49 CFR 219.103 - Prescribed and over-the-counter drugs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Prescribed and over-the-counter drugs. 219.103... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Prohibitions § 219.103 Prescribed and over-the-counter drugs. (a) This subpart does not prohibit the use of a controlled substance (on...

49 CFR 219.103 - Prescribed and over-the-counter drugs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Prescribed and over-the-counter drugs. 219.103... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Prohibitions § 219.103 Prescribed and over-the-counter drugs. (a) This subpart does not prohibit the use of a controlled substance (on...

49 CFR 219.103 - Prescribed and over-the-counter drugs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Prescribed and over-the-counter drugs. 219.103... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Prohibitions § 219.103 Prescribed and over-the-counter drugs. (a) This subpart does not prohibit the use of a controlled substance (on...

Over-the-Counter Medicines and Diabetes Care.

PubMed

Taylor, Jeff

2017-12-01

People with diabetes turn to over-the-counter (OTC) medicines for many ailments. The focus of this brief review is the impact common OTC medicines might have on this group of patients. Three types of OTC medicines were selected as most deserving of attention: 3 herbal agents, nonsteroidal anti-inflammatory drugs (NSAIDs) and cough/cold products. Existing literature was used to determine precautions that might be in order. Herbal/natural agents with the potential to impact blood sugar have been identified in various reports. In discussing 3, glucosamine and cinnamon (at doses recommended on commercial products) should have minimal impact on diabetic management, whereas St. John's wort is a concern involving potential drug interactions. For colds, of about 11 active ingredients, only decongestants (primarily oral) need be considered for their possible effects on blood sugar. Finally, NSAIDs (even at OTC doses) must be used with caution, given their cardiovascular, renal and gastrointestinal risks. Care guidelines do encourage patients to take ownership of their condition. Yet the ability to self-medicate safely is not a certainty. In spite of easy access and a reasonable level of safety, OTC medicines still can negatively impact a user. NSAIDs available without prescription continue to cause concern. Before the use of any medicine, a person must ensure it will be safe. A health-care provider can be asked for assistance, but that option may not always be employed. Package information is there to provide critical information in lieu of that, something the self-medicating patient will, it is hoped, embrace. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Prescription Drugs, Over-the-Counter Drugs, Supplements and Herbal Products

MedlinePlus

... at risk? Zika virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how ... the-counter drugs, supplements and herbal products Prescription drugs, over-the-counter drugs, supplements and herbal products ...

Clinical study of the safety and effectiveness of a novel over-the-counter bleaching tray system

PubMed Central

Ghalili, K Michael; Khawaled, Kamal; Rozen, Doran; Afsahi, Veda

2014-01-01

We investigated color change, gingival irritation, and tooth sensitivity in patients undergoing at-home vital tooth bleaching with a novel over-the-counter bleaching tray system. Tooth color shade in anterior teeth, supragingival plaque and gingivitis in Ramfjord teeth, as well as visual assessment of teeth gingival tissues and mucosa were evaluated in-office prior to treatment, after two consecutive applications of the 9% hydrogen peroxide bleaching product, after eight applications (10 minutes/day for 3 days at home), and after ten applications (50 minutes exposure over 5 days). Color stability was evaluated at 3 months after completing the treatment regimen. Over-the-counter bleaching products can be used by the patient at home without dentist supervision, but are frequently associated with gingival irritation and tooth sensitivity despite low concentrations of peroxide agents. Our investigations showed that the treatment is tolerable and safe with a low incidence of adverse effects. Any adverse effects associated with use of the whitening gel and tray are temporary, easily controlled, and often disappear within minutes of treatment. Statistical analysis revealed significant improvement in teeth whitening following treatment (mean color change of seven shades) and at three months after treatment. PMID:24591847

High use of over-the-counter analgesic; possible warnings of reduced quality of life in adolescents - a qualitative study.

PubMed

Skarstein, Siv; Lagerløv, Per; Kvarme, Lisbeth Gravdal; Helseth, Sølvi

2016-01-01

Use of over-the-counter analgesics among adolescents has increased markedly. High consumption of over-the-counter analgesics among adolescents is associated with frequent pain, lower self-esteem, reduced sleep, lower educational ambition, binge drinking, higher caffeine consumption, and part-time employment. Knowledge about life experiences of adolescents who frequently use over-the-counter analgesics may be useful to prevent health problems. The purpose of the study was to increase knowledge about adolescents who suffer from frequent pain and have a high consumption of over-the-counter analgesics. A qualitative study, employing one-on-one, in-depth interviews using a thematic interview guide. Data were collected in Norway in 2013-2014. Three boys and sixteen girls; aged 14-16 years, who continuously consumed over-the-counter analgesics were recruited from ten high schools in urban and suburban districts. Candidate participants were excluded if they were medically diagnosed with an acute or chronic illness, requiring extended use of over-the-counter analgesics within the last year. The interviews were taped, transcribed and analysed as text according to Kvale's three contexts of interpretation: self-understanding, common sense and theory. All participants disclosed unresolved physical and psychosocial distress characterized as pain. Frequent pain from various body parts made everyday life challenging. Methods of pain self-appraisal and over-the-counter analgesics use often mimicked maternal patterns. Participants reported being raised under unpredictable circumstances that contributed to long lasting family conflicts and peer-group problems. Participants wanted to feel appreciated and to be socially and academically successful. However, pain reduced their ability to manage everyday life, hampered experienced possibilities for success, and made social settings difficult. Childhood experiences influence how adolescents experience pain and use over-the-counter

Informational and symbolic content of over-the-counter drug advertising on television.

PubMed

Tsao, J C

1997-01-01

The informational and symbolic content of 150 over-the-counter drug commercials on television are empirically analyzed in this study. Results on the informational content suggest that over-the-counter drug ads tend to focus on the concern of what the drug will do for the consumer, rather than on the reasons why the drug should be ingested. Accordingly, advertising strategy is centered on consumer awareness of the product as the primary goal. Educational commitment, however, did not seem to be blended into the promotional efforts for over-the-counter drugs. Findings on the symbolic content of over-the-counter drug ads reveal that drug images have been distorted. Performance of most drugs has been portrayed to be simple resolutions to relieve the symptom. Moreover, a casual attitude toward drug usage is encouraged in the commercials, while time lapse of drug effects is overlooked.

Over-the-counter sales of antibiotics from community pharmacies in Abu Dhabi.

PubMed

Dameh, Majd; Green, James; Norris, Pauline

2010-10-01

The aim of this study is to investigate over-the-counter sale of antibiotics from community pharmacies in Abu Dhabi city, focusing on the extent, demographic and socioeconomic determinants of this practice. The study was conducted in the capital of the United Arab Emirates, Abu Dhabi, and involved 17 randomly selected private pharmacies. A cross-sectional design using structured observations of 30 clients purchasing antibiotics from a pharmacy staff (either a pharmacist or pharmacy assistant) at each selected pharmacy. A total of 510 interactions were observed. Statistical analysis was performed using SPSS. The extent and types of antibiotics sold over-the-counter in Abu Dhabi city as observed in the selected sample of community pharmacies, and the demographic and socioeconomic factors that contributed to this practice. Sixty eight percent (68.4%) of the observed antibiotic sales were sold over-the-counter without prescriptions. Injection antibiotics constituted 2.2% of the antibiotics sold, 45.5% of which were sold over-the-counter. Combination of penicillins including β-lactamase inhibitors (34.0%), penicillins with extended spectrum (22.3%) and second generation cephalosporins (11.2%) were the mostly commonly sold antibiotic groups. Respiratory conditions (63.1%) were the most frequent reason for purchasing antibiotics. Over-the-counter sales of antibiotics were related to client ethnicity and age, gender of pharmacy staff and health complaint. Our study revealed high sales of over-the-counter antibiotics, despite this being illegal. The ineffectiveness of antibiotics in treating respiratory conditions of viral origin and effects of such practice on the emergence of bacterial resistance necessitates prompt action.

Over-the-counter medications containing diphenhydramine and doxylamine used by older adults to improve sleep.

PubMed

Abraham, Olufunmilola; Schleiden, Loren; Albert, Steven M

2017-08-01

Background The unintentional misuse of over-the-counter sleep aids among older adults is an important public health problem and a focus of Healthy People 2020. Accordingly, the 2015 Beers Criteria for Potentially Inappropriate Medication Use in Older Adults recommends that individuals 65 years or older avoid use of diphenhydramine and doxylamine; however, many over-the-counter sleep products contain these active ingredients. Objective To identify the proportion of older adults using an over-the-counter medication containing diphenhydramine or doxylamine, and compare their characteristics with older adults using an over-the-counter medication that does not contain these ingredients. Setting Study participants were recruited from the Community Registry of the Pittsburgh Claude D. Pepper Older Americans Independence Center. Method The study sample was taken from a larger survey of 1025 participants on sleep health and over-the-counter sleep medication use conducted from February to April 2015. A subset of 169 participants aged 65 and older reporting taking at least one over-the-counter product to improve sleep within the past 30 days (16.5%) were selected for our analysis on associations between participant characteristics and potentially inappropriate use of over-the-counter sleep medications. Main outcome measure The proportion and characteristics of older adults taking at least one over-the-counter medication containing diphenhydramine or doxylamine. Results Of the 223 over-the-counter sleep medications listed by participants, 115 (52%) contained diphenhydramine or doxylamine. Using the Beers Criteria, we found that more than half of participants (59%) had used a potentially inappropriate over-the-counter medication containing diphenhydramine or doxylamine to improve sleep within the past 30 days. Participants taking at least one diphenhydramine or doxylamine containing medication were less likely to be aware of any safety risks in taking over-the-counter sleep

Clinical utility of marketing terms used for over-the-counter dermatologic products.

PubMed

Boozalis, Emily; Patel, Shivani

2018-05-08

Cosmetic products are commonly marketed using dermatologic terms such as 'hypoallergenic', 'non-comedogenic', 'fragrance-free', etc. The clinical relevance of these claims can be confusing to both patients and clinicians. A systematic review was performed via a PubMed search of published articles from January 1985 to October 2017 to further describe and elucidate the clinical utility of a predefined list of common dermatologic terms used by pharmaceutical companies to market over-the-counter products. The terms 'fragrance-free', 'hypoallergenic', 'non-comedogenic', and 'oil-free' on cosmetic product labels are not regulated by any governing body and provide varied clinical utility. Products labeled as having 'natural ingredients' are not necessarily safer or less irritating to patients with atopy or a history of allergic contact dermatitis. Despite the increasing popularity of 'paraben-free' cosmetics, parabens are safe for patients in the quantities used in cosmetic products and can be safely used in patients who do not exhibit contact dermatitis to this preservative. A working knowledge of common cosmetic ingredients may help dermatologists to counsel patients on which products to avoid for their specific dermatologic conditions.

Hispanic youth involvement in over-the-counter drug use: parent, peer, and school factors.

PubMed

Vidourek, Rebecca A; King, Keith A; Fehr, Sara K

2014-01-01

Research on substance use among Hispanic youth is lacking. The purpose of this study was to examine over-the-counter drug use among Hispanic youth. Of Hispanic youth, 23.9% used an over-the-counter drug for the purpose of getting high. Involvement in prosocial behaviors was correlated with decreased over-the-counter use for females and high school students. Involvement in risky behaviors increased the risk of use for males, females, junior high school students, and high school students. Significant differences were found based on parent, peer, teacher, and school factors. Prevention and intervention programs should address over-the-counter drug use among Hispanic youth.

Assessing the relationship between pharmacists' job satisfaction and over-the-counter counselling at community pharmacies.

PubMed

Urbonas, Gvidas; Kubilienė, Loreta

2016-04-01

Community pharmacies have an increasing role in self-medication and community health is dependent on the quality of counselling services provided to patients. Some studies show that pharmacists' job satisfaction affects their work quality; other studies found that higher involvement in clinical services increases pharmacists' job satisfaction. To test the relationship between job satisfaction and over-the-counter counselling practice at community pharmacies. Community pharmacies in Lithuania. A convenience sample (n = 305) of community pharmacists participated in the cross-sectional survey where they expressed satisfaction with job and reported on their over-the-counter counselling behaviour on self-report scales. The Partial Least Squares Structural Equation Modelling approach was employed for data analysis. The strength of the relationship between job satisfaction and over-the-counter counselling service. A bidirectional relationship between job satisfaction and over-the-counter counselling service was found. In addition, job satisfaction and over-the-counter counselling quality depended on pharmacists' age. Organizations were recommended to create a counselling friendly environment that would increase pharmacists' job satisfaction and, in return, counselling quality. Also, additional motivation of the retired pharmacists, as well as development of counselling skills of the younger pharmacy workforce, were seen as a means to improve both organizational climate and counselling quality over the counter.

21 CFR 201.315 - Over-the-counter drugs for minor sore throats; suggested warning.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Over-the-counter drugs for minor sore throats... Drug Products § 201.315 Over-the-counter drugs for minor sore throats; suggested warning. The Food and... counter for the relief of minor irritations of the mouth or throat. It will not object to the labeling of...

21 CFR 201.315 - Over-the-counter drugs for minor sore throats; suggested warning.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Over-the-counter drugs for minor sore throats... Drug Products § 201.315 Over-the-counter drugs for minor sore throats; suggested warning. The Food and... counter for the relief of minor irritations of the mouth or throat. It will not object to the labeling of...

Analysis of Marketing Strategy for Food Supplements and Over-The-Counter Medicines.

PubMed

Dzeparoski, Marjan; Trajkovic-Jolevska, Suzana

2016-09-15

Marketing strategy is correlated with the regulations for the corresponding product category. Accordingly, there is a big difference in the marketing strategy of food supplements and over-the-counter medicines. In this paper are presented 2 different marketing strategies of a new small pharmaceutical company in two studies. The findings of studies analysis can be used for developing marketing strategies in the wider sense and other products, for other small to medium sized companies in other countries of interest with similar regulations and help them understand how to position and promote themselves and their products.

Use of Over-the-Counter Medication among Pregnant Women in Sharjah, United Arab Emirates

PubMed Central

Mustafa, Hafsa

2017-01-01

Background Over-the-counter medications are widely available in pharmacies Their safety profile, however, does not extend to pregnant women. Accordingly, there should be educational programs developed for pregnant women to protect them from the harms of the side effects. Aim This study was planned and designed with the aim of exploring the awareness and assessing the usage of OTC medications among pregnant women in Sharjah, UAE. Method A cross-sectional survey using a self-administered questionnaire. Results More than three-quarters (75.7%) reported that they are familiar with the term “over-the-counter drugs.” Interestingly, 40% of the respondents reported that they took OTC drugs during pregnancy, and the majority (94.2%) agreed with the survey statement “not all OTC medications are safe to be taken during pregnancy.” Constipation was the most frequent side effect that most of the participants reported during the study period. Folic acid (36%), calcium (28.6%), and iron (35.1%) were the most common supplements used by the pregnant women responding. Conclusion The reported 40% usage of OTC medications among pregnant women in this study is worrisome and calls for the need to educate, counsel, and increase awareness among pregnant women regarding the dangers of OTC drugs usage while pregnant in Sharjah, UAE. PMID:28804652

26 CFR 1.1092(c)-3 - Qualifying over-the-counter options.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Qualifying over-the-counter options. 1.1092(c)-3...-counter options. (a) In general. Under section 1092(c)(4)(B)(i), an equity option is not a qualified covered call option unless it is traded on a national securities exchange that is registered with the...

Partnership in optimizing management of reflux symptoms: a treatment algorithm for over-the-counter proton-pump inhibitors.

PubMed

Boardman, Helen F; Delaney, Brendan C; Haag, Sebastian

2015-01-01

Uncomplicated heartburn and acid regurgitation are increasingly treated and managed using over-the-counter medications. However, with over-the-counter availability of antacids, alginates, histamine 2 receptor antagonists (H2RAs), and proton-pump inhibitors (PPIs), consumers need guidance as to appropriate options and how to use them. Relevant guidelines, studies, and reviews were identified via literature searches of PubMed/Medline and Google Scholar, as well as cross-referencing from the identified papers. Antacids, alginates, and H2RAs are best suited to management of occasional heartburn, taken either before provocative meals or other triggers or on demand when symptoms arise. Over-the-counter PPIs are appropriate options across the range of symptom severity/frequency typically encountered in the pharmacy, but may be particularly appropriate for treatment of those with frequent and/or very bothersome heartburn. A 2-4 week course of daily PPIs can lead to complete resolution of frequent heartburn. Counseling is important to ensure that patients understand that failure of symptoms to resolve or a rapid return of symptoms while taking a PPI is an indication to consult a doctor, whereas a return of symptoms after a period of months may be an indication for just another course of treatment. The need for effective communication and for ensuring use of the correct medication in the over-the-counter setting puts much of the responsibility for management of heartburn and acid regurgitation on the pharmacist. A proposed algorithm that details when and how to use available over-the-counter medications is presented. This algorithm also highlights alarm features and atypical symptoms indicative of other underlying conditions that should be referred directly to a physician. Implementation of a simple algorithm will empower pharmacists and consumers alike and ensure consistent and appropriate care.

Analysis of Marketing Strategy for Food Supplements and Over-The-Counter Medicines

PubMed Central

Dzeparoski, Marjan; Trajkovic-Jolevska, Suzana

2016-01-01

Marketing strategy is correlated with the regulations for the corresponding product category. Accordingly, there is a big difference in the marketing strategy of food supplements and over-the-counter medicines. In this paper are presented 2 different marketing strategies of a new small pharmaceutical company in two studies. The findings of studies analysis can be used for developing marketing strategies in the wider sense and other products, for other small to medium sized companies in other countries of interest with similar regulations and help them understand how to position and promote themselves and their products. PMID:27703582

A preliminary examination of over-the-counter medication misuse rates in older adults.

PubMed

Stone, Jamie A; Lester, Corey A; Aboneh, Ephrem A; Phelan, Cynthia H; Welch, Lauren L; Chui, Michelle A

Older adults are the largest consumers of over the counter (OTC) medications. Of the older adults who are at risk of a major adverse drug event, more than 50% of these events involve an OTC medication. To explore how older adults select and hypothetically use OTC medications and if the selected medications would be considered safe for use. Walking interviews were conducted with 20 community-dwelling older adults in a community pharmacy. Each participant selected an OTC medication for a hypothetical pain and sleep scenario. Data were analyzed for four types of misuse: drug-drug interaction, drug-disease interaction, drug-age interaction, and excess usage. At least one instance of potential misuse was found in 95% of participants. For sleep medications, drug-drug interactions and drug-age interactions were more common, affecting 50% and 65% of participants respectively. The most common type of misuse noted in the pain products selected was that of drug-drug interaction, with a total of 39 occurrences, affecting 60% of the participants. OTC misuse is common among older adults, and it is important for older adults to seek out resources, such as a pharmacist, to help them make safe OTC decisions. Copyright © 2016 Elsevier Inc. All rights reserved.

[Factors related to purchasing over-the-counter medications online].

PubMed

Kishimoto, Keiko; Yoshida, Takeshi; Fukushima, Noriko

2009-09-01

We conducted a Web-based survey of approximately 40,000 Internet users on the purchase of over-the-counter (OTC) medications online in March 2009. The valid response rate was 97.8% and the number of responses was 39,208. The number of people who had purchased OTC medications online was 4,653 (11.9%), prescription medicines 792 (2.0%), and medical contact lenses 1,993 (5.1%). As a result of the multiple logistic regression analysis, independent variables with odds ratios (ORs) >1.5 were experience of purchasing prescription-only medicine online (OR=4.997, 95%CI=4.288-5.824), regular supplement use (OR=2.384, 95%CI=2.233-2.548), experience of purchasing colored contact lenses online (OR=2.206, 95%CI=1.632-2.983), no time to visit drugstores (OR=2.092, 95%CI=1.928-2.270), usage of Web sites of uncertain reliability (OR=1.992, 95%CI=1.857-2.137), and experience of purchasing therapeutic contact lenses online (OR=1.796, 95%CI=1.597-2.020). As some people have purchased prescription-only medicine or medical devices and had problems with drug information sources, the development of awareness of medical and pharmaceutical supplies and health and medical information literacy are key priorities to ensure safe OTC medication sales systems.

78 FR 19718 - Modifications To Labeling of Nicotine Replacement Therapy Products for Over-the-Counter Human Use

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

...] Modifications To Labeling of Nicotine Replacement Therapy Products for Over-the-Counter Human Use AGENCY: Food...-counter nicotine replacement therapy products, related to concomitant use with other nicotine-containing... over-the- counter nicotine replacement therapy products for their approved intended use as aids to...

Remedy or cure? Lay beliefs about over-the-counter medicines for coughs and colds.

PubMed Central

Johnson, Gina; Helman, Cecil

2004-01-01

BACKGROUND: Over 500 million is spent in the United Kingdom every year on over-the-counter medicines for coughs and colds. Evidence for their pharmacological efficacy is lacking. AIM: To examine lay beliefs about over-the-counter medicines for coughs and colds. To explore whether the distinction between symptom relief and cure has the same relevance to lay people as it does to medical professionals. DESIGN OF STUDY: Small pilot study using qualitative techniques. SETTING: Variety sample of 11 patients attending the National Health Service walk-in centre, Birmingham, England. METHOD: In-depth semi-structured interviews, including pile-sorting and fictional case histories, were used to explore participants' beliefs about the effects of over-the-counter medicines on coughs and colds. RESULTS: Eight of the 11 participants believed that at least one over the-counter cough medicine (most frequently Benylin for Chesty Coughs) could shorten, or "cure", an illness. Five participants thought that the majority of the medicines that they recognised would speed recovery rather than just relieve symptoms. CONCLUSIONS: There is a common confusion in the lay person's mind between the ability of a medicine to relieve symptoms, and its ability to cure a disease or to hasten recovery. This misunderstanding may affect the demand for primary care consultations. PMID:14965387

American and German students' knowledge, perceptions, and behaviors with respect to over-the-counter pain relievers.

PubMed

Hanoch, Yaniv; Katsikopoulos, Konstantinos V; Gummerum, Michaela; Brass, Eric P

2007-11-01

To better understand the knowledge base and perceptions involved in the decision to buy and use over-the-counter pain relievers (OTCPRs) by taking into account the environment in which these decisions are made. The authors expected that the differences in access and marketing would affect knowledge and decision making related to OTCPRs in the United States and Germany. A survey was given to 108 undergraduate university students in the United States and Germany (58 and 50 participants, respectively). The authors found that significantly more Americans than Germans take OTCPRs and that they also take significantly more OTCPRs. Americans exhibited less knowledge about side effects than their German counterparts. When asked when they consulted package labels, Americans reported they were more likely to do so before buying a product, whereas Germans reported consulting labels before taking OTCPRs for the first time. Package labels affected more Americans' decisions to purchase OTCPRs; Americans were also less likely to consult a doctor when feeling pain but more likely to take OTCPRs. Finally, Americans viewed OTCPRs as riskier after their status changed from prescription only to over the counter, whereas Germans believed they posed less risk. This study analyzed health-related behavior by looking at how environmental factors shape decision processes related to over-the-counter drug use. The results indicate that looking at environmental factors does help to explain differences in knowledge, perceptions, and behaviors among German and American students. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Tobacco counter-advertising: a review of the literature and a conceptual model for understanding effects.

PubMed

Agostinelli, Gina; Grube, Joel W

2003-01-01

The tobacco counter-advertising literature is reviewed as it relates to basic process questions concerning what makes counter-advertisements effective. Limitations in addressing (a) counter-advertisement content and the psychological mediators targeted, (b) counter-advertisement style and the affective reactions targeted, (c) prior smoking experience, and (d) other audience factors are enumerated. A theoretical model based on alcohol advertising research is presented to address those limitations. The model addresses the practical research question of predicting when tobacco counter-advertising will work by examining the independent influence of each of these enumerated factors, as well as how these factors operate in concert, qualifying each other. The model also addresses the process question of explaining how counter-advertising works by identifying affective and cognitive processes as mediators. By understanding the processes that underlie the qualified findings, one can better advise the designers of tobacco counter-advertisements how to be more effective.

The role of the pharmacist in the selection and use of over-the-counter proton-pump inhibitors.

PubMed

Boardman, Helen F; Heeley, Gordon

2015-10-01

Heartburn and other symptoms of gastro-oesophageal reflux occur in ~30% of survey respondents in multiple countries worldwide. Heartburn and acid regurgitation are common complaints in the pharmacy, where patients frequently seek relief through medication and advice. The growing number of proton-pump inhibitors available in the over-the-counter setting provides an efficacious choice to patients experiencing frequent heartburn. Pharmacists can assist patients in their treatment decisions whilst inquiring about alarm symptoms that should prompt a physician referral. Aim of the review Provide pharmacists with a review of current clinical research and expert guidelines on use of over-the-counter proton-pump inhibitors. This narrative review was conducted to identify publications relevant to the following themes: overview of available treatments for frequent episodes of heartburn/acid regurgitation; treatment algorithms providing guidance on when to use over-the-counter proton-pump inhibitors; and the role of the pharmacist in the use of over-the-counter proton-pump inhibitors. Frequent symptoms of acid reflux, such as heartburn and acid regurgitation, can interfere substantially with daily life activities. Proton-pump inhibitors are the most efficacious treatment for frequent reflux symptoms and are recommended as an appropriate initial treatment in uncomplicated cases. Proton-pump inhibitors have varying pharmacokinetics and pharmacodynamics across the class; 20 mg esomeprazole has higher bioavailability and exposure than over-the-counter omeprazole, for example. However, differences in clinical efficacy for symptom relief have not been demonstrated. The safety and tolerability of proton-pump inhibitors have been well established in clinical trial and post-marketing settings, and use of a short regimen is associated with a very low likelihood of missing a more serious condition. Pharmacists can assist patients with accurate self-diagnosis by asking short, simple

Medicines in My Home: Information for Adults on Using Over-the-Counter Medicines Safely

MedlinePlus

Medicines In My Home More about using medicines safely Medicines in My Home: www.fda.gov/medsinmyhome FDA Consumer Medicine Education: www.fda.gov/usemedicinesafely National Council on Patient Information and ...

Understanding older adults' medication decision making and behavior: A study on over-the-counter (OTC) anticholinergic medications.

