study, 50% of the errors were severe errors (overdosing medications with narrow therapeutic index or over-riding allergies), 46.28% were moderate errors (overdosing, wrong dosing, duplicate orders, or prescribing multiple antibiotics), and 3.71% were not harmful errors (wrong dosing or incomplete orders). The errors were also categorized according to the class of medication. Errors in antibiotic prescription accounted for 53.9% of all errors. The pharmacist detected all these prescription errors as the prescriptions were reviewed in the CPOE system. Prescription errors are common medical errors seen in hospitals. The CPOE system has prevented and alerted the prescriber and pharmacist to dosage errors and allergies. Involvement of the pharmacist in reviewing the prescription and alerting the physician has minimized prescription errors to a great degree in our hospital setting. The incidence of prescription errors before the CPOE has been reported to range from 3 to 99 per 1000 prescriptions. The disparity could be due to

  12. Introducing a structured prescription form improves the quality of handwritten prescriptions in limited resource setting of developing countries.

    PubMed

    Raza, Usman Ahmad; Latif, Sana; Naseer, Anum; Saad, Maryam; Zeeshan, Muhammad Fazal; Qazi, Umair

    2016-10-01

    Incomplete or illegible prescriptions can lead to serious errors in administration of the prescribed medication, which can become hazardous. Our aim is to determine if a structured prescription form can improve the quality of handwritten prescription in terms of completeness and legibility. We conducted a prospective, non-randomized, time series study of quality of written prescriptions of general practitioners at a tertiary teaching hospital in Peshawar, Pakistan. The study involved an intervention, composed of the introduction of a pre-printed structured prescription form. The data were collected within 4 weeks including a 2-week pre-intervention phase and 2-week post-intervention phase. Completeness, quality of prescriptions and legibility were compared before and after the intervention of the pre-printed structured prescription form. A total of 463 prescriptions were obtained (260 in the pre-intervention phase and 203 in the post-intervention phase). Between pre-intervention phase and post-intervention phase, the Pakistan Medical and Dental Council registration number presence in prescriptions improved from 73.1% to 100% (P < 0.0005). The presence of prescriber's signature improved from 92.7% to 99% (P = 0.001). Drug duration was not missing in 99.5% in post-intervention phase as compared with 90.4% in pre-intervention phase (P < 0.0005). Prescriptions with no legibility problems improved from 76.2% to 94.1% (P < 0.0005). Although not statistically significant, prescriptions in which drug dosage was not missing improved from 85% to 90.6% (P = 0.07). We have a limited single-center study. A larger study in multiple settings is needed to develop adequate evidence for such interventions. Subjective nature of prescription legibility can also be considered as a limitation. Structuring a prescription form alone may improve certain aspects of quality of written prescription in terms of completeness and legibility. © 2016 John Wiley & Sons, Ltd.

  13. Prescription drugs: issues of cost, coverage, and quality.

    PubMed

    Copeland, C

    1999-04-01

    This Issue Brief closely examines expenditures on prescription drugs, and discusses their potential to substitute for other types of health care services. In addition, it describes employer coverage of prescription drugs, direct-to-consumer advertising of prescription drugs, and potential legislation affecting the prescription drug market. Prescription drug expenditures grew at double-digit rates during almost every year since 1980, accelerating to 14.1 percent in 1997. In contrast, total national health expenditures, hospital service expenditures, and physician service expenditures growth rates decreased from approximately 13 percent in 1980 to less than 5 percent in 1997. Private insurance payments for prescription drugs increased 17.7 percent in 1997, after growing 22.1 percent in 1995 and 18.3 percent in 1996. This growth in prescription drug payments compares with 4 percent or less overall annual growth in private insurance payments for each of those three years. From 1993 to 1997, the overwhelming majority of the increases in expenditures on prescription drugs were attributable to increased volume, mix, and availability of pharmaceutical products. In 1997, these factors accounted for more than 80 percent of the growth in prescription drug expenditures. A leading explanation for the sharp growth in drug expenditures is that prescription drugs are a substitute for other forms of health care. While it is difficult to determine the extent to which this substitution occurs, various studies have associated cost savings with the use of pharmaceutical products in treating specific diseases. Evidence suggests that more appropriate utilization of prescription drugs has the potential to lower total expenditures and improve the quality of care. Also, some studies indicate the U.S. health care system needs to improve the way patients use and physicians prescribe current medications. Prescription drug plans offered by employers are likely to undergo changes to ensure that

  14. Chemical composition and geologic history of saline waters in Aux Vases and Cypress Formations, Illinois Basin

    USGS Publications Warehouse

    Demir, I.; Seyler, B.

    1999-01-01

    Seventy-six samples of formation waters were collected from oil wells producing from the Aux Vases or Cypress Formations in the Illinois Basin. Forty core samples of the reservoir rocks were also collected from the two formations. Analyses of the samples indicated that the total dissolved solids content (TDS) of the waters ranged from 43,300 to 151,400 mg/L, far exceeding the 35,400 mg/mL of TDS found in typical seawater. Cl-Br relations suggested that high salinities in the Aux Vases and Cypress formation waters resulted from the evaporation of original seawater and subsequent mixing of the evaporated seawater with concentrated halite solutions. Mixing with the halite solutions increased Na and Cl concentrations and diluted the concentration of other ions in the formation waters. The elemental concentrations were influenced further by diagenetic reactions with silicate and carbonate minerals. Diagenetic signatures revealed by fluid chemistry and rock mineralogy delineated the water-rock interactions that took place in the Aux Vases and Cypress sandstones. Dissolution of K-feldspar released K into the solution, leading to the formation of authigenic illite and mixed-layered illite/smectite. Some Mg was removed from the solution by the formation of authigenic chlorite and dolomite. Dolomitization, calcite recrystallization, and contribution from clay minerals raised Sr levels significantly in the formation waters. The trend of increasing TDS of the saline formation waters with depth can be explained with density stratification. But, it is difficult to explain the combination of the increasing TDS and increasing Ca/Na ratio with depth without invoking the controversial 'ion filtration' mechanism.

  15. Identification of ARF and AUX/IAA gene families in Rafflesia cantleyi

    NASA Astrophysics Data System (ADS)

    Elias, Nur Atiqah Mohd; Goh, Hoe-Han; Isa, Nurulhikma Md; Wan, Kiew-Lian

    2016-11-01

    Rafflesia is a unique plant that produces the largest flowers in the world. It has a short blooming period of 6 to 7 days. Due to its rarity and limited accessibility, little is known about the growth and developmental process in the Rafflesia plant. In all plant species, auxin is the key hormone that is involved in growth and development. The auxin signal transduction involves members of the ARF transcription factor and AUX/IAA regulator families, which activate or inhibit the regulation of auxin response genes, thereby control the developmental process in plants. To gain a better understanding of molecular regulations in the Rafflesia plant development during flowering, members of the ARF and AUX/IAA gene families were identified from the transcriptome data of flower blooming stages in Rafflesia cantleyi. Based on Rafflesia unique transcripts (UTs) against the Arabidopsis TAIR database using BLASTX search, a total of nine UTs were identified as ARF transcription factors, while another seven UTs were identified as AUX/IAA regulators. These genes were found to be expressed in all three R. cantleyi flower stages i.e. days 1 (F1), 3 (F2), and 5 (F3). Gene expression analysis identified three genes that are differentially expressed in stage F1 vs. F2 i.e. IAA4 is upregulated while IAA8 and ARF3 are downregulated. These genes may be involved in the activation and/or inhibition of the auxin signal transduction pathway. Further analysis of these genes may unravel their function in the phenotypic development of the Rafflesia plant.

  16. Silver birch (Betula pendula) plants with aux and rol genes show consistent changes in morphology, xylem structure and chemistry.

    PubMed

    Piispanen, Riikka; Aronen, Tuija; Chen, Xiwen; Saranpää, Pekka; Häggman, Hely

    2003-08-01

    The effects of Agrobacterium pRiA4 rol and aux genes, controlled by their endogenous promoters, on tree growth and wood anatomy and chemistry were studied in 5- and 7-year-old silver birch (Betula pendula Roth) plants. Southern hybridization confirmed the following rol and aux gene combinations: control plants (no genes transferred); plants with rolC and rolD genes; plants with rolA, rolB, rolC and rolD genes; and plants with rolA, rolB, rolC, rolD, aux1 and aux2 genes. Transgene mRNA was most abundant in phloem/cambium samples and in the developing xylem, whereas no expression was detected in leaves. Plants with rolC and rolD genes or with all the rol genes were significantly shorter and had smaller leaves and a more bushy growth habit than control plants or plants with both aux and rol genes. Morphological observations and wood chemistry analyses revealed that plants with rol genes produced less xylem and broke bud later than control plants or plants with both aux and rol genes. Tension wood was detected in both control and transgenic plants irrespective of their gene combination, probably as a result of greenhouse cultivation. Xylem fibers were shorter in transgenic plants than in control plants, and plants with all the rol genes were characterized by shorter vessels compared with the control plants and a smaller proportional area of vessels compared with the other groups. In addition, silver birch plants with all the rol genes had approximately a 3.3% lower concentration of total acid soluble carbohydrates than control plants. We conclude that the rolC and rolD genes induced the typical "rol-phenotype," and that this was emphasized by concomitant expression of the rolA and rolB genes and alleviated by the presence of aux1 and aux2 genes. We observed consistent phenotypic effects of rol and aux genes on the morphology, anatomy and cell wall chemistry of the plants.

  17. L'intérêt de l'accoutumance aux antituberculeux majeurs

    PubMed Central

    Aniked, Sarra; Bakouh, Ouiam; Bourkadi, Jamal Eddine

    2014-01-01

    Les réactions d’ hypersensibilité aux antituberculeux sont relativement rares et graves par leur caractère imprévisible, elles conduisent généralement à l'arrêt ou au changement thérapeutique. Nous rapportons un cas d'hypersensibilité à trois antibacillaires majeurs (Isoniazide, Pyrazinamide, Ethombutol). Une accoutumance orale à ces trois médicaments a été réalisée permettant à la patiente de bénéficier d'un traitement antibacillaire optimal. PMID:25821550

  18. Arabidopsis seed germination speed is controlled by SNL histone deacetylase-binding factor-mediated regulation of AUX1

    PubMed Central

    Wang, Zhi; Chen, Fengying; Li, Xiaoying; Cao, Hong; Ding, Meng; Zhang, Cun; Zuo, Jinghong; Xu, Chaonan; Xu, Jimei; Deng, Xin; Xiang, Yong; Soppe, Wim J. J.; Liu, Yongxiu

    2016-01-01

    Histone acetylation is known to affect the speed of seed germination, but the molecular regulatory basis of this remains ambiguous. Here we report that loss of function of two histone deacetylase-binding factors, SWI-INDEPENDENT3 (SIN3)-LIKE1 (SNL1) and SNL2, results in accelerated radicle protrusion and growth during seed germination. AUXIN RESISTANT 1 (AUX1) is identified as a key factor in this process, enhancing germination speed downstream of SNL1 and SNL2. AUX1 expression and histone H3 acetylation at lysines 9 and 18 is regulated by SNL1 and SNL2. The D-type cyclins encoding genes CYCD1;1 and CYCD4;1 display increased expression in AUX1 over-expression lines and the snl1snl2 double mutant. Accordingly, knockout of CYCD4;1 reduces seed germination speed of AUX1 over-expression lines and snl1snl2 suggesting the importance of cell cycling for radicle protrusion during seed germination. Together, our work identifies AUX1 as a link between histone acetylation mediated by SNL1 and SNL2, and radicle growth promoted by CYCD1;1 and CYCD4;1 during seed germination. PMID:27834370

  19. The role of AUX1 gene and auxin content to the branching phenotype of Kenaf (Hibiscus cannabinus L.).

    PubMed

    Arumingtyas, Estri L; Mastuti, R; Indriyani, S

    2010-01-01

    The objectives of this research were to identify auxin gene, AUX1, and to determine the plant auxin content and their role in conferring branching on Kenaf. PCR analysis using AUX1 primer capable to amplify the DNA of non branching (KR11) and branching kenaf mutant, resulting in 800 bp PCR product. The sequence of the PCR product showed high degree of homology with the sequence of AUX1 gene of other plants in the NCBI GenBank database, confirming kenaf possession of the gene AUX1. However, some variation on the DNA sequence was found between branching and non branching phenotype indicated allele differences of the same gene which were responsible for the variation in the type of branching. Identification of auxin content in the roots, apical shoot, and axillary branches using spectrophotometry method showed that the branching plant has higher auxin content in the apical shoot compared to the content in the branches. This indicate that AUX1 controls the formation of branches by controlling either the content of auxin in the apical shoot and branches, or the ratio of auxin content in the shoot and branches.

  20. Identification and management of prescription drug abuse in pregnancy.

    PubMed

    Worley, Julie

    2014-01-01

    Prescription drug abuse is a growing problem in the United States and many other countries. Estimates of prescription drug abuse rates during pregnancy range from 5% to 20%. The primary prescription drugs designated as controlled drugs with abuse potential in pregnancy are opiates prescribed for pain, benzodiazepines prescribed for anxiety, and stimulants prescribed for attention-deficit/hyperactivity disorder. Prescription drugs are obtained for abuse through diversion methods, such as purchasing them from others or by doctor shopping. The use of prescription drugs puts both the mother and the fetus at high risk during pregnancy. Identification of women who are abusing prescription drugs is important so that treatment can be ensured. It is crucial for healthcare professionals to use a multidisciplinary approach and be supportive and maintain a good rapport with pregnant women who abuse prescription drugs. Management includes inpatient hospitalization for detoxification and withdrawal symptoms, and in the case of opiate abuse, opiate maintenance is recommended for pregnant women for the duration of their pregnancy to reduce relapse rates and improve maternal and fetal outcomes. Other recommendations include referral for support groups and supportive housing.

  1. The feasibility of QR-code prescription in Taiwan.

    PubMed

    Lin, C-H; Tsai, F-Y; Tsai, W-L; Wen, H-W; Hu, M-L

    2012-12-01

    An ideal Health Care Service is a service system that focuses on patients. Patients in Taiwan have the freedom to fill their prescriptions at any pharmacies contracted with National Health Insurance. Each of these pharmacies uses its own computer system. So far, there are at least ten different systems on the market in Taiwan. To transmit the prescription information from the hospital to the pharmacy accurately and efficiently presents a great issue. This study consisted of two-dimensional applications using a QR-code to capture Patient's identification and prescription information from the hospitals as well as using a webcam to read the QR-code and transfer all data to the pharmacy computer system. Two hospitals and 85 community pharmacies participated in the study. During the trial, all participant pharmacies appraised highly of the accurate transmission of the prescription information. The contents in QR-code prescriptions from Taipei area were picked up efficiently and accurately in pharmacies at Taichung area (middle Taiwan) without software system limit and area limitation. The QR-code device received a patent (No. M376844, March 2010) from Intellectual Property Office Ministry of Economic Affair, China. Our trial has proven that QR-code prescription can provide community pharmacists an efficient, accurate and inexpensive device to digitalize the prescription contents. Consequently, pharmacists can offer better quality of pharmacy service to patients. © 2012 Blackwell Publishing Ltd.

  2. Prescribing costs when computers are used to issue all prescriptions.

    PubMed Central

    Donald, J. B.

    1989-01-01

    The aim of the study was to see whether the use of a computer to issue prescriptions in conjunction with a computerised, customized drug formulary affects prescribing costs. Data on prescribing costs were obtained from the Scottish Prescription Pricing Bureau for 1978-87. A microcomputer system was introduced into the practice in 1983 and used initially to issue repeat prescriptions, but from 1985 onwards a new system was added to issue all prescriptions; a personal computerised drug formulary was developed in 1983. Personal prescribing costs before and after computerisation were compared with those of the other partners and those of the Lothian Health Board and Scotland combined. The prescribing costs of the partners and Lothian Health Board and Scotland combined increased almost linearly in line with inflation from 1978 to 1987. Personal prescribing costs increased steadily until 1983, when repeat prescriptions were issued by computer, and remained static for a year. Thereafter they increased steadily until 1985, when all prescriptions were issued by computer, and then showed a steady and sustained fall. Personal prescribing costs were 21.5% lower than those of the partners in 1986 and 29.5% lower in 1987. Prescribing costs were reduced when a computer was used to issue all prescriptions in conjunction with a personal, computerised formulary. PMID:2503199

  3. Non-prescription antimicrobial use worldwide: a systematic review

    PubMed Central

    Morgan, Daniel J; Okeke, Iruka N; Laxminarayan, Ramanan; Perencevich, Eli N; Weisenberg, Scott

    2012-01-01

    In much of the world antimicrobial drugs are sold without prescription or oversight by health-care professionals. The scale and effect of this practice is unknown. We systematically reviewed published works about non-prescription antimicrobials from 1970–2009, identifying 117 relevant articles. 35 community surveys from five continents showed that non-prescription use occurred worldwide and accounted for 19–100% of antimicrobial use outside of northern Europe and North America. Safety issues associated with non-prescription use included adverse drug reactions and masking of underlying infectious processes. Non-prescription use was common for non-bacterial disease, and antituberculosis drugs were available in many areas. Antimicrobial-resistant bacteria are common in communities with frequent non-prescription use. In a few settings, control efforts that included regulation decreased antimicrobial use and resistance. Non-prescription antimicrobial and antituberculosis use is common outside of North America and northern Europe and must be accounted for in public health efforts to reduce antimicrobial resistance. PMID:21659004

  4. Influence of pharmaceutical marketing on prescription practices of physicians.

    PubMed

    Narendran, Roshni; Narendranathan, M

    2013-01-01

    In India same drug molecules are sold under different brand names by different pharmaceuticals. To persuade the physicians to prescribe their brands pharmaceuticals engage in marketing techniques like giving samples, gifts, sponsoring travel etc. Many countries are striving to reduce the impact of incentives on prescription behaviour. This study explores the influence of pharmaceutical marketing on the prescription practices of doctors in India. There were 103 study subjects - 50 doctors and 53 sales personnel. Data collection was done by a self administered questionnaire. Data were collected on 36 variables which were supposed to influence prescription. The effectiveness of the promotional strategies on prescription behaviour was marked in a seven point Likert scale ranging from "not at all effective" (score=1) to "extremely effective" (score=7). Open ended questions were used to collect qualitative data. Good rapport with the doctor, launch meetings, reputation of the company, quality of the drug and brand names significantly influenced prescription behaviour, while direct mailers, advertisements in journals and giving letter pads and other brand reminders were less effective. Commonly used method of giving samples was not among the twenty most effective methods influencing prescription. Product quality and good company are still factors that influence prescription. Pharmaceutical marketing influences the choice of brands by a physician. The more expensive strategies involved in public relations are more effective. Sending mails and journal advertisements are less effective strategies. How expensive marketing strategies affect cost of the medicines has to be explored further.

  5. [Analysis of the induced prescription in a primary care region].

    PubMed

    Pérez Gil, S; Millas Ros, J; López Zúñiga, M C; Arzuaga Arambarri, M J; Aldanondo Gabilondo, A; San Vicente Blanco, R

    2010-01-01

    To find out the prevalence, origin and cost associated with Induced Prescription (IP) in Primary Health Care (PHC) in the West of Gipuzkoa (WG). To find out the extent to which PHC doctors agree with IP. To analyse the adaptation of IP to PHC clinical management contract indicators. Design descriptive multi-centre cross-study. Primary Health Care, 38 doctors from 17 WG PHC units. Pharmaceutical prescriptions eligible for finance over a period of two days in outpatients and chronic diseases generated by the Osabide computer application. Variables analysed: type of prescription, origin, prescriber, diagnosis, price and level of agreement. A total of 6.919 prescriptions were made out, with 44% (95% CI: 42.8-45.1) being IP. Of the total cost, 62.2% was put down to IP, with an average price per prescription of €22.3,and in non-induced prescription (NIP) it was €10.62. The therapeutic subgroups with the highest cost were lipid lowering and bronchodilator drugs. The level of disagreement of the doctors taking part in IP was 28.8%. The adaptation to the quality indicators of the prescription was higher in NIP than in IP. There is a high percentage of IP associated with high costs attributed to PHC. The percentage of disagreement in PHC with regard to IP is significant. There is a high influence of IP on the evaluation of the quality indicators established in PHC. Copyright © 2009 SECA. Published by Elsevier Espana. All rights reserved.

  6. [Misuse and dependence on prescription opioids: Prevention, identification and treatment].

    PubMed

    Rolland, B; Bouhassira, D; Authier, N; Auriacombe, M; Martinez, V; Polomeni, P; Brousse, G; Schwan, R; Lack, P; Bachellier, J; Rostaing, S; Bendimerad, P; Vergne-Salle, P; Dematteis, M; Perrot, S

    2017-02-14

    Since the 1990s, the use of prescription opioids has largely spread, which has brought a real progress in the treatment of pain. The long-term use of prescription opioid is sometimes required, and may lead to pharmacological tolerance and withdrawal symptoms, i.e. pharmacological dependence on prescription opioids. Occasionally, this may also lead to misuse of prescription opioids (MPO). MPO preferentially occurs in vulnerable individuals, i.e., those with a young age, history of other addictive or psychiatric disorders, especially anxious and depressive disorders. MPO is associated with numerous complications, including an increased risk of fatal overdose. Prevention of MPO begins before the opioid prescription, with the identification of potential vulnerability factors. A planned and personalized monitoring should be systematically implemented. In vulnerable patients, contractualizing the prescription is warranted. During follow-up, the relevance of the prescription should be regularly reconsidered, according to the benefit observed on pain and the potential underlying signs of MPO. Patients with suspected MPO should be referred early to pain or addiction centers. The treatment of MPO should be based on multidisciplinary strategies, involving both the addiction and pain aspects: progressive opioid withdrawal, non-pharmacological measures against pain, or switching to medication-assisted treatment of addiction (i.e., buprenorphine or methadone).