PubMed

Holden, Richard J; Srinivas, Preethi; Campbell, Noll L; Clark, Daniel O; Bodke, Kunal S; Hong, Youngbok; Boustani, Malaz A; Ferguson, Denisha; Callahan, Christopher M

2018-03-06

Older adults purchase and use over-the-counter (OTC) medications with potentially significant adverse effects. Some OTC medications, such as those with anticholinergic effects, are relatively contraindicated for use by older adults due to evidence of impaired cognition and other adverse effects. To inform the design of future OTC medication safety interventions for older adults, this study investigated consumers' decision making and behavior related to OTC medication purchasing and use, with a focus on OTC anticholinergic medications. The study had a cross-sectional design with multiple methods. A total of 84 adults participated in qualitative research interviews (n = 24), in-store shopper observations (n = 39), and laboratory-based simulated OTC shopping tasks (n = 21). Simulated shopping participants also rank-ordered eight factors on their importance for OTC decision making. Findings revealed that many participants had concerns about medication adverse effects, generally, but were not aware of age-related risk associated with the use of anticholinergic medications. Analyses produced a map of the workflow of OTC-related behavior and decision making as well as related barriers such as difficulty locating medications or comparing them to an alternative. Participants reported effectiveness, adverse effects or health risks, and price as most important to their OTC medication purchase and use decisions. A persona analysis identified two types of consumers: the habit follower, who frequently purchased OTC medications and considered them safe; and the deliberator, who was more likely to weigh their options and consider alternatives to OTC medications. A conceptual model of OTC medication purchase and use is presented. Drawing on study findings and behavioral theories, the model depicts dual processes for OTC medication decision making - habit-based and deliberation-based - as well as the antecedents and consequences of decision making. This model suggests

Consumer involvement: effects on information processing from over-the-counter medication labels.

PubMed

Sansgiry, S S; Cady, P S; Sansgiry, S

2001-01-01

The objective of this study was to evaluate the effects of consumer involvement on information processing from over-the-counter (OTC) medication labels. A sample of 256 students evaluated simulated OTC product labels for two product categories (headache and cold) in random order. Each participant evaluated labels after reading a scenario to simulate high and low involvement respectively. A questionnaire was used to collect data on variables such as label comprehension, attitude-towards-product label, product evaluation, and purchase intention. The results indicate that when consumers are involved in their purchase of OTC medications they are significantly more likely to understand information from the label and evaluate it accordingly. However, involvement does not affect attitude-towards-product label nor does it enhance purchase intention.

Rosacea Patient Perspectives on Homeopathic and Over-the-counter Therapies

PubMed Central

Lan, Lucy; Kuo, Sandy; Huang, Karen E.; Taylor, Sarah L.; Feldman, Steven R.

2015-01-01

Background: Rosacea patients commonly employ nonprescription therapies. The authors’ aim was to understand rosacea patients’ perceptions of over-the-counter products, complementary and alternative medicine, and homeopathic therapies. Method: A public, online discussion forum comprising 3,350 members and 27,051 posts provided a source of 346 posts on patient perceptions on alternative rosacea treatments. Results: Three major themes of nonprescription treatment were identified—motivation for use, patient-provider discussions, and experience with these treatments. Perceived medication failure, barriers to treatment, and distrust of physicians drive patients to seek nonprescription therapies. Still, patients prefer to consult a physician on incorporating nonprescription therapies into treatment. Complementary and alternative medicine natural products (19.4% of posts), complementary and alternative medicine practices (16.5%), and homeopathic medicine (3.8%) were commonly discussed. Conclusion: Physicians have an opportunity to be a trusted source of information on the strengths and weaknesses of skin care products and other complementary treatments for rosacea. PMID:26557217

Over-the-Counter Data's Impact on Educators' Data Analysis Accuracy

ERIC Educational Resources Information Center

Rankin, Jenny Grant

2013-01-01

There is extensive research on the benefits of making data-informed decisions, but research also contains evidence many educators incorrectly interpret student data. Meanwhile, the types of detailed labeling on over-the-counter medication have been shown to improve use of "non"-medication products, as well. However, data systems most…

Ion mobility spectrometry for the rapid analysis of over-the-counter drugs and beverages

PubMed Central

Fernández-Maestre, Roberto

2009-01-01

In the pharmaceutical industry, there are increasing requirements for analytical methods in quality assessment for the production of drugs. In this investigation, ion mobility spectrometry (IMS) was used for the rapid qualitative separation and identification of active ingredients in generic over-the-counter drugs and food additives in beverages. The active ingredients determined in drugs were acetaminophen, aspartame, bisacodyl, caffeine, dextromethorphan, diphenhydramine, famotidine, glucosamine, guaifenesin, loratadine, niacin, phenylephrine, pyridoxine, thiamin, and tetrahydrozoline. Aspartame and caffeine were determined in beverages. Fourteen over-the-counter drugs and beverages were analyzed. Analysis times below 10 s were obtained for IMS, and reduced mobilities were reported for the first time for 12 compounds. A quadrupole mass spectrometer coupled to a mobility spectrometer was used to assure a correct peak assignation. The combination of fast analysis, low cost, and inexpensive maintenance of IMS instruments makes IMS an attractive technique for the qualitative determination of the active ingredients in over-the-counter drugs and food additives in manufacture quality control and cleaning verification for the drug and food industries. PMID:20835390

Over-the-Counter Data's Impact on Educators' Data Analysis Accuracy

ERIC Educational Resources Information Center

Rankin, Jenny Grant

2013-01-01

There is extensive research on the benefits of making data-informed decisions, but research also contains evidence many educators incorrectly interpret student data. Meanwhile, the types of detailed labeling on over-the-counter medication have been shown to improve use of non-medication products, as well. However, data systems most educators use…

21 CFR 310.540 - Drug products containing active ingredients offered over-the-counter (OTC) for use as stomach...

Code of Federal Regulations, 2013 CFR

2013-04-01

... offered over-the-counter (OTC) for use as stomach acidifiers. 310.540 Section 310.540 Food and Drugs FOOD... ingredients offered over-the-counter (OTC) for use as stomach acidifiers. (a) Betaine hydrochloride, glutamic...-counter (OTC) drug products for use as stomach acidifiers. Because of the lack of adequate data to...

21 CFR 310.540 - Drug products containing active ingredients offered over-the-counter (OTC) for use as stomach...

Code of Federal Regulations, 2014 CFR

2014-04-01

... offered over-the-counter (OTC) for use as stomach acidifiers. 310.540 Section 310.540 Food and Drugs FOOD... ingredients offered over-the-counter (OTC) for use as stomach acidifiers. (a) Betaine hydrochloride, glutamic...-counter (OTC) drug products for use as stomach acidifiers. Because of the lack of adequate data to...

21 CFR 310.540 - Drug products containing active ingredients offered over-the-counter (OTC) for use as stomach...

Code of Federal Regulations, 2012 CFR

2012-04-01

... offered over-the-counter (OTC) for use as stomach acidifiers. 310.540 Section 310.540 Food and Drugs FOOD... ingredients offered over-the-counter (OTC) for use as stomach acidifiers. (a) Betaine hydrochloride, glutamic...-counter (OTC) drug products for use as stomach acidifiers. Because of the lack of adequate data to...

21 CFR 310.540 - Drug products containing active ingredients offered over-the-counter (OTC) for use as stomach...

Code of Federal Regulations, 2011 CFR

2011-04-01

... offered over-the-counter (OTC) for use as stomach acidifiers. 310.540 Section 310.540 Food and Drugs FOOD... ingredients offered over-the-counter (OTC) for use as stomach acidifiers. (a) Betaine hydrochloride, glutamic...-counter (OTC) drug products for use as stomach acidifiers. Because of the lack of adequate data to...

Over-the-Counter Access to Oral Contraceptives.

PubMed

Grossman, Daniel

2015-12-01

Making oral contraceptives (OCs) available over the counter (OTC) could help to reduce the high rate of unintended pregnancy in the United States. Surveys show widespread support for OTC access to OCs among US women. Studies indicate that women can accurately use checklists to identify contraindications to OCs. Continuation is as good or better among OTC users compared with women using OCs obtained by prescription. Women and clinicians have expressed concerns related to making OCs available OTC. These concerns can be addressed by existing data or through research required by the Food and Drug Administration as part of the application to make OCs available OTC. Copyright © 2015 Elsevier Inc. All rights reserved.

A Comparison of Over-the-Counter Mechanical Nasal Dilators: A Systematic Review.

PubMed

Kiyohara, Nicole; Badger, Christopher; Tjoa, Tjoson; Wong, Brian

2016-09-01

The internal nasal valve is the narrowest part of the nasal airway and a common site of inspiratory collapse and obstruction of nasal airflow. Over-the-counter mechanical nasal dilators are an alternative to surgical intervention that attempts to improve airflow through the internal nasal valve. To determine the efficacy of over-the-counter mechanical nasal dilators and classify these products by mechanism. A database of 33 available over-the-counter mechanical nasal dilators was generated via a PubMed search as well as an internet search via Amazon.com and Google, conducted from April 1, 2013, through December 31, 2015. Products determined to be unavailable or discontinued were excluded from the database. Of the devices examined in published literature, efficacy was based on objective measures, such as measured airflow, the cross-sectional area of the nasal valve, and changes in resistance. Measures of reported sleep quality or patient perception were excluded. An analysis of each product's mechanism revealed 4 broad classes: external nasal dilator strips, nasal stents, nasal clips, and septal stimulators. A review demonstrated 5 studies supporting the use of external nasal dilator strips, 4 studies supporting the use of nasal clips, 1 study supporting the use of nasal stents, and no studies supporting the use of septal stimulators. Our findings suggest that external nasal dilator strips and nasal clips effectively relieve obstruction of the internal nasal valve and may be an alternative to surgical intervention in some patients.

Safety and Quality Concerns Regarding Over-the-Counter Sexual Enhancement Products Sold in the USA Market Pose a Major Health Risk.

PubMed

Ahmed, Mohammed; Kumari, Suneeta; Manali, Partam; Sonje, Snezana; Malik, Mansoor

2016-10-01

Safety and quality concerns regarding over the counter sexual enhancement products sold in the USA market pose a major health risk to the general public. Nevertheless, the use of herbal medicines continues to expand rapidly across world and many people perceive usage of herbal medication as a safe and reliable way to improve health outcome. The safety of herbal supplements has become a globally major concern in national and international health authorities due to increasing adverse events and adulterations associated with usage of herbal medications. These non FDA approved products with unknown ingredients are widely accessible for purchase ranging from local food, drug stores and to the internet. These Erectile Dysfunction (ED) pills may contain Sildenafil, the active ingredient of Viagra in much higher quantity then legally prescribed by a licensed physician or they may contain unknown quantities of Thiosildenafil, the active ingredient in Cialis. The types of chemicals found in these medications are making it harder for regulatory authorities to track them down. These products keep the consumer in the dark in terms of the quantity, ingredients, effectiveness and possible side effects. These sexual enhancement products are being sold as safe and natural with false hopes to resolve erectile dysfunction. Patients who are prone to impulsive hypersexual behavior such as patients with bipolar disorder, substance use, borderline personality disorder and those who may feel adamant to discuss erectile dysfunction with their physicians are more likely to become the victims of using illicit medications/ drugs with serious health risks consequences. We present a case report of an individual with bipolar disorder and hypersexual behavior who became victim to over the counter sexual enhancement products/supplements which caused serious health and life threatening consequences.

Investigating the Stability of Benzoyl Peroxide in Over-the-Counter Acne Medications

ERIC Educational Resources Information Center

Kittredge, Marina Canepa; Kittredge, Kevin W.; Sokol, Melissa S.; Sarquis, Arlyne M.; Sennet, Laura M.

2008-01-01

One of the most commonly used ingredients in over-the-counter acne treatments in cream, gel, and wash form is benzoyl peroxide. It is an anti-bacterial agent that kills the bacterium ("Propionibacterium acne") involved in the formation of acne. The formulation of these products is extremely difficult owing to the instability of benzoyl peroxide.…

[Over the counter drugs--a new era in Israel].

PubMed

Abadi-Korek, Ifat; Vaknin, Sharona; Marom, Eli; Shemer, Joshua; Luxenburg, Osnat

2011-01-01

The reformation in the marketing of non-prescription medicinal products has been launched. As of May 10th 2005, the pharmacist regulations 2004 (marketing of over-the-counter (OTC) drugs outside of pharmacies, as well as not by a pharmacist) will be in effect. This change aLlows the marketing of medicines outside of pharmacies, as has been the custom in the U.S.A., England and some of the European Union countries for many years. This reformation is incorporated in a policy that encourages self-medication by the use of non-prescription drugs. The self-medication policy originates from the point of view of the consumers who wish to be responsible for their own health and save precious time wasted on doctor visits; and the government's assumption that self-medication of OTC medicines by citizens wiLL decrease expenses for the HMOs in both doctor's billings as well as medication costs. In order to regulate the marketing terms of these medicinal products, regulations and complimentary guidelines were written and published. These documents encompass the following issues: the list of OTC medicines, marketing reguLations, packaging regulations, Licensed marketing Locations, storage regulations as well as display regulations, advertising regulations, monitoring and control. The medicinal products in this category only included medicines containing "safe" active ingredients with restrictions regarding the strength/concentration and packaging size; this category does not include medicines requiring special storage conditions (such as refrigeration or freezing), medicines containing an active ingredient that is addictive, medicines containing an active ingredient with danger of poisoning if misused, and medicines containing an active ingredient that has the potential to harm. The implementation of the regulations and guidelines will improve the consumer's ability to diagnose and treat oneself when sick with minor ailments, without consulting a doctor.

21 CFR 310.527 - Drug products containing active ingredients offered over-the-counter (OTC) for external use as...

Code of Federal Regulations, 2012 CFR

2012-04-01

... offered over-the-counter (OTC) for external use as hair growers or for hair loss prevention. 310.527... products containing active ingredients offered over-the-counter (OTC) for external use as hair growers or for hair loss prevention. (a) Amino acids, aminobenzoic acid, ascorbic acid, benzoic acid, biotin and...

21 CFR 310.527 - Drug products containing active ingredients offered over-the-counter (OTC) for external use as...

Code of Federal Regulations, 2014 CFR

2014-04-01

... offered over-the-counter (OTC) for external use as hair growers or for hair loss prevention. 310.527... products containing active ingredients offered over-the-counter (OTC) for external use as hair growers or for hair loss prevention. (a) Amino acids, aminobenzoic acid, ascorbic acid, benzoic acid, biotin and...

21 CFR 310.527 - Drug products containing active ingredients offered over-the-counter (OTC) for external use as...

Code of Federal Regulations, 2013 CFR

2013-04-01

... offered over-the-counter (OTC) for external use as hair growers or for hair loss prevention. 310.527... products containing active ingredients offered over-the-counter (OTC) for external use as hair growers or for hair loss prevention. (a) Amino acids, aminobenzoic acid, ascorbic acid, benzoic acid, biotin and...

Exploring Ovulation & Pregnancy Using Over-the-Counter Products: A Novel Guided Inquiry

ERIC Educational Resources Information Center

Venditti, Jennifer J.; Surmacz, Cynthia A.

2012-01-01

In this guided inquiry, students explore the complex hormonal regulation of the female reproductive cycle using inexpensive ovulation and pregnancy detection kits that are readily available over the counter. This hands-on activity engages students in the practice of doing science as highlighted by the "National Science Education Standards." The…

Developing a Nursing Protocol for Over-the-Counter Medications in High School

ERIC Educational Resources Information Center

Awbrey, Lucinda Mejdell; Juarez, Sandra M.

2003-01-01

Management of medications in school is one of the critical roles that school nurses carry out in the school setting. In recent years, parents have come to question the medication procedures that school districts follow. Parents question why a physician's order is required for school personnel to provide over-the-counter (OTC) medications to their…

Effect of four over-the-counter tooth-whitening products on enamel microhardness.

PubMed

Majeed, A; Grobler, S R; Moola, M H; Oberholzer, T G

2011-10-01

This in vitro study evaluated the effect of four over-the-counter tooth-whitening products on enamel microhardness. Fifty enamel blocks were prepared from extracted human molar teeth. The enamel surfaces were polished up to 1200 grit fineness and the specimens randomly divided into five groups. Enamel blocks were exposed to: Rapid White (n=10); Absolute White (n=10); Speed White (n=10) and White Glo (n=10) whitening products, according to the manufacturers' instructions. As control, ten enamel blocks were kept in artificial saliva at 37 degrees C without any treatment. Microhardness values were obtained before exposure (baseline) and after 1, 7 and 14-day treatment periods using a digital hardness tester with a Vickers diamond indenter. Data were analysed using Wilcoxon Signed Rank Sum Test, one-way ANOVA and Tukey-Kramer Multiple Comparison Test (p<0.05). Both Rapid White and Absolute White reduced enamel microhardness. Speed White increased the microhardness of enamel, while White Glo and artificial saliva had no effect on hardness. Over-the-counter tooth-whitening products might decrease enamel microhardness depending on the type of product.

Periconceptional Over-the-Counter Nonsteroidal Anti-inflammatory Drug Exposure and Risk for Spontaneous Abortion

PubMed Central

Velez Edwards, Digna R.; Aldridge, Tiara; Baird, Donna D.; Funk, Michele Jonsson; Savitz, David A.; Hartmann, Katherine E.

2012-01-01

Objective To estimate the association between over-the-counter nonsteroidal anti-inflammatory drug (NSAID) exposure during the early first-trimester and risk for spontaneous abortion (gestation prior to 20 weeks) in a prospective cohort. Methods Women were enrolled in the Right from the Start study (2004–2010). Exposure data regarding over-the-counter NSAID use from the last menstrual period through the 6th week of pregnancy were obtained from intake and first-trimester interviews. Pregnancy outcomes were self-reported and verified by medical records. Gestational age was determined from last menstrual period. Stage of development prior to loss was determined from study ultrasound. Cox proportional hazards regression models were used to estimate the association between NSAID exposure and pregnancy outcome, taking into account candidate confounders. Results Among 2,780 pregnancies, 367 women (13%) experienced an spontaneous abortion. NSAID exposure was reported by 1,185 (43%) women. NSAID exposure was not associated with spontaneous abortion risk in unadjusted models (hazard ratio [HR] = 1.01, 95% confidence interval [CI] 0.82, 1.24) or models adjusted for maternal age (adjusted [aHR] = 1.00, 95% CI 0.81, 1.23). Conclusions Our findings suggest that use of non-prescription over-the-counter NSAIDs in early pregnancy does not put women at increased risk of spontaneous abortion. PMID:22914399

High Blood Pressure and Cold Remedies: Which Are Safe?

MedlinePlus

... counter cold remedies safe for people who have high blood pressure? Answers from Sheldon G. Sheps, M.D. Over- ... remedies aren't off-limits if you have high blood pressure, but it's important to make careful choices. Among ...

Implementing an Over-the-Counter Medication Administration Policy in an Elementary School

ERIC Educational Resources Information Center

Foster, Lori S.; Keele, Rebecca

2006-01-01

A major focus of school nursing interventions is to improve school attendance. In many schools, parents are required to leave work and/or to arrange transportation to bring their children over-the-counter medicines. Many times these children went home, missing class and making it difficult to keep up with class work. The purpose of this study was…

21 CFR 310.547 - Drug products containing quinine offered over-the-counter (OTC) for the treatment and/or...

Code of Federal Regulations, 2014 CFR

2014-04-01

...-counter (OTC) for the treatment and/or prevention of malaria. 310.547 Section 310.547 Food and Drugs FOOD... over-the-counter (OTC) for the treatment and/or prevention of malaria. (a) Quinine and quinine salts have been used OTC for the treatment and/or prevention of malaria, a serious and potentially life...

21 CFR 310.547 - Drug products containing quinine offered over-the-counter (OTC) for the treatment and/or...

Code of Federal Regulations, 2013 CFR

2013-04-01

...-counter (OTC) for the treatment and/or prevention of malaria. 310.547 Section 310.547 Food and Drugs FOOD... over-the-counter (OTC) for the treatment and/or prevention of malaria. (a) Quinine and quinine salts have been used OTC for the treatment and/or prevention of malaria, a serious and potentially life...

21 CFR 310.547 - Drug products containing quinine offered over-the-counter (OTC) for the treatment and/or...

Code of Federal Regulations, 2012 CFR

2012-04-01

...-counter (OTC) for the treatment and/or prevention of malaria. 310.547 Section 310.547 Food and Drugs FOOD... over-the-counter (OTC) for the treatment and/or prevention of malaria. (a) Quinine and quinine salts have been used OTC for the treatment and/or prevention of malaria, a serious and potentially life...

21 CFR 310.547 - Drug products containing quinine offered over-the-counter (OTC) for the treatment and/or...

Code of Federal Regulations, 2011 CFR

2011-04-01

...-counter (OTC) for the treatment and/or prevention of malaria. 310.547 Section 310.547 Food and Drugs FOOD... over-the-counter (OTC) for the treatment and/or prevention of malaria. (a) Quinine and quinine salts have been used OTC for the treatment and/or prevention of malaria, a serious and potentially life...

21 CFR 310.547 - Drug products containing quinine offered over-the-counter (OTC) for the treatment and/or...

Code of Federal Regulations, 2010 CFR

2010-04-01

...-counter (OTC) for the treatment and/or prevention of malaria. 310.547 Section 310.547 Food and Drugs FOOD... over-the-counter (OTC) for the treatment and/or prevention of malaria. (a) Quinine and quinine salts have been used OTC for the treatment and/or prevention of malaria, a serious and potentially life...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2014 CFR

2014-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2012 CFR

2012-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2013 CFR

2013-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2011 CFR

2011-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2010 CFR

2010-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

Ischemic stroke after using over the counter products containing ephedra.

PubMed

Chen, Cassandra; Biller, Jose; Willing, Steven J; Lopez, Alfredo M

2004-01-15

Dietary supplements containing Ephedra used for weight loss and physical performance enhancement such as "herbal ecstasy" are widely available, and it is estimated that at least 1% of the adult population have taken these products. Ephedra products including Ephedra alkaloids such as phenylpropanolamine or other ephedrine compounds are sold under different names such as Metabolife 356, Ripped Fuel, Thermadrene, and Shape-Fast Plus. Over 2 years, five patients with ischemic infarctions associated with use of Ephedra products were evaluated at Indiana University Hospital. Ephedrine, like other sympathomimetic agents, predisposes patients to both ischemic and hemorrhagic strokes. People who take over the counter Ephedra products that claim to boost weight loss, increase energy, or bolster physical performance are at risk of adverse events including ischemic and hemorrhagic strokes.

Factors influencing consumers' attitudinal and behavioral responses to direct-to-consumer and over-the-counter drug advertising.

PubMed

Lee, Mina; Whitehill King, Karen; Reid, Leonard N

2015-04-01

Using a model developed from the research literature, the authors compared consumers' attitudinal and behavioral responses to direct-to-consumer prescription drug advertising (DCTA) and over-the-counter nonprescription drug advertising (OTCA) of drugs. Adults 18 years of age and older who had taken any prescription drugs in the past 6 months completed online survey questionnaires. Variables measured included demographics (age, gender, race, education, and income), health-related characteristics (health status, prescription and over-the-counter drug use, health consciousness, and involvement with prescription or over-the-counter drugs), perceived amount of attention and exposure to DTCA and OTCA, attitudinal outcomes (skepticism toward DTCA/OTCA and attitude toward DTCA/OTCA), and behavioral outcomes triggered by DTCA and OTCA. The findings indicate that exposure to drug advertising is one of the most significant predictors of attitudinal and behavioral outcomes. Some audience factors such as health status, involvement with drugs, health consciousness, drug use, income, and age also were differentially associated with consumer responses to drug advertising.

Adverse drug reactions and drug–drug interactions with over-the-counter NSAIDs

PubMed Central

Moore, Nicholas; Pollack, Charles; Butkerait, Paul

2015-01-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen have a long history of safe and effective use as both prescription and over-the-counter (OTC) analgesics/antipyretics. The mechanism of action of all NSAIDs is through reversible inhibition of cyclooxygenase enzymes. Adverse drug reactions (ADRs) including gastrointestinal bleeding as well as cardiovascular and renal effects have been reported with NSAID use. In many cases, ADRs may occur because of drug–drug interactions (DDIs) between the NSAID and a concomitant medication. For example, DDIs have been reported when NSAIDs are coadministered with aspirin, alcohol, some antihypertensives, antidepressants, and other commonly used medications. Because of the pharmacologic nature of these interactions, there is a continuum of risk in that the potential for an ADR is dependent on total drug exposure. Therefore, consideration of dose and duration of NSAID use, as well as the type or class of comedication administered, is important when assessing potential risk for ADRs. Safety findings from clinical studies evaluating prescription-strength NSAIDs may not be directly applicable to OTC dosing. Health care providers can be instrumental in educating patients that using OTC NSAIDs at the lowest effective dose for the shortest required duration is vital to balancing efficacy and safety. This review discusses some of the most clinically relevant DDIs reported with NSAIDs based on major sites of ADRs and classes of medication, with a focus on OTC ibuprofen, for which the most data are available. PMID:26203254

Counter traction makes endoscopic submucosal dissection easier.

PubMed

Oyama, Tsuneo

2012-11-01

Poor counter traction and poor field of vision make endoscopic submucosal dissection (ESD) difficult. Good counter traction allows dissections to be performed more quickly and safely. Position change, which utilizes gravity, is the simplest method to create a clear field of vision. It is useful especially for esophageal and colon ESD. The second easiest method is clip with line method. Counter traction made by clip with line accomplishes the creation of a clear field of vision and suitable counter traction thereby making ESD more efficient and safe. The author published this method in 2002. The name ESD was not established in those days; the name cutting endoscopic mucosal resection (EMR) or EMR with hook knife was used. The other traction methods such as external grasping forceps, internal traction, double channel scope, and double scopes method are introduced in this paper. A good strategy for creating counter traction makes ESD easier.

Surveillance and uncertainty: community pharmacy responses to over the counter medicine abuse.