  7. Patterns of prescription medication diversion among drug dealers

    PubMed Central

    Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

    2012-01-01

    This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South Florida. In-depth semi-structured interviews (n = 50) were conducted with an ethnically diverse sample of prescription drug dealers from a variety of milieus to assess patterns of diversion. Audiotapes of the interviews were transcribed, coded, and thematically analysed using the NVivo 8 software program. Dealers relied on a wide array of diversion methods including visiting multiple pain clinics, working with pharmacy employees to steal medications from pharmacies, and purchasing medications from indigent patients. The type of medication most commonly sold by dealers was prescription opioid analgesics, and to a lesser extent benzodiazepines such as alprazolam. These findings inform public health policy makers, criminal justice officials, the pharmaceutical industry and government regulatory agencies in their efforts to reduce the availability of diverted prescription drugs in the illicit market. Specifically, these data support the need for statewide prescription drug monitoring programs and increased training for healthcare workers who have access to controlled medications. PMID:22665955

  8. Medicare Beneficiary Knowledge of and Experience with Prescription Drug Cards

    PubMed Central

    Rudolph, Noemi V.; Williams, Sunyna S.

    2007-01-01

    Medicare beneficiaries used prescription drug discount cards, both Medicare and non-Medicare cards, to assist them in paying for the cost of prescription drugs. This article describes the beneficiary's awareness and understanding, sources of information, and experience with drug discount cards a year prior and during the implementation of the Medicare-Approved Prescription Drug Discount Card program. Also, it explores beneficiary characteristics that contribute to card ownership and knowledge about drug discount cards. Understanding these experiences and factors can inform future outreach and education campaigns for the Medicare Drug Coverage program. PMID:18624082

  9. Prescription medication abuse and illegitimate internet-based pharmacies.

    PubMed

    Jena, Anupam B; Goldman, Dana P; Foster, Susan E; Califano, Joseph A

    2011-12-20

    Abuse of controlled prescription medications in the United States exceeds that of all illicit drugs combined except marijuana and has grown considerably in the past decade. Although available through traditional channels, controlled prescription medications can also be purchased on the Internet without a prescription. This issue has gained the attention of federal regulators, law enforcement, and the media, but physician awareness of the problem is scarce. This article describes the nature of the problem and its magnitude, discusses the challenges to federal and private efforts to combat illegitimate online pharmacies, and outlines strategies for physicians to recognize and minimize the unwarranted effects of the availability of these medications on the Internet.

  10. Future Challenges and Opportunities in Online Prescription Drug Promotion Research

    PubMed Central

    Southwell, Brian G.; Rupert, Douglas J.

    2016-01-01

    Despite increased availability of online promotional tools for prescription drug marketers, evidence on online prescription drug promotion is far from settled or conclusive. We highlight ways in which online prescription drug promotion is similar to conventional broadcast and print advertising and ways in which it differs. We also highlight five key areas for future research: branded drug website influence on consumer knowledge and behavior, interactive features on branded drug websites, mobile viewing of branded websites and mobile advertisements, online promotion and non-US audiences, and social media and medication decisions. PMID:26927597

  11. Extended possibilities of pharmaceuticals delivery to patients using dematerialized prescriptions.

    PubMed

    Urbański, Andrzej P

    2004-01-01

    This paper considers the requirement for e-commerce enabled delivery of pharmaceutical prescriptions. First, currently available solutions are critically reviewed and an ideal solution is specified and then the concept of the proposed solution--Dematerialized Prescription (DP), is outlined. Next, the information flows required to enable such a service are considered. The paper then considers a number of possible services which could be made available with DP to deliver medicals to patients. Finally, a proposed solution, which enables physician to fill dematerialized prescriptions online using inexpensive mobile Internet devices is presented in detail, the advantages of such a model are summarized and future research directions are suggested.

  12. Direct-to-consumer advertising of prescription drugs.

    PubMed

    Frosch, Dominick L; Grande, David

    2010-01-01

    In 2007, the pharmaceutical industry spent more than $4.9 billion on direct-to-consumer advertising (DTCA) of prescription drugs in the U.S. Controversy over DTCA has grown since the Food and Drug Administration liberalized its regulations in 1997. Proponents claim that such advertising educates consumers, promotes patient participation in clinical decisions, and improves patient adherence to medication instructions. Opponents argue that such advertising is meant to persuade, not educate, and that it promotes inappropriate use of prescription drugs, or diverts consumers from better alternatives. This Issue Brief summarizes the evidence about the effects of DTCA, and proposes guidelines for improving the utility of prescription drug advertising.

  13. [Prescription patterns in the treatment of schizophrenia].

    PubMed

    Leiderman, Eduardo A; Lorenzo, Laura

    2015-01-01

    The aim of this study was to determine prescribing patterns for the pharmacological treatment of schizophrenia in a sample of Argentinean psychiatrists and to compare some results with those obtained in a previous survey done on a similar population. A self-administered survey was conducted among psychiatrists who attended a conference of psychopharmacology held in August 2012 in Buenos Aires city. Answers were analyzed descriptively and some of them were compared with results of another survey done in 2006 in a psychiatry conference. Ninety six percent of the surveyed psychiatrists considered that every schizophrenic patient with an acute episode must be pharmacologically treated. For the acute and chronic treatment of positive symptoms most psychiatrists chose risperidone, haloperidol, olanzapine and quetiapine. In contrast, for the chronic treatment of negative symptomatology, physicians preferred risperidone, aripiprazole, olanzapine, quetiapine and clozapine. An increased choice of quetiapine and aripiprazole was observed between this survey and the previous one. Sixty four percent of respondents reported using antipsychotic combination, similar as assessed in the previous survey. Most preferred to maintain pharmacological treatment during the pregnancy, although changing the antipsychotic to haloperidol. Ninety eight percent stated that they use some kind of psychotherapy in the treatment. In the pharmacological treatment of schizophrenia, similarities between reported clinical practice and current treatment guidelines were observed. There were no significant differences in the prescription patterns referred by psychiatrists between 2006 and 2012.

  14. [Exercise prescription: indications, dosage and side effects].

    PubMed

    Subirats Bayego, Enric; Subirats Vila, Gemma; Soteras Martínez, Iñigo

    2012-01-21

    The prescription of exercise is particularly useful for preventing premature death from all causes, ischemic heart disease, stroke, hypertension, colon and breast cancer, type 2 diabetes, metabolic syndrome, obesity, osteoporosis, sarcopenia, functional dependence and falls in the elderly, cognitive impairment, anxiety and depression. This benefit is observed in both sexes and increases with the volume or intensity of exercise. These benefits are obtained through moderate aerobic exercise for at least 30 minutes 5 days per week or vigorous exercise for at least 20 minutes 3 days a week. It is recommended to add a minimum of 2 nonconsecutive days, each week, to practice 8-10 exercises that develop the strength of most muscle groups (arms, shoulders, chest, abdomen, back, hips and legs). It is also advisable to spend 2 sessions of 10 minutes per week to practice 8-10 exercises that maintain the flexibility of most groups of muscles and tendons. The exercise may involve musculoskeletal injuries and cardiovascular risk, but the benefit outweighs the risk. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  15. Use of prescription medicines in Malaysia 2005.

    PubMed

    Sarojini, S; Faridah, A; Lim, C M; Sameerah, S A R; Lim, T O; Lai, L S; Chew, S M

    2008-08-01

    The National Medicines Use Survey (NMUS) which started in 2004 and is still ongoing was conducted with the intent to continuously and systematically collect data on the use of medicines, to provide an overview on the use of medicines in Malaysia. The objective of the NMUS is therefore to quantify the present state and time trends of medicines utilization at various levels of our health care system whether national, regional, local or institutional. From the data available, for the Year 2005, the most commonly used medicine in Malaysia were anti-diabetic medications, of which glibenclamide is the most common followed by metformin, were the top 2 of the list of drugs utilized in DDD/1000 population/day. Collectively, however, taking into account the various antihypertensives by therapeutic groups, anti-hypertensive medicines were more commonly used than anti-diabetics. Hypertension and diabetes mellitus are the two most prevalent chronic disorders in the country and thus, such high medicines utilization rates for these conditions are to be expected. From the general practice prescription data, it was estimated that a patient with hypertension was prescribed a median of only one (1) anti-hypertensive medication. This means, the vast majority of patients (81%) were on monotherapy, which is hardly sufficient to achieve treatment target. Clearly then, given the prevalence of hypertension, many patients were not on drug treatment at all, and of those treated, their drug treatment are likely to be inadequate.

  16. Evaluating information prescriptions in two clinical environments*

    PubMed Central

    Oliver, Kathleen Burr; Lehmann, Harold P; Wolff, Antonio C; Davidson, Laurie W; Donohue, Pamela K; Gilmore, Maureen M; Craven, Catherine K.

    2011-01-01

    Objective: The research sought to evaluate whether providing personalized information services by libraries can improve satisfaction with information services for specific types of patients. Methods: Adult breast cancer (BrCa) clinic patients and mothers of inpatient neonatal intensive care unit (NICU) patients were randomized to receive routine information services (control) or an IRx intervention. Results: The BrCa trial randomized 211 patients and the NICU trial, 88 mothers. The BrCa trial showed no statistically significant differences in satisfaction ratings between the treatment and control groups. The IRx group in the NICU trial reported higher satisfaction than the control group regarding information received about diagnosis, treatments, respiratory tradeoffs, and medication tradeoffs. BrCa patients posed questions to librarians more frequently than did NICU mothers, and a higher percentage reported using the website. Questions asked of the librarians by BrCa patients were predominantly clinical and focused on the areas of treatment and side effects. Conclusions: Study results provide some evidence to support further efforts to both implement information prescription projects in selected settings and to conduct additional research on the costs and benefits of services. PMID:21753916

  17. Viscosity Prescription for Gravitationally Unstable Accretion Disks

    NASA Astrophysics Data System (ADS)

    Rafikov, Roman R.

    2015-05-01

    Gravitationally unstable accretion disks emerge in a variety of astrophysical contexts—giant planet formation, FU Orioni outbursts, feeding of active galactic nuclei, and the origin of Pop III stars. When a gravitationally unstable disk is unable to cool rapidly, it settles into a quasi-stationary, fluctuating gravitoturbulent state, in which its Toomre Q remains close to a constant value {{Q}0}∼ 1. Here we develop an analytical formalism describing the evolution of such a disk, which is based on the assumptions of Q={{Q}0} and local thermal equilibrium. Our approach works in the presence of additional sources of angular momentum transport (e.g., MRI), as well as external irradiation. Thermal balance dictates a unique value of the gravitoturbulent stress {{α }gt} driving disk evolution, which is a function of the local surface density and angular frequency. We compare this approach with other commonly used gravitoturbulent viscosity prescriptions, which specify the explicit dependence of stress {{α }gt} on Toomre Q in an ad hoc fashion, and identify the ones that provide consistent results. We nevertheless argue that our Q={{Q}0} approach is more flexible, robust, and straightforward and should be given preference in applications. We illustrate this with a couple of analytical calculations—locations of the snow line and of the outer edge of the dead zone in a gravitoturbulent protoplanetary disk—which clearly show the simplicity and versatility of the Q={{Q}0} approach.

  18. Kiwifruit: our daily prescription for health.

    PubMed

    Stonehouse, Welma; Gammon, Cheryl S; Beck, Kathryn L; Conlon, Cathryn A; von Hurst, Pamela R; Kruger, Rozanne

    2013-06-01

    Kiwifruit are unequalled, compared with other commonly consumed fruit, for their nutrient density, health benefits, and consumer appeal. Research into their health benefits has focussed on the cultivars Actinidia deliciosa 'Hayward' (green kiwifruit) and Actinidia chinensis 'Hort 16A', ZESPRI(®) (gold kiwifruit). Compared with other commonly consumed fruit, both green and gold kiwifruit are exceptionally high in vitamins C, E, K, folate, carotenoids, potassium, fibre, and phytochemicals acting in synergy to achieve multiple health benefits. Kiwifruit, as part of a healthy diet, may increase high-density lipoprotein cholesterol, and decrease triglycerides, platelet aggregation, and elevated blood pressure. Consuming gold kiwifruit with iron-rich meals improves poor iron status, and green kiwifruit aids digestion and laxation. As a rich source of antioxidants, they may protect the body from endogenous oxidative damage. Kiwifruit may support immune function and reduce the incidence and severity of cold or flu-like illness in at-risk groups such as older adults and children. However, kiwifruit are allergenic, and although symptoms in most susceptible individuals are mild, severe reactions have been reported. While many research gaps remain, kiwifruit with their multiple health benefits have the potential to become part of our "daily prescription for health."

  19. Precise AuxPt1−x Alloy Nanoparticle Array of Tunable Composition for Catalytic Applications

    PubMed Central

    Jahn, Sarah; Lechner, Sebastian J.; Freichels, Helene; Möller, Martin; Spatz, Joachim P.

    2016-01-01

    A 3-dimensional Block Copolymer Micellar nanoLithography (BCML) process was used to prepare AuxPt1−x alloy nanoparticles (NPs) monodisperse in size and composition, strongly anchored onto SiO2-particles (0.2 wt.% AuxPt1−x/SiO2). The particles possess a face-centered cubic (fcc) crystal structure and their size could be varied from 3–12 nm. We demonstrate the uniformity of the Au/Pt composition by analyzing individual NPs by energy-dispersive X-ray spectroscopy. The strongly bound AuxPt1−x NPs catalyzed the oxidation of CO with high activity. Thermal ageing experiments in pure CO2 as well as in ambient atmosphere demonstrated stability of the size distribution for times as long as 22 h. PMID:26856888

  20. Precise AuxPt1‑x Alloy Nanoparticle Array of Tunable Composition for Catalytic Applications

    NASA Astrophysics Data System (ADS)

    Jahn, Sarah; Lechner, Sebastian J.; Freichels, Helene; Möller, Martin; Spatz, Joachim P.

    2016-02-01

    A 3-dimensional Block Copolymer Micellar nanoLithography (BCML) process was used to prepare AuxPt1‑x alloy nanoparticles (NPs) monodisperse in size and composition, strongly anchored onto SiO2-particles (0.2 wt.% AuxPt1‑x/SiO2). The particles possess a face-centered cubic (fcc) crystal structure and their size could be varied from 3–12 nm. We demonstrate the uniformity of the Au/Pt composition by analyzing individual NPs by energy-dispersive X-ray spectroscopy. The strongly bound AuxPt1‑x NPs catalyzed the oxidation of CO with high activity. Thermal ageing experiments in pure CO2 as well as in ambient atmosphere demonstrated stability of the size distribution for times as long as 22 h.

  1. Novel auxin transport inhibitors phenocopy the auxin influx carrier mutation aux1.

    PubMed

    Parry, G; Delbarre, A; Marchant, A; Swarup, R; Napier, R; Perrot-Rechenmann, C; Bennett, M J

    2001-02-01

    The hormone auxin is transported in plants through the combined actions of diffusion and specific auxin influx and efflux carriers. In contrast to auxin efflux, for which there are well documented inhibitors, understanding the developmental roles of carrier-mediated auxin influx has been hampered by the absence of specific competitive inhibitors. However, several molecules that inhibit auxin influx in cultured cells have been described recently. The physiological effects of two of these novel influx carrier inhibitors, 1-naphthoxyacetic acid (1-NOA) and 3-chloro-4-hydroxyphenylacetic acid (CHPAA), have been investigated in intact seedlings and tissue segments using classical and new auxin transport bioassays. Both molecules do disrupt root gravitropism, which is a developmental process requiring rapid auxin redistribution. Furthermore, the auxin-insensitive and agravitropic root-growth characteristics of aux1 plants were phenocopied by 1-NOA and CHPAA. Similarly, the agravitropic phenotype of inhibitor-treated seedlings was rescued by the auxin 1-naphthaleneacetic acid, but not by 2,4-dichlorophenoxyacetic acid, again resembling the relative abilities of these two auxins to rescue the phenotype of aux1. Further investigations have shown that none of these compounds block polar auxin transport, and that CHPAA exhibits some auxin-like activity at high concentrations. Whilst results indicate that 1-NOA and CHPAA represent useful tools for physiological studies addressing the role of auxin influx in planta, 1-NOA is likely to prove the more useful of the two compounds.

  2. Exposition précoce aux aliments et allergies alimentaires chez les enfants

    PubMed Central

    Chin, Benetta; Chan, Edmond S.; Goldman, Ran D.

    2014-01-01

    Résumé Question J’étais sous l’impression qu’on devrait éviter de donner aux nourrissons des aliments potentiellement allergènes comme des noix, du lait de vache et des œufs pour prévenir le développement de réactions allergiques. Quels conseils devrait-on donner aux parents concernant l’introduction des aliments durant la petite enfance et le développement des allergies alimentaires? Réponse Il n’y a pas de données probantes indiquant que retarder l’introduction d’aliments particuliers après l’âge de 6 mois aide à prévenir les allergies. Une récente déclaration de la Société canadienne de pédiatrie ne recommande aucun délai quant à l’introduction d’aliments durant la petite enfance. De récentes études de recherche semblent aussi faire valoir que l’introduction précoce (entre 4 et 6 mois) d’aliments possiblement allergènes procure une forme de protection et contribue à prévenir les allergies, mais il faudrait plus de recherche à ce sujet.

  3. Superconducting parameters of BaPt4-xAuxGe12 filled skutterudite

    NASA Astrophysics Data System (ADS)

    Maisuradze, A.; Gumeniuk, R.; Schnelle, W.; Nicklas, M.; Baines, C.; Khasanov, R.; Amato, A.; Leithe-Jasper, A.

    2012-11-01

    We report on a study of the superconducting properties for a series of polycrystalline BaPt4-xAuxGe12 filled skutterudite compounds for x=0, 0.5, 0.75, and 1. Muon spin rotation (μSR) spectroscopy as well as magnetization, specific-heat, and electrical resistivity measurements were performed. The magnetic penetration depth λ, the coherence length ξ, and the Ginzburg-Landau parameter κ are evaluated. The temperature dependence of the superfluid density is well described by an s-wave superconducting gap and this classical scenario is supported by the field-independent λ. The gap-to-Tc ratio Δ0/kBTc increases with the Au content from 1.70 for x=0 to 2.1(1) for x=1. By combining μSR, magnetization, and specific-heat data, we find that BaPt4-xAuxGe12 compounds are in between the dirty and clean limits with mean free paths of the carriers l˜ξ. Interestingly, resistivity data for BaPt4Ge12 indicate a much higher upper critical field, which is probably due to defects or impurities close to the surface of the crystallites.

  4. Exploring emergency contraception knowledge, prescription practices, and barriers to prescription for adolescents in the emergency department.

    PubMed

    Goyal, Monika; Zhao, Huaqing; Mollen, Cynthia

    2009-03-01

    The objective of this study was to assess the proportion of emergency medicine physicians who had prescribed emergency contraception pills to adolescents, to identify potential barriers to emergency contraception pill prescription for adolescents, and to assess physician knowledge of emergency contraception pills. A cross-sectional, anonymous, Internet-based survey of members of the American Academy of Pediatrics Section of Emergency Medicine was conducted. Providers were included in analysis if they were attending physicians caring for children (<22 years of age) in the emergency department setting >30% of the time. Survey questions included demographics, emergency contraception pill prescription rates for adolescents, attitudes toward emergency contraception pills for adolescents, and emergency contraception pill knowledge questions. A total of 1005 Section of Emergency Medicine members were contacted; 424 (42%) responded, and 133 did not meet inclusion criteria. Of the 291 eligible respondents, 282 had complete surveys. Eighty-five percent of the respondents stated that they had prescribed emergency contraception pills to adolescents, 71% within the previous year. Of those, 81% prescribed emergency contraception pills <5 times. The 5 most frequently cited barriers were concern for lack of follow-up (72%), time constraints (40%), lack of clinical resources (33%), discouraging regular contraceptive use (29%), and concern about birth defects (27%). Thirty-nine percent of respondents identified >/=5 barriers to emergency contraception pill prescriptions for adolescents. Forty-three percent incorrectly answered >50% of the questions. Physicians were more likely to report prescribing emergency contraception pills if they had answered >3 of the knowledge-based questions correctly and were less likely to report prescribing if they identified >5 barriers. Although a large proportion of emergency department physicians reported prescribing emergency contraception pills to

  5. Expanded pharmacy technician roles: Accepting verbal prescriptions and communicating prescription transfers.

    PubMed

    Frost, Timothy P; Adams, Alex J

    2016-11-29

    As the role of the clinical pharmacist continues to develop and advance, it is critical to ensure pharmacists can operate in a practice environment and workflow that supports the full deployment of their clinical skills. When pharmacy technician roles are optimized, patient safety can be enhanced and pharmacists may dedicate more time to advanced clinical services. Currently, 17 states allow technicians to accept verbal prescriptions called in by a prescriber or prescriber's agent, or transfer a prescription order from one pharmacy to another. States that allow these activities generally put few legal limitations on them, and instead defer to the professional judgment of the supervising pharmacist whether to delegate these tasks or not. These activities were more likely to be seen in states that require technicians to be registered and certified, and in states that have accountability mechanisms (e.g., discipline authority) in place for technicians. There is little evidence to suggest these tasks cannot be performed safely and accurately by appropriately trained technicians, and the track record of success with these tasks spans four decades in some states. Pharmacists can adopt strong practice policies and procedures to mitigate the risk of harm from verbal orders, such as instituting read-back/spell-back techniques, or requiring the indication for each phoned-in medication, among other strategies. Pharmacists may also exercise discretion in deciding to whom to delegate these tasks. As the legal environment becomes more permissive, we foresee investment in more robust education and training of technicians to cover these activities. Thus, with the adoption of robust practice policies and procedures, delegation of verbal orders and prescription transfers can be safe and effective, remove undue stress on pharmacists, and potentially free up pharmacist time for higher-order clinical care. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Update on prescription monitoring in clinical practice: a survey study of prescription monitoring program administrators.

    PubMed

    Katz, Nathaniel; Houle, Brian; Fernandez, Kathrine C; Kreiner, Peter; Thomas, Cindy Parks; Kim, MeeLee; Carrow, Grant M; Audet, Adele; Brushwood, David

    2008-01-01

    Prescription drug abuse and undertreatment of pain are public health priorities in the United States. Few options to manage these problems are balanced, in simultaneously supporting pain relief and deterring prescription drug abuse. Prescription monitoring programs (PMPs) potentially offer a balanced approach; however, the medical/scientific communities are not well informed about their current status and potential risks/benefits. The purpose of this study was to provide a benchmark of the current status of PMPs for healthcare providers upon which to engage PMP administrators. A Web survey of current PMP directors with a telephone follow-up conducted in June-July 2006 regarding goals, data captured, data sharing procedures, healthcare provider training, and evaluation efforts. Eighteen of 23 states with operating PMPs at that time participated. Eleven programs allowed physician access to PMP data. Data were delivered by mail (N = 6), fax (N = 8), e-mail (N = 1), and Websites (N = 8). Eight programs provided data to providers within 1 hour. Three states have developed provider PMP usage guidelines. Eight states developed or are developing educational programs. Two states completed or are conducting evaluations of the public health impact of PMP implementation. Five states have begun utilizing PMP data as an epidemiological tool. Initial public safety orientation of PMPs is evolving to include improving public health and patient care. Beginning with efforts to engage healthcare providers through data sharing and education, and progressively including program evaluation on public health and patient care, our results suggest a rapid movement in the direction of utilization of PMPs to improve health care.

  7. Exercise Prescription and the Low Back--Kinesiological Factors.

    ERIC Educational Resources Information Center

    Sharpe, Gina L.; And Others

    1988-01-01

    This article presents kinesiological factors pertaining to the lower back which should be considered in exercise prescription for youth. Three specific areas of concern are reviewed--abdominal muscular strength, trunk flexibility, and postural conditioning in jogging. (IAH)

  8. Resistance Training: Exercise Prescription (Part 4 of 4).

    ERIC Educational Resources Information Center

    Kraemer, William J.; Fleck, Steven J.

    1988-01-01

    Resistance training as an exercise prescription is discussed and a program design process is outlined. The importance of preliminary assessments; defining goals and expectations; and evaluating individual needs and goals are discussed. (Author/JL)

  9. Which Classes of Prescription Drugs Are Commonly Misused?

    MedlinePlus

    ... Trends and Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Prescription ... addiction. Chemically, these medications are very similar to heroin, which was originally synthesized from morphine as a ...

  10. Elaboration and Validation of the Medication Prescription Safety Checklist 1

    PubMed Central

    Pires, Aline de Oliveira Meireles; Ferreira, Maria Beatriz Guimarães; do Nascimento, Kleiton Gonçalves; Felix, Márcia Marques dos Santos; Pires, Patrícia da Silva; Barbosa, Maria Helena

    2017-01-01

    ABSTRACT Objective: to elaborate and validate a checklist to identify compliance with the recommendations for the structure of medication prescriptions, based on the Protocol of the Ministry of Health and the Brazilian Health Surveillance Agency. Method: methodological research, conducted through the validation and reliability analysis process, using a sample of 27 electronic prescriptions. Results: the analyses confirmed the content validity and reliability of the tool. The content validity, obtained by expert assessment, was considered satisfactory as it covered items that represent the compliance with the recommendations regarding the structure of the medication prescriptions. The reliability, assessed through interrater agreement, was excellent (ICC=1.00) and showed perfect agreement (K=1.00). Conclusion: the Medication Prescription Safety Checklist showed to be a valid and reliable tool for the group studied. We hope that this study can contribute to the prevention of adverse events, as well as to the improvement of care quality and safety in medication use. PMID:28793128

  11. Prescription Medication Sharing: A Systematic Review of the Literature

    PubMed Central

    Beyene, Kebede A.; Sheridan, Janie; Aspden, Trudi

    2014-01-01

    We reviewed the literature on nonrecreational prescription medication sharing. We searched PubMed, EMBASE, PsycINFO, and a customized multidatabase for all relevant articles published through 2013; our final sample comprised 19 studies from 9 countries with 36 182 participants, ranging in age from children to older adults, and published between 1990 and 2011. The prevalence rate for borrowing someone’s prescription medication was 5% to 51.9% and for lending prescription medication to someone else was 6% to 22.9%. A wide range of medicines were shared between family members, friends, and acquaintances. Sharing of many classes of prescription medication was common. Further research should explore why people share, how they decide to lend or borrow, whether they are aware of the risks, and how they assess the relevance of those risks. PMID:24524496

  12. The Language of Civil Engineering: Descriptive, Prescriptive, and Persuasive.

    ERIC Educational Resources Information Center

    Machauf, Liora

    1990-01-01

    Focuses on the language of civil engineering as manifested in the professional journal "Civil Engineering ASCE." Articles are analyzed, both syntactically and lexically, in terms of three major rhetorical functions: description, prescription, and persuasion. (17 references) (GLR)

  13. Half of Opioid Prescriptions Go to People with Mental Illness

    MedlinePlus

    ... Half of Opioid Prescriptions Go to People With Mental Illness Those with psychological conditions more likely to overdose ... United States, 60 million are for adults with mental illness, according to the researchers. "Despite representing only 16 ...

  14. Cholesterol-Lowering Supplements: Lower Your Numbers without Prescription Medication

    MedlinePlus

    ... cholesterol and LDL cholesterol May cause nausea, indigestion, gas, diarrhea or constipation; may be ineffective if you take ezetimibe (Zetia), a prescription cholesterol medication Soy protein as a substitute for other high-fat protein sources May reduce ...

  15. Exercise Prescription and the Low Back--Kinesiological Factors.

    ERIC Educational Resources Information Center

    Sharpe, Gina L.; And Others

    1988-01-01

    This article presents kinesiological factors pertaining to the lower back which should be considered in exercise prescription for youth. Three specific areas of concern are reviewed--abdominal muscular strength, trunk flexibility, and postural conditioning in jogging. (IAH)

  16. 21 CFR 1306.21 - Requirement of prescription.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of a paper prescription or order for medication transmitted by the practitioner or the practitioner's....05 except for the signature of the individual practitioner), or pursuant to an order for medication...

  17. 21 CFR 1306.21 - Requirement of prescription.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... of a paper prescription or order for medication transmitted by the practitioner or the practitioner's....05 except for the signature of the individual practitioner), or pursuant to an order for medication...

  18. 21 CFR 1306.21 - Requirement of prescription.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... of a paper prescription or order for medication transmitted by the practitioner or the practitioner's....05 except for the signature of the individual practitioner), or pursuant to an order for medication...

  19. Adding in Prescription for Partner Boosts STD Care

    MedlinePlus

    ... in Prescription for Partner Boosts STD Care Lower chlamydia, gonorrhea rates seen when one person can obtain ... States that let doctors prescribe drugs to treat chlamydia or gonorrhea in both partners when only one ...

  20. Americans Taking More Prescription Drugs Than Ever: Survey

    MedlinePlus

    ... of prescriptions filled for American adults and children rose 85 percent between 1997 and 2016, from 2. ... Quintile IMS. During that time, the U.S. population rose 21 percent. In 2014, nearly 1.3 million ...

  1. U.S. Opioid Prescriptions Fall, But Numbers Still High

    MedlinePlus

    ... many people being provided lengthy prescriptions of the narcotics at high doses. "We're still seeing too ... Human Services. More Health News on Health Disparities Opioid Abuse and Addiction Recent Health News Related MedlinePlus Health Topics Health ...

  2. The “Black Box” of Prescription Drug Diversion

    PubMed Central

    Inciardi, James A.; Surratt, Hilary L.; Cicero, Theodore J.; Kurtz, Steven P.; Martin, Steven S.; Parrino, Mark W.

    2009-01-01

    A variety of surveys and studies are examined in an effort to better understand the scope of prescription drug diversion and to determine if there are consistent patterns of diversion among various populations of prescription drug abusers. Data are drawn from the RADARS® System, the National Survey of Drug Use and Health (NSDUH), the Delaware School Survey, and a series of quantitative and qualitative studies conducted in Miami, Florida. The data suggest that the major sources of diversion include drug dealers, friends and relatives, smugglers, pain patients, and the elderly, but these vary by the population being targeted. In all of the studies examined, the use of the Internet as a source for prescription drugs is insignificant. Little is known about where drug dealers are obtaining their supplies, and as such, prescription drug diversion is a “black box” requiring concentrated systematic study. PMID:20155603

  3. 'Colored' and Decorative Contact Lenses: A Prescription Is a Must

    MedlinePlus

    ... Home For Consumers Consumer Updates 'Colored' and Decorative Contact Lenses: A Prescription Is A Must Share Tweet ... care.” back to top Where NOT to Buy Contact Lenses FDA is aware that many places illegally ...

  4. Medicare program; Medicare prescription drug benefit. Final rule.

    PubMed

    2005-01-28

    This final rule implements the provisions of the Social Security Act (the Act) establishing and regulating the Medicare Prescription Drug Benefit. The new voluntary prescription drug benefit program was enacted into law on December 8, 2003 in section 101 of Title I of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173). Although this final rule specifies most of the requirements for implementing the new prescription drug program, readers should note that we are also issuing a closely related rule that concerns Medicare Advantage organizations, which, if they offer coordinated care plans, must offer at least one plan that combines medical coverage under Parts A and B with prescription drug coverage. Readers should also note that separate CMS guidance on many operational details appears or will soon appear on the CMS website, such as materials on formulary review criteria, risk plan and fallback plan solicitations, bid instructions, solvency standards and pricing tools, plan benefit packages. The addition of a prescription drug benefit to Medicare represents a landmark change to the Medicare program that will significantly improve the health care coverage available to millions of Medicare beneficiaries. The MMA specifies that the prescription drug benefit program will become available to beneficiaries beginning on January 1, 2006. Generally, coverage for the prescription drug benefit will be provided under private prescription drug plans (PDPs), which will offer only prescription drug coverage, or through Medicare Advantage prescription drug plans (MA PDs), which will offer prescription drug coverage that is integrated with the health care coverage they provide to Medicare beneficiaries under Part C of Medicare. PDPs must offer a basic prescription drug benefit. MA-PDs must offer either a basic benefit or broader coverage for no additional cost. If this required level of coverage is offered, MA-PDs or PDPs, but not

  5. 21 CFR 1306.05 - Manner of issuance of prescriptions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... not permitted, prescriptions shall be written with ink or indelible pencil or typewriter and shall be... written with ink or indelible pencil, typewriter, or printed on a computer printer and shall be manually...

  6. Buying Prescription Medicine Online: A Consumer Safety Guide

    MedlinePlus

    ... Drugs Home Drugs Resources for You Buying Prescription Medicine Online: A Consumer Safety Guide Share Tweet Linkedin ... A Consumer Safety Guide (PDF - 53KB) Buying your medicine online can be easy. Just make sure you ...

  7. [Predictive factors of drug prescription: profile of the overprescribing physician].

    PubMed

    Espigares Arroyo, M; Montes Salas, G; Altimiras Roset, J; Iglesias Sánchez, J M; Brioso Jerez, F

    1994-01-01

    Because of increasing pharmaceutical costs, several programs aimed at optimizing physician's prescription have been set up in the last years. However, factors determining prescription volume are not well known yet. The aim of study is to determine which the characteristics of the practitioner (GP) or the working place are related with a higher amount of drug prescription. With data obtained from PE-29, PE-20, and the managing center Human Resources Department databases, concerning the whole GP staff (N = 293), via a multiple regression model, we were able to determine the following factors predicting higher prescription:rural work place, longer distance to reference specialty center, care to children, lack of postgraduate education, short term work contract, and part time staff.

  8. Reaching Beyond the Prescription Pad to Treat Pain

    MedlinePlus

    ... specialists believe widespread use of powerful prescription painkillers led to the current heroin and opioid epidemic ravaging ... three or four sessions. Over two years, they led to significant reductions in opioid use, depression and ...

  9. Adverse selection in the Medicare prescription drug program.

    PubMed

    Riley, Gerald F; Levy, Jesse M; Montgomery, Melissa A

    2009-01-01

    The Medicare Part D drug benefit created choices for beneficiaries among many prescription drug plans with varying levels of coverage. As a result, Medicare enrollees with high prescription drug costs have strong incentives to enroll in Part D, especially in plans with more comprehensive coverage. To measure this potential problem of "adverse selection," which could threaten plans' finances, we compared baseline characteristics among groups of beneficiaries with various drug coverage arrangements in 2006. We found some significant differences. For example, enrollees in stand-alone prescription drug plans, especially in plans offering benefits in the coverage gap, or "doughnut hole," had higher baseline drug costs and worse health than enrollees in Medicare Advantage prescription drug plans. Although risk-adjusted payments and other measures have been put in place to account for selection, these patterns could adversely affect future Medicare costs and should be watched carefully.

  10. Diagnosis-Prescription in the Context of Instructional Management

    ERIC Educational Resources Information Center

    Besel, Ronald

    1973-01-01

    Author argues that individual assessment of the students learning style should precede the decision of which teaching method is appropriate. He applies the medical terminology of diagnosis-prescription to this method of instructional development for management. (HB)

  11. Exercise a Great Prescription to Help Older Hearts

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_164253.html Exercise a Great Prescription to Help Older Hearts Not ... 2017 THURSDAY, March 23, 2017 (HealthDay News) -- Regular exercise is potent medicine for older adults with heart ...

  12. Comparison of Different Hearing Aid Prescriptions for Children.

    PubMed

    Marriage, Josephine E; Vickers, Deborah A; Baer, Thomas; Glasberg, Brian R; Moore, Brian C J

    2017-07-06

    To assess whether there are significant differences between speech scores for different hearing aid prescription methods, specifically DSL i/o, DSL V, and NAL-NL1, using age-appropriate closed- and open-set speech tests with young children, designed to avoid floor and ceiling effects. Participants were 44 children with moderate or severe bilateral hearing loss, 8 aged 2 to 3 years, 15 aged 4 to 5 years, and 21 aged 6 to 9 years. Children wore bilateral hearing aids fitted with each prescription method in turn in a balanced double-blind design. The speech tests used with each child (and for some tests the levels) were chosen so as to avoid floor and ceiling effects. For the closed-set tests, the level used was selected for each child based on their hearing loss. The tests used were: (1) The closed-set Consonant Confusion Test of word identification; (2) The closed-set Chear Auditory Perception Test (CAPT) of word identification. This has separate sections assessing discrimination of consonants and vowels and detection of consonants; (3) The open-set Cambridge Auditory Word Lists for testing word identification at levels of 50 and 65 dBA, utilizing 10 consonant-vowel-consonant real words that are likely to be familiar to children aged 3 years or older; (4) The open-set Common Phrases Test to measure the speech reception threshold in quiet; (5) Measurement of the levels required for identification of the Ling 5 sounds, using a recording of the sounds made at the University of Western Ontario. Scores for the Consonant Confusion Test and CAPT consonant discrimination and consonant detection were lower for the NAL-NL1 prescription than for the DSL prescriptions. Scores for the CAPT vowel-in-noise discrimination test were higher for DSL V than for either of the other prescriptions. Scores for the Cambridge Auditory Word Lists did not differ across prescriptions for the level of 65 dBA, but were lower for the NAL-NL1 prescription than for either of the DSL prescriptions

  13. The influence of prescription monitoring programs on chronic pain management.

    PubMed

    Wang, Jing; Christo, Paul J

    2009-01-01

    Abuse of prescribed controlled substance has become a serious social as well as health care issue over the past decade. A particularly alarming trend exists among patients aged 12 to 17. Common abuse behaviors include doctor shopping, drug theft, feigned pain symptoms to gain health care access, drug sharing, prescription forgery, and improper prescription practices. In response to this epidemic of abuse, many states have adopted prescription monitoring programs (PMPs). Such programs first originated in the early twentieth century. As of 2006, 38 states had such programs, many of which are supported by federal grants. As PMPs become more widespread, they have also increased in sophistication. By keeping a record of the prescription and dispensing of narcotics, these programs are able to build a comprehensive data network for tracking prescription medications. These databases aid law enforcement agencies in investigations of narcotic trafficking; they also help state regulatory boards to monitor improper prescription practices. This manuscript examines the basic structure of a PMP, including the way the data are collected and the way these data are stored and used. It also looks at the organizational differences amongst state programs. NASPER and Harold Rogers are two federal programs that provide funding to the state PMPs, and the current study examines the differences as well as similarities between these 2 programs. This study also compares the results of 2 reports: the U.S. General Accounting Office Study and the Twillman study.& Both studies have evaluated the efficiency of the PMPs. The U.S. General Accounting Office Study showed that while considerable differences exist among the state PMPs, these programs not only reduce the time and effort for law enforcement agencies to conduct investigations, but also cut the supply of prescription medications. However, the Twillman report suggests that prescription programs caused a shift in prescription practice, while

  14. Paediatric Prescription Analysis in a Primary Health Care Institution

    PubMed Central

    Devassykutty, Denny

    2016-01-01

    Introduction Paediatric prescription analysis was done by vari-ous studies in tertiary care centers but not much published data, at primary care level. The Medical Council of India introduced new prescription format and also antibiotic stewardship program was launched by Government of Kerala in the year 2015. So in these contexts this study was conducted. Aim To analyse the patterns of prescriptions and drug dis-pensing in pediatric patients using WHO core drug use indicators and parameters in the prescription format prescribed by Medical Council of India. Materials and Methods Prospective study was done at a community health center, for a period of four months where parents of children attending the outpatient department were interviewed and the prescriptions and medicines that is with them was examined and analysed for any prescription errors or dispensing errors. For statistical analysis, quantitative variables were expressed in mean and standard deviation and qualitative variables in percentages. Results The mean age of the patients was 6.1 (SD±3.4) years. The average number of drugs prescribed was 2.29 (SD±35.91), 98.4% drugs were prescribed by generic name. Majority of drugs prescribed were in the form of syrups (62.73%), use of antibiotics was frequent (73.18%), but injection use was very minimal (0.006%). Weight of the patient was recorded in 58.33% of the prescriptions. Only 30 prescriptions (5.43%) were written in capital letters. A 100% of the prescriptions contain the details of the child along with provisional diagnosis and signature of the doctor. A 98.44% of the drugs prescribed were from the essential drug list. Copy of the essential drug list is available at the institution. The availability of key drugs was 100%. 98.73% knew the correct dosages and 100% of the drugs were adequately labeled. Conclusion The prescription pattern is in accordance with the standard guidelines of WHO. Interventions are needed to rectify over prescription of

  15. [Actual antimicrobial chemotherapy prescription in infant and child].

    PubMed

    Bourrillon, A; Benoist, G; Cohen, R; Bingen, E

    2007-07-01

    Antimicrobial chemotherapy prescription should take into account the following items: 1) accurate diagnosis (most often clinical) and definition criteria of infectious diseases; 2) treatment justification; 3) confirmation of a bacterial etiology (now facilitated in some clinical situations by broadly available easy-to-use rapid diagnosis tests); 4 evidence-based antimicrobial choices; 5) modalities of prescriptions guided by official authorities (guidelines from French agency of medicinal products).

  16. Rates of Anomalous Bupropion Prescriptions in Ontario, Canada

    PubMed Central

    Steele, Leah S.; Macdonald, Erin M.; Gomes, Tara; Hollands, Simon; Paterson, J. Michael; Mamdani, Muhammad M.; Juurlink, David N.

    2015-01-01

    PURPOSE Reports of bupropion misuse have increased since it was first reported in 2002. The purpose of this study was to explore trends in bupropion prescribing suggestive of misuse or diversion in Ontario, Canada. METHODS A serial cross-sectional study was conducted of Ontarians aged younger than 65 years who received prescriptions under Ontario’s public drug program from April 1, 2000, to March 31, 2013. We determined the number of potentially inappropriate prescriptions in each quarter, defined as early refills dispensed within 50% of the duration of the preceding prescription, as well as potentially duplicitous prescriptions, defined as similarly early refills originating from a different prescriber and different pharmacy. We replicated these analyses for citalopram and sertraline, antidepressants not known to be prone to abuse. RESULTS We identified 1,780,802 prescriptions for bupropion, 3,402,462 for citalopram, and 1,775,285 for sertraline. Rates of early refills for bupropion declined during the study from 4.8% to 3.1%. In the final quarter, rates of early refills for bupropion were more common than for citalopram (3.1% vs 2.2%) (P <.001) but not for sertraline (3.1% vs 2.9%) (P =.16). Potentially duplicitous prescriptions for bupropion increased dramatically, from <0.05% of all prescriptions in early 2000 to 0.47% in early 2013 and by the final quarter were more common than both citalopram (0.11%) and sertraline (0.12%) (P <.001). CONCLUSIONS Although no marked differences were seen for early refills of bupropion relative to its comparators, potentially duplicitous prescriptions have increased dramatically in Ontario, suggesting growing misuse of the drug. PMID:26195679

  17. Pain Management Perceptions among Prescription Opioid Dependent Individuals

    PubMed Central

    McCauley, Jenna L.; Mercer, Mary Ashley; Barth, Kelly S.; Brady, Kathleen T.; Back, Sudie E.