PubMed

Cooper, Richard

2013-05-01

The sale of over-the-counter (OTC) medicines from community pharmacies offers important opportunities for members of the public to access medicines and self-treat conditions. They are increasingly recognised, however, as having the potential for abuse and harm despite their perceived relative safety. This study reports on a qualitative study that explored the experiences and views of community pharmacy staff in relation to current practices and concerns, management and support relating to OTC medicine abuse. Semi-structured interviews were undertaken with a purposive sample of ten pharmacists and seven medicines counter assistants in the United Kingdom. Analysis of interviews indicated that a range of medicines was implicated, including opiates, sedative antihistamines, laxatives and decongestants. A surveillance role was apparent for assistants, who placed emphasis on regulations, procedure and monitoring frequency of purchases to manage abuse, with referral on to pharmacists. Frequency of purchase was central to assistants' definition of those suspected of OTC medicine abuse, which pharmacists also utilised as well as a distinction between intentional abuse and unintentional medicine misuse. A lack of information about customers, easy access to, and poor communication between community pharmacies were emergent barriers to pharmacists providing more support. Many appeared uncertain of referral options or how pharmacists could effectively stop the problem of abuse. The commercial environment was a particular concern, in relation to customer expectations, medicine advertising and easy access to different community pharmacies. A key tension emerged between providing medicine supplies that permitted consumer freedom, with the needs of healthcare professionals to understand more about those consumers qua patients. Policy implications include the need for improved knowledge for community pharmacy staff about signposting to relevant services, increased awareness of who

Abuse of the over-the-counter antispasmodic butylscopolamine for the home synthesis of psychoactive scopolamine.

PubMed

Kummer, Sebastian; Rickert, Annette; Daldrup, Thomas; Mayatepek, Ertan

2016-07-01

We report on two patients who ingested psychoactive scopolamine that was synthesized at home from butylscopolamine (Buscopan®), which is available as over-the-counter antispasmodic in nearly 100 countries worldwide. Patient 1 presented with severe central anticholinergic toxidrome, while patient 2 suffered from minor symptoms. An empty blister of Buscopan® was found in the patients' home, but initially was not suspected to be causative for the observed central anticholinergic symptoms, as Buscopan® is not able to pass the blood-brain barrier in its native form. Only later, the information by third parties and a Google search helped to identify homemade scopolamine derived from Buscopan® as the responsible agent in these two cases. Retrospectively, scopolamine could be detected in serum and urine of both patients, while it was absent in one control after ingestion of native Buscopan®. Over-the-counter drugs can be used to synthesize psychoactives with means that are available in every household. Such knowledge can spread via social media and internet discussion boards long before appearing in medical literature. While typical clinical presentation often enables clinicians to adequately identify and treat specific toxidromes, these sources of information need to be increasingly taken into account by medical professionals for identification of its causative agent. This potential of Buscopan® might gain importance as an easily accessible source of psychoactive scopolamine. • Substances with central anticholinergic effects are known for their hallucinogenic potential and may be used as psychoactives. What is New: • The over-the-counter antispasmodic butylscopolamine (Buscopan®) can be abused to synthesize anticholinergic, psychoactive scopolamine at home with means that are available in every household.

Developing the Political Citizen: How Teachers Are Navigating the Statutory Demands of the Counter-Terrorism and Security Act 205 and the Prevent Duty

ERIC Educational Resources Information Center

Bryan, Hazel

2017-01-01

The "Revised Prevent Duty Guidance for England and Wales" presents statutory guidance under section 29 of the Counter-Terrorism and Security Act 2015. This guidance states that "Schools should be safe spaces in which children and young people can understand and discuss sensitive topics, including terrorism and the extremist ideas…

A review of over-the-counter drug therapy.

PubMed

Esmay, J B; Wertheimer, A I

1979-01-01

The authors review the extent of the use of nonprescription drugs as well as possible variables influencing such consumption. Various studies indicate that age, sex, personality characteristics, perceptions of health status, socioeconomic factors, parental example, and pharmacists all play parts in determining over-the-counter (OTC) drug utilization. Several sources express concern about the inaccessibility of accurate OTC drug information to the consumer. Indeed, even the FDA has occasional difficulty obtaining reliable facts on both the numbers and formulae of such products. Several studies indicate that consumers acquire information about their home remedies through advertising, friends and relatives, physicians, pharmacists, and product labels. By far the most influential of these is advertising, and much concern has been voiced over consumers' unquestioning faith in drug ads. Examples are cited of deceptive, inaccurate, and unfair advertising practices used by some OTC drug manufacturers. The pros and cons of the "drug-oriented society" theory are discussed, including an analysis of its underlying origins. Testing of the safety and efficacy of nonrescription remedies has proved to be controversial, especially when considering the ramifications of the placebo effect. Different surveys report widespread misuse of OTC's by consumers through overuse, taking several drugs concurrently, and using home remedies to treat potentially serious diseases.

Efficacy and Tolerability of Steroid-Free, Over-the-Counter Treatment Formulations in Infants and Children With Atopic Dermatitis

PubMed Central

Weber, Teresa M.; Herndon, James H.; Ewer, Melissa; Stephens, Thomas J.; Flick, Iris; Filbry, Alexander; Neufang, Gitta; Schoelermann, Andrea M.

2015-01-01

ABSTRACT Background Two steroid-free, over-the-counter skin protectant products have been developed for the care and treatment of atopic dermatitis (AD)—Eucerin Eczema Relief Body Crème (Body Cream) for daily skin moisturization and Eucerin Eczema Relief Instant Therapy cream (Instant Therapy) for treatment of AD flare-ups. We tested the efficacy and tolerability of these formulations in infants and children with AD. Methods Study 1: Body Cream was applied twice daily to the lower legs of 64 children with a history of AD (aged 3 months to 12 years) for 14 days. Study 2: Instant Therapy was applied to active lesions and surrounding skin of 29 children (aged 3 months to 12 years) with active atopic lesions. Assessments were performed at baseline and Days 7 and 14. Symptoms were assessed using the Atopic Dermatitis Severity Index in Study 2. Results Body Cream significantly improved skin hydration and reduced itching, burning/stinging, erythema, and tactile roughness. Instant Therapy significantly improved skin hydration and AD symptoms, notably pruritus, erythema, and lichenification. Both products were safe and well tolerated. Discussion Body Cream and Instant Therapy were effective and well tolerated in the treatment of AD in children. These products provide steroid-free, nonprescription therapy for the maintenance and treatment of acute eczema and were proven effective and safe in infants as young as 3 months. PMID:25699134

Use of over-the-counter (OTC) drugs and perceptions of OTC drug safety among German adults.

PubMed

Barrenberg, E; Garbe, E

2015-11-01

In Europe, little empirical evidence is available about over-the-counter (OTC) drug consumption and risk perceptions. The objective of this study was to describe consumers' OTC drug use and perceptions of OTC drug safety in Germany. An online survey based on a quota sample with combined strata for age, gender, and education of 300 adult German participants was conducted in June and July 2013. The survey questionnaire covered the participants' OTC and prescription drug use, risk perceptions of OTC and prescription drugs, package leaflet reading habits, and OTC drug off-label use. Seven day prevalences of OTC drug use were higher in women (52.0%) than in men (40.8%). The risk perception of specific OTC drugs was impacted by the route of administration, the indication, and the drugs' ingredients. Products for dermal application or plant-based products were considered 'rather not risky' by 82.7-96.6 of the participants, depending on the product. Products for oral use or chemically synthesized substances were considered less safe. While 48.0% of consumers reported always reading the package leaflet of OTC drugs, 44.5% reported not reading it if they knew the drug or believed the drug was very safe. People, 60 years and older, reported significantly lower levels of OTC drug off-label use (9.3%) than younger people (22.0%). The 7-day prevalence of OTC drug use in Germany is high, especially among women. Consumers generally have balanced perceptions regarding OTC drug safety. Behaviours and knowledge related to OTC drug use should be considered by health care providers and regulators.

Managing Use of Over-the-Counter Medications in the School Setting: Keeping Kids in School and Ready to Learn.

PubMed

Wallace, Anne C

2016-07-01

The use of over-the-counter (OTC) medications in our unique school setting has proven to be a cost-effective and valuable tool in keeping students in the classroom and prepared to learn. Disruptions in educational time due to minor complaints become frustrating for students and teachers. Utilizing the assessment skills of the school nurse and treatment options available through the use of OTC medications decreases those disruptions and protects the educational time. The opportunity to increase student understanding and health literacy regarding the correct use of OTC medications is a valuable way to protect the health of students. Lessons learned in the residential setting may have application to other school settings. © 2016 The Author(s).

Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.

PubMed

Petrov, Megan E; Howard, Virginia J; Kleindorfer, Dawn; Grandner, Michael A; Molano, Jennifer R; Howard, George

2014-09-01

Preliminary evidence suggests sleep medications are associated with risk of vascular events; however, the long-term vascular consequences are understudied. This study investigated the relation between sleep medication use and incident stroke. Within the REasons for Geographic And Racial Differences in Stroke study, 21,678 black participants and white participants (≥45 years) with no history of stroke were studied. Participants were recruited from 2003 to 2007. From 2008 to 2010, participants self reported their prescription and over-the-counter sleep medication use over the past month. Suspected stroke events were identified by telephone contact at 6-month intervals and associated medical records were retrieved and physician-adjudicated. Proportional hazards analysis was used to estimate hazard ratios for incident stroke associated with sleep medication use (0, 1-14, and 15+ days per month) controlling for sociodemographics, stroke risk factors, mental health symptoms, and sleep apnea risk. At the sleep assessment, 9.6% of the sample used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3 ± 1.0 years, 297 stroke events occurred. Over-the-counter sleep medication use was associated with increased risk of incident stroke in a frequency-response relationship (P = .014), with a 46% increased risk for 1-14 days of use per month (hazards ratio [HR] = 1.46; 95% confidence interval [CI], .99-2.15) and a 65% increased risk for 15+ days (HR = 1.65; 95% CI, .96-2.85). There was no significant association with prescription sleep medications (P = .80). Over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Unravelling the "Safe" Concept in Teaching: What Can We Learn from Teachers' Understanding?

ERIC Educational Resources Information Center

Turner, Sarah; Braine, Margaret

2015-01-01

The word "safe" is widely used in everyday education speak in phrases such as "safe learning environment", but how do trainee and experienced teachers interpret, understand and use this word in their everyday teaching? Teachers are acting as observers of pupils' well-being, and one of their roles in the classroom is to offer…

High-frequency use of over-the-counter analgesics among adolescents: reflections of an emerging difficult life, a cross-sectional study.

PubMed

Skarstein, Siv; Rosvold, Elin O; Helseth, Sølvi; Kvarme, Lisbeth G; Holager, Tanja; Småstuen, Milada C; Lagerløv, Per

2014-03-01

To examine characteristics of 15- to 16-year-old adolescents who used over-the-counter analgesics daily to weekly (high-frequency users) as compared to those who used less or no analgesics (low-frequency users). Further to analyse the differences in pain experience, lifestyle, self-esteem, school attendance and educational ambition. An anonymous cross-sectional questionnaire-based study. The questionnaire covered the use of over-the-counter analgesics, pain experience, sociodemographics, lifestyle factors, self-esteem, school absence and future educational plans. The study took place in the 10th grade in six junior high schools in a medium-sized town in Norway. The local sales data for analgesics and antipyretics were close to the national average. We invited 626 adolescents to participate. Of the 367 adolescents (59%) who responded, 51% were girls. Associations between the frequency of use of over-the-counter analgesic and the mentioned variables were analysed using multiple logistic regression. In total, 26% (42 boys and 48 girls) used over-the-counter analgesics daily to weekly. These high-frequency users experienced more widespread pain, slept less, had more paid spare-time work, drank more caffeinated drinks, participated more often in binge drinking, had lower self-esteem, less ambitious educational plans and more frequent school absence than did the low-frequency users. These associations remained significant when controlling for gender, cultural background and self-evaluated economic status. Adolescent, who are high-frequency users of over-the-counter analgesics, suffer more pain and have identifiable characteristics indicative of complex problems. Their ability to handle stress appears to be discordant with the kind of situations to which they are exposed. The wear and tear associated with allostatic mechanisms counteracting stress may heighten their pain experience. © 2013 Nordic College of Caring Science. Published by Blackwell Publishing Ltd.

31 CFR 359.34 - May I purchase definitive Series I savings bonds over-the-counter?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false May I purchase definitive Series I savings bonds over-the-counter? 359.34 Section 359.34 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT...

31 CFR 351.46 - May I purchase definitive Series EE savings bonds over-the-counter?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false May I purchase definitive Series EE savings bonds over-the-counter? 351.46 Section 351.46 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT...

Off the prescription pad and over the counter: the trend toward drug deregulation grows.

PubMed Central

Morgan, P P; Cohen, L

1995-01-01

In the future, regulatory agencies may authorize the switch of more drugs from prescription-only to over-the-counter status. This could have the double effect of reducing the number of doctor visits and cutting drug costs. Although some physicians worry about the escape of reasonably potent drugs from medical surveillance, pharmacists are assuming a more significant counselling and medication-tracking role. This article looks at the negative and positive sides of drug deregulation from the perspectives of the physician, pharmacist and patient. PMID:7828102

Understanding the occupational and organizational boundaries to safe hospital discharge.

PubMed

Waring, Justin; Marshall, Fiona; Bishop, Simon

2015-01-01

Safe hospital discharge relies upon communication and coordination across multiple occupational and organizational boundaries. Our aim was to understand how these boundaries can exacerbate health system complexity and represent latent sociocultural threats to safe discharge. An ethnographic study was conducted in two local health and social care systems (health economies) in England, focusing on two clinical areas: stroke and hip fracture patients. Data collection involved 345 hours of observations and 220 semi-structured interviews with health and social care professionals, patients and their lay carers. Hospital discharge involves a dynamic network of interactions between heterogeneous health and social care actors, each characterized by divergent ways of organizing discharge activities; cultures of collaboration and interaction and understanding of what discharge involves and how it contributes to patient recovery. These interrelated dimensions elaborate the occupational and organisational boundaries that can influence communication and coordination in hospital discharge. Hospital discharge relies upon the coordination of multiple actors working across occupational and organizational boundaries. Attention to the sociocultural boundaries that influence communication and coordination can help inform interventions that might support enhanced discharge safety. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

76 FR 35678 - SPF Labeling and Testing Requirements and Drug Facts Labeling for Over-the-Counter Sunscreen Drug...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

... [Docket No. FDA-2011-N-0449] SPF Labeling and Testing Requirements and Drug Facts Labeling for Over-the... testing requirements for over-the-counter (OTC) sunscreen products containing specified ingredients and... techniques, when appropriate, and other forms of information technology. SPF Labeling and Testing...

Over-the-counter topical skincare products: a review of the literature.

PubMed

Nolan, Katherine A; Marmur, Ellen S

2012-02-01

Topical "anti-aging" products, with their seemingly limitless list of ingredients, make extensive claims to reduce wrinkles, fine lines, and sun damage, among others. Sales in the United States alone for cosmeceutical products are expected to increase by 7.4% per year to $8.2 billion by 2012. However, in this enormous industry, there has been a significant lack of rigorous controlled trials of efficacy. It is difficult for both dermatologists and consumers to make informed decisions in a market that is yet to be clearly defined and regulated. We elucidate the scientific basis for, as well as the literature behind, common active ingredients found in products intended to reverse photoaging, discuss some interesting new activities, and provide a review of several comprehensive studies on over-the-counter (OTC) products.

Over the Counter, under the Radar: Inequitably Distributing New York City's Late-Enrolling High School Students

ERIC Educational Resources Information Center

Arvidsson, Toi Sin; Fruchter, Norm; Mokhtar, Christina

2013-01-01

Every year, some 36,000 students who enroll in New York City high schools without participating in the high school choice process are labeled as "over-the-counter" or OTC students and are assigned a school by the New York City Department of Education (DOE). These young people are among the school system's highest-needs students: new…

Parent, Teacher, and School Factors Associated with Over-the-Counter Drug Use among Multiracial Youth

ERIC Educational Resources Information Center

Vidourek, Rebecca A.; King, Keith A.

2013-01-01

Background: Over-the-counter (OTC) drug use is an increasing health issue among adolescents. Purpose: This study investigated OTC drug use among 7th through 12th grade multiracial students in one metropolitan area. Methods: A total of 2134 students completed the PRIDE Questionnaire, which examines alcohol and other drug use. Results: A total of…

21 CFR 310.537 - Drug products containing active ingredients offered over-the-counter (OTC) for oral...

Code of Federal Regulations, 2012 CFR

2012-04-01

... offered over-the-counter (OTC) for oral administration for the treatment of fever blisters and cold sores... the treatment of fever blisters and cold sores. (a) l-lysine (lysine, lysine hydrochloride... products to treat fever blisters and cold sores. There is a lack of adequate data to establish general...

21 CFR 310.537 - Drug products containing active ingredients offered over-the-counter (OTC) for oral...

Code of Federal Regulations, 2014 CFR

2014-04-01

... offered over-the-counter (OTC) for oral administration for the treatment of fever blisters and cold sores... the treatment of fever blisters and cold sores. (a) l-lysine (lysine, lysine hydrochloride... products to treat fever blisters and cold sores. There is a lack of adequate data to establish general...

21 CFR 310.537 - Drug products containing active ingredients offered over-the-counter (OTC) for oral...

Code of Federal Regulations, 2013 CFR

2013-04-01

... offered over-the-counter (OTC) for oral administration for the treatment of fever blisters and cold sores... the treatment of fever blisters and cold sores. (a) l-lysine (lysine, lysine hydrochloride... products to treat fever blisters and cold sores. There is a lack of adequate data to establish general...

21 CFR 310.537 - Drug products containing active ingredients offered over-the-counter (OTC) for oral...

Code of Federal Regulations, 2011 CFR

2011-04-01

... offered over-the-counter (OTC) for oral administration for the treatment of fever blisters and cold sores... the treatment of fever blisters and cold sores. (a) l-lysine (lysine, lysine hydrochloride... products to treat fever blisters and cold sores. There is a lack of adequate data to establish general...

Interest in over-the-counter access to oral contraceptives among women in the United States.

PubMed

Grossman, Daniel; Grindlay, Kate; Li, Rick; Potter, Joseph E; Trussell, James; Blanchard, Kelly

2013-10-01

A growing body of evidence indicates that over-the-counter (OTC) access to oral contraceptive pills (OCPs) is safe and effective. We performed a nationally representative survey of adult women at risk of unintended pregnancy using a probability-based online panel. In November-December 2011, 2046 eligible women completed the survey. Weighted proportions were calculated, and logistic regression was used to identify covariates associated with support for and interest in using an OTC OCP. A total of 62.2% said they were strongly (31.4%) or somewhat (30.9%) in favor of OCPs being available OTC. A total of 37.1% of participants reported being likely to use OCPs if available OTC, including 58.7% of current users, 28.0% using no method and 32.7% using a less effective method. Covariates associated with a higher odds of reporting interest in using OTC OCPs were younger age; being divorced, being separated or living with a partner (versus married); being uninsured or having private insurance (versus public insurance); living in the south (versus northeast); and current use of OCPs or less effective methods, or nonuse of contraception (versus use of another hormonal method or intrauterine device). Among respondents who said they were likely to use OTC OCPs, the highest amount they were willing to pay was on average $20. US women are supportive of OTC access to OCPs, and many would obtain refills OTC or start using OCPs if they were available OTC. Copyright © 2013. Published by Elsevier Inc.

Designing an over-the-counter consumer decision-making tool for older adults.

PubMed

Martin-Hammond, Aqueasha M; Abegaz, Tamirat; Gilbert, Juan E

2015-10-01

Older adults are at increased risk of adverse drug events due to medication. Older adults tend to take more medication and are at higher risk of chronic illness. Over-the-counter (OTC) medication does not require healthcare provider oversight and understanding OTC information is heavily dependent on a consumer's ability to understand and use the medication appropriately. Coupling health technology with effective communication is one approach to address the challenge of communicating health and improving health related tasks. However, the success of many health technologies also depends on how well the technology is designed and how well it addresses users needs. This is especially true for the older adult population. This paper describes (1) a formative study performed to understand how to design novel health technology to assist older adults with OTC medication information, and (2) how a user-centered design process helped to refine the initial assumptions of user needs and help to conceptualize the technology. An iterative design process was used. The process included two brainstorming and review sessions with human-computer interaction researchers and design sessions with older adults in the form of semi-structured interviews. Methods and principles of user-centered research and design were used to inform the research design. Two researchers with expertise in human-computer interaction performed expert reviews of early system prototypes. After initial prototypes were developed, seven older adults were engaged in semi-structured interviews to understand usability concerns and features and functionality older adults may find useful for selecting appropriate OTC medication. Eight usability concerns were discovered and addressed in the two rounds of expert review, and nine additional usability concerns were discovered in design sessions with older adults. Five themes emerged from the interview transcripts as recommendations for design. These recommendations

A cross-sectional survey of pharmacists to understand their personal preference of brand and generic over-the-counter medications used to treat common health conditions.

PubMed

Patel, Mira; Slack, Marion; Cooley, Janet; Bhattacharjee, Sandipan

2016-01-01

Consumers are hesitant in choosing generic medications as they are under the assumption that they are not as safe nor effective as brand medications. However, pharmacists do have the education and training to know that this is not the case. The aim of this study was to determine pharmacists' preference of generic versus brand over-the-counter (OTC) medication for their personal use as self-treatment for various health symptoms. A prospective, cross sectional study was conducted on 553 licensed pharmacists who were presumed to have expertise in the use of generic and brand name OTC medications. In a single Southwestern state in the United States, from December 2014 to January 2015, a web-based questionnaire was sent to pharmacists to explore their preference of brand and generic medications based on various health symptoms. Thirty-one brand-generic medication pairs were used to identify which medication type pharmacists preferred when asked about nine health symptoms. Frequency counts of pharmacists' preference of a brand medication or a generic OTC medication overall and for each of the nine health symptoms were determined. Chi-squared analyses and one-way ANOVA were conducted to determine if there were any differences between the preferences of brand and generic OTC medications across each symptom. The study overall showed that pharmacists preferred generic OTC medications to brand OTC medications (62 to 5 %, respectively). Based on an 11-point rating scale, pharmacists were likely to take OTC generic medications (as their choice of self-treatment) when presented with health symptoms (mean = 7.32 ± 2.88). In addition, pharmacists chose generic OTC medications over brand medications regardless of health symptoms (p < 0.001). Pharmacists who have expertise in medications were shown to prefer using generic OTC medications rather than brand name OTC medications for self-treating a variety of health symptoms. These study findings support the theory that

Medicine reclassification processes and regulations for proper use of over-the-counter self-care medicines in Japan.

PubMed

Nomura, Kaori; Kitagawa, Yuki; Yuda, Yasukatsu; Takano-Ohmuro, Hiromi

2016-01-01

Japan has actively reclassified substances ranging from prescription drugs to over-the-counter (OTC) drugs in recent years. The sale of most OTC drugs was deregulated several times and pharmacists' supervision was deemed no longer mandatory. Japan established a new OTC evaluation system in 2015 to hear opinions from various stakeholders regarding medicine types to be reclassified. This study aimed to examine the new framework to identify candidate substances for reclassification. Moreover, we examined how to manage the safe, self-care use of OTC drugs in Japan. The necessary regulatory information on OTC approvals as of January 2015 was collected using an Internet search and relevant databases. To highlight the characteristics of OTC drugs in Japan, the UK was selected as a comparison country because it too was actively promoting the reclassification of medicines from prescription to nonprescription status, and because of economic similarity. Japan and the UK have a risk-based classification for nonprescription medicines. Japan has made OTC drugs available with mandatory pharmacists' supervision, face-to-face with pharmacists, or online instruction, which is similar to the "pharmacy medicine" practiced in the UK. Japan recently reformed the reclassification process to involve physicians and the public in the process; some interactions were back to "prescription-only medicine" in the UK. It is expected that the opinion of marketers, medical professionals, and the public will improve the discussion that will greatly contribute to the safe use of drugs. Monitoring the new system will be noteworthy to ensure that OTC drug users are managing their self-care properly and visiting a doctor only when necessary. The supply methods are similar in Japan and the UK; however, the expected growth in the Japanese OTC market by the Cabinet and the industry is still uncertain.

Medicine reclassification processes and regulations for proper use of over-the-counter self-care medicines in Japan

PubMed Central

Nomura, Kaori; Kitagawa, Yuki; Yuda, Yasukatsu; Takano-Ohmuro, Hiromi

2016-01-01

Objectives Japan has actively reclassified substances ranging from prescription drugs to over-the-counter (OTC) drugs in recent years. The sale of most OTC drugs was deregulated several times and pharmacists’ supervision was deemed no longer mandatory. Japan established a new OTC evaluation system in 2015 to hear opinions from various stakeholders regarding medicine types to be reclassified. This study aimed to examine the new framework to identify candidate substances for reclassification. Moreover, we examined how to manage the safe, self-care use of OTC drugs in Japan. Methods The necessary regulatory information on OTC approvals as of January 2015 was collected using an Internet search and relevant databases. To highlight the characteristics of OTC drugs in Japan, the UK was selected as a comparison country because it too was actively promoting the reclassification of medicines from prescription to nonprescription status, and because of economic similarity. Results Japan and the UK have a risk-based classification for nonprescription medicines. Japan has made OTC drugs available with mandatory pharmacists’ supervision, face-to-face with pharmacists, or online instruction, which is similar to the “pharmacy medicine” practiced in the UK. Japan recently reformed the reclassification process to involve physicians and the public in the process; some interactions were back to “prescription-only medicine” in the UK. Conclusion It is expected that the opinion of marketers, medical professionals, and the public will improve the discussion that will greatly contribute to the safe use of drugs. Monitoring the new system will be noteworthy to ensure that OTC drug users are managing their self-care properly and visiting a doctor only when necessary. The supply methods are similar in Japan and the UK; however, the expected growth in the Japanese OTC market by the Cabinet and the industry is still uncertain. PMID:27555801

21 CFR 201.308 - Ipecac syrup; warnings and directions for use for over-the-counter sale.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Ipecac syrup; warnings and directions for use for over-the-counter sale. 201.308 Section 201.308 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... poisonings, ipecac syrup is considered the emetic of choice. The immediate availability of this drug for use...

Over-the-Counter Hearing Aids: A Lost Decade for Change

PubMed Central

Chan, Zoe Yee Ting; McPherson, Bradley

2015-01-01

Background. Hearing aids sold directly to consumers in retail stores or through the internet, without individual prescription by audiological professionals, are termed over-the-counter (OTC) devices. This study aimed to determine whether there was any change in the electroacoustic characteristics of OTC devices compared to research carried out a decade earlier. The previous results indicated that most OTC devices were low-frequency-emphasis devices and were unsuitable for elderly people with presbycusis, who were likely to be the major consumers of these products. Methods. Ten OTC devices were selected and their electroacoustic performance was measured. Appropriate clients for the OTC devices were derived, using four linear prescription formulae, and OTC suitability for elderly persons with presbycusis was investigated. Results. OTC electroacoustic characteristics were similar to those in the earlier study. Most OTC devices were not acoustically appropriate for potential consumers with presbycusis. Although several of the devices could match prescriptive targets for individuals with presbycusis, their poor electroacoustic performance—including ineffective volume control function, high equivalent input noise, and irregular frequency response—may override their potential benefit. Conclusion. The low-cost OTC devices were generally not suitable for the main consumers of these products, and there has been little improvement in the appropriateness of these devices over the past decade. PMID:26557701

SAFE: SPARQL Federation over RDF Data Cubes with Access Control.