    2014-01-01

    Background Nearly two-thirds of prescription opioid dependent individuals report chronic pain conditions as both an initial and current motivation for prescription opioid use. However, to date, limited information exists regarding perceptions of the adequacy of pain management and pain management behaviors among prescription opioid dependent individuals with a history of treatment for chronic pain. Methods The current study examined perceptions of the medical management of chronic pain among community-recruited individuals (N=39) who met DSM-IV-TR criteria for current prescription opioid dependence and reported a history of treatment for chronic pain. Prescription opioid dependence, symptoms of depression, and pain management perceptions were assessed using the Structured Clinical Interview for DSM Disorders, Beck Depression Inventory, and the Pain Management Questionnaire, respectively. Results Reports of insufficient pain management were common (46.2%), as was utilization of emergency room services for pain management (56.4%). Nearly half reported a physician as their initial source (46.2%) and pain management as their primary initial reason for prescription opioid use (53.8%), whereas 35.9% reported pain relief as their primary reason for current prescription opioid use. Symptoms of depression were common (51.3%), as was comorbid abuse of other substances and history of treatment for substance abuse. Conclusions Results highlight the complicated clinical presentation and prevalent perception of the under-treatment of pain among this population. Findings underscore the importance of interdisciplinary approaches to managing the complex presentation of chronic pain patients with comorbid prescription opioid dependence. Implications for future research are discussed. PMID:25034899

  18. Prescription errors in cancer chemotherapy: Omissions supersede potentially harmful errors

    PubMed Central

    Mathaiyan, Jayanthi; Jain, Tanvi; Dubashi, Biswajit; Reddy, K Satyanarayana; Batmanabane, Gitanjali

    2015-01-01

    Objective: To estimate the frequency and type of prescription errors in patients receiving cancer chemotherapy. Settings and Design: We conducted a cross-sectional study at the day care unit of the Regional Cancer Centre (RCC) of a tertiary care hospital in South India. Materials and Methods: All prescriptions written during July to September 2013 for patients attending the out-patient department of the RCC to be treated at the day care center were included in this study. The prescriptions were analyzed for omission of standard information, usage of brand names, abbreviations and legibility. The errors were further classified into potentially harmful ones and not harmful based on the likelihood of resulting in harm to the patient. Descriptive analysis was performed to estimate the frequency of prescription errors and expressed as total number of errors and percentage. Results: A total of 4253 prescribing errors were found in 1500 prescriptions (283.5%), of which 47.1% were due to omissions like name, age and diagnosis and 22.5% were due to usage of brand names. Abbreviations of pre-medications and anticancer drugs accounted for 29.2% of the errors. Potentially harmful errors that were likely to result in serious consequences to the patient were estimated to be 11.7%. Conclusions: Most of the errors intercepted in our study are due to a high patient load and inattention of the prescribers to omissions in prescription. Redesigning prescription forms and sensitizing prescribers to the importance of writing prescriptions without errors may help in reducing errors to a large extent. PMID:25969654

  19. Rates of Anomalous Bupropion Prescriptions in Ontario, Canada.

    PubMed

    Steele, Leah S; Macdonald, Erin M; Gomes, Tara; Hollands, Simon; Paterson, J Michael; Mamdani, Muhammad M; Juurlink, David N

    2015-01-01

    Reports of bupropion misuse have increased since it was first reported in 2002. The purpose of this study was to explore trends in bupropion prescribing suggestive of misuse or diversion in Ontario, Canada. A serial cross-sectional study was conducted of Ontarians aged younger than 65 years who received prescriptions under Ontario's public drug program from April 1, 2000, to March 31, 2013. We determined the number of potentially inappropriate prescriptions in each quarter, defined as early refills dispensed within 50% of the duration of the preceding prescription, as well as potentially duplicitous prescriptions, defined as similarly early refills originating from a different prescriber and different pharmacy. We replicated these analyses for citalopram and sertraline, antidepressants not known to be prone to abuse. We identified 1,780,802 prescriptions for bupropion, 3,402,462 for citalopram, and 1,775,285 for sertraline. Rates of early refills for bupropion declined during the study from 4.8% to 3.1%. In the final quarter, rates of early refills for bupropion were more common than for citalopram (3.1% vs 2.2%) (P <.001) but not for sertraline (3.1% vs 2.9%) (P =.16). Potentially duplicitous prescriptions for bupropion increased dramatically, from <0.05% of all prescriptions in early 2000 to 0.47% in early 2013 and by the final quarter were more common than both citalopram (0.11%) and sertraline (0.12%) (P <.001). Although no marked differences were seen for early refills of bupropion relative to its comparators, potentially duplicitous prescriptions have increased dramatically in Ontario, suggesting growing misuse of the drug. © 2015 Annals of Family Medicine, Inc.

  20. Transferring Lens Prescriptions Between Lens-Design Programs

    NASA Technical Reports Server (NTRS)

    Stacy, John E.; Wooley, Laura; Carlin, Brian

    1989-01-01

    Optical Lens Prescription Data Formatter computer program enables user to transfer complicated lens prescriptions quickly and easily from one major optical-design program to another and back again. One can take advantage of inherent strength of either program. Programs are ACCOS V from Scientific Calculations, Inc., of Fishers, NY, and CODE V from Optical Research Associates of Pasadena, CA. VAX version written in FORTRAN.

  1. Abuse of prescription and over-the-counter medications.

    PubMed

    Lessenger, James E; Feinberg, Steven D

    2008-01-01

    The nonmedical use of prescription or over-the-counter (OTC) medications implies that the user is using them for reasons other than those indicated in the prescribing literature or on the box label. The abuse of these medications is a national issue. Intentional drug abuse of prescribed and OTC medicines has climbed steadily. Data from the 2005 National Survey on Drug Use and Health demonstrated that 6.4 million (2.6%) people aged 12 or older had used prescription drugs for nonmedical reasons during the past month. Of these, 4.7 million used pain relievers, 1.8 million used tranquilizers, and 1.1 million used stimulants. The nonmedical use of prescription drugs in the past month among young adults aged 18 to 25 increased from 5.4% in 2002 to 6.3% in 2005, primarily because of an increase in the abusive use of pain relievers. Physicians need to watch for prescription and OTC medication abuse. Treatment strategies include (1) inquiring about prescription, OTC, and herbal drug use at the initial examination (even though many individuals are drug-abuse savvy, some are naive and do not realize that OTC medications can be problematic); (2) inquiring about drug use during office visits; (3) providing disposal containers that patients can use to dispose of their unused or unneeded prescription or OTC medications; (4) treating pain aggressively and appropriately; (5) practicing careful record keeping of prescription refills and controls over prescription blanks; (6) referring patients who are addicted to medications to 12-step programs such as Alcoholic Anonymous, Narcotics Anonymous, and Pills Anonymous; and (7) considering detoxification.

  2. A design of tamper resistant prescription RFID access control system.

    PubMed

    Chen, Yu-Yi; Huang, Der-Chen; Tsai, Meng-Lin; Jan, Jinn-Ke

    2012-10-01

    In this paper, we propose a tamper resistant prescription RFID access control protocol for different authorized readers. Not only the authentication mechanism but also the access right authorization mechanism is designed in our scheme. Only the specific doctor, usually the patient's doctor, can access the tag. Moreover, some related information of patient's prescription is attached to a RFID tag for tamper resistance. The patients' rights will be guaranteed.

  3. [Antibiotic prescription usage and assessment in geriatric patients].

    PubMed

    Dinh, Aurélien; Davido, Benjamin; Salomon, Jérôme; Le Quintrec, Jean-Laurent; Teillet, Laurent

    2016-01-01

    Due to the high risk of infection, the geriatric population is regularly subjected to antibiotics. Faced with bacterial resistance, particularly among elderly dependent patients, it is essential to promote proper use and correct prescription of antibiotics. A study evaluated antibiotic prescription in a geriatric hospital with 598 beds and highlighted the importance of collaboration between geriatricians and infectious disease specialists. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Illegal "no prescription" internet access to narrow therapeutic index drugs.

    PubMed

    Liang, Bryan A; Mackey, Tim K; Lovett, Kimberly M

    2013-05-01

    Narrow therapeutic index (NTI) drugs, because of proximity of therapeutic amounts to toxic amounts, require close professional oversight, particularly when switching formulations. However, safe use may be compromised by unsupervised switching through access to online "no prescription" Web sites. We assessed no prescription online availability of NTI drugs, using an academically published list (core NTI drugs). Using the Google search term "buy DRUG no prescription," we reviewed the first 5 search result pages for marketing of no prescription NTI drugs. We further assessed if National Association of Boards of Pharmacy (NABP) Not Recommended vendors were marketing NTI drugs. Searches were conducted from November 3, 2012 to January 3, 2013. For core NTI drugs, we found 13 of 14 NTI drugs (92%) marketed as available without prescription, all from NABP Not Recommended vendors. On the basis of these initial findings, we expanded our core list to 12 additional NTI drugs; 11 of 12 of these drugs (92%) were available from no prescription Web sites. Overall, 24 of 26 NTI drugs (92%) were illegally marketed as available online without the need for a prescription. Suspect online NTI drug access from no prescription vendors represents a significant patient safety risk because of potential patient drug switching and risk of counterfeit versions. Further, state health care exchanges with coverage limitations may drive patients to seek formulations online. Food and Drug Administration harmonization with tighter international NTI drug standards should be considered, and aggressive action against suspect online marketers should be a regulatory and public health priority. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

  5. Neuropsychological functioning in college students who misuse prescription stimulants.

    PubMed

    Wilens, Timothy E; Carrellas, Nicholas W; Martelon, MaryKate; Yule, Amy M; Fried, Ronna; Anselmo, Rayce; McCabe, Sean Esteban

    2017-06-01

    Relatively little is known about the neuropsychological profiles of college students who misuse prescription stimulant medications. Data presented are from college students aged 18-28 years who misused prescription stimulants prescribed for attention-deficit/hyperactivity disorder and controls (no prescription stimulant misuse). Students were assessed neuropsychologically using the self-report Behavioral Rating Inventory of Executive Functioning (BRIEF-A), the Cambridge Automated Neuropsychological Test and Battery (CANTAB), and other tests of cognitive functioning. The analyses included 198 controls (age 20.7 ± 2.6 years) and 100 prescription stimulant misusers (age 20.7 ± 1.7 years). On the BRIEF-A, misusers were more likely than controls to endorse greater dysfunction on 8 of 12 measures including Inhibition, Self Monitor, Initiation, Working Memory, and Plan/Organize, when adjusting for race and sex (all p's < .05). Similarly, when dichotomizing the BRIEF-A as abnormal (T score ≥ 65), misusers had more abnormalities on five of nine subscales, as well as all major indices (p's < .05). Misusers also performed worse on several subtests of the CANTAB and standardized cognitive battery (p's < .05). A proxy of prescription stimulant misuse frequency was positively correlated with greater executive dysfunction on the BRIEF-A. These data demonstrate elevated risk for neuropsychological dysfunction among students who misuse prescription stimulants compared to non-misusing peers. The presence of ADHD contributed significantly to these cognitive findings. Students who misuse prescription stimulants should be screened for neuropsychological dysfunction. These data may better elucidate the neuropsychological profile of college-aged prescription stimulant misusers. (Am J Addict 2017;26:379-387). © 2017 American Academy of Addiction Psychiatry.

  6. Transferring Lens Prescriptions Between Lens-Design Programs

    NASA Technical Reports Server (NTRS)

    Stacy, John E.; Wooley, Laura; Carlin, Brian

    1989-01-01

    Optical Lens Prescription Data Formatter computer program enables user to transfer complicated lens prescriptions quickly and easily from one major optical-design program to another and back again. One can take advantage of inherent strength of either program. Programs are ACCOS V from Scientific Calculations, Inc., of Fishers, NY, and CODE V from Optical Research Associates of Pasadena, CA. VAX version written in FORTRAN.

  7. An Exercise Prescription Intervention Program with Periodic Ergometric Grading

    NASA Technical Reports Server (NTRS)

    Owen, C. A.; Beard, E. F.

    1970-01-01

    A long term exercise prescription type of physical conditioning program has been available to executive personnel of the NASA Manned Spacecraft Center for the past two years. Periodic ergometric testing with a heart rate controlled, automatically programmed, bicycle ergometer is used to follow the individual's progress and appropriately alter his exercise prescription from time to time. Such a program appears feasible, and acceptance is excellent, dropout rates small and periodic testing participation good. Subjects training diligently can maintain satisfactory levels of conditioning.

  8. Preventing Risky Drinking in Veterans Treated with Prescription Opioids

    DTIC Science & Technology

    2016-04-01

    prescription opioids to treat their chronic pain. This adaptive , patient-centered intervention provides integrated clinical assessment, brief...daily doses of prescription opioids and screen positive for risky alcohol use will be randomized to receive 12 months of an adaptive integrated...particularly if they are also using benzodiazepines. In this application, we propose to test an adaptive prevention intervention, designed to re- duce

  9. Electronic storage capacity of ceria: role of peroxide in Aux supported on CeO2(111) facet and CO adsorption.

    PubMed

    Liu, Yinli; Li, Huiying; Yu, Jun; Mao, Dongsen; Lu, Guanzhong

    2015-11-07

    Density functional theory (DFT+U) was used to study the adsorption of Aux (x = 1-4) clusters on the defective CeO2(111) facet and CO adsorption on the corresponding Aux/CeO2-x catalyst, in this work Aux clusters are adsorbed onto the CeO2-x + superoxide/peroxide surface. When Au1 is supported on the CeO2(111) facet with an O vacancy, the strong electronegative Au(δ-) formed is not favorable for CO adsorption. When peroxide is adsorbed on the CeO2(111) facet with the O vacancy, Aux was oxidized, resulting in stable Aux adsorption on the defective ceria surface with peroxide, which promotes CO adsorption on the Aux/CeO2-x catalyst. With more Au atoms in supported Aux clusters, CO adsorption on this surface becomes stronger. During both the Au being supported on CeO2-x and CO being adsorbed on Aux/CeO2-x, CeO2 acts as an electron buffer that can store/release the electrons. These results provide a scientific understanding for the development of high-performance rare earth catalytic materials.

  10. Self-prescription practices in recent Latino immigrants.

    PubMed

    Coffman, Maren J; Shobe, Marcia A; O'Connell, Beth

    2008-01-01

    Self-prescription involves the purchase and use of restricted medications without medical advice. Although common in Central and South American countries, little is known about this practice among Latino immigrants in the United States. The purpose of this study, therefore, was to explore how Latino immigrants obtain and use prescription medications without accessing the formal health care system. This exploratory descriptive study used focus groups to gain an understanding of the use of prescription medications without medical care. Three focus group discussions were held with 19 adult Latino immigrants who were new residents in the United States, and did not have health insurance; most were undocumented. Analysis of the data revealed 4 major themes: (a) health care barriers, (b) cultural norms, (c) self-care, and (d) self-prescription. The data indicate that this population experiences significant barriers to accessing health care, forcing them to seek treatment alternatives including the purchase and use of drugs manufactured in Mexico. There are many public health and safety concerns related to self-prescription practices. Nurses need to be aware of the barriers to health care that lead to these potentially dangerous medication practices, and to recognize and understand self-prescription.

  11. Doctor Shopping Behavior and the Diversion of Prescription Opioids

    PubMed Central

    Simeone, Ronald

    2017-01-01

    Objectives: “Doctor shopping” as a means of prescription opioid diversion is examined. The number and percentage of prescriptions and morphine-equivalent milligrams diverted in this manner are estimated by state and molecule for the period 2008-2012. Methods: Eleven billion prescriptions with unique patient, doctor, and pharmacy identifiers were used to construct diversion “events” that involved between 1 and 6 unique doctors and between 1 and 6 unique pharmacies. Diversion thresholds were established based on the probability of each contingency. Results: A geographically widespread decline occurred between 2008 and 2012. The number of prescriptions diverted fell from approximately 4.30 million (1.75% of all prescriptions) in 2008 to approximately 3.37 million (1.27% of all prescriptions) in 2012, and the number of morphine-equivalent milligrams fell from approximately 6.55 metric tons (2.95% of total metric tons) in 2008 to approximately 4.87 metric tons (2.19% of total metric tons) in 2012. Conclusions: Diversion control efforts have likely been effective. But given increases in opioid-related deaths, opioid-related drug treatment admissions, and the more specific resurgence of heroin-related events, it is clear that additional public health measures are required. PMID:28469426

  12. Predicting prosthetic prescription after major lower-limb amputation.

    PubMed

    Resnik, Linda; Borgia, Matthew

    2015-01-01

    We describe prosthetic limb prescription in the first year following lower-limb amputation and examine the relationship between amputation level, geographic region, and prosthetic prescription. We analyzed 2005 to 2010 Department of Veterans Affairs (VA) Inpatient and Medical Encounters SAS data sets, Vital Status death data, and National Prosthetic Patient Database data for 9,994 Veterans who underwent lower-limb amputation at a VA hospital. Descriptive statistics and bivariates were examined. Cox proportional hazard models identified factors associated with prosthetic prescription. Analyses showed that amputation level was associated with prosthetic prescription. The hazard ratios (HRs) were 1.41 for ankle amputation and 0.46 for transfemoral amputation compared with transtibial amputation. HRs for geographic region were Northeast = 1.49, Upper Midwest = 1.26, and West = 1.39 compared with the South (p < 0.001). African American race, longer length of hospital stay, older age, congestive heart failure, paralysis, other neurological disease, renal failure, and admission from a nursing facility were negatively associated with prosthetic prescription. Being married was positively associated. After adjusting for patient characteristics, people with ankle amputation were most likely to be prescribed a prosthesis and people with transfemoral amputation were least likely. Geographic variation in prosthetic prescription exists in the VA and further research is needed to explain why.

  13. Illicit Use of Prescription Opiates among Graduate Students.

    PubMed

    Varga, Matthew D; Parrish, Mark

    2015-01-01

    Through this study the authors assessed the prevalence rate, reasons for use, and poly-substance use of prescription opiates among graduate students. The authors employed a cross-sectional survey research design using an online, self-administered questionnaire to assess the prevalence rates of prescription opiate use among graduate students (N = 1,033), reasons for use, and their likelihood for poly-substance use. The survey was e-mailed to 5,000 graduate students. Graduate students (19.7%) reported illicit use of prescription opiates in their lifetime and 6.6% reported past-year illicit use. Those who indicated illicitly using prescription opiates did so for self-medication reasons; a few respondents indicated recreational use. Students using prescription opiates were 75% less likely to use marijuana; 79% less likely to use cocaine; and 75% less likely to use ecstasy. Graduate students are illicitly using prescription opiates, but primarily for self-medication, and, while doing so, are less likely to use other substances.

  14. Doctor Shopping Behavior and the Diversion of Prescription Opioids.

    PubMed

    Simeone, Ronald

    2017-01-01

    "Doctor shopping" as a means of prescription opioid diversion is examined. The number and percentage of prescriptions and morphine-equivalent milligrams diverted in this manner are estimated by state and molecule for the period 2008-2012. Eleven billion prescriptions with unique patient, doctor, and pharmacy identifiers were used to construct diversion "events" that involved between 1 and 6 unique doctors and between 1 and 6 unique pharmacies. Diversion thresholds were established based on the probability of each contingency. A geographically widespread decline occurred between 2008 and 2012. The number of prescriptions diverted fell from approximately 4.30 million (1.75% of all prescriptions) in 2008 to approximately 3.37 million (1.27% of all prescriptions) in 2012, and the number of morphine-equivalent milligrams fell from approximately 6.55 metric tons (2.95% of total metric tons) in 2008 to approximately 4.87 metric tons (2.19% of total metric tons) in 2012. Diversion control efforts have likely been effective. But given increases in opioid-related deaths, opioid-related drug treatment admissions, and the more specific resurgence of heroin-related events, it is clear that additional public health measures are required.

  15. The burden of the nonmedical use of prescription opioid analgesics.

    PubMed

    Gilson, Aaron M; Kreis, Paul G

    2009-07-01

    An increase in the prescribing of opioids over the past several years often has been perceived as the primary reason for the increase in the nonmedical use of prescription opioids. Determining the prevalence of this illicit use has been difficult, because of varied methodologies and terminologies that are used to estimate the number of people directly contributing to or affected by this burden. Despite these discrepancies, the findings from several nationally recognized surveys have demonstrated that the prevalence of nonmedical prescription opioid use is indeed significant and has been increasing in recent years. The considerable burden on society imposed by misuse and abuse of these drugs is largely due to the monetary costs associated with nonmedical use (e.g., strategies implemented to prevent or deter abuse, treatment programs for misusers, etc.), decreased economic productivity, and the indirect effect on access to appropriate health care. However, using various nonpharmacologic and pharmacologic approaches to treat patients who use prescription opioids illicitly can decrease its overall prevalence and associated impact, with the development of novel opioid formulations designed to reduce nonmedical use providing valuable clinical tools as part of an overall risk management program. In addition, prescription monitoring programs are a prevalent drug control system designed to identify and address abuse and diversion of prescription medications, including opioids. Such resources, along with an accurate understanding of the problem, extend greater hope that the public health challenge of nonmedical prescription opioid use can be effectively mitigated.