PubMed

Khan, Yasar; Saleem, Muhammad; Mehdi, Muntazir; Hogan, Aidan; Mehmood, Qaiser; Rebholz-Schuhmann, Dietrich; Sahay, Ratnesh

2017-02-01

Several query federation engines have been proposed for accessing public Linked Open Data sources. However, in many domains, resources are sensitive and access to these resources is tightly controlled by stakeholders; consequently, privacy is a major concern when federating queries over such datasets. In the Healthcare and Life Sciences (HCLS) domain real-world datasets contain sensitive statistical information: strict ownership is granted to individuals working in hospitals, research labs, clinical trial organisers, etc. Therefore, the legal and ethical concerns on (i) preserving the anonymity of patients (or clinical subjects); and (ii) respecting data ownership through access control; are key challenges faced by the data analytics community working within the HCLS domain. Likewise statistical data play a key role in the domain, where the RDF Data Cube Vocabulary has been proposed as a standard format to enable the exchange of such data. However, to the best of our knowledge, no existing approach has looked to optimise federated queries over such statistical data. We present SAFE: a query federation engine that enables policy-aware access to sensitive statistical datasets represented as RDF data cubes. SAFE is designed specifically to query statistical RDF data cubes in a distributed setting, where access control is coupled with source selection, user profiles and their access rights. SAFE proposes a join-aware source selection method that avoids wasteful requests to irrelevant and unauthorised data sources. In order to preserve anonymity and enforce stricter access control, SAFE's indexing system does not hold any data instances-it stores only predicates and endpoints. The resulting data summary has a significantly lower index generation time and size compared to existing engines, which allows for faster updates when sources change. We validate the performance of the system with experiments over real-world datasets provided by three clinical organisations as

Potential impact on cardiovascular public health of over-the-counter statin availability.

PubMed

Brass, Eric P; Allen, Shannon E; Melin, Jeffrey M

2006-03-15

Over-the-counter (OTC) statin availability has been hypothesized to represent a strategy for treating consumers at moderate risk of coronary heart disease (CHD) who are currently not receiving drug therapy. The viability of this strategy has been questioned, particularly with respect to the public health benefit that can be obtained in an unsupervised treatment environment. The previously reported Consumer Use Study of Over-the-Counter Lovastatin (CUSTOM) examined consumer behavior in a simulated OTC setting in which 20 mg lovastatin could be purchased. Framingham CHD risk scores were calculated for 981 self-selected consumers who used OTC lovastatin in CUSTOM. Overall, this group had a median 10-year CHD risk of 10%, but with significant numbers of consumers with estimated risks of <5% and >20%. According to the risk profile of CUSTOM consumers, the use of 20 mg lovastatin for 10 years would be expected to prevent approximately 33,100 CHD events per 1 million users. This represents a 10-year number needed to treat of 30 consumers. This optimal benefit may be reduced because some higher risk consumers in CUSTOM used lovastatin rather than appropriate, more aggressive supervised care. On the basis of the frequencies of diversion from optimal care observed in CUSTOM, the number of events prevented might be reduced to 23,000 (number needed to treat 43 consumers). Sensitivity analyses have demonstrated that these estimates are robust and that the predicted public health benefit likely falls in the range of 23,000 to 33,000 CHD events prevented per 1 million treated for 10 years. In conclusion, on a population basis, OTC statin availability is likely to result in clinically meaningful reductions in CHD morbidity and mortality. The analyses also identified opportunities for optimizing the use of OTC statins in the marketplace.

Samus Counter Lifting Fixture

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stredde, H.; /Fermilab

1998-05-27

A lifting fixture has been designed to handle the Samus counters. These counters are being removed from the D-zero area and will be transported off site for further use at another facility. This fixture is designed specifically for this particular application and will be transferred along with the counters. The future use of these counters may entail installation at a facility without access to a crane and therefore a lift fixture suitable for both crane and/or fork lift usage has been created The counters weigh approximately 3000 lbs. and have threaded rods extended through the counter at the top comersmore » for lifting. When these counters were first handled/installed these rods were used in conjunction with appropriate slings and handled by crane. The rods are secured with nuts tightened against the face of the counter. The rod thread is M16 x 2({approx}.625-inch dia.) and extends 2-inch (on average) from the face of the counter. It is this cantilevered rod that the lift fixture engages with 'C' style plates at the four top comers. The strongback portion of the lift fixture is a steel rectangular tube 8-inch (vertical) x 4-inch x .25-inch wall, 130-inch long. 1.5-inch square bars are welded perpendicular to the long axis of the rectangular tube at the appropriate lift points and the 'C' plates are fastened to these bars with 3/4-10 high strength bolts -grade 8. Two short channel sections are positioned-welded-to the bottom of the rectangular tube on 40 feet centers, which are used as locators for fork lift tines. On the top are lifting eyes for sling/crane usage and are rated at 3500 lbs. safe working load each - vertical lift only.« less

Countering Threat Networks

DTIC Science & Technology

2016-12-21

PLANNING TO COUNTER THREAT NETWORKS  Joint Intelligence Preparation of the Operational Environment and Threat Networks...Army Expeditionary Forensic Facility in Afghanistan ........ E-9 E-4 Exploitation Support to Intelligence Fusion and Decision Making ......... E-10...Approach The groundwork for successful countering threat networks activities starts with information and intelligence to develop an understanding

Barriers and Facilitators for Information Exchange during Over-The-Counter Consultations in Community Pharmacy: A Focus Group Study

PubMed Central

Seubert, Liza J; Boeni, Fabienne; Hattingh, Laetitia; Clifford, Rhonda M

2017-01-01

Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC) medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. The aim was to determine stakeholder perspectives regarding barriers and facilitators for information exchange during OTC consultations in community pharmacies and to understand the elicited themes in behavioural terms. Focus groups were undertaken with community pharmacist, pharmacy assistant and consumer participants. Independent duplicate analysis of transcription data was conducted using inductive and framework methods. Eight focus groups involving 60 participants were conducted. Themes that emerged indicated consumers did not understand pharmacists’ professional role, they were less likely to exchange information if asking for a specific product than if asking about symptom treatment, and they wanted privacy. Consumers were confident to self-diagnose and did not understand OTC medicine risks. Pharmacy personnel felt a duty of care to ensure consumer safety, and that with experience communication skills developed to better engage consumers in consultations. They also identified the need for privacy. Consumers need education about community pharmacists’ role and responsibilities to motivate them to engage in OTC consultations. They also require privacy when doing so. PMID:29211054

21 CFR 310.548 - Drug products containing colloidal silver ingredients or silver salts offered over-the-counter...

Code of Federal Regulations, 2011 CFR

2011-04-01

... ingredients or silver salts offered over-the-counter (OTC) for the treatment and/or prevention of disease. 310...) for the treatment and/or prevention of disease. (a) Colloidal silver ingredients and silver salts have... disease conditions. There are serious and complicating aspects to many of the diseases these silver...

21 CFR 310.548 - Drug products containing colloidal silver ingredients or silver salts offered over-the-counter...

Code of Federal Regulations, 2010 CFR

2010-04-01

... ingredients or silver salts offered over-the-counter (OTC) for the treatment and/or prevention of disease. 310...) for the treatment and/or prevention of disease. (a) Colloidal silver ingredients and silver salts have... disease conditions. There are serious and complicating aspects to many of the diseases these silver...

21 CFR 310.548 - Drug products containing colloidal silver ingredients or silver salts offered over-the-counter...

Code of Federal Regulations, 2013 CFR

2013-04-01

... ingredients or silver salts offered over-the-counter (OTC) for the treatment and/or prevention of disease. 310...) for the treatment and/or prevention of disease. (a) Colloidal silver ingredients and silver salts have... disease conditions. There are serious and complicating aspects to many of the diseases these silver...

21 CFR 310.548 - Drug products containing colloidal silver ingredients or silver salts offered over-the-counter...

Code of Federal Regulations, 2012 CFR

2012-04-01

... ingredients or silver salts offered over-the-counter (OTC) for the treatment and/or prevention of disease. 310...) for the treatment and/or prevention of disease. (a) Colloidal silver ingredients and silver salts have... disease conditions. There are serious and complicating aspects to many of the diseases these silver...

21 CFR 310.548 - Drug products containing colloidal silver ingredients or silver salts offered over-the-counter...

Code of Federal Regulations, 2014 CFR

2014-04-01

... ingredients or silver salts offered over-the-counter (OTC) for the treatment and/or prevention of disease. 310...) for the treatment and/or prevention of disease. (a) Colloidal silver ingredients and silver salts have... disease conditions. There are serious and complicating aspects to many of the diseases these silver...

Consumer perceptions of prescription and over-the-counter drug advertisements with promotional offers.

PubMed

Aikin, Kathryn J; Sullivan, Helen W; O'Donoghue, Amie C; Betts, Kevin R

2016-01-01

Information on the effects of promotional offers in direct-to-consumer prescription drug ads is limited. In two studies, we examined the effect of promotional offers (e.g., money-back guarantee) and ad type (creating prescription and over-the-counter drug ads by varying the presence of benefit and risk information). We found little effect of promotional offers. Adding benefit (risk) information to the ad increased consumers' knowledge of the benefit (risk) information and their efficacy (risk) perceptions. In most cases, adding risk information to an ad with benefit information increased risk knowledge and perceptions without decreasing benefit knowledge or perceptions.

Over-the-counter analgesics: a toxicology perspective.

PubMed

Jones, Alison

2002-01-01

The decision to use any analgesic is a balance of benefit and risk. In the case of analgesics, it is important to balance the therapeutic benefit against both the risk in therapeutic use and the risk (and ease of treatment) in overdose. Paracetamol in therapeutic dose carries little risk of adverse events. Less than 0.1% of the estimated 30 million paracetamol users in the United Kingdom attend hospital with a paracetamol overdose each year, and approximately 200 people die, most of whom presented late or did not receive antidote, N-acetylcysteine, within 12 hours. Nonsteriodal anti-inflammatory drugs (NSAIDs) have greater adverse effects in therapeutic use than paracetamol but also have a lower incidence of severe features or death in overdose. There is no antidote available for NSAID poisoning. Aspirin carries both significant adverse effects in therapeutic dose and a substantial risk in overdose, for which there is no antidote. Its risk-benefit profile is probably the poorest of all analgesics currently available over-the-counter (OTC); this is reflected in current trends both in analgesic use and overdose figures. Although a number of options to reduce deaths from poisoning by OTC analgesics have been considered, few are practical, and all must take account of the public health benefits provided by these drugs. A perspective should be retained that the vast majority of the population in Australia, the United States, the United Kingdom, and Denmark derive therapeutic benefit from OTC analgesics and do not take them in overdose. The majority of those who do take overdoses come to little or no harm. Management of serious poisoning by paracetamol, aspirin, or NSAIDs remains a medical challenge.

Purchasing Over-the-counter medicines from Australian pharmacy: What do the pharmacy customers value and expect?

PubMed

Chan, Vincent; Tran, Hung

2016-01-01

Over-the-counter medicines (OTC) are widely available and can be purchased without a prescription. Their availability means that a customer may choose to purchase them without the involvement of a pharmacy/pharmacist. It is important to understand customer OTC purchasing perceptions and behaviour from a pharmacy to better understand the needs and opportunities in this space. This study aimed to examine customers' key expectations and what they value when purchasing OTC and how the effect of health status/stress and perceived risks/benefits of purchasing OTCs from a pharmacy may influence their OTC shopping behaviour. Customers from two metropolitan pharmacies across two different suburbs in Brisbane, Queensland, Australia completed a self-administered questionnaire. Data collection was conducted over a six-week period. The questionnaire examined demographics, current level of health and stress, as well as a range of questions (seven-point Likert-scale) examining perceived benefits and risks, what they value, trust and expect when purchasing OTC. A total of 86 customers from a broad range of demographics were captured in this study. When asked about their current health state, 41% and 23% respectively indicated that they were stressed and tense when they arrived at the pharmacy but many were feeling well (38%). Most customers strongly agreed/agreed that trust in the advice from a pharmacy (96%), trust in the products (73%), and the altruistic approach of a pharmacy (95%) were critical to them. Further, 82% and 78% respectively disagreed that time pressures or costs were concerns, despite many feeling tense and stressed when they came in. When asked where they intend to buy their future OTC, 89% indicated pharmacy instead of a supermarket. High levels of trust, confidence and sense of altruism and care were key factors for customers buying OTC from a pharmacy, regardless of time pressures, costs or existing levels of stress and health.

Factors influencing consumer purchasing patterns of generic versus brand name over-the-counter drugs.

PubMed

Kohli, Erol; Buller, Allison

2013-02-01

US consumers spend more than $20 billion/year on over-the-counter (OTC) drugs. Although generic and brand name OTC drugs share the same active ingredients and undergo the same rigorous Food and Drug Administration approval process, brand name formulations continue to lead the OTC drug market with a higher market share. There is a limited amount of publicly available information regarding consumer perceptions and awareness about generic and brand name OTC drugs. The main objective of this research was to understand what factors influence US consumers to purchase generic versus brand name OTC drugs. The researchers used a 20-question, self-administered, multiple-choice survey to collect data on the factors influencing consumers' preferences for generic versus brand name OTC drugs. Results revealed that the single most influential factor for participants when purchasing OTC drugs was lower cost. Although economic factors play an important role in influencing consumers to choose generic formulations, a variety of other factors including advertisements, duration of the OTC effectiveness, severity of sickness, preferable form of OTC medication, safety of the OTC, relief of multiple symptoms, and preferred company will persuade others to pay more for brand name drugs. Ultimately, increased awareness and use of generic OTC drugs may result in substantial cost savings for consumers.

21 CFR 201.307 - Sodium phosphates; package size limitation, warnings, and directions for over-the-counter sale.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Sodium phosphates; package size limitation... Requirements for Specific Drug Products § 201.307 Sodium phosphates; package size limitation, warnings, and directions for over-the-counter sale. (a) Reports in the medical literature and data accumulated by the Food...

To the Federal Trade Commission in the Matter of a Trade Regulation Rule on Over-the-Counter Drug Advertising.

ERIC Educational Resources Information Center

Council on Children, Media, and Merchandising, Washington, DC.

This report supports amending the proposed Federal Trade Commission (FTC) Rule on Over-the Counter (OTC) Drug Advertising to insure better protection for children, illiterate populations, the deaf and the blind, from advertising on the air-waves. Several points are addressed: (1) the difficulties of combining the rule making schedules of the Food…

21 CFR 310.530 - Topically applied hormone-containing drug products for over-the-counter (OTC) human use.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Topically applied hormone-containing drug products... for Specific New Drugs or Devices § 310.530 Topically applied hormone-containing drug products for over-the-counter (OTC) human use. (a) The term “hormone” is used broadly to describe a chemical...

21 CFR 310.530 - Topically applied hormone-containing drug products for over-the-counter (OTC) human use.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Topically applied hormone-containing drug products... for Specific New Drugs or Devices § 310.530 Topically applied hormone-containing drug products for over-the-counter (OTC) human use. (a) The term “hormone” is used broadly to describe a chemical...

Sixties Protest Music: The Key to Understanding the Counter Culture.

ERIC Educational Resources Information Center

Harrison, Benjamin T.

During the 1960s, protest music was expressed primarily through the folk tradition; it was the most important medium of the counter culture. The folk music tradition of the 1960s found its roots in the music of Woody Guthrie and Pete Seeger. In their music, commercial success and professional standards were militantly opposed. Folk music raised…

Sulbutiamine, an 'innocent' over the counter drug, interferes with therapeutic outcome of bipolar disorder.

PubMed

Douzenis, Athanasios; Michopoulos, Ioannis; Lykouras, Lefteris

2006-01-01

A case of a patient with bipolar disorder with a history of hospitalizations and addiction to sulbutiamine is presented. Sulbutiamine is a precursor of thiamine that crosses the blood-brain barrier and is widely available without prescription in most countries or over the internet. Because of this patient's need to consume ever increasing quantities of sulbutiamine, his psychiatric care was severely compromised through him defaulting appointments and frequent changes of psychiatrists. This paper reviews the current scientific knowledge about sulbutiamine, and some of the information and claims available on the web about its use and potential. It is argued that doctors need to be aware of the potential misuse of medication available over the counter or on the internet and its potential harmful influence.

Over the Counter, under the Radar: Inequitably Distributing New York City's Late-Enrolling High School Students. Executive Summary

ERIC Educational Resources Information Center

Arvidsson, Toi Sin; Fruchter, Norm; Mokhtar, Christina

2013-01-01

Every year, some 36,000 students who enroll in New York City high schools without participating in the high school choice process are labeled as "over-the-counter" or OTC students and are assigned a school by the New York City Department of Education (DOE). These young people are among the school system's highest-needs students: new…

Clinical studies of sweat rate reduction by an over-the-counter soft-solid antiperspirant and comparison with a prescription antiperspirant product in male panelists.

PubMed

Swaile, D F; Elstun, L T; Benzing, K W

2012-03-01

Individuals with axillary hyperhidrosis have much higher than average sweat rates and are often prescribed anhydrous aluminum chloride (AlCl(3)) solutions. Topical application of these solutions can be irritating to the skin, resulting in poor compliance and lower than desired efficacy. Demonstrate the efficacy of an over the counter "clinical strength" soft-solid antiperspirant using a night time application regimen and compare to a prescription aluminum chloride (6.5%) antiperspirant using male panelists. Gravimetric hot room efficacy testing (100 F and 35% Humidity) was performed comparing an over the counter soft-solid antiperspirant to placebo in a single test. Two separate gravimetric tests were placed comparing a prescription aluminum chloride (6.5%) antiperspirant to the same soft solid product using an intent to treat model. Skin irritation was assessed daily by a trained grader. Placebo testing resulted in 85% of panelists having a reduction in sweating rate greater than 50%. Comparison testing showed the over the counter soft solid reduced sweat rate by an average of 34% better than the prescription product while resulting significantly less skin irritation. Over the counter "clinical strength" soft-solid antiperspirants can be considered as an alternative treatment to aluminum chloride antiperspirants for the treatment of heavy sweating. © 2012 The Author. BJD © 2012 British Association of Dermatologists.

21 CFR 310.541 - Over-the-counter (OTC) drug products containing active ingredients offered for use in the...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Over-the-counter (OTC) drug products containing active ingredients offered for use in the treatment of hypophosphatemia. 310.541 Section 310.541 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS Requirements for Specific...

21 CFR 310.542 - Over-the-counter (OTC) drug products containing active ingredients offered for use in the...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Over-the-counter (OTC) drug products containing active ingredients offered for use in the treatment of hyperphosphatemia. 310.542 Section 310.542 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS Requirements for Specific...

The effects of consultation on over-the-counter medication purchasing decisions.

PubMed

Nichol, M B; McCombs, J S; Johnson, K A; Spacapan, S; Sclar, D A

1992-11-01

This article examines factors that predict changes in consumer purchasing decisions of nonprescription medications. Variables corresponding to factors in Andersen's behavioral model are measured, in addition to data regarding characteristics of the 17 pharmacy consultants who provided counseling services. One thousand seven hundred and thirteen consumers in five stores in southern California were provided consultation during a 6-month period, resulting in 25.4% of the patients purchasing a different drug than intended when entering the pharmacy, 1.3% being referred to a physician, and 13.4% not purchasing any over-the-counter medication at all. Logistic regression techniques demonstrated that one enabling variable (availability of generic medications), and four need factors (the discussion of clinical issues, short encounters, cough and cold products, and vitamin products) were significant predictors of the consumer's decision to purchase a different product than intended. Consultant characteristics (introversion, external locus of control) were also important predictors, but opposite the expected direction. Consumers who received information from female consultants were more likely to change their purchasing decisions.

Developing alternative over-the-counter medicine label formats: How do they compare when evaluated by consumers?

PubMed

Tong, Vivien; Raynor, David K; Aslani, Parisa

2018-03-01

In recent years, the Australian Therapeutic Goods Administration (TGA) has proposed implementing a standardized over-the-counter (OTC) medicine label. However, there were mixed consumer opinions regarding a label proposed in 2012 and limited evidence demonstrating the usability of the revised (2014) format. To develop and examine the usability of alternative OTC medicine label formats for standardization, and explore consumer perspectives on the labels. Four alternative labels were developed for the exemplar medicine diclofenac. One was based on the Medicine Information label proposed by the TGA ('Medicine Information'), one was based on the U.S. Drug Facts label ('Drug Facts'), and two were based on suggestions proposed by consumers in the earlier needs analysis phase of this research (referred to as the 'Medicine Facts' and 'Consumer Desires' label formats). Five cohorts of 10 participants were recruited. Each cohort was assigned to user test one of the alternative labels or an existing label for a proprietary diclofenac product (which acted as a comparator) for diagnostic purposes. Each participant then provided feedback on all 5 labels. Each interview consisted of the administration of a user testing questionnaire, measuring consumers' ability to find and understand key points of information, and a semi-structured interview exploring consumer perspectives. Overall, all 4 alternative label formats supported consumers' ability to find and understand key points. The existing comparator label was the poorer label with respect to participants' ability to find and understand key points. Factors such as perceived usability, color, design, content, and/or content ordering impacted consumer preferences. The 'Consumer Desires' or 'Drug Facts' label formats were most often preferred by consumers for use as the standardized OTC label over the TGA proposed format. All alternative label formats demonstrated satisfactory usability and could be considered for use in OTC label

Over-the-counter but out of reach: a pharmacy-based survey of OTC syringe sales in Tijuana, Mexico.

PubMed

Pollini, Robin A; Gallardo, Manuel; Ruiz, Serena; Case, Patricia; Zaller, Nickolas; Lozada, Remedios

2014-05-01

Sterile syringe access is critical to HIV prevention efforts targeting injection drug users (IDUs) but some pharmacies do not sell syringes over-the-counter (OTC) even where such sales are legal. We conducted a pharmacy survey in Tijuana, Mexico (where OTC sales are legal) to characterize attitudes toward syringe sales and to explore support for expanding pharmacy-based HIV prevention efforts. Of 203 respondents, 28% supported OTC syringe sales to IDUs and 74% said their pharmacy required a prescription for at least some syringe sales. Support for OTC syringe sales was independently associated with selling OTC syringes, understanding the role of sterile syringes in HIV prevention, and recognizing pharmacies as an important health resource for IDUs. Most respondents supported an expanded role for pharmacies in HIV prevention, exclusive of OTC syringe sales. Our study provides information for developing interventions to promote OTC syringe sales and expanding pharmacy-based distribution of HIV-related information and resources.

Evidence-based treatment of frequent heartburn: the benefits and limitations of over-the-counter medications.

PubMed

McRorie, Johnson W; Gibb, Roger D; Miner, Philip B

2014-06-01

This review summarizes the pharmacological effects of over-the-counter (OTC) heartburn drugs, and the implications for treating frequent heartburn. PubMed and SCOPUS were searched across all years to identify well-controlled, randomized clinical studies that assessed mechanism of action and efficacy. Antacids can transiently neutralize acid in the esophagus, but do not significantly affect gastric pH or prevent subsequent heartburn episodes. Histamine-2 receptor antagonists (H2 RAs) rapidly develop tolerance with repeat dosing, and exhibit an analgesic effect that may provide heartburn relief while leaving the esophagus exposed to acid. Proton pump inhibitors (PPIs) provide a sustained inhibition of gastric acid production, and are superior to antacids and H2 RAs for control of gastric acid and treatment of frequent heartburn. When recommending therapies for frequent heartburn, it is of particular importance to understand the strengths and weaknesses of available OTC medications. Antacids and H2 RAs are not recommended for treatment of frequent heartburn, while OTC PPIs are both indicated for, and effective for, treatment of frequent heartburn. A PPI dose of 20 mg is optimal for empiric treatment of frequent heartburn, and consistent with the 2013 treatment guidelines established by the American College of Gastroenterology (ACG) for treatment with a minimum effective dose. ©2014 The Author(s) ©2014 American Association of Nurse Practitioners.

Switching, Adverse Effects and Use of Over-the-Counter Analgesics among Users of Oral Anticoagulants: A Pharmacy-based Survey.

PubMed

Hellfritzsch, Maja; Hyllested, Lea Maria Rønneberg; Meegaard, Line; Wiberg-Hansen, Alexander; Grove, Erik Lerkevang; Pottegård, Anton

2017-07-01

Oral anticoagulants are widely used but information on important aspects in that respect is not available from medical registers or clinical databases. Therefore, we conducted a survey including patients filling a prescription for oral anticoagulants at two large Danish community pharmacies. We collected information concerning the patients' knowledge of their anticoagulant treatment including prior drug switching. Further, patients were asked about use of over-the-counter analgesics, adverse effects and how the treatment affected their everyday life. Among 335 eligible patients, 301 (90%) agreed to participate. Atrial fibrillation was the most common indication (65%), and most patients filled a prescription for a non-vitamin K antagonist oral anticoagulant (NOAC) (58%). Among the 12% (n = 35) of participants who had switched oral anticoagulant treatment, 69% had switched from a vitamin K antagonist (VKA) to a NOAC. Switching was most frequently caused by inconvenience (34%) and adverse effects (23%). Although half of all patients had recently bought over-the-counter analgesics, purchase of ibuprofen and aspirin was rare (6%). More VKA users than NOAC users felt limited in their everyday life because of anticoagulant treatment (18% versus 9%). Among non-incident NOAC users, 21% had experienced adverse effects during their current treatment. Based on first-hand information from a large sample of anticoagulant users, we conclude that the main drug-related issues leading to anticoagulant switching and perceived limitations in everyday life were inconvenience and adverse effects. This varied between drug groups. Further, use of NSAIDs obtained over the counter was rare. © 2017 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

"Just Advil": Harm reduction and identity construction in the consumption of over-the-counter medication for chronic pain.

PubMed

Eaves, Emery R

2015-12-01

Direct-to-consumer marketing has sparked ongoing debate concerning whether ads empower consumers to be agents of their own care or shift greater control to the pharmaceutical industry. Ads for over-the-counter (OTC) medications in particular portend to offer simple, harmless solutions for meeting the demands of social life. Rather than join the longstanding debate between consumer agency and social control in pharmaceutical advertising, I approach self-medication with over-the-counter (OTC) analgesics using Harm Reduction as a framework. From this perspective, consumption of OTC analgesics by chronic pain sufferers is a means of seeking some level of relief while also avoiding the stigma associated with prescription pain medication. Qualitative methods are used to analyze data from two sources: (1) semi-structured qualitative interviews with 95 participants in a trial examining the effectiveness of Traditional Chinese Medicine for Temporomandibular Disorders (TMD) from 2006 to 2011 in Tucson, AZ and Portland, OR; and (2) print, online, and television advertisements for three major brands of OTC pain medication. Participants described their use of OTC medications as minimal, responsible, and justified by the severity of their pain. OTC medication advertising, while ostensibly ambiguous and targeting all forms of pain, effectively lends support to the consumption of these medications as part of the self-projects of chronic pain sufferers, allowing them to reconcile conflicting demands for pain relief while being stoic and maintaining a positive moral identity. Describing OTC medication as "just over-the-counter" or "not real pain medication," sufferers engage in ideological harm reduction, distinguishing themselves from "those people who like taking pain medication" while still seeking relief. Justifying one's use of OTC medication as minimal and "normal," regardless of intake, avoids association with the addictive potential of prescription pain medications and

Over-the-Counter and Out-of-Control: Legal Strategies to Protect Youths From Abusing Products for Weight Control

PubMed Central

Taylor, Lisa M.; Austin, S. Bryn

2013-01-01

Abuse of widely available, over-the-counter drugs and supplements such as laxatives and diet pills for weight control by youths is well documented in the epidemiological literature. Many such products are not medically recommended for healthy weight control or are especially susceptible to abuse, and their misuse can result in serious health consequences. We analyzed the government’s role in regulating these products to protect public health. We examined federal and state regulatory authority, and referred to international examples to inform our analysis. Several legal interventions are indicated to protect youths, including increased warnings and restrictions on access through behind-the-counter placement or age verification. We suggest future directions for governments internationally to address this pervasive public health problem. PMID:23237149

21 CFR 310.527 - Drug products containing active ingredients offered over-the-counter (OTC) for external use as...

Code of Federal Regulations, 2011 CFR

2011-04-01

... offered over-the-counter (OTC) for external use as hair growers or for hair loss prevention. 310.527... for hair loss prevention. (a) Amino acids, aminobenzoic acid, ascorbic acid, benzoic acid, biotin and... in OTC drug products for external use as hair growers or for hair loss prevention. There is a lack of...

Purchasing Over-the-counter medicines from Australian pharmacy: What do the pharmacy customers value and expect?

PubMed Central

2016-01-01

Background: Over-the-counter medicines (OTC) are widely available and can be purchased without a prescription. Their availability means that a customer may choose to purchase them without the involvement of a pharmacy/pharmacist. It is important to understand customer OTC purchasing perceptions and behaviour from a pharmacy to better understand the needs and opportunities in this space. Objective: This study aimed to examine customers’ key expectations and what they value when purchasing OTC and how the effect of health status/stress and perceived risks/benefits of purchasing OTCs from a pharmacy may influence their OTC shopping behaviour. Methods: Customers from two metropolitan pharmacies across two different suburbs in Brisbane, Queensland, Australia completed a self-administered questionnaire. Data collection was conducted over a six-week period. The questionnaire examined demographics, current level of health and stress, as well as a range of questions (seven-point Likert-scale) examining perceived benefits and risks, what they value, trust and expect when purchasing OTC. Results: A total of 86 customers from a broad range of demographics were captured in this study. When asked about their current health state, 41% and 23% respectively indicated that they were stressed and tense when they arrived at the pharmacy but many were feeling well (38%). Most customers strongly agreed/agreed that trust in the advice from a pharmacy (96%), trust in the products (73%), and the altruistic approach of a pharmacy (95%) were critical to them. Further, 82% and 78% respectively disagreed that time pressures or costs were concerns, despite many feeling tense and stressed when they came in. When asked where they intend to buy their future OTC, 89% indicated pharmacy instead of a supermarket. Conclusions: High levels of trust, confidence and sense of altruism and care were key factors for customers buying OTC from a pharmacy, regardless of time pressures, costs or existing

Hand-Held Instrument Fights Acne, Tops Over-the-Counter Market

NASA Technical Reports Server (NTRS)

2007-01-01

Tyrell Inc., a Houston-based medical technologies company, was able to access engineering support in redesigning a heating element for a hand-held acne-fighting device through SATOP, NASA's Space Alliance Technology Outreach Program. SATOP put Tyrell in contact with The Boeing Company, which assessed the design and made several major contributions. The product, named Zeno, is now the highest selling over-the-counter medical device for the treatment of acne, and in 2006, Zeno was named the "SATOP Texas, Success Story of the Year." Zeno employs proprietary ClearPoint technology to provide relief of mild to moderate inflammatory acne by delivering a precisely controlled low-level dosage of heat to the blemish, causing the bacteria at the root of more than 90 percent of acne to self-destruct. Within its first year on the market, Zeno was cited by various publications for several awards, including Allure's 2005 "Best of Beauty," Marie Claire's "10 Best Gadgets for Girls," and Popular Science's 2005 "Best of What's New." A variation of the Zeno for use in treating herpetic lesions such as cold sores, by killing the virus that causes them, is currently undergoing FDA trials.

Exploration of over the counter sales of antibiotics in community pharmacies of Addis Ababa, Ethiopia: pharmacy professionals' perspective.

PubMed

Gebretekle, Gebremedhin Beedemariam; Serbessa, Mirgissa Kaba

2016-01-01

Over the counter sale of antibiotics is a global problem and it is increasingly recognized as a source of antibiotic misuse and is believed to increase treatment costs, adverse effects of treatment and emergence of resistance. The increasing trend of over the counter sale of antibiotics in Ethiopia calls for exploration of why such dispensing is practiced. This study aims to explore reasons for over the counter sale of antibiotics in the community pharmacies of Addis Ababa, Ethiopia. A phenomenological qualitative study was conducted in five randomly selected community pharmacies of Addis Ababa. One pharmacy professional from each pharmacy were interviewed at the spot using semi-structured, open-ended interview checklist. Besides, observation of professionals' dispensing practice was made for at least one hour in the same community pharmacies using an observation checklist. Findings were categorized into specific themes that were developed following the objectives. This was facilitated by use of OpenCode 3.6 software. All participants pointed out that antibiotics were frequently dispensed without prescription and contend that the trend of such dispensing has been increasing. The findings indicated that the nonprescription sales of antibiotics were common for Amoxicillin, Ciprofloxacin and Cotrimoxazole. The poor, less educated and younger groups of the population were reported to frequently request antibiotics without prescription. The main reasons for nonprescription sale of antibiotics by pharmacy professionals were found to be related to pharmacy owner's influence to maximize revenue, customer's pressure, weak regulatory mechanism and professional conflicts of interest. The study shows that nonprescription sale of antibiotics was common practice at least in Addis Ababa. The main reasons for this malpractice were the need to maximize revenue and weak regulatory mechanism. Hence, strong regulatory enforcement and community awareness campaign is called for to limit

Obstruction of critical information on over-the-counter medication packages by external tags.

PubMed

Sansgiry, Sujit S; Pawaskar, Manjiri D

2005-02-01

Over-the-counter (OTC) medication packages are important sources of information for consumers during product selection and use. Consumers may not be able to access information from OTC packages if external tags, namely price or anti-theft tags, are improperly placed. To determine the amount and type of information concealed by anti-theft tags and price tags affixed on OTC drug packages. A field study was performed by evaluating packages containing acetaminophen and combinations of acetaminophen in stores located in Houston. Five packages for 4 products selected from each store after an initial survey for presence of an external tag were examined. A data collection sheet was prepared that extracted the type and amount of information concealed by these tags. Data were analyzed by performing descriptive analyses to provide an understanding of the information obscured. A total of 24 stores were considered in the study, and 67 products and 285 packages were evaluated. External tags, both anti-theft and price tags, obscured significant amounts of information on the principal display panel (53.4%) and the Drug Facts panel (47.7%) of OTC packages. These tags concealed crucial information on various aspects of labels such as brand names (42.3%), product description (36.3%), warnings (51.5%), uses (10.4%), and purposes (7.2%). Results suggest that improper use of external tags clearly obscured important information on OTC medication packages necessary for consumers to make informed decisions regarding product selection and use. Tagging practices should be altered to allow consumers full access to drug information on the product.

Evaluation of marketing claims, ingredients, and nutrient profiles of over-the-counter diets marketed for skin and coat health of dogs.

PubMed

Johnson, Lily N; Heinze, Cailin R; Linder, Deborah E; Freeman, Lisa M

2015-06-15

To evaluate marketing claims, ingredients, and nutrient profiles of over-the-counter diets marketed for skin and coat health of dogs. Cross-sectional study. 24 over-the-counter dry and canned diets marketed for skin and coat health of dogs. Data on marketing claims and ingredients were collected from diet packaging and manufacturer websites. Concentrations of selected nutrients were obtained by contacting the manufacturers and were compared against minimum values for Association of American Feed Control Officials Dog Food Nutrient Profiles for adult dog maintenance based on calorie content. Most diets incorporated marketing terms such as digestive health, sensitive, or premium that are poorly defined and may have limited relevance to skin, coat, or general health. The types and numbers of major ingredients (ie, potential to contribute protein to the diet) differed. The total number of unique major ingredients in each diet ranged from 3 to 8 (median, 5.5), but the total number of unique ingredients in each diet ranged from 28 to 68 (median, 38). Concentrations of nutrients associated with skin and coat condition also differed widely. Results indicated that the large variation among over-the-counter diets marketed for skin and coat health may cause confusion for owners during diet selection. Owners of a dog with dermatologic problems should consult their veterinarian to select a good-quality diet that meets specific nutrient goals.

Nonmedical Use of Over-the-Counter Medications Is Significantly Associated with Nonmedical Use of Prescription Drugs among University Students

ERIC Educational Resources Information Center

Le, Vi T.; Norris Turner, Abigail; McDaniel, Anne; Hale, Kenneth M.; Athas, Christina; Kwiek, Nicole C.

2018-01-01

Objective: To examine the association between nonmedical use of over-the-counter medications (NMUOTC) and nonmedical use of prescription drugs (NMUPD). Participants: University students surveyed on NMUOTC and NMUPD between August and December 2011 (N = 939). Methods: Cross-sectional data analysis of online survey. Results: The majority of…

21 CFR 310.527 - Drug products containing active ingredients offered over-the-counter (OTC) for external use as...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Drug products containing active ingredients offered over-the-counter (OTC) for external use as hair growers or for hair loss prevention. 310.527 Section 310.527 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS Requirement...

Designer steroids - over-the-counter supplements and their androgenic component: review of an increasing problem.

PubMed

Rahnema, C D; Crosnoe, L E; Kim, E D

2015-03-01

Colloquially referred to by various misleading monikers ('pro-hormones', 'natural steroids', 'testosterone boosters', etc.) designer anabolic steroids have been popular now for over a decade as a way to achieve classic anabolic steroid-like results from products sold in the legal marketplace. Recent evidence suggests that anabolic steroid use may be the most common cause of hypogonadism in men of reproductive age. Despite recent regulatory efforts that have banned specific compounds, many anabolic-androgenic steroids (AAS) remain available in over-the-counter dietary supplements that are legally sold in the United States. Severe side effects including hepatotoxicity, cholestasis, renal failure, hypogonadism, gynecomastia, and infertility have been reported secondary to the use of these products. While some of these side effects may be reversible, more aggressive use may result in more permanent end-organ damage as has been previously described for the case of aggressive AAS users (Rahnema et al., Fertil Steril, 2014). Designer AAS remain easily available for purchase in over-the-counter bodybuilding supplements and these products appear to be increasingly popular, despite the known health risks associated with their use. We conducted a systematic search to identify the designer steroids that are most commonly sold in dietary supplements as of April 2014 and review what is known regarding their potency and toxicity. We propose that the impact of AAS use on the reproductive and hormonal health of men is underestimated in the literature owing to previous studies' failure to account for designer steroid use. Lastly, we make clinical recommendations to help physicians steer patients away from potentially harmful supplements, and summarize key regulatory obstacles that have allowed potent androgens to remain unregulated in the legal marketplace. © 2015 American Society of Andrology and European Academy of Andrology.

21 CFR 310.533 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as an...

Code of Federal Regulations, 2012 CFR

2012-04-01

... offered over-the-counter (OTC) for human use as an anticholinergic in cough-cold drug products. 310.533... in cough-cold drug products. (a) Atropine sulfate, belladonna alkaloids, and belladonna alkaloids as contained in Atropa belladonna and Datura stramonium have been present as ingredients in cough-cold drug...

21 CFR 310.533 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as an...

Code of Federal Regulations, 2014 CFR

2014-04-01

... offered over-the-counter (OTC) for human use as an anticholinergic in cough-cold drug products. 310.533... in cough-cold drug products. (a) Atropine sulfate, belladonna alkaloids, and belladonna alkaloids as contained in Atropa belladonna and Datura stramonium have been present as ingredients in cough-cold drug...

21 CFR 310.533 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as an...

Code of Federal Regulations, 2013 CFR

2013-04-01

... offered over-the-counter (OTC) for human use as an anticholinergic in cough-cold drug products. 310.533... in cough-cold drug products. (a) Atropine sulfate, belladonna alkaloids, and belladonna alkaloids as contained in Atropa belladonna and Datura stramonium have been present as ingredients in cough-cold drug...

[Use and potential risks of over-the-counter analgesics].

PubMed

Freytag, A; Quinzler, R; Freitag, M; Bickel, H; Fuchs, A; Hansen, H; Hoefels, S; König, H-H; Mergenthal, K; Riedel-Heller, S G; Schön, G; Weyerer, S; Wegscheider, K; Scherer, M; van den Bussche, H; Haefeli, W E; Gensichen, J

2014-04-01

We investigated the use of prescription and non-prescription (over-the-counter, OTC) analgesics and the associated risks in elderly patients with multiple morbidities. Pain medication use was evaluated from the baseline data (2008/2009) of the MultiCare cohort enrolling elderly patients with multiple morbidities who were treated by primary care physicians (trial registration: ISRCTN89818205). We considered opioids (N02A), other analgesics, and antipyretics (N02B) as well as nonsteroidal anti-inflammatory drugs (NSAIDs; M01A). OTC use, duplicate prescription, dosages, and interactions were examined for acetylsalicylic acid, diclofenac, (dex)ibuprofen, naproxen, and acetaminophen. Of 3,189 patients with multiple morbidities aged 65-85 years, 1,170 patients reported to have taken at least one prescription or non-prescription analgesic within the last 3 months (36.7 %). Of these, 289 patients (24.7 % of 1,170) took at least one OTC analgesic. Duplicate prescription was observed in 86 cases; 15 of these cases took the analgesics regularly. In two cases, the maximum daily dose of diclofenac was exceeded due to duplicate prescription. In 235 cases, patients concurrently took a drug with a potentially clinically relevant interaction. In 43 cases (18.3 % of 235) an OTC analgesic, usually ibuprofen, was involved. About one third of the elderly patients took analgesics regularly or as needed. Despite the relatively high use of OTC analgesics, the proportions of duplicate prescription, medication overdoses, and adverse interactions due to OTC products was low.

RADIATION COUNTER

DOEpatents

Goldsworthy, W.W.

1958-02-01

This patent relates to a radiation counter, and more particularly, to a scintillation counter having high uniform sensitivity over a wide area and capable of measuring alpha, beta, and gamma contamination over wide energy ranges, for use in quickly checking the contami-nation of personnel. Several photomultiplier tubes are disposed in parallel relationship with a light tight housing behind a wall of scintillation material. Mounted within the housing with the photomultipliers are circuit means for producing an audible sound for each pulse detected, and a range selector developing a voltage proportional to the repetition rate of the detected pulses and automatically altering its time constant when the voltage reaches a predetermined value, so that manual range adjustment of associated metering means is not required.

21 CFR 310.529 - Drug products containing active ingredients offered over-the-counter (OTC) for oral use as insect...

Code of Federal Regulations, 2011 CFR

2011-04-01

... for orally administered OTC insect repellent drug products: “Oral mosquito repellent,” “mosquitos... mosquitos.” Therefore, any drug product containing ingredients offered for oral use as an insect repellent... offered over-the-counter (OTC) for oral use as insect repellents. 310.529 Section 310.529 Food and Drugs...

21 CFR 310.529 - Drug products containing active ingredients offered over-the-counter (OTC) for oral use as insect...

Code of Federal Regulations, 2013 CFR

2013-04-01

... for orally administered OTC insect repellent drug products: “Oral mosquito repellent,” “mosquitos... mosquitos.” Therefore, any drug product containing ingredients offered for oral use as an insect repellent... offered over-the-counter (OTC) for oral use as insect repellents. 310.529 Section 310.529 Food and Drugs...

21 CFR 310.529 - Drug products containing active ingredients offered over-the-counter (OTC) for oral use as insect...

Code of Federal Regulations, 2010 CFR

2010-04-01

... for orally administered OTC insect repellent drug products: “Oral mosquito repellent,” “mosquitos... mosquitos.” Therefore, any drug product containing ingredients offered for oral use as an insect repellent... offered over-the-counter (OTC) for oral use as insect repellents. 310.529 Section 310.529 Food and Drugs...

21 CFR 310.529 - Drug products containing active ingredients offered over-the-counter (OTC) for oral use as insect...

Code of Federal Regulations, 2012 CFR

2012-04-01

... for orally administered OTC insect repellent drug products: “Oral mosquito repellent,” “mosquitos... mosquitos.” Therefore, any drug product containing ingredients offered for oral use as an insect repellent... offered over-the-counter (OTC) for oral use as insect repellents. 310.529 Section 310.529 Food and Drugs...

21 CFR 310.529 - Drug products containing active ingredients offered over-the-counter (OTC) for oral use as insect...

Code of Federal Regulations, 2014 CFR

2014-04-01

... for orally administered OTC insect repellent drug products: “Oral mosquito repellent,” “mosquitos... mosquitos.” Therefore, any drug product containing ingredients offered for oral use as an insect repellent... offered over-the-counter (OTC) for oral use as insect repellents. 310.529 Section 310.529 Food and Drugs...

Receipt and use of spoken and written over-the-counter medicine information: insights into Australian and UK consumers' experiences.

PubMed

Tong, Vivien; Raynor, David K; Aslani, Parisa

2018-04-01

To explore Australian and UK consumers' receipt and use of spoken and written medicine information and examine the role of leaflets for consumers of over-the-counter (OTC) medicines. Semistructured interviews were conducted with 37 Australian and 39 UK consumers to explore information received with their most recent OTC medicine purchase, and how information was used at different times post-purchase. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Similarities were evident between the key themes identified from Australian and UK consumers' experiences. Consumers infrequently sought spoken information and reported that pharmacy staff provided minimal spoken information for OTC medicines. Leaflets were not always received or wanted and had a less salient role as an information source for repeat OTC purchases. Consumers tended not to read OTC labels or leaflets. Product familiarity led to consumers tending not to seek information on labels or leaflets. When labels were consulted, directions for use were commonly read. However, OTC medicine information in general was infrequently revisited. As familiarity is not an infallible proxy for safe and effective medication use, strategies to promote the value and use of these OTC medicine information sources are important and needed. Minimal spoken information provision coupled with limited written information use may adversely impact medication safety in self-management. © 2017 Royal Pharmaceutical Society.

Potential public sector cost-savings from over-the-counter access to oral contraceptives.

PubMed

Foster, Diana G; Biggs, M Antonia; Phillips, Kathryn A; Grindlay, Kate; Grossman, Daniel

2015-05-01

This study estimates how making oral contraceptive pills (OCPs) available without a prescription may affect contraceptive use, unintended pregnancies and associated contraceptive and pregnancy costs among low-income women. Based on published figures, we estimate two scenarios [low over-the-counter (OTC) use and high OTC use] of the proportion of low-income women likely to switch to an OTC pill and predict adoption of OCPs according to the out-of-pocket costs per pill pack. We then estimate cost-savings of each scenario by comparing the total public sector cost of providing OCPs OTC and medical care for unintended pregnancy. Twenty-one percent of low-income women at risk for unintended pregnancy are very likely to use OCPs if they were available without a prescription. Women's use of OTC OCPs varies widely by the out-of-pocket pill pack cost. In a scenario assuming no out-of-pocket costs for the over-the counter pill, an additional 11-21% of low-income women will use the pill, resulting in a 20-36% decrease in the number of women using no method or a method less effective than the pill, and a 7-25% decrease in the number of unintended pregnancies, depending on the level of use and any effect on contraceptive failure rates. If out-of-pocket costs for such pills are low, OTC access could have a significant effect on use of effective contraceptives and unintended pregnancy. Public health plans may reduce expenditures on pregnancy and contraceptive healthcare services by covering oral contraceptives as an OTC product. Interest in OTC access to oral contraceptives is high. Removing the prescription barrier, particularly if pill packs are available at low or zero out-of-pocket cost, could increase the use of effective methods of contraception and reduce unintended pregnancy and healthcare costs for contraceptive and pregnancy care. Copyright © 2015 Elsevier Inc. All rights reserved.

Reproductive health preventive screening among clinic vs. over-the-counter oral contraceptive users

PubMed Central

Hopkins, Kristine; Grossman, Daniel; White, Kari; Amastae, Jon; Potter, Joseph E.

2015-01-01

Background Interest is growing in moving oral contraceptives over-the-counter (OTC), although concerns exist about whether women would continue to get preventive health screening. Study Design We recruited cohorts of US-resident women who obtained oral contraceptives from US family planning clinics (n=532) and OTC from pharmacies in Mexico (n=514) and interviewed them four times over 9 months. Based on self-reports of having a Pap smear within 3 years or ever having had a pelvic exam, clinical breast exam and testing for sexually transmitted infections (STIs), we assessed the prevalence of preventive screening using Poisson regression models. Results The prevalence of screening was high for both groups (>88% for Pap smear, pelvic exam and clinical breast exam and >71% for STI screening), while the prevalence ratios for screening were higher for clinic users, even after multivariable adjustment. Conclusions Results suggest that most women would obtain reproductive health preventive screening if oral contraceptives were available OTC, and also highlight the need to improve access to preventive screening for all low-income women. PMID:22520645

The Counter Terrorist Classroom: Religion, Education, and Security

ERIC Educational Resources Information Center

Gearon, Liam

2013-01-01

The article identifies international cases--from the United States, Europe, and the United Nations--of an emergent interface of religion, education, and security. This is manifest in the uses of religion in education to counter religious extremism, the notional "counter terrorist classroom." To avoid an over-association of extremism with…

Do patients adhere to over-the-counter artemisinin combination therapy for malaria? evidence from an intervention study in Uganda

PubMed Central

2012-01-01

Background Increasing affordability of artemisinin combination therapy (ACT) in the African retail sector could be critical to expanding access to effective malaria treatment, but must be balanced by efforts to protect the efficacy of these drugs. Previous research estimates ACT adherence rates among public sector patients, but adherence among retail sector purchasers could differ substantially. This study aimed to estimate adherence rates to subsidized, over-the-counter ACT in rural Uganda. Methods An intervention study was conducted with four licensed drug shops in Eastern Uganda in December 2009. Artemether-lumefantrine (AL) was made available for sale at a 95% subsidy over-the counter. Customers completed a brief survey at the time of purchase and then were randomly assigned to one of three study arms: no follow-up, follow-up after two days or follow-up after three days. Surveyors recorded the number of pills remaining through blister pack observation or through self-report if the pack was unavailable. The purpose of the three-day follow-up arm was to capture non-adherence in the sense of an incomplete treatment course ("under-dosing"). The purpose of the two-day follow-up arm was to capture whether participants completed the full course too soon ("over-dosing"). Results Of the 106 patients in the two-day follow-up sample, 14 (13.2%) had finished the entire treatment course by the second day. Of the 152 patients in the three-day follow-up sample, 49 (32.2%) were definitely non-adherent, three (2%) were probably non-adherent and 100 (65.8%) were probably adherent. Among the 52 who were non-adherent, 31 (59.6%) had more than a full day of treatment remaining. Conclusions Overall, adherence to subsidized ACT purchased over-the-counter was found to be moderate. Further, a non-trivial fraction of those who complete treatment are taking the full course too quickly. Strategies to increase adherence in the retail sector are needed in the context of increasing

On the Occurrence of Afternoon Counter Electrojet Over Indian Longitudes During June Solstice in Solar Minimum

NASA Astrophysics Data System (ADS)

Pandey, Kuldeep; Sekar, R.; Anandarao, B. G.; Gupta, S. P.; Chakrabarty, D.

2018-03-01

Studies made earlier using ground-based observations of geomagnetic field over the Indian longitudes revealed that the occurrence of equatorial counter electrojet (CEJ) events in afternoon hours is more frequent during June solstice (May-June-July-August) in solar minimum than in other periods. In general, the June solstice solar minimum CEJ events occur between 1500 local time (LT) and 1800 LT with peak strength of about -10 nT at around 1600 LT. In order to understand the frequent occurrence of these CEJ events, an investigation is carried out using an equatorial electrojet model (Anandarao, 1976, https://doi.org/10.1029/GL003i009p00545) and the empirical vertical drift model by Fejer et al. (2008, https://doi.org/10.1029/2007JA012801). The strength, duration, peak value, and the occurrence time of CEJ obtained using electrojet model match remarkably well with the corresponding observation of average geomagnetic field variations. The occurrence of CEJ is found to be due to solar quiet (Sq) electric field in the westward direction which is manifested as downward drift in Fejer et al. (2008, https://doi.org/10.1029/2007JA012801) model output during 1500-1800 LT. Further, the occurrence of afternoon reversal of Sq electric field in this season is shown to be consistent with earlier studies from Indian sector. Therefore, this investigation provides explicit evidence for the role of westward Sq electric field on the generation of afternoon CEJ during June solstice in solar minimum periods over the Indian sector indicating the global nature of these CEJ events.

Developing Understandings of Race: Preservice Teachers' Counter-Narrative (Re)Constructions of People of Color in Young Adult Literature

ERIC Educational Resources Information Center

Glenn, Wendy J.