  16. Tracking Performance Requirements for Tracking Performance Requirements for Rotorcraft Instrument Approaches to Reduced Minima. Phase 1. Preliminary Study (Exigences Relatives Aux Performances De Suivi D’Approche Aux Instruments D’Un Giravion Afin De Reduire Les)

    DTIC Science & Technology

    1991-02-01

    A l’a~ronautique jug~es importantes, completes et durables en termes de contribution aux connaissances actuelles. CAHIERS D’AERONAUTIQUE (AN...83 large overshoot of pad (50 + feet); late in power application 84 past pad by 10 feet; large flare 85 stopped short - taxied to pad 86 50-75 foot

  17. Defining risk of prescription opioid overdose: pharmacy shopping and overlapping prescriptions among long-term opioid users in medicaid.

    PubMed

    Yang, Zhuo; Wilsey, Barth; Bohm, Michele; Weyrich, Meghan; Roy, Kakoli; Ritley, Dominique; Jones, Christopher; Melnikow, Joy

    2015-05-01

    Use of multiple pharmacies concurrently (pharmacy shopping) and overlapping prescriptions may be indicators of potential misuse or abuse of prescription opioid medications. To evaluate strategies for identifying patients at high risk, we first compared different definitions of pharmacy shopping and then added the indicator of overlapping opioid prescriptions. We identified a cohort of 90,010 Medicaid enrollees who used ≥ 3 opioid prescriptions for ≥ 90 days during 2008 to 2010 from a multistate Medicaid claims database. We compared the diagnostic odds ratios for opioid overdose events of 9 pharmacy shopping definitions. Within a 90-day interval, a threshold of 4 pharmacies had the highest diagnostic odds ratio and was used to define pharmacy shopping. The overdose rate was higher in the subgroup with overlapping prescriptions (18.5 per 1,000 person-years [PYs]) than in the subgroup with pharmacy shopping as the sole indicator (10.7 per 1,000 PYs). Among the subgroup with both conditions, the overdose rate was 26.3 per 1,000 PYs, compared with 4.3 per 1,000 PYs for those with neither condition. Overlapping opioid prescriptions and pharmacy shopping measures had adjusted hazard ratios of 3.0 and 1.8, respectively, for opioid overdose. Using these measures will improve accurate identification of patients at highest risk of opioid overdose, the first step in implementing targeted prevention policies. Long-term prescription opioid use may lead to adverse events, including overdose. Both pharmacy shopping and overlapping opioid prescriptions are associated with adverse outcomes. This study demonstrates that using both indicators will better identify those at high risk of overdose. Published by Elsevier Inc.

  18. The AUX1 LAX family of auxin influx carriers is required for the establishment of embryonic root cell organization in Arabidopsis thaliana

    PubMed Central

    Ugartechea-Chirino, Yamel; Swarup, Ranjan; Swarup, Kamal; Péret, Benjamin; Whitworth, Morag; Bennett, Malcolm; Bougourd, Sue

    2010-01-01

    Background and Aims The root meristem of the Arabidopsis thaliana mature embryo is a highly organized structure in which individual cell shape and size must be regulated in co-ordination with the surrounding cells. The objective of this study was to determine the role of the AUX1 LAX family of auxin import carriers during the establishment of the embryonic root cell pattern. Methods The radicle apex of single and multiple aux1 lax mutant mature embryos was used to evaluate the effect of this gene family upon embryonic root organization and root cap size, cell number and cell size. Key Results It was demonstrated here that mutations within the AUX1 LAX family are associated with changes in cell pattern establishment in the embryonic quiescent centre and columella. aux1 lax mutants have a larger radicle root cap than the wild type and this is associated with a significant increase in the root-cap cell number, average cell size, or both. Extreme disorganization of the radicle apex was observed among quadruple aux1 lax1 lax2 lax3 mutant embryos, but not in single aux1 null or in lax1, lax2 and lax3 single mutants, indicating redundancy within the AUX1 LAX family. Conclusions It was determined that the AUX1 LAX family of auxin influx facilitators participates in the establishment of cell pattern within the apex of the embryonic root in a gene-redundant fashion. It was demonstrated that aux1 lax mutants are affected in cell proliferation and cell growth within the radicle tip. Thus AUX1 LAX auxin importers emerge as new players in morphogenetic processes involved in patterning during embryonic root formation. PMID:19952011

  19. Localized iron supply triggers lateral root elongation in Arabidopsis by altering the AUX1-mediated auxin distribution.

    PubMed

    Giehl, Ricardo F H; Lima, Joni E; von Wirén, Nicolaus

    2012-01-01

    Root system architecture depends on nutrient availability, which shapes primary and lateral root development in a nutrient-specific manner. To better understand how nutrient signals are integrated into root developmental programs, we investigated the morphological response of Arabidopsis thaliana roots to iron (Fe). Relative to a homogeneous supply, localized Fe supply in horizontally separated agar plates doubled lateral root length without having a differential effect on lateral root number. In the Fe uptake-defective mutant iron-regulated transporter1 (irt1), lateral root development was severely repressed, but a requirement for IRT1 could be circumvented by Fe application to shoots, indicating that symplastic Fe triggered the local elongation of lateral roots. The Fe-stimulated emergence of lateral root primordia and root cell elongation depended on the rootward auxin stream and was accompanied by a higher activity of the auxin reporter DR5-β-glucuronidase in lateral root apices. A crucial role of the auxin transporter AUXIN RESISTANT1 (AUX1) in Fe-triggered lateral root elongation was indicated by Fe-responsive AUX1 promoter activities in lateral root apices and by the failure of the aux1-T mutant to elongate lateral roots into Fe-enriched agar patches. We conclude that a local symplastic Fe gradient in lateral roots upregulates AUX1 to accumulate auxin in lateral root apices as a prerequisite for lateral root elongation.

  20. The benefits of prescription information leaflets (1).

    PubMed Central

    Gibbs, S; Waters, W E; George, C F

    1989-01-01

    1. Prescription information leaflets (PILs) giving information about non-steroidal anti-inflammatory drugs (NSAIDs), beta-adrenoceptor antagonists and inhaled bronchodilators were evaluated in three small Hampshire towns, while a fourth, in which no leaflets were distributed, acted as a control. 2. Seven hundred and nineteen (82%) patients prescribed one of these medicines agreed to be interviewed in their homes, 1 to 2 weeks after the medicine had been prescribed. Four hundred and nineteen of them had received leaflets, while 300 received no written information. Two hundred and sixty patients received their leaflets from a pharmacist while 159 were given them by their general practitioner. 3. Patients who received leaflets were better informed about every item of knowledge tested, except for the name of the medicine. Awareness of the side effects showed the greatest improvement, but there was no evidence that these leaflets produced spurious side effects. 4. Much improved levels of satisfaction were recorded amongst patients who received leaflets, especially those for NSAIDs (P less than 0.001) and for beta-adrenoceptor antagonists (P less than 0.01). 5. Subsequently, three hundred and fifty-eight (77%) of the patients prescribed either a NSAID or a beta-adrenoceptor antagonist 1 year earlier responded to a postal questionnaire. The benefits in terms of knowledge and satisfaction were still apparent, although less marked than previously. Of the patients still taking beta-adrenoceptor antagonists 70% had retained their leaflets over the intervening 12 months. 6. Ninety-seven per cent of patients read their leaflet regardless of whether it was distributed by a general practitioner or pharmacist. However, those who obtained it from a pharmacist tended to be more knowledgeable and satisfied. 7. We conclude that patients welcome the idea of receiving PILs. They improve patients' knowledge of how to take their medicines correctly and their awareness of potential side

  1. Soins primaires aux adultes ayant une déficience développementale

    PubMed Central

    Sullivan, William F.; Berg, Joseph M.; Bradley, Elspeth; Cheetham, Tom; Denton, Richard; Heng, John; Hennen, Brian; Joyce, David; Kelly, Maureen; Korossy, Marika; Lunsky, Yona; McMillan, Shirley

    2011-01-01

    Résumé Objectif Mettre à jour les lignes directrices canadiennes de 2006 sur les soins primaires aux adultes ayant une déficience développementale (DD) et présenter des recommandations pratiques fondées sur les connaissances actuelles pour traiter des problèmes de santé particuliers chez des adultes ayant une DD. Qualité des preuves Des professionnels de la santé expérimentés participant à un colloque et un groupe de travail subséquent ont discuté et convenu des révisions aux lignes directrices de 2006 en se fondant sur une recherche documentaire exhaustive, la rétroaction obtenue des utilisateurs du guide de pratique et les expériences cliniques personnelles. La plupart des preuves disponibles dans ce domaine viennent de l’opinion d’experts ou de déclarations consensuelles publiées (niveau III). Message principal Les adultes ayant une DD ont des problèmes de santé complexes, dont plusieurs diffèrent de ceux de la population en général. De bons soins primaires permettent d’identifier les problèmes de santé particuliers dont souffrent les adultes ayant une DD pour améliorer leur qualité de vie et leur accès aux soins de santé et prévenir la morbidité et le décès prématuré. Ces lignes directrices résument les problèmes de santé générale, physique, comportementale et mentale des adultes ayant une DD que devraient connaître les professionnels des soins primaires et présentent des recommandations pour le dépistage et la prise en charge en se basant sur les connaissances actuelles que les cliniciens peuvent mettre en pratique. En raison de l’interaction des facteurs biologiques, psychoaffectifs et sociaux qui contribuent à la santé et au bien-être des adultes ayant une DD, ces lignes directrices insistent sur la participation des aidants, l’adaptation des interventions, au besoin, et la consultation auprès de divers professionnels de la santé quand ils sont accessibles. Elles mettent aussi en évidence la

  2. Development of PET imaging-based dose-painting prescriptions

    NASA Astrophysics Data System (ADS)

    Bowen, Stephen R.

    Historically, prescriptions in radiation therapy are based on physician experience drawn from the results of extensive clinical trials in order to establish standard-of-care guidelines. The doses of radiation are generally uniform across target volumes to reflect a fixed level of local neoplastic disease control of the population mean. However, inter-patient and intra-tumor variation in response to uniform doses can result in diminished tumor control and poor clinical outcome for certain patients. Recent research endeavors are emphasizing the need to individualize prescriptions by incorporating patient-specific biological markers with prognostic and predictive value. Quantitative imaging with positron emission tomography (PET) of tumor glucose metabolism, cell proliferation, and hypoxia has been suggested as a sensitive and specific technique to tailor patient prescriptions in a manner that may significantly improve clinical outcome. The concept of prescribing and delivering non-uniform dose based on molecular imaging, termed dose painting, hinges on the establishment of a dose-response relationship at the image voxel scale that optimizes a particular clinical endpoint. This doctoral thesis presented two methods of defining dose-painting prescriptions based on PET imaging: the first was a heuristic model derivation of hypoxia dose-painting prescriptions in head-and-neck cancer patients; the second was an empirical imaging surrogate endpoint derivation of prescriptions in veterinary sinonasal cancer patients. The clinical implementation of these dose painting prescriptions was investigated, which emphasized treatment planning and delivery solutions. Lastly, a summary and discussion of the future of dose painting to forge links between tumor biology and clinical outcome was presented. The compelling dose painting concept is fast becoming a clinical reality that may positively impact cancer patient lives.

  3. [Prescription appropriateness: Indication of citicoline in Primary Care].

    PubMed

    Padilla Luz, A; Reyes Rodríguez, J F; Gómez Rodríguez de Acuña, A; González Gómez, C M; Álvarez Dorta, I; Pérez Cánovas, M E

    2015-01-01

    The economic situation has made it necessary to optimize resources by adjusting the pharmaceutical expenditure. Citicoline was (2011) the 10th drug by rank of billed amount. Its approved indications are stroke (acute and sub-acute) and head injury, but not cognitive decline associated with age, the presumed indication for most of its use. To assess the conditions of use of citicoline in the Health Area of Tenerife, in order to detect deviations from the indications of use as stipulated in the prescribing information sheet and the pattern of prescription, with emphasis on the analysis of its use in dementia where currently it has no indication or evidence to support it. Cross-sectional study of prescription-indication. A 680 patient sample, segmented by reference hospital (error±5%; CI: 0.95%; P=0.5) was taken from the 4036 patients with a prescription of citicoline billed during august-october 2011 (obtained from the prescription database program, Farmacanarias). We found that 123 patients (18.1%) had an appropriate indication. By including the prescription regimen, 28 patients (4.1%) had adequate indication and dose levels, and in only 2 patients (0.2%) an appropriate indication, dosage and duration were found. "The correct prescription-indication" of citicoline is inappropiate in almost all patients studied. Impact actions are needed in order to optimize prescription, improve patient safety by reducing potential interactions, and the occurrence of adverse effects, and improve efficiency by promoting savings. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. [Impact of guidelines on ambulatory pediatric antibiotic prescriptions].

    PubMed

    Sellam, A; Chahwakilian, P; Cohen, R; Béchet, S; Vie Le Sage, F; Lévy, C

    2015-06-01

    The emergence of antibiotics resistance as a major public health threat has led, in France as in other countries, to the establishment of "antibiotics plans" based in part on practice guidelines. The objectives of this study were to determine the structure (number, causes, distribution of compounds) of antibiotic prescriptions by infectious diseases pediatricians (belonging to a pediatric infectious diseases research group), to check their compliance with guidelines and compare their prescriptions to other French pediatricians and general practitioners (GPs). In a survey on acute otitis media (AOM), outpatient pediatricians reported prospectively from October 2013 to February 2014 all antibiotics prescribed and the reasons for these prescriptions. These results were compared with prescription data from a panel of other pediatricians and GPs in France (IMS Health panels). Between October 2013 and February 2014, 27 pediatricians from the Infectious Disease Pediatricians Group conducted 54,212 visits, 10.7 % of which resulted in antibiotic prescriptions, all diseases combined, compared to 12 % for other pediatricians and 21 % for GPs in the same period. AOM was the leading cause of prescriptions for infectious disease pediatricians and panel pediatricians, and GPs (respectively, 72.6 %, 33 %, and 25 %). Amoxicillin was the most frequently prescribed antibiotic (respectively, 71.7 %, 49.9 %, and 28.2 %). Cephalosporins were prescribed in 6.4 % of cases by infectious disease pediatricians versus 19 % for panel pediatricians and 19.9 % for GPs. The prescriptions of infectious disease pediatricians are in accordance with the French guidelines. The differences with the IMS data justify the need for continuous medical training and recommendations to promote these guidelines. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  5. Prescription drug misuse among young adults: looking across youth cultures.

    PubMed

    Kelly, Brian C; Wells, Brooke E; Leclair, Amy; Tracy, Daniel; Parsons, Jeffrey T; Golub, Sarit A

    2013-05-01

    Youth cultures play a key role in the social organisation of drug trends among young people; the current prescription drug misuse trend is no different. The authors evaluated whether patterns of prescription drug misuse differed across several youth cultures. Using field survey methods and time-space sampling during 2011, the authors assessed the patterns and prevalence of prescription drug misuse among young adults who are socially active in various urban youth cultures (n = 1781). The prevalence of lifetime prescription drug misuse is highest within indie rock scenes (52.5%), electronic dance music scenes (52.1%), lesbian parties (53.8%) and alt scenes (50.9%). Prescription drug misuse was lowest among young adults in hip-hop scenes (25.0%). These findings were upheld in logistic regression analyses that accounted for demographic differences across youth cultures: indie rock scenes (adjusted odds ratio = 2.11), electronic dance music scenes (adjusted odds ratio = 2.20), lesbian parties (adjusted odds ratio = 2.30) and alt scenes (adjusted odds ratio = 2.65) all reported statistically significant (P < 0.05) higher odds of misuse than college bar scenes. Recent prescription drug misuse mirrored patterns for lifetime misuse. The differing prevalence of prescription drug misuse across distinct youth cultures suggests that the trend has not diffused equally among young people. The differing prevalence across youth cultures indicates that the most efficacious strategies for youth intervention may be targeted approaches that account for the subculturally rooted differences in attitudes and social norms. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  6. Nonmedical use of prescription opioids and stimulants among student pharmacists.

    PubMed

    Lord, Sarah; Downs, George; Furtaw, Paul; Chaudhuri, Anamika; Silverstein, Amy; Gammaitoni, Arnold; Budman, Simon

    2009-01-01

    To examine the prevalence and patterns of nonmedical use of prescription opioid analgesics and stimulants among student pharmacists. Descriptive, nonexperimental, cross-sectional study. Private urban college of pharmacy in the United States in fall 2006. 1,538 PharmD students. Online survey. Lifetime and past-year nonmedical prescription opioid and stimulant use. Response rate for the survey was 62%. Lifetime prevalence of opioid misuse was 8%, and 5% of students had misused in the past year. Lifetime prevalence of stimulant misuse was 7%, and 5% had misused in the past year. Whites and fraternity or sorority members were more likely than their peers to have ever misused opioids. Past-year opioid misuse was more likely among whites, men, and low academic achievers compared with their peers. Lifetime stimulant misuse was more likely among students who were white, older, and fraternity or sorority members, while past-year misuse was more likely among whites and low academic achievers. Common motives for opioid misuse were to have fun, to relax, and to deal with chronic pain. Stimulants were used to improve concentration and academic performance. Friends were the most common source of prescription opioids and stimulants. Nonmedical prescription use was associated with greater likelihood of alcohol and other illicit substance use. The prevalence of prescription medication misuse among student pharmacists was lower than (opioids) or comparable with (stimulants) reported rates in college populations. Subgroups of students demonstrated higher rates of nonmedical use, including whites, students involved with fraternities or sororities, and low academic achievers. That friends were the primary source of misused medications indicates that diversion of prescription-only controlled substances likely occurs among student pharmacists. Nonmedical prescription medication use should be considered in the context of other substance use.

  7. Nonmedical Use of Prescription Opioids: Motive and Ubiquity Issues

    PubMed Central

    Zacny, James P.; Lichtor, Stephanie A.

    2008-01-01

    Two issues relating to prescription opioid nonmedical use that to our knowledge have not been comprehensively addressed in the peer-reviewed literature are discussed: Motives for nonmedical use and the extent of nonmedical use of prescription opioids in other countries. The United States’ national annual survey on illicit drug use in the general population (National Survey on Drug Use and Health) asks respondents whether they have used prescription opioids for nonmedical purposes but does not assess motives for such use. By not assessing motives, nonmedical users who use only for pain relief and nonmedical users who have other motives for use are grouped together, but 2 recent epidemiological studies suggest that these 2 groups may differ in a propensity to have substance use–related problems. We suggest that the survey add a question that assesses motives for nonmedical use. Regarding whether countries besides the United States have problems associated with nonmedical use of prescription opioids, after searching for epidemiological surveys and other materials potentially relevant to this issue, we were unable to determine the extent of nonmedical use of prescription opioids in other countries or draw cross-national comparisons. We suggest that more countries include specific questions about nonmedical use of prescription opioids in their national epidemiological surveys. Perspective We believe that critical information surrounding the nonmedical use of prescription opioids is not being gathered. Such information would allow for a better understanding of the problem. We invite discussion and commentaries regarding the issues we raise to more effectively address this public health issue. PMID:18342577

  8. Relationship between E-Prescriptions and Community Pharmacy Workflow

    PubMed Central

    Odukoya, Olufunmilola K.; Chui, Michelle A.

    2013-01-01

    Objectives To understand how community pharmacists use electronic prescribing (e-prescribing) technology; and to describe the workflow challenges pharmacy personnel encounter as a result of using e-prescribing technology. Design Cross-sectional qualitative study. Setting Seven community pharmacies in Wisconsin from December 2010 to March 2011 Participants 16 pharmacists and 14 pharmacy technicians (in three chain and four independent pharmacies). Interventions Think-aloud protocol and pharmacy group interviews. Main outcome measures Pharmacy staff description of their use of e-prescribing technology and challenges encountered in their daily workflow related to this technology. Results Two contributing factors were perceived to influence e-prescribing workflow: issues stemming from prescribing or transmitting software, and issues from within the pharmacy. Pharmacies experienced both delays in receiving, and inaccurate e-prescriptions from physician offices. Receiving an overwhelming number of e-prescriptions with inaccurate or unclear information resulted in significant time delays for patients as pharmacists contacted physicians to clarify wrong information. In addition, pharmacy personnel reported that lack of formal training and the disconnect between the way pharmacists verify accuracy and conduct drug utilization review and the presentation of e-prescription information on the computer screen significantly influenced the speed of processing an e-prescription. Conclusion E-prescriptions processing can hinder pharmacy workflow. As the number of e-prescriptions transmitted to pharmacies increases due to legislative mandates; it is essential that the technology that supports e-prescriptions (both on the prescriber and pharmacy operating systems) be redesigned to facilitate pharmacy workflow processes and to prevent unintended consequences, such as increased medication errors, user frustration, and stress. PMID:23229979

  9. Prescription Drug Misuse among Young Adults: Looking Across Youth Cultures

    PubMed Central

    Kelly, Brian C; Wells, Brooke E; LeClair, Amy; Tracy, Daniel; Parsons, Jeffrey T; Golub, Sarit A

    2012-01-01

    Aims Youth cultures play a key role in the social organisation of drug trends among young people; the current prescription drug misuse trend is no different. The authors evaluated whether patterns of prescription drug misuse differed across several youth cultures. Methods Using field survey methods and time-space sampling during 2011, the authors assessed the patterns and prevalence of prescription drug misuse among young adults who are socially active in various urban youth cultures (n = 1781). Findings The prevalence of lifetime prescription drug misuse is highest within indie rock scenes (52.5%), electronic dance music scenes (52.1%), lesbian parties (53.8%) and alt scenes (50.9%). Prescription drug misuse was lowest among young adults in hip-hop scenes (25.0%). These findings were upheld in logistic regression analyses that accounted for demographic differences across youth cultures: indie rock scenes (adjusted odds ratio = 2.11), electronic dance music scenes (adjusted odds ratio = 2.20), lesbian parties (adjusted odds ratio = 2.30) and alt scenes (adjusted odds ratio = 2.65) all reported statistically significant (P < 0.05) higher odds of misuse than college bar scenes. Recent prescription drug misuse mirrored patterns for lifetime misuse. Conclusions: The differing prevalence of prescription drug misuse across distinct youth cultures suggests that the trend has not diffused equally among young people. The differing prevalence across youth cultures indicates that the most efficacious strategies for youth intervention may be targeted approaches that account for the subculturally rooted differences in attitudes and social norms. PMID:23190213

  10. Medicare program; Medicare Advantage and prescription drug benefit programs: negotiated pricing and remaining revisions; prescription drug benefit program: payments to sponsors of retiree prescription drug plans. Final rule.