2012-01-01

This qualitative study reveals the ways in which reading and reflecting on two counter-narrative young adult novels fostered opportunities for preservice English teachers to think more acutely about their understandings of race within and beyond the text. Participants expressed feelings of empathy with and connection to characters whose cultural…

Over-the-counter drugs block heart accumulation of MIBG

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sherman, P.S.; Fisher, S.J.; Wieland, D.M.

1985-05-01

Previous work in the authors' laboratory using chemically sympathectomized animals showed that > 50% of meta-iodobenzyl-guanidine (MIBG) in the heart is localized in adrenergic nerves. In the present study, commonly used drugs known to alter the uptake and/or release of norepinephrine by adrenergic neurons have been evaluated for their effect on the biodistribution of MIBG. Pseudoephedrine (Sudafed), phenylpropanolamine (Dexatrim) and phenylephrine (Neosynephrine) were administered (5 mg/kg, i.p.) to rats; amphetamine was also evaluated (0.8mg/kg, i.p.). Thirty minutes later I-125-MIBG (0.2-0.4 Ci/mm) was injected i.v.; animals (N=3) were sacrificed 2 h following radiotracer. Compared to controls (N = 3), drug pretreatmentsmore » resulted in large decreases in radiotracer concentration in adrenergic-rich tissues such as left atrium, left ventricle, spleen and parotid glands. Pseudoephedrine caused decreases (%) of 78, 57, 48 and 35 in the four tissues, respectively. Each of the four drugs caused a greater decrease in I-125-MIBG concentration in the left atrium than in the left ventricle. Comparative studies using H-3-norepinephrine are in progress. Entex, a nasal decongestant containing both phenylephrine and phenylpropanolamine, markedly diminished the heart and salivary gland accumulation of I-123-MIBG in a normal male volunteer. These preliminary studies suggest that commonly used sympathomimetic agents, including some over-the-counter preparations, decrease the accumulation of MIBG in adrenergic neurons. These results also suggest that patients should be carefully screened for drug usage prior to MIBG scintigraphy of the heart.« less

Perspectives among a Diverse Sample of Women on the Possibility of Obtaining Oral Contraceptives Over the Counter: A Qualitative Study.

PubMed

Baum, Sarah; Burns, Bridgit; Davis, Laura; Yeung, Miriam; Scott, Cherisse; Grindlay, Kate; Grossman, Daniel

2016-01-01

There is increasing support among stakeholders in the United States to make oral contraceptives (OCs) available over the counter (OTC). Previous research on the topic has focused on representative samples of U.S. women, Latina women, low-income women, and abortion clients. However, little is known about the perspectives of African American women, Asian American women, and young women. We conducted 14 focus group discussions with 138 women. Twenty-three percent of participants were ages 18 or younger, 61% were African American, and 26% were Asian American/Pacific Islander. Community organizations recruited participants through convenience sampling and hosted the discussions. Focus groups were transcribed and coded thematically. Women reported potential benefits of OTC access, including convenience and privacy. Many believed OTC availability of OCs would help to reduce unintended pregnancy and help to destigmatize birth control. Participants also expressed concerns about OTC access, such as worry that first-time users and young adolescents would not have enough information to use the pill safely and effectively, as well as concerns about whether women would still obtain preventive screenings. Women were also worried that the cost of OTC OCs would be higher if insurance no longer covered them. Overall, women were interested in the option of obtaining the pill OTC. Future research and advocacy efforts should explore women's concerns, including whether adolescents can effectively use OTC pills and ensuring insurance coverage for OTC contraception. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

A study of time over threshold (TOT) technique for plastic scintillator counter

NASA Astrophysics Data System (ADS)

Wu, Jin-Jie; Heng, Yue-Kun; Sun, Zhi-Jia; Wu, Chong; Zhao, Yu-Da; Yang, Gui-An; Jiang, Chun-Hua

2008-03-01

A new charge measurement method, time over threshold (TOT), has been used in some gas detectors lately. Here TOT is studied for TOF system, made of plastic scintillator counter, which can simplify the electronics of the system. The signal characteristics are measured and analyzed with a high quality oscilloscope, including noise, pedestal, signal amplitude, total charge, rise time and the correlation between them. The TOT and charge are related and can be fitted by some empirical formula. The charge measurement resolution by TOT is given and this will help the design of TOF electronics. Supported by BEPCII Project, CAS Knowledge Innovation Program U602 and U-34 (IHEP)

Low latency counter event indication

DOEpatents

Gara, Alan G [Mount Kisco, NY; Salapura, Valentina [Chappaqua, NY

2008-09-16

A hybrid counter array device for counting events with interrupt indication includes a first counter portion comprising N counter devices, each for counting signals representing event occurrences and providing a first count value representing lower order bits. An overflow bit device associated with each respective counter device is additionally set in response to an overflow condition. The hybrid counter array includes a second counter portion comprising a memory array device having N addressable memory locations in correspondence with the N counter devices, each addressable memory location for storing a second count value representing higher order bits. An operatively coupled control device monitors each associated overflow bit device and initiates incrementing a second count value stored at a corresponding memory location in response to a respective overflow bit being set. The incremented second count value is compared to an interrupt threshold value stored in a threshold register, and, when the second counter value is equal to the interrupt threshold value, a corresponding "interrupt arm" bit is set to enable a fast interrupt indication. On a subsequent roll-over of the lower bits of that counter, the interrupt will be fired.

Low latency counter event indication

DOEpatents

Gara, Alan G.; Salapura, Valentina

2010-08-24

A hybrid counter array device for counting events with interrupt indication includes a first counter portion comprising N counter devices, each for counting signals representing event occurrences and providing a first count value representing lower order bits. An overflow bit device associated with each respective counter device is additionally set in response to an overflow condition. The hybrid counter array includes a second counter portion comprising a memory array device having N addressable memory locations in correspondence with the N counter devices, each addressable memory location for storing a second count value representing higher order bits. An operatively coupled control device monitors each associated overflow bit device and initiates incrementing a second count value stored at a corresponding memory location in response to a respective overflow bit being set. The incremented second count value is compared to an interrupt threshold value stored in a threshold register, and, when the second counter value is equal to the interrupt threshold value, a corresponding "interrupt arm" bit is set to enable a fast interrupt indication. On a subsequent roll-over of the lower bits of that counter, the interrupt will be fired.

Consumer behavior in the setting of over-the-counter statin availability: lessons from the consumer use study of OTC Mevacor.

PubMed

Brass, Eric P

2004-11-04

Despite the proven benefits of statins, large numbers of patients meeting guideline criteria for therapy are not receiving these drugs. It has been suggested that over-the-counter (OTC) availability of statins would allow more consumers to use statins and achieve cardiovascular risk reduction. However, concerns have been raised as to the consumers' ability to self-manage hyperlipidemia and use statins safely. The Consumer Use Study of OTC Mevacor (CUSTOM) was designed to define consumer behaviors in the setting of OTC statin availability. The study was conducted in a simulated OTC setting and allowed consumers to purchase once-daily lovastatin 20 mg. The CUSTOM dataset includes >3,300 consumers who evaluated OTC lovastatin for potential purchase at study sites and follow-up information on purchasers for up to 6 months of self-managed therapy. These data have been analyzed to address consumers' knowledge of their cholesterol concentrations as well as their ability to make OTC use decisions based on their cardiovascular risk, avoid drug-drug interactions, self-manage their cholesterol treatment after deciding to use the OTC product, and maintain interactions with physicians while using lovastatin OTC. The results showed that most study participants appropriately self-selected OTC statin therapy and managed their treatment. Use of OTC statins by consumers needing more intensive statin therapy or facing the risk of potential drug-drug interactions remains an area of concern but occurred infrequently in CUSTOM. These data are important for making an informed risk-benefit decision concerning OTC statin availability.

Australian pharmacies prevent potential adverse reactions in patients taking warfarin requesting over-the-counter analgesia.

PubMed

MacFarlane, Brett V; Bergin, Jenny K; Reeves, Peter; Matthews, Andrew

2015-06-01

The objective of this article was to assess if Australian pharmacy staff prevent potential adverse reactions in warfarin patients requesting over-the-counter (OTC) analgesia. Mystery shoppers entered 170 pharmacies across Australia to request OTC analgesia for a hypothetical patient with a wrist injury who currently takes warfarin following a heart valve replacement. The request was made to the first pharmacist or non-pharmacist staff member to approach the mystery shopper. The interaction was audio-taped and assessed by a pharmacist. The OTC analgesic recommended was assessed for the potential to cause an adverse bleeding event. The quality of advice given with the OTC analgesic was assessed against determined criteria. Results were compared with scenarios of similar request type where the hypothetical patient was not taking warfarin. Mystery shoppers enquiring about taking OTC analgesics concomitantly with warfarin had access to the pharmacist in 97.0% of cases. All 170 pharmacies recommended OTC analgesics that were less likely to cause adverse events when taken with warfarin. The advice given and the communication between pharmacy staff and mystery shoppers were of high quality. Australian pharmacies support the quality use of medicines by patients taking warfarin by providing expeditious access to the pharmacist, appropriate recommendations of OTC analgesics, high standards of quality of advice and they communicate in a way to ensure ease of understanding by the consumer. The protocols used by pharmacy staff help prevent potentially serious adverse drug events. © 2014 Royal Pharmaceutical Society.

Predictors of over-the-counter medication: A cross-sectional Indian study.

PubMed

Panda, Abinash; Pradhan, Supriya; Mohapatro, Gurukrushna; Kshatri, Jaya Singh

2017-01-01

The determinants of over-the-counter (OTC) medication need to be understood to design adequate drug information policies. To determine the prevalence and predictors of OTC medication among the adult population of Berhampur town in Odisha, India. It was a prospective, cross-sectional, observational study carried out in the private retail pharmacy on a convenience sample of 880 adults over a period of 6 months at Berhampur, Odisha, India. Medication use behavior was explored using a data collection form that had three parts. The first part captured data on the sociodemographic characteristics of drug consumers. The second and third part collected data on drug history and attitude toward the available health-care facility, respectively. Descriptive statistics was used to represent the prevalence of OTC medication. Odds ratio and 95% confidence intervals (CIs) were used to determine the predictors of OTC medication. The overall prevalence of OTC medication use was 18.72% (95% CI: 15.34-47.16%). Younger age, male gender, lower income, and poor lifestyle were the predictors of OTC medication. Perception of poor accessibility to health care, the presence of chronic diseases and having a symptom count of more than two significantly increased the likelihood of OTC medication ( P < 0.05). Sociodemographic profile, drug history, and attitude toward health-care availability in the locality can predict OTC medication behavior. Interventions aimed at changing the perceptions of the public regarding accessibility, affordability of the health care is likely to influence OTC medication behavior and make it safer.

Over-the-Counter Medication and Herbal or Dietary Supplement Use in College: Dose Frequency and Relationship to Self-Reported Distress

ERIC Educational Resources Information Center

Stasio, Michael J.; Curry, Kim; Sutton-Skinner, Kelly M.; Glassman, Destinee M.

2008-01-01

Objective: A growing number of researchers have examined the use of over-the-counter (OTC) medications and herbal or dietary supplements among college students. There is concern about the efficacy and safety of these products, particularly because students appear to use them at a higher rate than does the general public. Participants and Methods:…

[Evaluation of Dissolution Profiles of Famotidine from Over-the-counter Drugs].

PubMed

Saito, Yuji; Adachi, Naoki; Kato, Miki; Nadai, Masayuki

2018-03-27

  In recent years, self-medication has started to receive more attention in Japan owing to increasing medical costs and health awareness among people. One of the main roles of pharmacists in self-medication is to provide appropriate information regarding over-the-counter (OTC) drugs. However, pharmacists promoting the proper use of OTC drugs have little information on their formulation properties. In this study, we performed dissolution tests on both OTC drugs and ethical drug (ED) containing famotidine, and evaluated the differences in their dissolution profiles. Marked differences in dissolution profiles of OTC drugs were observed in test solutions at pH 1.2, 4.0, and 6.8 and in water. To evaluate the differences quantitatively, we calculated the lag time and dissolution rate constant from the dissolution profiles. Significant differences in lag times and dissolution rate constants between some OTC drugs and ED were observed. We also used similarity factor (f2), to quantify the similarity between dissolution profiles of OTC drugs and ED. f2 values less than 42 were observed in some OTC drugs, suggesting that these differences might influence absorption in vivo resulting in differences in their onset time and efficacy. The findings of this study will provide useful information for the promotion of proper use of OTC drugs.

The drugs don't sell: DIY heart health and the over-the-counter statin experience.

PubMed

Will, Catherine M; Weiner, Kate

2015-04-01

This paper draws on a study of over-the-counter statins to provide a critical account of the figure of the 'pharmaceutical consumer' as a key actor in the pharmaceuticalisation literature. A low dose statin, promising to reduce cardiovascular risk, was reclassified to allow sale in pharmacies in the UK in 2004. We analysed professional and policy debates about the new product, promotional and sales information, and interviews with consumers and potential consumers conducted between 2008 and 2011, to consider the different consumer identities invoked by these diverse actors. While policymakers constructed an image of 'the citizen-consumer' who would take responsibility for heart health through exercising the choice to purchase a drug that was effectively rationed on the NHS and medical professionals raised concerns about 'a flawed consumer' who was likely to misuse the product, both these groups assumed that there would be a market for the drug. By contrast, those who bought the product or potentially fell within its target market might appear as 'health consumers', seeking out and paying for different food and lifestyle products and services, including those targeting high cholesterol. However, they were reluctant 'pharmaceutical consumers' who either preferred to take medication on the advice of a doctor, or sought to minimize medicine use. In comparison to previous studies, our analysis builds understanding of individual consumers in a market, rather than collective action for access to drugs (or, less commonly, compensation for adverse effects). Where some theories of pharmaceuticalisation have presented consumers as creating pressure for expanding markets, our data suggests that sociologists should be cautious about assuming there will be demand for new pharmaceutical products, especially those aimed at prevention or asymptomatic conditions, even in burgeoning health markets. Copyright © 2014 Elsevier Ltd. All rights reserved.

Over the counter (OTC) artificial tear drops for dry eye syndrome.

PubMed

Pucker, Andrew D; Ng, Sueko M; Nichols, Jason J

2016-02-23

Over the counter (OTC) artificial tears historically have been the first line of treatment for dry eye syndrome and dry eye-related conditions like contact lens discomfort, yet currently we know little regarding the overall efficacy of individual, commercially available artificial tears. This review provides a much needed meta-analytical look at all randomized and quasi-randomized clinical trials that have analyzed head-to-head comparisons of OTC artificial tears. To evaluate the effectiveness and toxicity of OTC artificial tear applications in the treatment of dry eye syndrome compared with another class of OTC artificial tears, no treatment, or placebo. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2015, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to December 2015), EMBASE (January 1980 to December 2015), Latin American and Caribbean Health Sciences (LILACS) (January 1982 to December 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) and the US Food and Drugs Administration (FDA) website (www.fda.gov). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 4 December 2015. We searched reference lists of included trials for any additional trials not identified by the electronic searches. This review includes randomized controlled trials with adult participants who were diagnosed with dry eye, regardless of race and gender. We included trials in which the age of participants was not reported, and clinical trials comparing OTC artificial tears with another class of OTC artificial tears, placebo, or no treatment. This review did not consider head-to-head comparisons of artificial tears with

Access to Emergency Contraception in the Over-the-Counter Era

PubMed Central

Cleland, Kelly; Bass, Jamie; Doci, Florida; Foster, Angel M.

2016-01-01

Introduction After years of complex regulatory changes, levonorgestrel emergency contraception (LNG EC) is now approved for unrestricted sale in the US. Timely access to EC pills is critical because they are more likely to work the sooner they are taken. This study assesses whether LNG EC is sold in accordance with current Food and Drug Administration regulations. Methods We distributed an online questionnaire through an EC-focused listserv for reproductive health professionals, asking data collectors to visit local stores and document product names, price, over-the-counter (OTC) shelf availability, and misinformation about age restrictions. We used Chi-square analysis to assess bivariate associations and t-tests and Wilcoxon rank-sum tests to determine differences in means. Results We collected information about 220 stores. The majority (65%) stocked EC on OTC shelves, although only 22% of these displayed it without a locked security enclosure. Chain pharmacies were more likely to shelf-stock EC than independent pharmacies (77% vs 5%; p=0.000), but variation existed among stores within the same chain. Among stores that were asked, 40% incorrectly reported an age restriction for non-prescription purchase of LNG EC, while 95% correctly reported that men can buy LNG EC. The average price of branded and generic LNG EC was $49.64 and $40.05, respectively. Conclusion Changes in the regulatory status of LNG EC have resulted in widespread confusion about how EC can be sold, and its high price contributes to access barriers. Retailers should ensure that consumers can access LNG EC quickly and easily by stocking the product on OTC shelves and educating staff about current regulations. PMID:27682018

Evaluation of two over-the-counter natural thyroid hormone preparations in human volunteers.

PubMed

Csako, G; Corso, D M; Kestner, J; Bokser, A D; Kennedy, P E; Pucino, F

1992-04-01

To determine the pharmacologic activity of over-the-counter (OTC) thyroid preparations. In vitro analysis and a prospective, crossover study in vivo. Tertiary care center. Two healthy adult volunteers. Three OTC preparations (Thyrotrophin PMG [bovine thyroid PMG extract], Thyro Forte [thyroid lymphogland concentrate with synergistic complex], and Thyro Complex [thyroid lyophilized gland concentrate with synergistic complex]) were analyzed in vitro. Volunteers were administered two times the manufacturer's maximum recommended daily dose of either Thyrotrophin PMG or Thyro Forte for one week, washed out for four to five weeks, and crossed over to receive the opposite tablet preparation for an additional week. The triiodothyronine (T3) and thyroxine (T4) contents of OTC preparations were measured by HPLC. Vital signs, serum total and free T4, total T3, thyroid stimulating hormone, thyroxine binding globulin, thyroglobulin, and general chemistry tests (including glucose and cholesterol) were monitored before, during, and between administration of the products. HPLC analysis of the three OTC preparations showed no T4 but did show possible T3 in two of these products. We found no definite clinical or laboratory evidence of thyroid hormone excess with either product. Healthcare professionals should advise against the use of these scientifically unsound and relatively expensive OTC thyroid preparations, of which the therapeutic efficacy is unknown.

How adolescents experience and cope with pain in daily life: a qualitative study on ways to cope and the use of over-the-counter analgesics

PubMed Central

Lagerløv, Per; Rosvold, Elin Olaug; Holager, Tanja; Helseth, Sølvi

2016-01-01

Objective The aim of this study was to describe how different adolescents experience and manage pain in their daily life, with a focus on their use of over-the-counter analgesics. More specifically, the aim was to explore different patterns among the adolescents in pain descriptions, in the management of pain, in relationships with others, and in their daily life. Design Qualitative semistructured interviews on experiences with pain, pain management and involvement of family and friends during pain. Pain and stress management strategies and attachment theory will be in focus for interpretations. Participants and setting 25 participants aged 15–16-years from six different junior high schools, both genders, with and without immigrant background were interviewed at their local schools in Norway. Results We identified 4 groups of adolescents with similarities in attitudes and management strategies to pain: ‘pain is manageable’, ‘pain is communicable’, ‘pain is inevitable’ and ‘pain is all over’. The participants within each group differed in how they engaged their parents in pain; how they perceived, communicated and managed pain; and how they involved emotions and used over-the-counter analgesics. Conclusions The adolescents’ different involvement with the family during pain related to their pain perception and management. Knowledge of the different ways of approaching pain is important when supporting adolescents and may be a subject for further research on the use of over-the-counter analgesics in the family. PMID:26932141

Relationships between perceptual attributes and rheology in over-the-counter vaginal products: a potential tool for microbicide development.

PubMed

Mahan, Ellen D; Zaveri, Toral; Ziegler, Gregory R; Hayes, John E

2014-01-01

Vaginal microbicides are believed to have substantial potential to empower women to protect themselves from HIV, although clinical trials to date have had mixed results at best. Issues with patient adherence in these trials suggest additional emphasis should be placed on optimizing acceptability. Acceptability is driven, in part, by the sensory properties of the microbicide, so better understanding of the relationships between sensory properties and the physical and rheological properties of microbicides should facilitate the simultaneous optimization of sensory properties in parallel with the biophysical properties required for drug deployment. Recently, we have applied standard methods to assess the potential acceptability of microbicide prototypes ex vivo and to quantify the sensory properties of microbicide surrogates. Here, we link quantitative perceptual data to the rheological properties of 6 over-the counter (OTC) vaginal products used as ex vivo microbicide surrogates. Shear-thinning behavior (n) and tan δ (10 rad/s) showed no relationship with any perceptual attributes while shear storage modulus, G' (10 rad/s) was correlated with some attributes, but did not appear to be a strong predictor of sensory properties. Conversely, the storage loss modulus, G" (10 rad/s) and the consistency coefficient, K, were correlated with several sensory attributes: stickiness, rubberiness, and uniform thickness for G'' and stickiness, rubberiness, and peaking for K. Although these relationships merit confirmation in later studies, this pilot study suggests rheological principles can be used to understand the sensory properties evoked by microbicide surrogates assessed ex vivo. Additional work is needed to determine if these findings would apply for microbicides in vivo.

Relationships between Perceptual Attributes and Rheology in Over-the-Counter Vaginal Products: A Potential Tool for Microbicide Development

PubMed Central

Mahan, Ellen D.; Zaveri, Toral; Ziegler, Gregory R.; Hayes, John E.

2014-01-01

Vaginal microbicides are believed to have substantial potential to empower women to protect themselves from HIV, although clinical trials to date have had mixed results at best. Issues with patient adherence in these trials suggest additional emphasis should be placed on optimizing acceptability. Acceptability is driven, in part, by the sensory properties of the microbicide, so better understanding of the relationships between sensory properties and the physical and rheological properties of microbicides should facilitate the simultaneous optimization of sensory properties in parallel with the biophysical properties required for drug deployment. Recently, we have applied standard methods to assess the potential acceptability of microbicide prototypes ex vivo and to quantify the sensory properties of microbicide surrogates. Here, we link quantitative perceptual data to the rheological properties of 6 over-the counter (OTC) vaginal products used as ex vivo microbicide surrogates. Shear-thinning behavior (n) and tan δ (10 rad/s) showed no relationship with any perceptual attributes while shear storage modulus, G’ (10 rad/s) was correlated with some attributes, but did not appear to be a strong predictor of sensory properties. Conversely, the storage loss modulus, G” (10 rad/s) and the consistency coefficient, K, were correlated with several sensory attributes: stickiness, rubberiness, and uniform thickness for G’’ and stickiness, rubberiness, and peaking for K. Although these relationships merit confirmation in later studies, this pilot study suggests rheological principles can be used to understand the sensory properties evoked by microbicide surrogates assessed ex vivo. Additional work is needed to determine if these findings would apply for microbicides in vivo. PMID:25188244

Advertising health: the case for counter-ads.

PubMed Central

Dorfman, L; Wallack, L

1993-01-01

Public service advertisements have been used by many in hopes of "selling" good health behaviors. But selling good behavior--even if it could be done more effectively--is not the best goal for using mass media to prevent health problems. Personal behavior is only part of what determines health status. Social conditions and the physical environment are important determinants of health that are usually ignored by health promotion advertising. Public service advertising may be doing more harm than good if it is diverting attention from more effective socially based health promotion strategies. Counter-ads are one communications strategy that could be used to promote a broader responsibility for rectifying health problems. In the tradition of advocacy advertising directly promoting policy rather than products, counter-ads promote views consistent with a public health perspective. Counter-ads set the agenda for health issues, conferring status on policy-oriented strategies for addressing health problems. The primary purpose of counter-ads is to challenge the dominant view that public health problems reflect personal health habits. They are controversial because they place health issues in a social and political context. Advertising strategies for health promotion range over a spectrum from individually oriented public service advertising to socially oriented counter-advertising. The recent anti-tobacco campaign from the California Department of Health Services represents advertisements across the spectrum. Counter-ads that focus on a politically controversial definition for health problems are an appropriate and necessary alternative to public service advertising. PMID:8265756

Advertising health: the case for counter-ads.

PubMed

Dorfman, L; Wallack, L

1993-01-01

Public service advertisements have been used by many in hopes of "selling" good health behaviors. But selling good behavior--even if it could be done more effectively--is not the best goal for using mass media to prevent health problems. Personal behavior is only part of what determines health status. Social conditions and the physical environment are important determinants of health that are usually ignored by health promotion advertising. Public service advertising may be doing more harm than good if it is diverting attention from more effective socially based health promotion strategies. Counter-ads are one communications strategy that could be used to promote a broader responsibility for rectifying health problems. In the tradition of advocacy advertising directly promoting policy rather than products, counter-ads promote views consistent with a public health perspective. Counter-ads set the agenda for health issues, conferring status on policy-oriented strategies for addressing health problems. The primary purpose of counter-ads is to challenge the dominant view that public health problems reflect personal health habits. They are controversial because they place health issues in a social and political context. Advertising strategies for health promotion range over a spectrum from individually oriented public service advertising to socially oriented counter-advertising. The recent anti-tobacco campaign from the California Department of Health Services represents advertisements across the spectrum. Counter-ads that focus on a politically controversial definition for health problems are an appropriate and necessary alternative to public service advertising.

Effect on smoking cessation of switching nicotine replacement therapy to over-the-counter status.

PubMed

Thorndike, Anne N; Biener, Lois; Rigotti, Nancy A

2002-03-01

This study examined whether the change in nicotine replacement therapy sales from prescription to over the counter (OTC) status affected smoking cessation. We used the 1993-1999 Massachusetts Tobacco Surveys to compare data from adult current smokers and recent quitters before and after the OTC switch. No significant change over time occurred in the proportion of smokers who used nicotine replacement therapy at a quit attempt in the past year (20.1% pre-OTC vs 21.4% post-OTC), made a quit attempt in the past year (48.1% vs 45.2%), or quit smoking in the past year (8.1% vs 11.1%). Fewer non-Whites used nicotine replacement therapy after the switch (20.7% pre-OTC vs 3.2% post-OTC, P =.002), but the proportion of Whites using nicotine replacement therapy did not change significantly (20.6% vs 24.0%). We observed no increase in Massachusetts smokers' rates of using nicotine replacement therapy, making a quit attempt, or stopping smoking after nicotine replacement therapy became available for OTC sale. There appear to be other barriers to the use of nicotine replacement therapy besides visiting a physician, especially among minority smokers.

Interest in Over-the-Counter Access to a Progestin-Only Pill among Women in the United States.

PubMed

Grindlay, Kate; Grossman, Daniel

A progestin-only pill may be the first pill formulation to become available over the counter in the United States; however, no research on over-the-counter (OTC) pill interest has focused on progestin-only pills or a representative sample of teens. The objective of this study was to assess U.S. women and teens' interest in OTC progestin-only pill use. In October 2015, we conducted a nationally representative, cross-sectional, online survey with 2,026 sexually active adult women aged 18 to 44 not currently desiring pregnancy, and 513 female teens aged 15 to 17. Logistic regression was used to identify characteristics associated with likely OTC progestin-only pill use. We also assessed reasons for use or nonuse, duration of use, and willingness to pay. Thirty-nine percent of adults and 29% of teens reported likely use, with a greater likelihood if covered by insurance. Adults were willing to pay $15 per month and teens $10 per month on average. Among adults, women who were never married or living alone (vs. married), uninsured (vs. privately insured), current pill or less effective method users (vs. ring, patch, injectable, or intrauterine device), tried to get a birth control prescription in the past year, or ever used an oral contraceptive pill or progestin-only pill had higher odds of likely use. Among teens, Spanish speakers and those who ever had sex had higher odds of likely use; Black teens (vs. White) had lower odds. Teens and adults are interested in using an OTC progestin-only pill. These findings indicate a large pool of interested users and the potential for improved contraceptive access by making an OTC progestin-only pill available. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Emergency Contraceptive Pill (ECP) Use and Experiences at College Health Centers in the Mid-Atlantic United States: Changes since ECP Went Over-the-Counter

ERIC Educational Resources Information Center

Miller, Laura M.

2011-01-01

Objective: To investigate the availability of emergency contraceptive pills (ECPs) at college health centers since ECP went over-the-counter (OTC) in 2006. Related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, and staff attitudes, were…

Emergency contraceptive pills over-the-counter: a population-based survey of young Swedish women.

PubMed

Larsson, Margareta; Eurenius, Karin; Westerling, Ragnar; Tydén, Tanja

2004-04-01

One year after emergency contraceptive pills (ECP) had become prescription-free, we sent a questionnaire to 800 randomly selected women in mid-Sweden. The aim was to investigate women's knowledge, attitudes and practices regarding the method. The response rate was 71% (n = 564). The majority of the women, 65%, would prefer to purchase ECP over-the-counter (OTC) in a pharmacy. Attitudes toward the method were predominantly positive, but one fourth (24%) had worries about side effects and one third (33%) considered ECP to be a kind of abortion. Logistic regression showed that correct knowledge of and positive attitudes toward ECP contributed to estimated future use of ECP. Although women favored the OTC option, persistent misunderstanding about ECP implies that routine information from gynecologists and health professionals as well as media campaigns is needed along with the deregulation in order to make ECP an accepted and properly used contraceptive method.

Lack of pregnancy warnings on over-the-counter dermatologic products containing potentially harmful hydroquinone.

PubMed

Bio, L L; Cies, J J

2017-07-01

To determine the presence of pregnancy warnings on over-the-counter (OTC) dermatologic products with hydroquinone, a potentially harmful ingredient. Data were obtained from the Food and Drug Administration National Drug Code Directory and Label Repository to identify OTC dermatologic products containing hydroquinone. Products were stratified based on pregnancy or general warning presence (WP) or absence (WA). Product characteristics were compared between groups: hydroquinone concentration, presence of external packaging, indication and warning statements. Of the 112 products studied, 21 had a pregnancy warning and 3 included a general warning against use: WP (n=24) and WA (n=88) group. External packaging was more prevalent in the WP group compared to WA (62.5% vs 29.5%, P=0.004). Majority of OTC dermatologic products containing hydroquinone did not have a pregnancy warning. This highlights the need for improved labeling and informs providers caring for pregnant women of OTC labeling limitations.

A naturalistic cohort study on effectiveness, safety and usage pattern of an over-the-counter nicotine patch. Cohort study on smoking cessation.

PubMed

Hasford, Joerg; Fagerstrom, Karl Olov; Haustein, Knut-Olav

2003-09-01

INTRODUCTION. Nicotine replacement therapies (NRT) are effective for smoking cessation. After having received over-the-counter (OTC) status in Germany, concerns grew about effectiveness, increased risks, especially of adverse cardiovascular reactions, and inappropriate use of NRT. Thus, a pharmacy-based cohort study was launched. OBJECTIVES. To assess effectiveness, safety and appropriateness of use of an OTC nicotine patch (Nicotinell, Novartis Ltd.). Every customer who bought an OTC Nicotinell patch was eligible. All data were collected by self-administered questionnaires at weeks 2, 4, 8, 12 and 24 after inclusion. Six hundred and thirty-three customers were admitted, median duration of smoking was 19 years. Of the participants, 6% smoked up to 10 cigarettes per day, 43.6% between 11 and 20, 34.3% between 21 and 30, and 16.1% more than 30 cigarettes. Twenty-four weeks later, 351 participants replied: 28% (177 of 633) had quit smoking completely. Considering replies only the proportion of complete responders raised to 50.4%. There were no serious adverse events reported; 62.9% complied with the directions for use and did not use the patch for more than 3 months. About 45% smoked simultaneously with NRT. Pharmacy-based cohort studies are feasible. This study indicates that the nicotine patch is effective and safe in an OTC setting. There is still room to improve compliance with the directions for use.

Counter-Punishment, Communication, and Cooperation among Partners

PubMed Central

Andrighetto, Giulia; Brandts, Jordi; Conte, Rosaria; Sabater-Mir, Jordi; Solaz, Hector; Székely, Áron; Villatoro, Daniel

2016-01-01

We study how communication affects cooperation in an experimental public goods environment with punishment and counter-punishment opportunities. Participants interacted over 30 rounds in fixed groups with fixed identifiers that allowed them to trace other group members' behavior over time. The two dimensions of communication we study are asking for a specific contribution level and having to express oneself when choosing to counter-punish. We conduct four experimental treatments, all involving a contribution stage, a punishment stage, and a counter-punishment stage in each round. In the first treatment communication is not possible at any of the stages. The second treatment allows participants to ask for a contribution level at the punishment stage and in the third treatment participants are required to send a message if they decide to counter-punish. The fourth combines the two communication channels of the second and third treatments. We find that the three treatments involving communication at any of the two relevant stages lead to significantly higher contributions than the baseline treatment. We find no difference between the three treatments with communication. We also relate our results to previous results from treatments without counter-punishment opportunities and do not find that the presence of counter-punishment leads to lower cooperation level. The overall pattern of results shows that given fixed identifiers the key factor is the presence of communication. Whenever communication is possible contributions and earnings are higher than when it is not, regardless of counter-punishment opportunities. PMID:27092065

Over-the-counter treatments and perineal hygiene in postmenopausal women.

PubMed

Erekson, Elisabeth A; Martin, Deanna K; Brousseau, E Christine; Yip, Sallis O; Fried, Terri R

2014-03-01

The objective of this descriptive study was to quantify the personal hygiene habits/practices of, as well as the over-the-counter (OTC) products used by, postmenopausal women. Specifically, we were interested in any product that would contact the vulva or vagina. We performed a cross-sectional study of postmenopausal women seeking routine gynecologic care. We developed a questionnaire on their personal hygiene habits/practices and the OTC products that they use that would contact the vulva or vagina. We recruited postmenopausal women seeking gynecologic care from two separate gynecology practices. Descriptive statistics were performed as appropriate to characterize the frequency of reported treatments and practices. The questionnaire on OTC treatments and perineal hygiene was completed by 114 postmenopausal women. Fifty-eight women (50.9%) reported using at least one OTC vulvovaginal treatment in the last 3 months, including barrier treatments, topical anesthetics, powders, and antifungals. Women often used more than one OTC product. Thirty-seven women (32.5%) reported the use of two or more OTC products. Powders were used by 34 women (29.8%). Talcum powder was the most commonly used powder (26 of 34; 76.5%). Nine postmenopausal women (7.9%) reported douching in the last 3 months. We found that more than half of postmenopausal women seeking gynecologic care have used an OTC product for vulvovaginal symptoms in the last 3 months and that one third of women use two or more products. Because the use of OTC products is very common, our study highlights the need for a detailed history inquiry about OTC product use and perineal hygiene practices.

Ex vivo effectiveness of French over-the-counter products against head lice (Pediculus humanus capitis De Geer, 1778).

PubMed

Combescot-Lang, Catherine; Vander Stichele, Robert H; Toubate, Berthine; Veirron, Emilie; Mumcuoglu, Kosta Y

2015-05-01

Head lice infestation is still a public health problem worldwide, with an intracountry and intercountry prevalence variation of 0.7 to 59%. There is a large variety of over-the-counter anti-louse products, but their efficacy is not always well assessed. Our objective was to test the pediculicidal and ovicidal efficacy of 21 over-the-counter head louse products, available in France during the period of 2008 to 2012. We tested children living in Tours City in central France and visiting preschools, primary schools, kindergarten, camps, and child care facilities, as well as children in their family houses, and were examined for the presence of lice. The products were collected from randomly selected pharmacies by covert investigators and then tested in the laboratory on an ex vivo sample of head lice and their eggs, collected from the hair of infested children. Living lice and unharmed eggs were collected from the scalps of 3-12 years old. The laboratory conditions for ex vivo testing mimicked the manufacturers' instructions for exposure time and application method. In 21 runs, 3919 living lice and 4321 undamaged living eggs were collected from the scalp of over 400 children. The 21 products were classified in three groups: 6 products in a group of potentially 100% pediculicidal activity and potentially 100% ovicidal activity, 8 products in a group of potentially 100% pediculicidal activity but insufficient ovicidal activity (including 2 products with claims of single application treatment), and 7 products in a group of insufficient pediculicidal activity and ovicidal activity. The pharmaceutical market for head lice products in France is swamped with poorly tested and ineffective products. Rigorous efficacy testing preregistration and periodic screening and testing of effectiveness in the post-registration period should be endorsed by the health authorities.

Effect on Smoking Cessation of Switching Nicotine Replacement Therapy to Over-the-Counter Status

PubMed Central

Thorndike, Anne N.; Biener, Lois; Rigotti, Nancy A.

2002-01-01

Objectives. This study examined whether the change in nicotine replacement therapy sales from prescription to over the counter (OTC) status affected smoking cessation. Methods. We used the 1993–1999 Massachusetts Tobacco Surveys to compare data from adult current smokers and recent quitters before and after the OTC switch. Results. No significant change over time occurred in the proportion of smokers who used nicotine replacement therapy at a quit attempt in the past year (20.1% pre-OTC vs 21.4% post-OTC), made a quit attempt in the past year (48.1% vs 45.2%), or quit smoking in the past year (8.1% vs 11.1%). Fewer non-Whites used nicotine replacement therapy after the switch (20.7% pre-OTC vs 3.2% post-OTC, P = .002), but the proportion of Whites using nicotine replacement therapy did not change significantly (20.6% vs 24.0%). Conclusions. We observed no increase in Massachusetts smokers' rates of using nicotine replacement therapy, making a quit attempt, or stopping smoking after nicotine replacement therapy became available for OTC sale. There appear to be other barriers to the use of nicotine replacement therapy besides visiting a physician, especially among minority smokers. (Am J Public Health. 2002;92:437–442) PMID:11867326

Supplementation of Vitamin D Deficiency in Patients with Neuroendocrine Tumors Using Over-the-Counter Vitamin D3 Preparations.

PubMed

Robbins, Helen L; Symington, Megan; Mosterman, Barbara; Goodby, Josie; Davies, Louise; Dimitriadis, Georgios K; Kaltsas, Gregory; Randeva, Harpal S; Weickert, Martin O

2018-05-21

Vitamin D (vit-D) deficiency is highly prevalent in patients with gastro-entero-pancreatic neuroendocrine tumors (GEP-NET) and has been linked to reduced overall survival. We here assessed the vit-D status in 183 patients with GEP-NET at the time of their first presentation in the ARDEN NET Centre. We further examined the effect of simple advice to increase vit-D intake using over-the-counter vit-D preparations [colecalciferol (Vit-D3), 1,000-2,000 units/day], over a prospective observation period of 24 mo. At baseline, only 33.3% of patients showed vit-D sufficiency (25-OH-vit-D; >50 nmol/L), the remainder was insufficient (31.3%; 25-OH-vit-D; 25-50 nmol/L) or deficient (35.5%; 25-OH-vit-D; <25 nmol/L). Repeated advice to increase vit-D intake at routine 6-monthly follow-up appointments was associated with increased 25-OH-vit-D from 37.8 ± 3.5 nmol/L at baseline to 60.4 ± 5.6 nmol/L (P < 0.0001) and 56.8 ± 7.0 nmol/L (P = 0.039) after 12 and 24 mo. Percentage of vit-D insufficiency decreased from 66.6% at baseline to 44.9% and 46.2% after 12 and 24 months, respectively. Previous abdominal surgery, but not treatment with somatostatin analogues predicted 25-OH-vit-D levels in bootstrapped linear regression analyses (P = 0.037). In summary, simple advice to increase vit-D intake using over-the-counter preparations was associated with significant improvement of vit-D deficiency/insufficiency, although, 15% of GEP-NET patients remained deficient and may benefit from additional measures of vit-D replacement.

Limited effectiveness of over-the-counter plant preparations used for the treatment of urinary tract infections as inhibitors of the urease activity from Staphylococcus saprophyticus.

PubMed

Deutch, C E

2017-05-01

Urease is a key virulence factor for the Gram-positive urinary tract pathogen Staphylococcus saprophyticus and a potential target for antimicrobial therapy. The enzyme from S. saprophyticus is unusual in that it does not contain cysteine at the active site. The aims of this study were to test 14 over-the-counter plant preparations as inhibitors of this urease and to determine whether they can prevent the increase in pH that normally occurs in bacterial cultures containing urea. Urease activity was measured colorimetrically by the formation of ammonium ions. The green tea and Uva-Ursi preparations reduced urease activity in a soluble extract of S. saprophyticus by more than 75%. Two herbal mixtures were weakly inhibitory and reduced activity by about 25%, but the other products had little or no effect. The green tea and Uva-Ursi extracts also inhibited urease activity in whole cells by more than 75%. One of the herbal products (WishGarden UTI) showed some inhibition of urease activity but the other (UTI Clear) did not. The green tea and Uva-Ursi preparations prevented the increase in pH that normally occurs when S. saprophyticus is grown in an artificial urine medium, but this was due primarily to bacterial death. The WishGarden UTI preparation could partially delay the pH increase while allowing some cells to remain viable. These results indicate that only a few of the commercially available over-the-counter plant preparations commonly used for the treatment of urinary tract infections (UTIs) can inhibit the urease activity from S. saprophyticus. While over-the-counter plant preparations may be considered an alternative to traditional antibiotics for the treatment of UTIs, they should be used with caution and a product should be matched to the properties of the virulence factors of the bacterial pathogen involved. © 2017 The Society for Applied Microbiology.

Over the counter (OTC) artificial tear drops for dry eye syndrome

PubMed Central

Pucker, Andrew D; Ng, Sueko M; Nichols, Jason J

2016-01-01

Background Over the counter (OTC) artificial tears historically have been the first line of treatment for dry eye syndrome and dry eye-related conditions like contact lens discomfort, yet currently we know little regarding the overall efficacy of individual, commercially available artificial tears. This review provides a much needed meta-analytical look at all randomized and quasi-randomized clinical trials that have analyzed head-to-head comparisons of OTC artificial tears. Objectives To evaluate the effectiveness and toxicity of OTC artificial tear applications in the treatment of dry eye syndrome compared with another class of OTC artificial tears, no treatment, or placebo. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2015, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to December 2015), EMBASE (January 1980 to December 2015), Latin American and Caribbean Health Sciences (LILACS) (January 1982 to December 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) and the US Food and Drugs Administration (FDA) website (www.fda.gov). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 4 December 2015. We searched reference lists of included trials for any additional trials not identified by the electronic searches. Selection criteria This review includes randomized controlled trials with adult participants who were diagnosed with dry eye, regardless of race and gender. We included trials in which the age of participants was not reported, and clinical trials comparing OTC artificial tears with another class of OTC artificial tears, placebo, or no treatment. This review did not

Over-the-Counter Agents for the Treatment of Occasional Disturbed Sleep or Transient Insomnia: A Systematic Review of Efficacy and Safety

PubMed Central

Culpepper, Larry; Wingertzahn, Mark A.

2015-01-01

Objective: To investigate the level of evidence supporting the use of common over-the-counter (OTC) agents (diphenhydramine, doxylamine, melatonin, and valerian) for occasional disturbed sleep or insomnia. Data sources: A systematic review of the literature was conducted on July 31, 2014, using MEDLINE (PubMed) and the search terms (insomnia OR sleep) AND (over*the*counter OR OTC OR non*prescription OR antihistamine OR doxylamine OR diphenhydramine OR melatonin OR valerian) with the filters English, human, and clinical trials. Study selection: Identified publications (from 2003 to July 31, 2014, following previous published literature reviews) that met the inclusion criteria were selected. The criteria included randomized placebo-controlled clinical studies that utilized overnight objective (polysomnography) or next-day participant-reported sleep-related endpoints and that were conducted in healthy participants with or without occasional disturbed sleep or diagnosed insomnia. Results: Measures of efficacy and tolerability were summarized for each study individually and grouped according to OTC agent: H1 antagonists or antihistamines (3 studies, diphenhydramine), melatonin (8), and valerian or valerian/hops (7). Of the 3 sleep agents, studies conducted with melatonin, especially prolonged-release formulations in older individuals with diagnosed insomnia, demonstrated the most consistent beneficial effects (vs placebo) on sleep measures, specifically sleep onset and sleep quality, with favorable tolerability. In contrast, the clinical trial data for diphenhydramine, immediate-release melatonin, and valerian suggested limited beneficial effects. Conclusions: A review of randomized controlled studies over the past 12 years suggests commonly used OTC sleep-aid agents, especially diphenhydamine and valerian, lack robust clinical evidence supporting efficacy and safety. PMID:27057416

The Impact of Restricting Over-the-Counter Sales of Antimicrobial Drugs

PubMed Central

Moura, Maria Luísa; Boszczowski, Icaro; Mortari, Naíma; Barrozo, Lígia Vizeu; Neto, Francisco Chiaravalloti; Lobo, Renata Desordi; Pedroso de Lima, Antonio Carlos; Levin, Anna S.

2015-01-01

Abstract To describe the nationwide impact of a restrictive law on over-the-counter sales of antimicrobial drugs, implemented in Brazil in November 2010. Approximately 75% of the population receives healthcare from the public health system and receives free-of-charge medication if prescribed. Total sales in private pharmacies as compared with other channels of sales of oral antibiotics were evaluated in this observational study before and after the law (2008–2012). Defined daily dose per 1000 inhabitants per day (DDD/TID) was used as standard unit. In private pharmacies the effect of the restrictive law was statistically significant (P < 0.001) with an estimated decrease in DDD/TID of 1.87 (s.e. =  0.18). In addition, the trend of DDD/TID before the restrictive law was greater than after the intervention (P < 0.001). Before November 2010, the slope for the trend line was estimated as 0.08 (s.e. = 0.01) whereas after the law, the estimated slope was 0.03 (s.e. = 0.01). As for the nonprivate channels, no difference in sales was observed (P = 0.643). The impact in the South and Southeast (more developed) regions was higher than in the North, Northeast, and Mid-West. The state capitals had a 19% decrease, compared with 0.8% increase in the rest of the states. Before the law, the sales of antimicrobial drugs were steadily increasing. From November 2010, with the restrictive law, there was an abrupt drop in sales followed by an increase albeit at a significantly lower rate. The impact was higher in regions with better socio-economic status. PMID:26402824

Usage patterns of 'over-the-counter' vs. prescription-strength nonsteroidal anti-inflammatory drugs in France.

PubMed

Duong, Mai; Salvo, Francesco; Pariente, Antoine; Abouelfath, Abdelilah; Lassalle, Regis; Droz, Cecile; Blin, Patrick; Moore, Nicholas

2014-05-01

Most risks of nonsteroidal anti-inflammatory drugs (NSAIDs) are pharmacological, dose and duration dependent. Usage patterns of prescription-only (POM) or 'over-the-counter (OTC)' NSAIDs may influence risks, but are not commonly described. The Echantillon Généraliste de Bénéficiaires database, the permanent 1/97 representative sample from the French national healthcare insurance systems, was queried over 2009-2010 to identify usage patterns, concomitant chronic diseases and cardiovascular medication in OTC and POM NSAID users. Over 2 years, 229 477 of 526 108 patients had at least one NSAID dispensation; 44 484 patients (19%) were dispensed only OTC NSAIDs (93% ibuprofen) and 121 208 (53%) only POM NSAIDs. The OTC users were younger (39.9 vs. 47.4 years old) and more often female (57 vs. 53%); 69% of OTC users and 49% of POM users had only one dispensation. A mean of 14.6 defined daily doses (DDD) were dispensed over 2 years for OTC vs. 53 for POM; 93% OTC vs. 60% POM patients bought ≤ 30 DDD over 2 years, and 1.5 vs. 12% bought ≥ 90 DDD. Chronic comorbidities were found in 19% of OTC users vs. 28% of POM users; 24 vs. 37% had at least one dispensation of a cardiovascular drug over the 2 years. Most of the use of NSAIDs appears to be short term, especially for OTC-type NSAIDs, such as ibuprofen. The validity of risk estimates for NSAIDs extrapolated from clinical trials or from observational studies not including OTC-type usage may need to be revised. © 2013 The British Pharmacological Society.

Over the counter drugs (and dietary supplement) exercise: a team-based introduction to biochemistry for health professional students.

PubMed

Phadtare, Sangita; Abali, Emine; Brodsky, Barbara

2013-01-01

For successful delivery of basic science topics for health-professional students, it is critical to reduce apprehension and illustrate relevance to clinical settings and everyday life. At the beginning of the Biochemistry course for Physician Assistants, a team-based assignment was designed to develop an understanding of the mechanism of action, effectiveness, and toxicity of five common over the counter (OTC) drugs and dietary supplements, and place these familiar medicines in a political and historical context. The objectives of this exercise were to stimulate interest in biochemistry; to provide basic information on enzymes and enzyme inhibitors related to these drugs to be expanded upon later in the course; and to encourage active and interactive learning. Teams of five students were formed, and each student was given an information sheet on aspirin, alpha-galactosidase, orlistat, dextromethorphan, or simvastatin, a low dose statin, which was previously available without prescription at pharmacies in the UK. After each member of the team acquired information on one OTC drug/dietary supplement by reading an assigned information sheet, the team was asked to go through a series of questions, and then submit answers to a quiz as a group. A high rate of success on the quiz, an overwhelmingly positive response on formal course evaluations, and enthusiastic exchanges during class suggested this team-based session accomplished its goals. Copyright © 2013 Wiley-Liss, Inc.

Safe Sleep Guideline Adherence in Nationwide Marketing of Infant Cribs and Products.

PubMed

Kreth, Matthew; Shikany, Tammy; Lenker, Claire; Troxler, R Bradley

2017-01-01

Sudden infant death syndrome and sleep-related sudden unexpected infant death remain leading causes of infant mortality in the United States despite 4 safe sleep guideline restatements over the previous 24 years. Advertising and retail crib displays often promote infant sleep environments that are counter to the most recent American Academy of Pediatrics (AAP) guidelines. Magazine advertisements featuring sleep in parenting magazines from 1992, 2010, and 2015 were reviewed for adherence. Crib displays from nationwide retailers were surveyed for adherence to the latest AAP safe sleep guidelines. The primary outcome was adherence to the guidelines. Of 1758 retail crib displays reviewed, only half adhered to the latest AAP guidelines. The most common reasons for nonadherence were the use of bumper pads and loose bedding. The depiction of infant cribs and sleep products in magazine advertising has become significantly more adherent over time; however, 35% of current advertisements depict nonadherent, unsafe sleep environments. Magazine advertising portraying safe sleep environments revealed racial and ethnic disparities. Although improvements have been made over time with increased adherence to AAP safe sleep guidelines, significant deficiencies remain. Advertising continues to depict unsafe sleep environments. Crib manufacturers and retail establishments continue to market and sell bedding and sleep products considered unsafe by the AAP in approximately half of retail crib displays. Pediatric and public health care providers should continue educational and advocacy efforts aimed at the public, but should also include retailers, manufacturers, and advertising professionals to foster improved sleep environments for all children. Copyright © 2017 by the American Academy of Pediatrics.

Gender dysphoria and the controversy over the Safe Schools program.

PubMed

Parkinson, Patrick

2017-10-01

The Safe Schools program has attracted great controversy. On one end of the spectrum, it is defended as an anti-bullying program for young people who identify themselves as gay or lesbian, or have issues concerning their gender identity. On the other end of the spectrum, it is regarded as social engineering. This article seeks to promote a discussion of the way in which gender identity issues are addressed in the Safe Schools program. It is argued that the information in this program to Principals, teachers and young people is inaccurate and misleading. The program, as presently designed, may actually cause harm to children and young people who experience gender identity issues because it promotes gender transitioning without expert medical advice. The Safe Schools materials do not acknowledge that the great majority of children resolve gender dysphoria issues around the time of puberty. It may be much more difficult for a child to accept his or her gender at puberty if he or she has already changed name and gender identity in primary school. These deficits need to be addressed if the program is to continue.

Occurrence of phthalate esters in over-the-counter medicines from China and its implications for human exposure.

PubMed

Jia, Lu-Lu; Lou, Xiang-Ying; Guo, Ying; Leung, Kelvin Sze-Yin; Zeng, Eddy Y

2017-01-01

Food, air, personal care products and indoor dust have been recognized as the main routes of exposure to phthalates in Chinese population, but other sources may have been overlooked, e.g., medicines. To fill the knowledge gap, phthalate esters were measured in 96 over-the-counter medicines made in China, including selected 71 Chinese patented medicines and 25 western medicines. It was found that none of the medicines was free of phthalates. The mean concentrations of individual phthalates ranged from 0.001μg/g (dicyclohexyl phthalate) to 5.85μg/g (diethyl phthalate). Among 9 targeted phthalates, di-n-butyl phthalate was the dominant congener, accounting for >65% of the total phthalates in all medicine samples, followed by di-(2-ethylhexyl) phthalate and diethyl phthalate. Phthalates in medicines appeared to derive from gastroresistant film coatings, plastic packing materials or phthalate contaminated rural herbal plants (especially for Chinese patented medicines). Daily human exposure to phthalates was estimated for local patients for one treatment cycle (e.g., one week) based on suggested consumption dosage and phthalate concentrations. Almost all exposure levels were below the guidelines suggested by the United States Environmental Protection Agency or European Food Safety Authority, indicating low health risk with phthalates from consumption of the medicines. In addition, concentration levels of phthalates in patients would increase upon administration but are expected to decrease to the same values as those in patients before they took medicines in several days. Because the number of medicine samples was limited and the concentrations of phthalates varied in a large range, further investigations are needed to acquire more data for better assessment of human health effects for Chinese population. Capsule: Distribution of phthalate esters in over-the-counter medicines and related exposure for Chinese population are examined. Copyright © 2016 Elsevier Ltd

An experimental study of a change from over-the-counter to self-service sales of alcoholic beverages in monopoly outlets.