    PubMed

    2012-01-12

    This final rule implements and finalizes provisions regarding the reporting of gross covered retiree plan-related prescription drug costs (gross retiree costs) and retained rebates by Retiree Drug Subsidy (RDS) sponsors; and the scope of our waiver authority under the Social Security Act (the Act).

  11. Promotion of prescription drugs to consumers: case study results.

    PubMed

    Glasgow, Christina; Schommer, Jon C; Gupta, Kiran; Pierson, Krista

    2002-01-01

    Identify key factors related to patients. medication adherence and health outcomes after they received a prescription that they requested based on a prescription drug advertisement. During January 2002, 6 individuals who requested advertised prescription medications and received a prescription from their physician were interviewed. Qualitative analysis was employed to allow for preservation of individual findings and variances in effects for each subject. In all, the 6 patients received 10 prescriptions. For 8 of the 10 requests (80%), the patients were given a prescription for the specific products requested. Of the 10 prescriptions granted to the patients, only one (10%) of the medications was discontinued by the patient due to lack of efficacy. In addition, one patient discontinued one of the products because it was withdrawn from the market. The results showed that individuals (a) may be willing to.just try. new therapies to see if they work better than their existing therapies, (b) appear to make decisions about the usefulness or value of the drug product after a short-term trial, (c) compare the value of the product with the out-of-pocket cost of the product after a short trial, (d) value and seek the advice of their physician about information they see in advertisements, (e) become extremely pleased when they find that the new product actually helps them, and (f) may develop favorable views about advertised prescription drug products, in general, if they had a favorable experience with the first product they requested. Some patients experienced disappointment, side effects, new challenges about how to fit the newly prescribed therapy into their lifestyle and existing drug regimen, the need for follow-up appointments with their physician, and the unwelcome challenge of how to pay for their newly prescribed therapy. Each study subject had unique experiences and outcomes after asking his or her physician for an advertised prescription drug product. Both

  12. Dental Opioid Prescribing and Multiple Opioid Prescriptions Among Dental Patients: Administrative data from the South Carolina Prescription Drug Monitoring Program

    PubMed Central

    McCauley, Jenna L.; Hyer, J. Madison; Ramakrishnan, V. Ramesh; Leite, Renata; Melvin, Cathy L.; Fillingim, Roger B.; Frick, Christie; Brady, Kathleen T.

    2016-01-01

    Background Despite increased attention to dentists’ role in curbing opioid misuse, abuse, and diversion, information regarding prescribing practices and the frequency of multiple concurrent opioid prescriptions among dental patients is limited. Methods Prescription drug monitoring program (PDMP) data for South Carolina representing dispensed medication for patients prescribed at least one opioid by a dentist over the most recently available two-year frame (2012–2013) was reviewed. Descriptive analyses examined: (1) types, frequency of dental opioid prescriptions; and, (2) frequency of existing multiple concurrent opioid prescriptions among dental patients. Results Nearly all dispensed dental opioid prescriptions (99.9%; n = 653,650) were for immediate release opioids and were initial fills (96.2%). Hydrocodone (76.1%) and oxycodone (12.2%) combination products were the most frequently dispensed opioids prescribed by dentists. Individuals under 21 years of age received 11.2% of dentist prescribed opioids dispensed. Patients with multiple concurrent opioid prescriptions were identified within 30-day (n=113,818), 90-day (n=166,124), and 180-day (n=205,576) timeframes. Conclusions Dentists prescribed a high volume of immediate release opioids dispensed in South Carolina. A notable minority of dental patients had incident(s) of multiple pre-existing opioid prescriptions, a factor implicated in patient misuse, abuse, overdose, and diversion Practical Implications Use of a PDMP prior to prescribing provides a record of controlled substances dispensed to a patient, and may inform prescribing, coordination of care, and addiction screening or referral. Patients should be provided information regarding misuse behaviors and their risks, as well as the importance of secure storage and disposal of leftover opioid medications. PMID:27055600

  13. Benzodiazepine prescriptions and falls in older men and women.

    PubMed

    Martinez-Cengotitabengoa, Monica; Diaz-Gutierrez, Maria Jose; Besga, Ariadna; Bermúdez-Ampudia, Cristina; López, Purificación; Rondon, Marta B; Stewart, Donna E; Perez, Patricia; Gutierrez, Miguel; Gonzalez-Pinto, Ana

    2017-03-02

    Despite cautions by professional associations, benzodiazepines (BZD) and Z hypnotics (BZD/Z) are widely prescribed to older adults who are particularly susceptible to insomnia and anxiety, but who are also more sensitive to drugs adverse events. In this study, we assessed the prescription of BZD/Z drugs in a sample of older adults (≥65) who presented for emergency care after a fall. We collected the type, number and dose of BZD/Z drugs prescribed and explored gender differences in the prescription. BZD/Z drugs were prescribed to 43.6% of the sample (n=654) and more frequently to women; 78.4% of prescriptions were for BZD/Z drugs with a short half-life. The majority of patients (83.5%) were prescribed only one type of BZD/Z, but 16.5% had been prescribed multiple BZD/Z drugs, with no gender difference. Doses higher than those recommended for older adults were prescribed to 58% of patients, being the doses significantly higher for men compared to women (70.0% vs 53.1%). Over 40% of older adults presenting for emergency care after a fall had previously been prescribed BZD/Z drugs. Some important gender differences in the prescription of BZD/Z drugs were seen, especially prescription above the recommended dose and of drugs with a long-half life. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. The attitudes of consumers toward direct advertising of prescription drugs.

    PubMed Central

    Morris, L A; Brinberg, D; Klimberg, R; Rivera, C; Millstein, L G

    1986-01-01

    Attitudes about prescription drug advertising directed to consumers were assessed in 1,509 persons who had viewed prototypical advertisements for fictitious prescription drug products. Although many subjects were generally favorable toward the concept of drug advertising directed to consumers, strong reservations were also expressed, especially about television advertising. Prescription drug advertising did not appear to undermine the physician's authority, since respondents viewed the physician as the primary drug decision-maker. However, the physician was not perceived as the sole source of prescription drug information. Television advertising appeared to promote greater information-seeking about particular drugs; however, magazine ads were more fully accepted by subjects. Furthermore, magazine ads led to enhanced views of the patient's authority in drug decision-making. The greater information conveyed in magazine ads may have given subjects more confidence in their own ability to evaluate the drug and the ad. Ads that integrated risk information into the body of the advertisement were more positively viewed than ads that gave special emphasis to the risk information. The results suggest that consumer attitudes about prescription drug advertising are not firmly held and are capable of being influenced by the types of ads people view. Regulation of such ads may need to be flexed to adapt to the way different media are used and processed by consumers. PMID:3080797

  15. Misuse of Prescription Opioid Medication among Women: A Scoping Review.

    PubMed

    Hemsing, Natalie; Greaves, Lorraine; Poole, Nancy; Schmidt, Rose

    2016-01-01

    Background. National data from Canada and the United States identify women to be at greater risk than men for the misuse of prescription opioid medications. Various sex- and gender-based factors and patient and physician practices may affect women's use and misuse of prescription opioid drugs. Objectives. To explore the particular risks, issues, and treatment considerations for prescription opioid misuse among women who experience chronic noncancer pain and trauma. Methods. A scoping review for articles published between January 1990 and May 2014 was conducted on sex- and gender-based risks and treatment considerations among women who experience chronic noncancer pain and trauma. Results. A total of 57 articles were identified. The present narrative review summarizes the specific risks for the misuse of prescription opioid medication among women who have experienced violence and trauma, Aboriginal women, adolescents and young women, older women, pregnant women, women of a sexual minority, and transwomen. Discussion. The majority of the literature is descriptive, with few studies that evaluate approaches and interventions to respond to the issue of chronic pain, trauma, and misuse of prescription opioids among women, particularly vulnerable subgroups of women. Conclusions. Trauma-informed and women-centred approaches that address women's vulnerabilities and complex needs require further attention.

  16. Misuse of Prescription Opioid Medication among Women: A Scoping Review

    PubMed Central

    Greaves, Lorraine; Poole, Nancy; Schmidt, Rose

    2016-01-01

    Background. National data from Canada and the United States identify women to be at greater risk than men for the misuse of prescription opioid medications. Various sex- and gender-based factors and patient and physician practices may affect women's use and misuse of prescription opioid drugs. Objectives. To explore the particular risks, issues, and treatment considerations for prescription opioid misuse among women who experience chronic noncancer pain and trauma. Methods. A scoping review for articles published between January 1990 and May 2014 was conducted on sex- and gender-based risks and treatment considerations among women who experience chronic noncancer pain and trauma. Results. A total of 57 articles were identified. The present narrative review summarizes the specific risks for the misuse of prescription opioid medication among women who have experienced violence and trauma, Aboriginal women, adolescents and young women, older women, pregnant women, women of a sexual minority, and transwomen. Discussion. The majority of the literature is descriptive, with few studies that evaluate approaches and interventions to respond to the issue of chronic pain, trauma, and misuse of prescription opioids among women, particularly vulnerable subgroups of women. Conclusions. Trauma-informed and women-centred approaches that address women's vulnerabilities and complex needs require further attention. PMID:27445597

  17. An Evidence-Based Approach To Exercise Prescriptions on ISS

    NASA Technical Reports Server (NTRS)

    Ploutz-Snyder, Lori

    2009-01-01

    This presentation describes current exercise countermeasures and exercise equipment for astronauts onboard the ISS. Additionally, a strategy for evaluating evidence supporting spaceflight exercise is described and a new exercise prescription is proposed. The current exercise regimen is not fully effective as the ISS exercise hardware does not allow for sufficient exercise intensity, the exercise prescription is adequate and crew members are noncompliant with the prescription. New ISS hardware is proposed, Advanced Resistance Exercise Device (ARED), which allows additional exercises, is instrumented for data acquisition and offers improved loading. The new T2 hardware offers a better harness and subject loading system, is instrumented to allow ground reaction force data, and offers improved speed. A strategy for developing a spaceflight exercise prescription is described and involves identifying exercise training programs that have been shown to maximize adaptive benefits of people exercising in both 0 and 1 g environments. Exercise intensity emerged as an important factor in maintaining physiologic adaptations in the spaceflight environment and interval training is suggested. New ISS exercise hardware should allow for exercise at intensities high enough to elicit adaptive responses. Additionally, new exercise prescriptions should incorporate higher intensity exercises and seek to optimize intensity, duration and frequency for greater efficiency.

  18. RxGen General Optical Model Prescription Generator

    NASA Technical Reports Server (NTRS)

    Sigrist, Norbert

    2012-01-01

    RxGen is a prescription generator for JPL's in-house optical modeling software package called MACOS (Modeling and Analysis for Controlled Optical Systems), which is an expert optical analysis software package focusing on modeling optics on dynamic structures, deformable optics, and controlled optics. The objectives of RxGen are to simplify and automate MACOS prescription generations, reducing errors associated with creating such optical prescriptions, and improving user efficiency without requiring MACOS proficiency. RxGen uses MATLAB (a high-level language and interactive environment developed by MathWorks) as the development and deployment platform, but RxGen can easily be ported to another optical modeling/analysis platform. Running RxGen within the modeling environment has the huge benefit that variations in optical models can be made an integral part of the modeling state. For instance, optical prescription parameters determined as external functional dependencies, optical variations by controlling the in-/exclusion of optical components like sub-systems, and/or controlling the state of all components. Combining the mentioned capabilities and flexibilities with RxGen's optical abstraction layer completely eliminates the hindering aspects for requiring proficiency in writing/editing MACOS prescriptions, allowing users to focus on the modeling aspects of optical systems, i.e., increasing productivity and efficiency. RxGen provides significant enhancements to MACOS and delivers a framework for fast prototyping as well as for developing very complex controlled optical systems.

  19. Prescription Opioid Abuse: Challenges and Opportunities for Payers

    PubMed Central

    Katz, Nathaniel P.; Birnbaum, Howard; Brennan, Michael J.; Freedman, John D.; Gilmore, Gary P.; Jay, Dennis; Kenna, George A.; Madras, Bertha K.; McElhaney, Lisa; Weiss, Roger D.; White, Alan G.

    2013-01-01

    Objective Prescription opioid abuse and addiction are serious problems with growing societal and medical costs, resulting in billions of dollars of excess costs to private and governmental health insurers annually. Though difficult to accurately assess, prescription opioid abuse also leads to increased insurance costs in the form of property and liability claims, and costs to state and local governments for judicial, emergency, and social services. This manuscript’s objective is to provide payers with strategies to control these costs, while supporting safe use of prescription opioid medications for patients with chronic pain. Method A Tufts Health Care Institute Program on Opioid Risk Management meeting was convened in June 2010 with private and public payer representatives, public health and law enforcement officials, pain specialists, and other stakeholders to present research, and develop recommendations on solutions that payers might implement to combat this problem. Results While protecting access to prescription opioids for patients with pain, private and public payers can implement strategies to mitigate financial risks associated with opioid abuse, using internal strategies, such as formulary controls, claims data surveillance, and claims matching; and external policies and procedures that support and educate physicians on reducing opioid risks among patients with chronic pain. Conclusion Reimbursement policies, incentives, and health technology systems that encourage physicians to use universal precautions, to consult prescription monitoring program (PMP) data, and to implement Screening, Brief Intervention, and Referral to6Treatment protocols, have a high potential to reduce insurer risks while addressing a serious public health problem. PMID:23725361

  20. Prescription practices involving opioid analgesics among Americans with Medicaid, 2010.

    PubMed

    Mack, Karin A; Zhang, Kun; Paulozzi, Leonard; Jones, Christopher

    2015-02-01

    Recent state-based studies have shown an increased risk of opioid overdose death in Medicaid populations. To explore one side of risk, this study examines indicators of potential opioid inappropriate use or prescribing among Medicaid enrollees. We examined claims from enrollees aged 18-64 years in the 2010 Truven Health MarketScan® Multi-State Medicaid database, which consisted of weighted and nationally representative data from 12 states. Pharmaceutical claims were used to identify enrollees (n=359,368) with opioid prescriptions. Indicators of potential inappropriate use or prescribing included overlapping opioid prescriptions, overlapping opioid and benzodiazepine prescriptions, long acting/extended release opioids for acute pain, and high daily doses. In 2010, Medicaid enrollees with opioid prescriptions obtained an average 6.3 opioid prescriptions, and 40% had at least one indicator of potential inappropriate use or prescribing. These indicators have been linked to opioid-related adverse health outcomes, and methods exist to detect and deter inappropriate use and prescribing of opioids.

  1. Prescription Practices involving Opioid Analgesics among Americans with Medicaid, 2010

    PubMed Central

    Mack, Karin A.; Zhang, Kun; Paulozzi, Leonard; Jones, Christopher

    2015-01-01

    Recent state-based studies have shown an increased risk of opioid overdose death in Medicaid populations. To explore one side of risk, this study examines indicators of potential opioid inappropriate use or prescribing among Medicaid enrollees. We examined claims from enrollees aged 18–64 years in the 2010 Truven Health MarketScan® Multi-State Medicaid database, which consisted of weighted and nationally representative data from 12 states. Pharmaceutical claims were used to identify enrollees (n=359,368) with opioid prescriptions. Indicators of potential inappropriate use or prescribing included overlapping opioid prescriptions, overlapping opioid and benzodiazepine prescriptions, long acting/extended release opioids for acute pain, and high daily doses. In 2010, Medicaid enrollees with opioid prescriptions obtained an average 6.3 opioid prescriptions, and 40% had at least one indicator of potential inappropriate use or prescribing. These indicators have been linked to opioid-related adverse health outcomes, and methods exist to detect and deter inappropriate use and prescribing of opioids. PMID:25702736

  2. The Adequacy of Phosphorus Binder Prescriptions Among American Hemodialysis Patients

    PubMed Central

    Huml, Anne M.; Sullivan, Catherine M.; Leon, Janeen B.; Sehgal, Ashwini R.

    2013-01-01

    Because hemodialysis treatment has a limited ability to remove phosphorus, dialysis patients must restrict dietary phosphorus intake and use phosphorus binding medication. Among patients with restricted dietary phosphorus intake (1000 mg/d), phosphorus binders must bind about 250 mg of excess phosphorus per day and among patients with more typical phosphorus intake (1500 mg/d), binders must bind about 750 mg per day. To determine the phosphorus binding capacity of binder prescriptions among American hemodialysis patients, we undertook a cross-sectional study of a random sample of in-center chronic hemodialysis patients. We obtained data for one randomly selected patient from 244 facilities nationwide. About one-third of patients had hyperphosphatemia (serum phosphorus level > 5.5 mg/dL). Among the 224 patients prescribed binders, the mean phosphorus binding capacity was 256 mg/d (SD 143). 59% of prescriptions had insufficient binding capacity for restricted dietary phosphorus intake, and 100% had insufficient binding capacity for typical dietary phosphorus intake. Patients using two binders had a higher binding capacity than patients using one binder (451 vs. 236 mg/d, p <0.001). A majority of binder prescriptions have insufficient binding capacity to maintain phosphorus balance. Use of two binders results in higher binder capacity. Further work is needed to understand the impact of binder prescriptions on mineral balance and metabolism and to determine the value of substantially increasing binder prescriptions. PMID:23013171

  3. The attitudes of consumers toward direct advertising of prescription drugs.

    PubMed

    Morris, L A; Brinberg, D; Klimberg, R; Rivera, C; Millstein, L G

    1986-01-01

    Attitudes about prescription drug advertising directed to consumers were assessed in 1,509 persons who had viewed prototypical advertisements for fictitious prescription drug products. Although many subjects were generally favorable toward the concept of drug advertising directed to consumers, strong reservations were also expressed, especially about television advertising. Prescription drug advertising did not appear to undermine the physician's authority, since respondents viewed the physician as the primary drug decision-maker. However, the physician was not perceived as the sole source of prescription drug information. Television advertising appeared to promote greater information-seeking about particular drugs; however, magazine ads were more fully accepted by subjects. Furthermore, magazine ads led to enhanced views of the patient's authority in drug decision-making. The greater information conveyed in magazine ads may have given subjects more confidence in their own ability to evaluate the drug and the ad. Ads that integrated risk information into the body of the advertisement were more positively viewed than ads that gave special emphasis to the risk information. The results suggest that consumer attitudes about prescription drug advertising are not firmly held and are capable of being influenced by the types of ads people view. Regulation of such ads may need to be flexed to adapt to the way different media are used and processed by consumers.

  4. Americans' access to prescription drugs stabilizes, 2007-2010.

    PubMed

    Boukus, Ellyn R; Carrier, Emily R

    2011-12-01

    Despite the weak economy and more people lacking health insurance, the proportion of Americans reporting problems affording prescription drugs remained level between 2007 and 2010, with more than one in eight going without a prescribed drug in 2010, according to a new national study from the Center for Studying Health System Change (HSC). While remaining stable overall, access to prescription drugs improved for working-age, uninsured people, likely reflecting a decline in visits to health care providers, as well as changes in the composition of the uninsured population. Likewise, elderly people eligible for both Medicare and Medicaid saw a sharp drop in prescription drug access problems. The most vulnerable people--the uninsured, those with low incomes, people in fair or poor health, and those with multiple chronic conditions--continued to face the most unmet prescription needs. For example, 48 percent of uninsured people in fair or poor health went without a prescription drug because of cost concerns in 2010, almost double the rate of insured people with the same reported health status.

  5. Drug prescription appropriateness in the elderly: an Italian study

    PubMed Central

    Allegri, Nicola; Rossi, Federica; Del Signore, Federica; Bertazzoni, Paolo; Bellazzi, Roberto; Sandrini, Giorgio; Vecchi, Tomaso; Liccione, Davide; Pascale, Alessia; Govoni, Stefano

    2017-01-01

    Purpose Correct drug prescription in the elderly is a difficult task that requires careful survey of the current pharmacological therapies. In this article, we reviewed the drug prescriptions provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy. Methods Subjects were recruited from a local nursing home, the Pavia and Vigevano Neuropsychological Center for Alzheimer’s Disease, general practitioners’ offices, and the local University of the Third Age. For each patient, the amount of potentially inappropriate prescriptions (PIPs), sedative and anticholinergic load (SL and AL, respectively), and drug–drug interactions were evaluated. Results Widespread polypharmacy, giving rise to 10.06% of PIPs in the whole collection of prescriptions, was observed. In particular, PIPs mainly concern drugs acting at the central nervous system level, mostly benzodiazepines and antipsychotics. Moreover, approximately one-fourth of the subjects had an elevated SL and approximately one-tenth a high AL. Drug–drug interactions were frequent (266 requiring medical attention), up to five for each single patient. Of concern was the underuse of antidementia drugs: only 20 patients received a cholinesterase inhibitor or memantine, although 183 patients were potentially suitable for this treatment. Conclusion These results demonstrate the need to develop novel strategies aimed at improving the quality of drug prescription. PMID:28228653

  6. [Comparisons outpatient drug prescriptions: France, Denmark, Norway, Sweden].

    PubMed

    Dezileaux, Barbara; Martinez, Florie

    2016-06-01

    Comparisons outpatient drug prescriptions: France, Denmark, Norway, Sweden. Project compares quantitatively outpatient drug prescriptions in France, Denmark, Norway and Sweden. Data were obtained from national databases; the unit of measurement was defined daily dose per 1000 inhabitants. The five most prescribed drug classes were compared in each country in 2009, then benzodiazepines and antibiotics from 2006 to 2012. A literature review was focused on the context of prescriptions for each country. In 2009, the five most prescribed drug classes in the four countries represented seven classes in total. France was not the biggest prescriber of drugs, but from 2006 to 2012 benzodiazepines and antibiotics were prescribed much more in France than in the other countries. The evolution of prescriptions was different for each country, and very stable in France. In 2009, France was not the biggest drugs consumer of all classes, but was characterized by high prescriptions in some classes. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  7. Nationwide and population-based prescription patterns in bipolar disorder.

    PubMed

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2016-03-01

    The aim of the present study was to describe prescription patterns and changes in these patterns over the last decade for patients diagnosed with bipolar disorder in mental healthcare, using population-based and nationwide data, and to relate the findings to recommendations from international guidelines. A population-based, nationwide study was carried out. It included register-based longitudinal data on all patients with a first-ever contact with mental healthcare with a diagnosis of mania/bipolar disorder from the entire Danish population, and all prescription data for this population during the decade from 2000 to 2011, inclusive. A total of 3,205 patients were included in the study. Lithium was prescribed less, and antiepileptic and atypical antipsychotic agents were prescribed substantially more during the study period. Lithium went from being the first drug prescribed to being the last, and was replaced by atypical antipsychotic agents. Antiepileptic agents went from being the fourth to the second drug class prescribed, and the prescription of antidepressants was virtually unchanged, at a high level, during the decade (one-year value 40-60%). The prescription of lamotrigine and quetiapine increased substantially. Combination therapy increased for all drug combinations, except for lithium combined with antidepressants. Major changes took place in drug prescriptions during the study period. The decrease in the use of lithium and the constant high use of antidepressants do not align with recommendations from international guidelines. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Oregon's strategy to confront prescription opioid misuse: a case study.

    PubMed

    McCarty, Dennis; Bovett, Rob; Burns, Thomas; Cushing, Judy; Glynn, Mary Ellen; Kruse, Senator Jeff; Millet, Lisa M; Shames, Jim

    2015-01-01

    Governor John Kitzhaber appointed a Prescription Drug Taskforce to address Oregon's opioid epidemic. This case study reviews the Taskforce's participation in the National Governors Association State Policy Academy on Reducing Prescription Drug Abuse. To address the challenge of the misuse and abuse of prescription opioids, the Taskforce developed a strategy for practice change, community education and enhanced access to safe opioid disposal using stakeholder meetings, consensus development, and five action steps: (1) fewer pills in circulation, (2) educate prescribers and the public on the risks of opioid use, (3) foster safe disposal of unused medication, (4) provide treatment for opioid dependence, and (5) continued leadership from the Governor, health plans and health professionals. Although the story is ongoing, there are lessons for leadership in other states and for public health and medical practitioners throughout the country.

  9. Prescription drug abuse among prisoners in rural Southwestern Virginia.

    PubMed

    Wunsch, Martha J; Nakamoto, Kent; Goswami, Anil; Schnoll, Sidney H

    2007-01-01

    Non-medical use of prescription medications is on the rise across the U.S., particularly in rural areas. In this study of 233 prisoners and probationers in southwestern Virginia, we add to an emerging profile of individuals abusing prescription medications. In this retrospective review of 2000-2004 augmented Addiction Severity Index data, those abusing prescription medications reported increased illicit drug and alcohol abuse, poly-drug abuse, psychiatric problems, and arrests for property crimes. Forty percent reported abuse of OxyContin, a drug implicated in a number of deaths in this region. Compared to non-users, OxyContin users were younger, more likely to be female, and more likely to abuse benzodiazepines, methadone, cocaine, and heroin. Longevity of abuse of these other drugs belies suggestions that OxyContin was acting as a "gateway" drug leading naïve users into addiction and risk of death.

  10. Prescription drug monitoring programs in the United States of America

    PubMed Central

    Félix, Sausan El Burai; Mack, Karin

    2015-01-01

    SYNOPSIS Since the late 1990s, the number of opioid analgesic overdose deaths has quadrupled in the United States of America (from 4 030 deaths in 1999 to 16 651 in 2010). The objectives of this article are to provide an overview of the problem of prescription drug overdose in the United States and to discuss actions that could help reduce the problem, with particular attention to the characteristics of prescription drug monitoring programs (PDMPs). These programs consist of state-level databases that monitor controlled substances. The information compiled in the databases is at the disposal of authorized persons (e.g., physicians, pharmacists, and other health-care providers) and may be used only for professional purposes. Suppliers can use such information to prevent interaction with other drugs or therapeutic duplication, or to identify drug-search behavior. Law enforcement agencies can use these programs to identify improper drug prescription or dispensing patterns, or drug diversion. PMID:25563153

  11. Getting to the Root of High Prescription Drug Prices.

    PubMed

    Waxman, Henry; Corr, Bill; Martin, Kristi; Duong, Sophia

    2017-07-01

    ISSUE: Historic increases in prescription drug prices and spending are contributing to unsustainable health care costs in the United States. There is widespread public support for elected officials to address the problem. GOAL: To document the drivers of high U.S. prescription drug prices and offer a broad range of feasible policy actions. METHODS: Interviews with experts and organizations engaged with prescription drug development and utilization, pricing, regulation, and clinical practice. Review of policy documents, proposals, and position statements from a variety of stakeholders. FINDINGS AND CONCLUSIONS: Congress and regulators can undertake a wide range of policy actions to begin to rebalance incentives for innovation and price competition, prioritize patient access and affordability, and maximize the availability of information to patients, providers, and payers.

  12. Medical and nonmedical users of prescription drugs among college students.

    PubMed

    Rozenbroek, Katelyn; Rothstein, William G

    2011-01-01

    To examine medical and nonmedical users of prescription opioids, central nervous system depressants, and stimulants taken individually and in combination. Undergraduates at an urban mid-Atlantic university with 12,000 students. A questionnaire administered in classes provided 413 responses, with a usable response rate of 94%. Nonmedical users obtained prescription drugs from friends and took them with friends. More nonmedical users than medical users took combinations of drugs. Nonmedical users did not show strong preferences for particular drugs. Nonmedical users compared to medical users who took only 1 drug were more likely to take stimulants and less likely to take opioids. The nonmedical use of prescription drugs by college students is a social activity that involves sharing drugs and taking combinations of drugs with friends. Discouraging nonmedical use must focus on the dangers of combining drugs, sharing drugs, and using social gatherings to consume drugs.

  13. Are prescription stimulants "smart pills"? The epidemiology and cognitive neuroscience of prescription stimulant use by normal healthy individuals.

    PubMed

    Smith, M Elizabeth; Farah, Martha J

    2011-09-01

    Use of prescription stimulants by normal healthy individuals to enhance cognition is said to be on the rise. Who is using these medications for cognitive enhancement, and how prevalent is this practice? Do prescription stimulants in fact enhance cognition for normal healthy people? We review the epidemiological and cognitive neuroscience literatures in search of answers to these questions. Epidemiological issues addressed include the prevalence of nonmedical stimulant use, user demographics, methods by which users obtain prescription stimulants, and motivations for use. Cognitive neuroscience issues addressed include the effects of prescription stimulants on learning and executive function, as well as the task and individual variables associated with these effects. Little is known about the prevalence of prescription stimulant use for cognitive enhancement outside of student populations. Among college students, estimates of use vary widely but, taken together, suggest that the practice is commonplace. The cognitive effects of stimulants on normal healthy people cannot yet be characterized definitively, despite the volume of research that has been carried out on these issues. Published evidence suggests that declarative memory can be improved by stimulants, with some evidence consistent with enhanced consolidation of memories. Effects on the executive functions of working memory and cognitive control are less reliable but have been found for at least some individuals on some tasks. In closing, we enumerate the many outstanding questions that remain to be addressed by future research and also identify obstacles facing this research. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  14. Is Mississippi's prescription-only precursor control law a prescription to decrease the production and raise the price of methamphetamine?

    PubMed

    Cunningham, Scott; Finlay, Keith; Stoecker, Charles

    2015-11-01

    In 2010, Mississippi became the second state to require a prescription to purchase pseudoephedrine-based medications. Proponents of "prescription-only" laws argue that they are necessary to disrupt methamphetamine markets, but critics note the costs to legal consumers of cold medications may offset some of the laws' intended benefits. We evaluated the effect of prescription-only restrictions for methamphetamine precursors on state-level methamphetamine lab seizures and methamphetamine prices. We used a synthetic control approach to create a control state comparable to Mississippi and then used permutation testing to determine if the resulting difference was statistically significant. We found that Mississippi's prescription-only law removed 2637 small methamphetamine labs in the two years after the law became effective, which represents a 77% reduction in small labs relative to the synthetic counterfactual. We found no evidence that the law impacted methamphetamine prices. We conclude that while prescription-only laws can reduce the number of domestic small methamphetamine labs in operation, methamphetamine availability is unlikely to be materially impacted. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Trends in direct-to-consumer advertising of prescription contraceptives.

    PubMed

    Wu, Min H; Bartz, Deborah; Avorn, Jerry; Seeger, John D

    2016-05-01

    Despite much speculation about the role of direct-to-consumer advertising (DTCA) in increasing demand for prescription contraceptives in the United States, there is little published research on this topic. We sought to quantify the prevalence and magnitude of DTCA for prescription contraceptives over the last decade. Using cross-sectional data from January 2005 through December 2014, we performed descriptive analyses on trends in DTCA expenditure for prescription contraceptives. We also quantified the amount of DTCA according to contraceptive method category and individual brand. During the study period, pharmaceutical companies spent a total of US$1.57 billion in the United States on DTCA of prescription contraceptives. Annual expenditure for contraceptive DTCA reached a peak value of US$260 million in 2008, with a progressive decline to a nadir of US$69 million by 2013. Of the contraceptive methods, oral contraceptive pills (OCPs) have been the most heavily promoted, with Yaz (drospirenone/ethinyl estradiol) - the most advertised brand - accounting for US$347 million of cumulative DTCA expenditure. However, DTCA spending on OCPs peaked in 2007 and was overtaken in 2012 by the DTCA of long-acting reversible contraceptives (LARCs), the contraceptive method now receiving the largest amount of DTCA promotion. DTCA is a major form of promotion for prescription contraceptives. Recent trends in DTCA expenditure indicate a shift from promotion of the OCPs to the LARCs. DTCA's effect on provider and patient utilization of various contraceptive methods has yet to be determined. This study provides the first quantitative evaluation of DTCA of prescription contraceptive methods and reveals DTCA's importance as a form of promotion. Recent DTCA trends indicate increased promotion of LARCs, coinciding with greater uptake of LARC methods by patients and prescribers. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Consumer response to dual incentives under multitiered prescription drug formularies.

    PubMed

    Gilman, Boyd H; Kautter, John

    2007-06-01

    To decompose the overall effect of multitiered formularies on drug utilization and spending into the following 2 observed effects on consumer behavior: first, higher copayments on drug equivalents create an incentive to reduce the number of prescriptions, and, second, wider differential copayments between drug equivalents create an incentive to use a greater proportion of generics. We merged drug claims for 352,760 retired Medicare enrollees having employer-sponsored health insurance with benefit information. Our unit of analysis was the enrollee. We used cross-sectional variation in incentive-based formularies to compare the effects of increased copayment amounts for drug equivalents with those of increased copayment differentials between drug equivalents. The study sample may not be representative of the Medicare population. Multivariate regression analysis using the 2002 MarketScan Medicare Supplemental and Coordination of Benefits database and Benefit Plan Design database. A 10% increase in copayments for drug equivalents was associated with a 1.3% reduction in total drug spending, a 16.0% increase in out-of-pocket expenditures, a 2.0% reduction in the number of prescriptions filled, and a 0.7% reduction in proportion of prescriptions filled with generics. A 10% increase in copayment differentials between drug equivalents was associated with a 1.0% reduction in total drug spending, a 4.1% increase in out-of-pocket expenditures, a 1.0% reduction in the number of prescriptions filled, and a 0.7% increase in proportion of prescriptions filled with generics. Increasing copayment differentials between drug equivalents is as effective a strategy for reducing total drug spending as increasing copayment amounts for drug equivalents but better maintains access to prescription medications.

  17. Prescription Opioid Analgesics Commonly Unused After Surgery: A Systematic Review.

    PubMed

    Bicket, Mark C; Long, Jane J; Pronovost, Peter J; Alexander, G Caleb; Wu, Christopher L

    2017-08-02

    Prescription opioid analgesics play an important role in the treatment of postoperative pain; however, unused opioids may be diverted for nonmedical use and contribute to opioid-related injuries and deaths. To quantify how commonly postoperative prescription opioids are unused, why they remain unused, and what practices are followed regarding their storage and disposal. MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched from database inception to October 18, 2016, for studies describing opioid oversupply for adults after a surgical procedure. The primary outcome-opioid oversupply-was defined as the number of patients with either filled but unused opioid prescriptions or unfilled opioid prescriptions. Two reviewers independently screened studies for inclusion, extracted data, and assessed the study quality. Six eligible studies reported on a total of 810 unique patients (range, 30-250 patients) who underwent 7 different types of surgical procedures. Across the 6 studies, 67% to 92% of patients reported unused opioids. Of all the opioid tablets obtained by surgical patients, 42% to 71% went unused. Most patients stopped or used no opioids owing to adequate pain control, and 16% to 29% of patients reported opioid-induced adverse effects. In 2 studies examining storage safety, 73% to 77% of patients reported that their prescription opioids were not stored in locked containers. All studies reported low rates of anticipated or actual disposal, but no study reported US Food and Drug Administration-recommended disposal methods in more than 9% of patients. Postoperative prescription opioids often go unused, unlocked, and undisposed, suggesting an important reservoir of opioids contributing to nonmedical use of these products, which could cause injuries or even deaths.

  18. Potential misuse and inappropriate prescription practices involving opioid analgesics.

    PubMed

    Liu, Ying; Logan, Joseph E; Paulozzi, Leonard J; Zhang, Kun; Jones, Christopher M

    2013-08-01

    Opioid misuse and abuse are growing concerns among the medical and public health communities. To examine the prevalence of indicators for potential opioid misuse in a large, commercially insured adult population. We adapted existing indicators developed by expert panels to include having overlapping opioid prescriptions, overlapping opioid and benzodiazepine prescriptions, long-acting/ extended release (LA/ER) opioids for acute pain,and high daily doses of opioids (>100 morphine milligram equivalents). These indicators were assessed among continuously enrolled individuals aged 18-64 years from the 2009 Truven Health MarketScan databases. Analyses were stratified by sex. We identified 3,391,599 eligible enrollees who received at least 1 opioid prescription. On average, enrollees obtained 3.3 opioid prescriptions, and the average annual days of supply was 47 days. Twice as many enrollees received opioid prescriptions for acute pain as for chronic pain. About a quarter of the enrollees had at least 1 indicator of either potential misuse by patients or inappropriate prescription practices by providers. About 15% of enrollees had high daily doses;7.8% had opioid overlap; and 7.9% had opioid and benzodiazepine overlap. Among those prescribed LA/ER opioids, 24.3% were treated for acute pain. Overlap indicators were more common among women. Our findings underscore the critical need to develop programs aimed at promoting appropriate use of opioids. Retrospective opioid utilization reviews similar to our analyses can potentially help managed care organizations and healthcare providers improve patient care and reduce the risk of adverse outcomes related to these medications.

  19. Perceptions of prescription warning labels within an underserved population

    PubMed Central

    Shiyanbola, Olayinka O.; Meyer, Brittney A.; Locke, Michelle R.; Wettergreen, Sara

    Objective To understand how underserved populations attend to prescription warning label (PWL) instructions, examine the importance of PWL instructions to participants and describe the challenges associated with interpreting the information on PWLs. Methods Adults from an underserved population (racial and ethnic minorities, individuals with low income, older adults) who had a history of prescription medication use and were able to understand English took part in semi-structured interviews. Participants were presented with eight different prescription bottles with an attached PWL. Participants were asked, “If this prescription was yours, what information would you need to know about the medicine?” The number of participants who attended to the warning labels was noted. Other questions assessed the importance of PWLs, the challenges with understanding PWLs, and ways a pharmacist could help participant understanding of the PWL. Results There were 103 participants. The mean age was 50.25 years (SD=18.05). Majority attended to the PWL. Participants not currently taking medications and who had limited health literacy were likely to overlook the warning labels. Majority rated the warning instructions to be extremely important (n=86, 83.5 %), wanted the pharmacist to help them understand PWLs by counseling them on the information on the label (n=63, 61.2%), and thought the graphics made the label information easy to understand. Conclusions PWLs are an important method of communicating medication information, as long as they are easily comprehensible to patients. In addition to placing PWLs on prescription bottles, health care providers need to counsel underserved populations on medication warnings, especially individuals with limited health literacy who are not currently using a prescription medication. PMID:24644523

  20. Prescription opioid analgesics increase the risk of depression.

    PubMed

    Scherrer, Jeffrey F; Svrakic, Dragan M; Freedland, Kenneth E; Chrusciel, Timothy; Balasubramanian, Sumitra; Bucholz, Kathleen K; Lawler, Elizabeth V; Lustman, Patrick J

    2014-03-01

    Prescription opioid analgesic use has quintupled recently. Evidence linking opioid use with depression emanates from animal models and studies of persons with co-occurring substance use and major depression. Little is known about depressogenic effects of opioid use in other populations. The purpose of this study was to determine whether prescription opioids are associated with increased risk of diagnosed depression. Retrospective cohort study, new user design. Medical record data from 49,770 US Department of Veterans Affairs (VA) health care system patients with no recent (24-month) history of opioid use or a diagnosis of depression in 1999 and 2000. Propensity scores were used to control for bias by indication, and the data were weighted to balance the distribution of covariates by duration of incident opioid exposure. Cox proportional hazard models with adjustment for painful conditions were used to estimate the association between duration of prescription opioid use and the subsequent risk of development of depression between 2001 and 2007. Of 49,770 patients who were prescribed an opioid analgesic, 91 % had a prescription for < 90 days, 4 % for 90-180 days, and 5 % for > 180 days. Compared to patients whose prescription was for < 90 days, the risk of depression increased significantly as the duration of opioid prescription increased (HR = 1.25; 95 % CI: 1.05-1.46 for 90-180 days, and HR = 1.51; 95 % CI:1.31-1.74 for > 180 days). In this sample of veterans with no recent (24-month) history of depression or opioid analgesic use, the risk of development of depression increased as the duration of opioid analgesic exposure increased. The potential for depressogenic effect should be considered in risk-benefit discussions, and patients initiating opioid treatment should be monitored for development of depression.

  1. A smart medication recommendation model for the electronic prescription.

    PubMed

    Syed-Abdul, Shabbir; Nguyen, Alex; Huang, Frank; Jian, Wen-Shan; Iqbal, Usman; Yang, Vivian; Hsu, Min-Huei; Li, Yu-Chuan

    2014-11-01

    The report from the Institute of Medicine, To Err Is Human: Building a Safer Health System in 1999 drew a special attention towards preventable medical errors and patient safety. The American Reinvestment and Recovery Act of 2009 and federal criteria of 'Meaningful use' stage 1 mandated e-prescribing to be used by eligible providers in order to access Medicaid and Medicare incentive payments. Inappropriate prescribing has been identified as a preventable cause of at least 20% of drug-related adverse events. A few studies reported system-related errors and have offered targeted recommendations on improving and enhancing e-prescribing system. This study aims to enhance efficiency of the e-prescribing system by shortening the medication list, reducing the risk of inappropriate selection of medication, as well as in reducing the prescribing time of physicians. 103.48 million prescriptions from Taiwan's national health insurance claim data were used to compute Diagnosis-Medication association. Furthermore, 100,000 prescriptions were randomly selected to develop a smart medication recommendation model by using association rules of data mining. The important contribution of this model is to introduce a new concept called Mean Prescription Rank (MPR) of prescriptions and Coverage Rate (CR) of prescriptions. A proactive medication list (PML) was computed using MPR and CR. With this model the medication drop-down menu is significantly shortened, thereby reducing medication selection errors and prescription times. The physicians will still select relevant medications even in the case of inappropriate (unintentional) selection. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Diagnostic investigation rates and use of prescription and non-prescription medications amongst dyspeptics: a population-based study of 2300 Australians.

    PubMed

    Westbrook, J I; Talley, N J

    2003-05-01

    : There is limited knowledge of the diagnostic investigation rates and use of prescription and non-prescription drugs amongst dyspeptics. : To assess the investigation rates and use of prescription and non-prescription anti-ulcer medications amongst dyspeptics in the population. : A cross-sectional survey was performed of 2300 Australians. : Of 748 dyspeptics, 422 (56%) had consulted a doctor regarding dyspepsia at some time in their life. Of the consulters, 64% had undergone investigations at some time: 37% an endoscopy, 54% a barium meal and 27% both. A diagnosis of peptic ulcer was reported by 31% of those investigated. The symptom profile of gastroscopy patients differed significantly from that of uninvestigated dyspeptics. Of the consulters, 36% had taken anti-ulcer prescription drugs in the last 3 months: Histamine-2 receptor antagonists (73% of prescriptions), proton pump inhibitors (17%), cytoprotectants (5%) and prokinetic drugs (5%). Antacids were taken by 30% of non-consulting dyspeptics, 44% of consulters not on prescription drugs and 58% of dyspeptics taking prescription drugs. Advancing age, but not gender, was associated with diagnostic investigation and prescription and non-prescription drug usage. : There are high rates of diagnostic investigation amongst dyspeptics who consult doctors. Many individuals with dyspepsia decide to self-medicate with antacids regardless of consulting or prescriptions, suggesting that current management is suboptimal.

  3. Prescription of fixed dose combination drugs for diarrhoea.

    PubMed

    Chakrabarti, Amit

    2007-01-01

    Fixed-dose combinations (FDCs) of an antiprotozoal and an antibacterial, for treatment of diarrhoea, have been available in the Indian pharmaceutical market for about a decade. There is little evidence to substantiate this combination therapy. We evaluated 2,163 physician prescriptions for diarrhoea and found that 59 per cent of prescriptions were for FDCs. This is unethical because prescribing such combinations exposes a patient to higher risks of adverse drug reactions and also increases the chances of drug resistance. Physicians' prescribing practices in India are influenced by socioeconomic factors and the pharmaceutical industry's marketing techniques that include giving incentives to physicians to prescribe certain drugs.

  4. An exercise prescription primer for people with depression.

    PubMed

    Stanton, Robert; Happell, Brenda M

    2013-08-01

    A substantial body of evidence supports the value of exercise in the treatment of people with depression. The guidelines for exercise prescription, however, are limited, and based on those developed for healthy populations. This article explores the evidence for exercise in the treatment of depression and the role mental health nurses may play in the delivery of this information. A model of exercise prescription is put forward based on the available evidence and taking into account the challenges faced by mental health nurses and people with depression.

  5. Health plans' strategies to control prescription drug spending.

    PubMed

    Wallack, Stanley S; Weinberg, Dana Beth; Thomas, Cindy Parks

    2004-01-01

    A number of recent studies have documented the sizable impact of consumer cost sharing without accounting for the other drug management strategies being adopted simultaneously. This qualitative case study of five of California's largest health plans examines the strategies and methods used to control prescription drug use and spending. Higher cost sharing is being used increasingly. Concurrently, major administrative efforts directed at physicians-including rules, incentives, and education-are being undertaken. These efforts have focused on lowering the cost per prescription by emphasizing generic substitution and therapeutic interchange of less costly drugs.

  6. Justice implications of a proposed Medicare prescription drug policy.

    PubMed

    Larkin, Heather

    2004-07-01

    Social justice is a core value to the mission of social work. Older people are among the most vulnerable populations for whom social workers are called on to advocate. Although Medicare prescription drug coverage has been a top legislative issue over the past few years, such a benefit expansion has yet to be implemented. This article examines the historical context of Medicare and reviews the proposals for prescription drug coverage, identifying the concerns raised. Literature critiquing the justice dimensions of health care for the elderly population is reviewed. Justice claims are identified and refined, and social justice theories are used in the analysis of the proposed policies.

  7. Who Cares What It Costs to Dispense a Medicaid Prescription?

    PubMed Central

    Lamphere-Thorpe, Jo Ann; Johnston, William P.; Kilpatrick, Kerry E.; Norwood, G. Joseph

    1994-01-01

    Results of a 1992 Medicaid cost-of-dispensing study among North Carolina pharmacies are presented. The estimated statewide weighted average cost incurred by pharmacies to dispense a prescription was $5.37 in 1991. The variation in dispensing costs found among pharmacies of various sizes, organizational types, and locations is identified. Higher average dispensing costs were reported for large chain pharmacies and those pharmacies in urban areas. Considering the potential for expanded prescription drug benefits under a reformed health care system, the implications of the study's findings for pharmacy payment policy are discussed. PMID:10137800

  8. Prevalence of the Prescription of Potentially Interacting Drugs

    PubMed Central

    Tragni, Elena; Casula, Manuela; Pieri, Vasco; Favato, Giampiero; Marcobelli, Alberico; Trotta, Maria Giovanna; Catapano, Alberico Luigi

    2013-01-01

    The use of multiple medications is becoming more common, with a correspondingly increased risk of untoward effects and drug-related morbidity and mortality. We aimed at estimating the prevalence of prescription of relevant potentially interacting drugs and at evaluating possible predictors of potentially interacting drug exposure. We retrospectively analyzed data on prescriptions dispensed from January 2004 to August 2005 to individuals of two Italian regions with a population of almost 2.1 million individuals. We identified 27 pairs of potentially interacting drugs by examining clinical relevance, documentation, and volume of use in Italy. Subjects who received at least one prescription of both drugs were selected. Co-prescribing denotes “two prescriptions in the same day”, and concomitant medication “the prescription of two drugs with overlapping coverage”. A logistic regression analysis was conducted to examine the predictors of potential Drug-Drug Interaction (pDDIs). 957,553 subjects (45.3% of study population) were exposed to at least one of the drugs/classes of the 27 pairs. Overall, pDDIs occurred 2,465,819 times. The highest rates of concomitant prescription and of co-prescription were for ACE inhibitors+NSAIDs (6,253 and 4,621/100,000 plan participants). Considering concomitance, the male/female ratio was <1 in 17/27 pairs (from 0.31 for NSAIDs-ASA+SSRI to 0.74 for omeprazole+clopidogrel). The mean age was lowest for methotrexate pairs (+omeprazole, 59.9 years; +NSAIDs-ASA, 59.1 years) and highest for digoxin+verapamil (75.4 years). In 13/27 pairs, the mean ages were ≥70 years. On average, subjects involved in pDDIs received ≥10 drugs. The odds of exposure were more frequently higher for age ≥65 years, males, and those taking a large number of drugs. A substantial number of clinically important pDDIs were observed, particularly among warfarin users. Awareness of the most prevalent pDDIs could help practitioners in preventing concomitant use

  9. Converging prescription brand shares as evidence of physician learning.

    PubMed

    Walker, Doug

    2012-01-01

    Within a drug category, there is an optimal brand the physician could choose to prescribe based on the patient's particular condition and characteristics. Physicians desire to prescribe the best brand for each patient for professional, moral, and legal reasons. Ideally, detailing provides information that supports this effort. This study finds that, over time, the proportion of prescriptions written for each brand moves toward a stable distribution--a convergence in which each brand's share in the category appears to match the proportion of prescription writing opportunities where the brand is the best choice for the patient. Detailing supports this convergence.

  10. [Prescription parsing of miao medicine Polygonum capitatum and kelintong capsule].

    PubMed

    Hu, Nan; Tang, Shi-Huan; Cheng, Long

    2014-04-01

    By literature survey searching references and parsing prescriptions, the auther has analyze the clinical advantage of Miao medicine in the treatment of symptom heat stranguria. Guizhou Miao medicine Polygonum capitatum has many advantages such as resources and clinical. After companying with Phellodendri Cortex, the compound prescription plays the pharmacological activity of antipyretic and diuretic, especially for the symptom heat stranguria, damp and hot junction based in the bladder. Miao medicine Kelintong capsule showed clinical advantage in the treatment of symptom heat stranguria, having a clinical advantage in improving the overall effectiveness and improve the overall aspects of the patient's symptoms.

  11. Prescription Drug Coverage and Spending for Medicare Beneficiaries

    PubMed Central

    Poisal, John A.; Murray, Lauren A.; Chulis, George S.; Cooper, Barbara S.

    1999-01-01

    Outpatient prescription drug coverage is not a Medicare covered benefit. Debate continues in Congress and elsewhere on modernizing the Medicare benefit package, including proposals that would help the Nation's seniors pay for prescription drugs. Very little is known about which persons within the Medicare population have drug coverage from other sources. Using 1995 data from the Medicare Current Beneficiary Survey (MCBS), the authors present information on who has coverage by various sociodemographic categories. The data indicate higher-than-average levels of coverage for minority persons, beneficiaries eligible for Medicare because of disability, and those with higher incomes. PMID:10558017

  12. 21 CFR 1306.25 - Transfer between pharmacies of prescription information for Schedules III, IV, and V controlled...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... prescription record. (ii) Record on the reverse of the invalidated prescription the name, address, and DEA...). (v) Pharmacy's name, address, DEA registration number, and prescription number from which the...) Pharmacy's name, address, DEA registration number, and prescription number from which the prescription...

  13. 21 CFR 1306.25 - Transfer between pharmacies of prescription information for Schedules III, IV, and V controlled...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... prescription record. (ii) Record on the reverse of the invalidated prescription the name, address, and DEA...). (v) Pharmacy's name, address, DEA registration number, and prescription number from which the...) Pharmacy's name, address, DEA registration number, and prescription number from which the prescription...

  14. Modelisation de la diffusion sur les surfaces metalliques: De l'adatome aux processus de croissance

    NASA Astrophysics Data System (ADS)

    Boisvert, Ghyslain

    Cette these est consacree a l'etude des processus de diffusion en surface dans le but ultime de comprendre, et de modeliser, la croissance d'une couche mince. L'importance de bien mai triser la croissance est primordiale compte tenu de son role dans la miniaturisation des circuits electroniques. Nous etudions ici les surface des metaux nobles et de ceux de la fin de la serie de transition. Dans un premier temps, nous nous interessons a la diffusion d'un simple adatome sur une surface metallique. Nous avons, entre autres, mis en evidence l'apparition d'une correlation entre evenements successifs lorsque la temperature est comparable a la barriere de diffusion, i.e., la diffusion ne peut pas etre associee a une marche aleatoire. Nous proposons un modele phenomenologique simple qui reproduit bien les resultats des simulations. Ces calculs nous ont aussi permis de montrer que la diffusion obeit a la loi de Meyer-Neldel. Cette loi stipule que, pour un processus active, le prefacteur augmente exponentiellement avec la barriere. En plus, ce travail permet de clarifier l'origine physique de cette loi. En comparant les resultats dynamiques aux resultats statiques, on se rend compte que la barriere extraite des calculs dynamiques est essentiellement la meme que celle obtenue par une approche statique, beaucoup plus simple. On peut donc obtenir cette barriere a l'aide de methodes plus precises, i.e., ab initio, comme la theorie de la fonctionnelle de la densite, qui sont aussi malheureusement beaucoup plus lourdes. C'est ce que nous avons fait pour plusieurs systemes metalliques. Nos resultats avec cette derniere approche se comparent tres bien aux resultats experimentaux. Nous nous sommes attardes plus longuement a la surface (111) du platine. Cette surface regorge de particularites interessantes, comme la forme d'equilibre non-hexagonale des i lots et deux sites d'adsorption differents pour l'adatome. De plus, des calculs ab initio precedents n'ont pas reussi a confirmer la

  15. Etude sur les tendons en materiaux composites et leur application aux ancrages postcontraints

    NASA Astrophysics Data System (ADS)

    Chennouf, Adil

    L'objectif general de la presente these est d'evaluer le comportement a l'arrachement et au fluage d'ancrages injectes constitues de tendons en materiaux composites afin d'etablir des recommandations plus appropriees et realistes pour le dimensionnement et la conception. Quatre types de tendons en materiaux composites, deux a base de fibres d'aramide et deux a base de fibres de carbone, ont ete utilises dans l'etude. Les travaux de recherche de cette these ont porte notamment sur: (I) Une caracterisation physique et mecanique des tendons en materiaux composites utilises dans l'etude. (II) Une etude en laboratoire sur les coulis de scellement. La premiere etape de cette etude a concerne le developpement d'un coulis de scellement performant adapte aux tendons en materiaux composites et a differentes situations d'injection. La seconde etape a traite des essais de caracterisations physique et mecanique du coulis de scellement developpe comparativement a trois coulis de scellement usuels d'un meme rapport E/L de 0,4. (III) Une etude sur des modeles reduits d'ancrages injectes. (IV) Une etude sur des modeles d'ancrages a grande echelle. La synthese de ces etudes a permis d'enoncer les principales conclusions suivantes: (1) Les valeurs moyennes des charges de rupture des tendons en materiaux composites ont ete de 1% a 29% superieures a celles specifiees par les manufacturiers. (2) L'etude sur les coulis de scellement a permis le developpement de coulis de ciment repondant aux criteres fixes, soient une grande stabilite, une bonne fluidite, une legere expansion et de bonnes caracteristiques mecaniques. (3) Les tendons en materiaux composites ont montre des contraintes d'adherence maximum superieures a celles des tendons en acier. (4) Le type de fibre, la configuration et le fini de surface des tendons en materiaux composites gouvernent leur resistance a l'adherence. (5) L'introduction de sable et d'autres ajouts comme les fines de silice et la poudre d'aluminium au coulis

  16. Tétanos associé aux soins: à propos d’un cas

    PubMed Central

    Mamoudou, Savadogo

    2016-01-01

    La prophylaxie antitétanique lors de la prise en charge des blessures, est une stratégie majeure de prévention du tétanos en milieu de soins. Toute défaillance de la prise en charge des blessures expose dangereusement les victimes à la maladie. Nous rapportons un cas de tétanos survenu à la suite d’une blessure frontale prise en charge dans une structure sanitaire sans prophylaxie antitétanique. L’objectif est de rappeler aux cliniciens sur l’importance de cette prophylaxie chez tout blessé non vacciné ou ayant un statut immunitaire douteux. Patient de 52 ans non vacciné contre le tétanos a été admisau CHU YO pour cervicalgie, dysphagie, difficulté à la marche et à l’ouverture de la bouche. Dans ses antécédents il souligne une blessure frontale profonde ayant été suturée sans prophylaxie antitétanique il y a trois semaines environ. L’examen à son admission notaitun trismus lâche, une contracture abdominale, une dysphagie, une température à 36°5Cet une cicatrice au niveau du front mesurant environ 7 cm. Le diagnostic d’un tétanos généralisé stade II à porte d’entrée frontale a été retenu. Sous traitement l’évolution a été favorable et il est sorti de l’hôpital le 18septembre 2015. La prévention du tétanos associé aux soins requiert l’application rigoureuse des mesures d’asepsie, la systématisation de la sérothérapie antitétanique lors de la prise en charge de toute blessure profonde du patient non vacciné ou ayant un statut immunitaire douteux. PMID:28292071

  17. Conséquences comportementales de la violence faite aux enfants

    PubMed Central

    Al Odhayani, Abdulaziz; Watson, William J.; Watson, Lindsay

    2013-01-01

    Résumé Objectif Discuter des répercussions de la violence sur le développement comportemental durant l’enfance, mettre en évidence certains signes comportementaux susceptibles d’alerter les médecins à la présence d’une maltraitance continue d’un enfant et explorer le rôle précis du médecin de famille dans une telle situation clinique. Sources des données Une recension systématique a servi à examiner la recherche pertinente, les articles de révision clinique et les sites web des organismes de protection de la jeunesse. Message principal Le comportement d’un enfant est une manifestation extériorisée de sa stabilité et de sa sécurité intérieures. C’est une lentille au travers de laquelle le médecin de famille peut observer le développement de l’enfant pendant toute sa vie. Tous les genres de violence sont dommageables pour les enfants, qu’elle soit physique, affective ou psychologique, et peuvent causer des problèmes à long terme dans le développement du comportement et de la santé mentale. Les médecins de famille doivent connaître les indices de maltraitance et de négligence envers les enfants et être aux aguets de ces derniers afin d’entreprendre les interventions appropriées et améliorer les résultats pour ces enfants. Conclusion La violence faite aux enfants peut causer un développement psychologique désordonné et des problèmes de comportement. Les médecins de famille exercent un rôle important dans la reconnaissance des signes comportementaux laissant présager une maltraitance, ainsi que pour offrir de l’aide afin de protéger les enfants.

  18. Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse.

    PubMed

    Singhal, Astha; Tien, Yu-Yu; Hsia, Renee Y

    2016-01-01

    Prescription drug abuse is a growing problem nationally. In an effort to curb this problem, emergency physicians might rely on subjective cues such as race-ethnicity, often unknowingly, when prescribing opioids for pain-related complaints, especially for conditions that are often associated with drug-seeking behavior. Previous studies that examined racial-ethnic disparities in opioid dispensing at emergency departments (EDs) did not differentiate between prescriptions at discharge and drug administration in the ED. We examined racial-ethnic disparities in opioid prescription at ED visits for pain-related complaints often associated with drug-seeking behavior and contrasted them with conditions objectively associated with pain. We hypothesized a priori that racial-ethnic disparities will be present among opioid prescriptions for conditions associated with non-medical use, but not for objective pain-related conditions. Using data from the National Hospital Ambulatory Medical Care Survey for 5 years (2007-2011), the odds of opioid prescription during ED visits made by non-elderly adults aged 18-65 for 'non-definitive' conditions (toothache, back pain and abdominal pain) or 'definitive' conditions (long-bone fracture and kidney stones) were modeled. Opioid prescription at discharge and opioid administration at the ED were the primary outcomes. We found significant racial-ethnic disparities, with non-Hispanic Blacks being less likely (adjusted odds ratio ranging from 0.56-0.67, p-value < 0.05) to receive opioid prescription at discharge during ED visits for back pain and abdominal pain, but not for toothache, fractures and kidney stones, compared to non-Hispanic whites after adjusting for other covariates. Differential prescription of opioids by race-ethnicity could lead to widening of existing disparities in health, and may have implications for disproportionate burden of opioid abuse among whites. The findings have important implications for medical provider education

  19. Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse

    PubMed Central

    Tien, Yu-Yu; Hsia, Renee Y.

    2016-01-01

    Prescription drug abuse is a growing problem nationally. In an effort to curb this problem, emergency physicians might rely on subjective cues such as race-ethnicity, often unknowingly, when prescribing opioids for pain-related complaints, especially for conditions that are often associated with drug-seeking behavior. Previous studies that examined racial-ethnic disparities in opioid dispensing at emergency departments (EDs) did not differentiate between prescriptions at discharge and drug administration in the ED. We examined racial-ethnic disparities in opioid prescription at ED visits for pain-related complaints often associated with drug-seeking behavior and contrasted them with conditions objectively associated with pain. We hypothesized a priori that racial-ethnic disparities will be present among opioid prescriptions for conditions associated with non-medical use, but not for objective pain-related conditions. Using data from the National Hospital Ambulatory Medical Care Survey for 5 years (2007–2011), the odds of opioid prescription during ED visits made by non-elderly adults aged 18–65 for ‘non-definitive’ conditions (toothache, back pain and abdominal pain) or ‘definitive’ conditions (long-bone fracture and kidney stones) were modeled. Opioid prescription at discharge and opioid administration at the ED were the primary outcomes. We found significant racial-ethnic disparities, with non-Hispanic Blacks being less likely (adjusted odds ratio ranging from 0.56–0.67, p-value < 0.05) to receive opioid prescription at discharge during ED visits for back pain and abdominal pain, but not for toothache, fractures and kidney stones, compared to non-Hispanic whites after adjusting for other covariates. Differential prescription of opioids by race-ethnicity could lead to widening of existing disparities in health, and may have implications for disproportionate burden of opioid abuse among whites. The findings have important implications for medical

  20. Estimating the cost of unclaimed electronic prescriptions at an independent pharmacy.

    PubMed

    Doucette, William R; Connolly, Connie; Al-Jumaili, Ali Azeez

    2016-01-01

    The increasing rate of e-prescribing is associated with a significant number of unclaimed prescriptions. The costs of unclaimed e-prescriptions could create an unwanted burden on community pharmacy practices. The objective of this study was to calculate the rate and costs of filled but unclaimed e-prescriptions at an independent pharmacy. This study was performed at a rural independent pharmacy in a Midwestern state. The rate and costs of the unclaimed e-prescriptions were determined by collecting information about all unclaimed e-prescriptions for a 6-month period from August 2013 to January 2014. The costs of unclaimed prescriptions included those expenses incurred to prepare the prescription, contact the patient, and return the unclaimed prescription to inventory. Two sensitivity analyses were conducted. The total cost of 147 unclaimed e-prescriptions equaled $3,677.70 for the study period. Thus, the monthly cost of unclaimed e-prescriptions was $612.92 and the average cost of each unclaimed prescription was $25.02. The sensitivity analyses showed that using a technician to perform prescription return tasks reduced average costs to $19.33 and that using a state Medicaid cost of dispensing resulted in average costs of $18.54 per prescription. The rate of unclaimed e-prescriptions was 0.82%. The percentage of unclaimed e-prescriptions in this pharmacy was less than 1%. In addition to increased cost, unclaimed e-prescriptions add inefficiency to the work flow of the pharmacy staff, which can limit the time that they are available for performing revenue-generating activities. Adjustments to work flow and insurer policies could help to reduce the burden of unclaimed e-prescriptions. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.