PubMed

Skog, O J

2000-01-01

To evaluate if a change from over-the-counter to self-service sales of alcoholic beverages in monopoly outlets has an impact on the sales volume. Fourteen Swedish towns were selected, each having only one state-run monopoly shop selling alcoholic beverages. Seven pairs were formed by matching towns in terms of demographic and economic criteria, and according to sales of alcoholic beverages. Within each pair, one town continued with the traditional over-the-counter sales, while the other switched to self-service sales of beer, wine and spirits. This was decided by randomization. The effect of switching to self-service was evaluated by comparing monthly sales volume of experimental and control towns over an extended period of time. In order to evaluate changes due to transfer of customers from neighboring towns, the sales statistics in these towns were analyzed. In two towns, this transfer was also evaluated with the aid of customer surveys before and after the change. It was found that the change produced an increase in sales volume of 17%. The increase was permanent. Approximately one half of the increase could be explained by an inflow of new customers from neighboring towns. The self-service shops became quite popular among the customers, and sales volume increased substantially. About one half of the increase appears to be due to new customers from neighboring towns. The remaining increase may be due to increased consumption by the local residents. Thus, the results seem to confirm the hypothesis that the physical availability of alcoholic beverages may affect consumption levels.

Fuel temperature counter

Treesearch

John R. Murray; Charles W. Philpot

1963-01-01

Fuel temperature is and has always been difficult to measure. To understand better the problem of fire and fire weather behavior, it is important to measure this variable. We have developed for field use a new fuel temperature counter which can be used to obtain such measurements quickly and easily. This electronic recording instrument is easy to construct and operate...

Forward shower counters for diffractive physics at the LHC

NASA Astrophysics Data System (ADS)

Albrow, Michael; Collins, Paula; Penzo, Aldo

2014-11-01

The LHC detectors have incomplete angular coverage in the forward direction, for example in the region 6 ≲ |η| ≲ 8, which can be improved with the addition of simple scintillation counters around the beam pipes about 50 m to 120 m from the intersection point. These counters detect showers created by particles hitting the beam pipes and nearby material. The absence of signals in these counters in low pileup conditions is an indication of a forward rapidity gap as a signature of diffraction. In addition, they can be used to detect hadrons from low mass diffractive excitations of the proton, not accompanied by a leading proton but adjacent to a rapidity gap over (e.g.) 3 ≲ |η| ≲ 6. Such a set of forward shower counters, originally used at CDF, was used in CMS (FSC) for high-β* running with TOTEM during LHC Run-1. During LS1 the CMS FSC system is being upgraded for future low pileup runs. A similar system, called HERSCHEL is being installed in LHCb. ALICE is implementing scintillation counters, ADA and ADC, with 4.5 ≲ |η| ≲ 6.4.

Hematology and pathology devices; reclassification of the automated differential cell counter. Final rule.

PubMed

2002-01-14

The Food and Drug Administration (FDA) is reclassifying the automated differential cell counter (ADCC) from class III (premarket approval) into class II (special controls). FDA is also identifying the guidance document entitled "Class II Special Controls Guidance Document: Premarket Notifications for Automated Differential Cell Counters for Immature or Abnormal Blood Cells; Final Guidance for Industry and FDA" as the special control that the agency believes will reasonably ensure the safety and effectiveness of the device. This reclassification is being undertaken based on new information submitted in a reclassification petition from the International Society for Laboratory Hematology (ISLH), under the Federal Food, Drug, and Cosmetic Act (the act), as amended by the Safe Medical Devices Act of 1990 and the FDA Modernization Act of 1997.

A Model of Consumer Response to Over-the-Counter Drug Advertising: Antecedents and Influencing Factors.

PubMed

Huh, Jisu; Delorme, Denise E; Reid, Leonard N

2016-01-01

Given the importance of over-the-counter (OTC) drugs in the health care marketplace and lack of systematic research on OTC drug advertising (OTCA) effects, this study tested a theory-based, product category-specific OTCA effects model. Structural equation modeling analysis of data for 1 OTC drug category, analgesics, supported the proposed model, explaining the OTCA effect process from key consumer antecedents to ad involvement, from ad involvement to ad attention, from ad attention to cognitive responses, then to affective/evaluative responses, leading to the final behavioral outcome. Several noteworthy patterns also emerged: (a) Product involvement was directly linked to ad attention, rather than exerting an indirect influence through ad involvement; (b) ad attention was significantly related to both cognitive and affective/evaluative responses to different degrees, with stronger links to cognitive responses; and (c) ad-prompted actions were influenced by both ad trust and ad attitude.

Data Safe Havens and Trust: Toward a Common Understanding of Trusted Research Platforms for Governing Secure and Ethical Health Research

PubMed Central

Nicholls, Jacqueline; Dobbs, Christine; Sethi, Nayha; Cunningham, James; Ainsworth, John; Heaven, Martin; Peacock, Trevor; Peacock, Anthony; Jones, Kerina; Laurie, Graeme; Kalra, Dipak

2016-01-01

In parallel with the advances in big data-driven clinical research, the data safe haven concept has evolved over the last decade. It has led to the development of a framework to support the secure handling of health care information used for clinical research that balances compliance with legal and regulatory controls and ethical requirements while engaging with the public as a partner in its governance. We describe the evolution of 4 separately developed clinical research platforms into services throughout the United Kingdom-wide Farr Institute and their common deployment features in practice. The Farr Institute is a case study from which we propose a common definition of data safe havens as trusted platforms for clinical academic research. We use this common definition to discuss the challenges and dilemmas faced by the clinical academic research community, to help promote a consistent understanding of them and how they might best be handled in practice. We conclude by questioning whether the common definition represents a safe and trustworthy model for conducting clinical research that can stand the test of time and ongoing technical advances while paying heed to evolving public and professional concerns. PMID:27329087

Countering Others’ Insurgencies: Understanding U.S. Small-Footprint Interventions in Local Context

DTIC Science & Technology

2014-01-01

gover - nance play crucial roles in explaining the multiplicity of counterinsur- gency strategies the state has adopted over the past decade. Later in...because of its weak economy, level of development, political capacity, and quality of gover - nance.10 In Table 2.2 of Chapter Two, Pakistan is identified...concluded (see Figure 5.2) and checkpoints also provided a safe environment for the revitalization of the cosmetic, agriculture, and tourism industries

The influence of need for cognition and principal display panel factors on over-the-counter drug facts label comprehension.

PubMed

Catlin, Jesse R; Pechmann, Cornelia; Brass, Eric P

2012-01-01

Nearly all work aimed at optimizing the ability of labeling to communicate over-the-counter (OTC) drug information has focused on back-of-the-package characteristics, such as the Drug Facts label. The effects of front of the package, or principal display panel (PDP) factors, have largely been neglected by researchers. Similarly, heterogeneity in consumers' approach to new information has received scant attention in the context of OTC drugs. This preliminary study tested the hypothesis that display of a drug's brand name on the PDP and individuals' need for cognition influence comprehension of Drug Facts label information. University students (n = 212) that had experienced heartburn but not used the drug class being studied constituted the primary analysis cohort. Students were randomly assigned to review one of two PDPs (brand name or generic), followed by a Drug Facts label and a series of questions related to selection and usage of the drug. Participants with low need for cognition were influenced by the brand name PDP, as those exposed to a PDP featuring a brand (vs. generic) spent less time reading the Drug Facts label and demonstrated lower comprehension of the label information on proper drug selection. These findings suggest that further research is needed to understand the impact of PDP contents and cognitive characteristics of consumers on the communication of OTC drug information. Health care providers should consider communication strategies that account for the challenges patients face in using OTC drugs properly.

Distributed performance counters

DOEpatents

Davis, Kristan D; Evans, Kahn C; Gara, Alan; Satterfield, David L

2013-11-26

A plurality of first performance counter modules is coupled to a plurality of processing cores. The plurality of first performance counter modules is operable to collect performance data associated with the plurality of processing cores respectively. A plurality of second performance counter modules are coupled to a plurality of L2 cache units, and the plurality of second performance counter modules are operable to collect performance data associated with the plurality of L2 cache units respectively. A central performance counter module may be operable to coordinate counter data from the plurality of first performance counter modules and the plurality of second performance modules, the a central performance counter module, the plurality of first performance counter modules, and the plurality of second performance counter modules connected by a daisy chain connection.

Use of multicriteria decision analysis for assessing the benefit and risk of over-the-counter analgesics.

PubMed

Moore, Andrew; Crossley, Anne; Ng, Bernard; Phillips, Lawrence; Sancak, Özgür; Rainsford, K D

2017-10-01

To test the ability of a multicriteria decision analysis (MCDA) model to incorporate disparate data sources of varying quality along with clinical judgement in a benefit-risk assessment of six well-known pain-relief drugs. Six over-the-counter (OTC) analgesics were evaluated against three favourable effects and eight unfavourable effects by seven experts who specialise in the relief of pain, two in a 2-day facilitated workshop whose input data and judgements were later peer-reviewed by five additional experts. Ibuprofen salts and solubilised emerged with the best benefit-risk profile, followed by naproxen, ibuprofen acid, diclofenac, paracetamol and aspirin. Multicriteria decision analysis enabled participants to evaluate the OTC analgesics against a range of favourable and unfavourable effects in a group setting that enabled all issues to be openly aired and debated. The model was easily communicated and understood by the peer reviewers, so the model should be comprehensible to physicians, pharmacists and other health professionals. © 2017 Royal Pharmaceutical Society.

Counter-rotating accretion discs

NASA Astrophysics Data System (ADS)

Dyda, S.; Lovelace, R. V. E.; Ustyugova, G. V.; Romanova, M. M.; Koldoba, A. V.

2015-01-01

Counter-rotating discs can arise from the accretion of a counter-rotating gas cloud on to the surface of an existing corotating disc or from the counter-rotating gas moving radially inwards to the outer edge of an existing disc. At the interface, the two components mix to produce gas or plasma with zero net angular momentum which tends to free-fall towards the disc centre. We discuss high-resolution axisymmetric hydrodynamic simulations of viscous counter-rotating discs for the cases where the two components are vertically separated and radially separated. The viscosity is described by an isotropic α-viscosity including all terms in the viscous stress tensor. For the vertically separated components, a shear layer forms between them and the middle part of this layer free-falls to the disc centre. The accretion rates are increased by factors of ˜102-104 over that for a conventional disc rotating in one direction with the same viscosity. The vertical width of the shear layer and the accretion rate are strongly dependent on the viscosity and the mass fraction of the counter-rotating gas. In the case of radially separated components where the inner disc corotates and the outer disc rotates in the opposite direction, a gap between the two components opens and closes quasi-periodically. The accretion rates are ≳25 times larger than those for a disc rotating in one direction with the same viscosity.

Counter-responses as organizers in adolescent analysis and therapy.

PubMed

Richmond, M Barrie

2004-01-01

The author introduces Counter-response as a phenomological term to replace theory-burdened terms like counter-transference, counter-identification, and counter-resistance. He discusses the analyst's use of self (drawing on the comparison with Winnicott's use of the object) in processing the expectable destabilizing counter-reactions that occur in working therapeutically with disturbed adolescents and their parents. Further; he discusses the counter-reaction to the patient's narrative, acting-out, and how re-enactments can serve as an organizer for understanding the patient's inner life when the analyst formulates his/her counter-response. Emphasis is placed on the therapist forming his or her own narrative with the adolescent that takes into account the evoked counter-reaction. For this purpose, the author recommends the use of a combined counter-response and metaphor-orienting perspective to acknowledge and work with the denial, illusions, reversal of perspective, and catastrophic anxieties experienced with these adolescents. The counter-response perspective permits the emergence of the disturbed adolescent's novel narrative; however, since these experiences can be destabilizing or disruptive, the author also recommends the use of a personal metaphor to anticipate the reluctance to examining, processing, and formulating the analyst's dysphoric counter-reaction. With the use of the counter-response, the analyst's therapeutic ideal is to achieve a more optimal balance between using accepted narrative theories and exploring novel enactment experiences. His swimming metaphor stratagem is designed to keep the analyst in these difficult encounters.

Finding Queer Allies: The Impact of Ally Training and Safe Zone Stickers on Campus Climate

ERIC Educational Resources Information Center

Ballard, Stephanie L.; Bartle, Eli; Masequesmay, Gina

2008-01-01

To counter heterosexism, homophobia, and gender binarism in higher education, "safe zone" or "ally" programs are efforts by American universities to create a welcoming environment for lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) members of the campus community. This study describes perceptions of campus…

Prices of over-the-counter drugs used by 15-year-old adolescents in Germany and their association with socioeconomic background.

PubMed

Italia, Salvatore; Wolfenstetter, Silke B; Brüske, Irene; Heinrich, Joachim; Berdel, Dietrich; von Berg, Andrea; Lehmann, Irina; Standl, Marie; Teuner, Christina M

2017-11-25

In Germany, over-the-counter (OTC) drugs are normally reimbursed up to the age of 12 years only. The aim of this study was to analyse prices of over-the-counter drugs used by adolescents in Germany and their association with socioeconomic factors. Based on the German GINIplus and LISAplus birth cohorts, data on drug utilization among 15-year-old adolescents (n = 4677) were collected using a self-administered questionnaire. The reported drugs were subdivided into prescription drugs and OTC drugs. The drugs' prices were tracked by the pharmaceutical identification numbers. Overall, 1499 OTC drugs with clearly identifiable prices were eligible for analysis. Their mean price was €9.75 (95% confidence interval: €9.27-10.22). About 75% of the OTC drugs cost less than €10. Higher mean prices were associated with residing in Munich (€10.74; 95% confidence interval: €9.97-11.52) and with higher paternal education (e.g. highest education level: €10.17; 95% confidence interval: €9.47-10.86). Adolescents residing in Munich (in comparison with the less wealthy region of Wesel) and adolescents with higher educated fathers were also significantly more likely to use OTC drugs costing ≥ €10 or ≥ €25, respectively. The price of €10 for non-reimbursable OTC drugs may represent a (psychological) threshold. Higher prices could discourage especially adolescents from a lower socioeconomic background from taking medically advisable but non-reimbursable OTC drugs.

Hypercalcemia, hypervitaminosis A and 3-epi-25-OH-D3 levels after consumption of an "over the counter" vitamin D remedy. a case report.

PubMed

Granado-Lorencio, F; Rubio, E; Blanco-Navarro, I; Pérez-Sacristán, B; Rodríguez-Pena, R; García López, F J

2012-06-01

Intoxication from vitamin D supplements has been rarely reported but, nowadays, it occurs more frequently. 3-epi-25-OH-D(3) is highly prevalent in adults and it is considered of biological relevance. We report a case of vitamin D toxicity with hypercalcemia, acute renal failure and hypervitaminosis A after consuming an over-the-counter vitamin D supplement. Our data suggest that the contribution of 3-epi-25-OH-D(3) is not altered during vitamin D toxicity, although the serum levels of 25-OH-D(3) and 3-epi-25-OH-D(3) may display a different rate of clearance. The patient also displayed hypervitaminosis A unrelated to diet, possibly caused by renal failure related to the hypercalcemia induced by vitamin D toxicity. Because of the increasing use of over-the-counter vitamin D supplements and the potential iatrogenic hypercalcemia related to hypervitaminosis A, the present case highlights the importance of evaluating both the use of (non-) prescribed medication and vitamin A status during vitamin D toxicity. Copyright © 2012 Elsevier Ltd. All rights reserved.

Nitrous Oxide Production in Co- Versus Counter-Diffusion Nitrifying Biofilms

PubMed Central

Peng, Lai; Sun, Jing; Liu, Yiwen; Dai, Xiaohu; Ni, Bing-Jie

2016-01-01

For the application of biofilm processes, a better understanding of nitrous oxide (N2O) formation within the biofilm is essential for design and operation of biofilm reactors with minimized N2O emissions. In this work, a previously established N2O model incorporating both ammonia oxidizing bacteria (AOB) denitrification and hydroxylamine (NH2OH) oxidation pathways is applied in two structurally different biofilm systems to assess the effects of co- and counter-diffusion on N2O production. It is demonstrated that the diffusion of NH2OH and oxygen within both types of biofilms would form an anoxic layer with the presence of NH2OH and nitrite ( ), which would result in a high N2O production via AOB denitrification pathway. As a result, AOB denitrification pathway is dominant over NH2OH oxidation pathway within the co- and counter-diffusion biofilms. In comparison, the co-diffusion biofilm may generate substantially higher N2O than the counter-diffusion biofilm due to the higher accumulation of NH2OH in co-diffusion biofilm, especially under the condition of high-strength ammonium influent (500 mg N/L), thick biofilm depth (300 μm) and moderate oxygen loading (~1–~4 m3/d). The effect of co- and counter-diffusion on N2O production from the AOB biofilm is minimal when treating low-strength nitrogenous wastewater. PMID:27353382

Nitrous Oxide Production in Co- Versus Counter-Diffusion Nitrifying Biofilms

NASA Astrophysics Data System (ADS)

Peng, Lai; Sun, Jing; Liu, Yiwen; Dai, Xiaohu; Ni, Bing-Jie

2016-06-01

For the application of biofilm processes, a better understanding of nitrous oxide (N2O) formation within the biofilm is essential for design and operation of biofilm reactors with minimized N2O emissions. In this work, a previously established N2O model incorporating both ammonia oxidizing bacteria (AOB) denitrification and hydroxylamine (NH2OH) oxidation pathways is applied in two structurally different biofilm systems to assess the effects of co- and counter-diffusion on N2O production. It is demonstrated that the diffusion of NH2OH and oxygen within both types of biofilms would form an anoxic layer with the presence of NH2OH and nitrite ( ), which would result in a high N2O production via AOB denitrification pathway. As a result, AOB denitrification pathway is dominant over NH2OH oxidation pathway within the co- and counter-diffusion biofilms. In comparison, the co-diffusion biofilm may generate substantially higher N2O than the counter-diffusion biofilm due to the higher accumulation of NH2OH in co-diffusion biofilm, especially under the condition of high-strength ammonium influent (500 mg N/L), thick biofilm depth (300 μm) and moderate oxygen loading (~1-~4 m3/d). The effect of co- and counter-diffusion on N2O production from the AOB biofilm is minimal when treating low-strength nitrogenous wastewater.

Efficacy and safety of an over-the-counter transdermal nicotine patch as an aid for smoking cessation.

PubMed

Davidson, M; Epstein, M; Burt, R; Schaefer, C; Whitworth, G; McDonald, A

1998-01-01

To evaluate the efficacy and safety of a transdermal nicotine patch as an aid for smoking cessation in an over-the-counter setting. Multicenter, double-blind, randomized, placebo-controlled trial of 6-week duration with 18 weeks of follow-up. Four shopping mall precincts. The randomized sample consisted of 802 adults (mean age, 39 years) and was 89% white and 54% female. A smoking history of at least 20 cigarettes per day for 1 year and a score of 5 (on a 10-point scale) on a motivational assessment questionnaire were required for enrollment. Poststudy follow-up was limited to those who had quit smoking at the end of 6 weeks. Nicotine patches were provided at the shopping mall. Guidance consisted only of package instructions and a smoking cessation self-help booklet. Quit rates were defined as total abstinence from smoking for 4 consecutive weeks (treatment weeks 3-6), point prevalence smoking status at week 6, or nonsmoker at week 6 and week 24 (6-month postquit date). Smoking status was assessed by diaries, and verification for the first 2 quit rates was obtained by confirmation of carbon monoxide of 8 ppm or less in expired breath. Safety was evaluated by self-reported adverse events. Quit rate was 12% for the active treatment group and 5.5% for the placebo group, based on total abstinence for 4 consecutive weeks (P = .001) compared with quit rates of 19.5% and 7.5% for active treatment and placebo groups, respectively, based on point prevalence data at week 6. At 24 weeks, 8.2% of nonsmokers in the active treatment group and 4.0% in the placebo group remained nonsmokers. At least 1 adverse event was reported by 57% receiving the nicotine patch and 39% receiving placebo (P<.001). When the nicotine patch was used in an over-the-counter setting, quit rates were comparable to those reported for medical settings. A 2:1 quit rate advantage was achieved at week 6 and was maintained at 24 weeks.

Over-the-counter sales of out-of-state and counterfeit tax stamp cigarettes in New York City.

PubMed

Silver, Diana; Giorgio, Margaret M; Bae, Jin Yung; Jimenez, Geronimo; Macinko, James

2016-09-01

New York City (NYC) has strict minimum cigarette price and tax stamp laws, but evidence regarding the extent of evasion of such laws in over-the-counter sales is scarce. 830 packs were purchased at licensed tobacco retailers at 92 randomly selected neighbourhoods in NYC in spring and fall 2014, following the establishment of NYC's minimum price law. The χ(2) analyses of illegal tax stamps on pack, by retailer type and data collection period, are presented. Over 15% of packs purchased had out-of-state (4.5%) or counterfeit tax stamps (10.6%). Purchases resulted in at least one illegal pack obtained in 70% of neighbourhoods, largely from independent stores. In 21.5% of sampled neighbourhoods, it was possible to purchase an illegal pack each collection period. Enhanced enforcement of retail sales of cigarettes is needed to ensure the full benefit of existing tobacco control laws in NYC. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effectiveness of FDA's new over-the-counter acetaminophen warning label in improving consumer risk perception of liver damage.

PubMed

Goyal, R K; Rajan, S S; Essien, E J; Sansgiry, S S

2012-12-01

The Food and Drug Administration (FDA) issued new organ-specific warning label requirements for over-the-counter (OTC) analgesic products in order to make consumers aware of the risk of liver damage when using acetaminophen. However, awareness of a health risk alone cannot ensure consumers' engagement in safe and preventive behaviour. In this study, we attempted to: (i) measure consumer risk perception of liver damage due to the OTC acetaminophen products and (ii) analyse the effectiveness of the new organ-specific warning label in improving consumer risk perception of liver damage and intention to perform protective behaviours while using OTC acetaminophen products. This within-subject experimental study used a convenience sample of English-speaking adults visiting OTC segments of selected pharmacy stores in Houston. Participants were randomly exposed to the old and new warning labels and their respective risk perception (measured on a visual analogue scale, 0%, no risk, to 100%, extreme risk) and behavioural intention (measured on a 7-point Likert scale) were recorded using a validated, self-administered questionnaire. Descriptive statistics and non-parametric Wilcoxon signed-rank tests were performed using sas statistical software (v 9.2) at a priori significance level of 0.05. Majority of participants (74.4%) were not aware of the new warnings; however, majority (67.8%) had prior knowledge of the risk. The mean risk perception score for the new warning label was found to be significantly higher (72.2% vs. 65.9%, P < 0.0001) than the old warning label. Similarly, the average intention score for the new warning label was significantly higher (5.06 vs. 4.86, P < 0.0001) than the old warning label. The new warning label mandated by FDA is effective in improving consumer risk perception of potential liver damage and may encourage protective behaviour. However, future studies are essential to assess the impact of the new label on actual changes in consumer behaviour

Effect of angular inflow on the vibratory response of a counter-rotating propeller

NASA Technical Reports Server (NTRS)

Turnberg, J. E.; Brown, P. C.

1985-01-01

This report presents the results of a propeller vibratory stress survey on the Fairey Gannet aircraft aimed at giving an assessment of the difference in vibratory response between single and counter-rotating propeller operation in angular inflow. The survey showed that counter-rotating operation of the propeller had the effect of increasing the IP response of the rear propeller by approximately 25 percent over comparable single-rotation operation while counter-rotating operation did not significantly influence the IP response of the front propeller.

Predictors of recall of over-the-counter and prescription non-steroidal anti-inflammatory drug exposure.

PubMed

Lewis, James D; Strom, Brian L; Kimmel, Stephen E; Farrar, John; Metz, David C; Brensinger, Colleen; Nessel, Lisa; Localio, A Russell

2006-01-01

Because of the difficulty in establishing a gold standard, data on accuracy of recall of over-the-counter (OTC) medication use are sparse. We studied a cohort of 1889 persons living in the Philadelphia area to assess recall of non-aspirin non-steroidal anti-inflammatory drug (NANSAID) use during the preceding 8 weeks. Our analyses were based on the assumption that among the group of subjects, on average, the reported usage of NANSAIDs should not vary over the previous 8 weeks. To model the effect of time on reported usage while allowing for the inherent correlation of responses within subjects over time, we employed alternating logistic regression. We documented a significant decline in reported use of OTC NANSAIDs but not prescription NANSAIDs during the 8-week study period (p = 0.3 for frequent prescription NANSAIDs, p = 0.2 for infrequent prescription NANSAIDs, p < 0.001 for frequent OTC NANSAIDs, and p < 0.001 for infrequent OTC NANSAIDs). Reported rates of frequent and infrequent OTC NANSAID consumption declined from 6.3 to 4.6% and from 17.1 to 12.8% between the most recent week and eight weeks prior, respectively. Interviews focusing on medications used on an as needed basis should be performed as close as possible to the index date. Likewise, data on frequent use of OTC NANSAIDs may be more reliable than that on infrequent use, particularly when subjects are asked to recall more than a few weeks back in time. (c) 2005 John Wiley & Sons, Ltd.

The effects of a customized over-the-counter mouth guard on neuromuscular force and power production in trained men and women.

PubMed

Dunn-Lewis, Courtenay; Luk, Hui-Ying; Comstock, Brett A; Szivak, Tunde K; Hooper, David R; Kupchak, Brian R; Watts, Ashley M; Putney, Brendan J; Hydren, Jay R; Volek, Jeff S; Denegar, Craig R; Kraemer, William J

2012-04-01

Although mouth guards were originally designed for injury prevention, even elite athletes are now using performance mouth guards to improve athletic success. Both expensive custom models and over-the-counter models are available, but the efficacy is not well known. Some athletes remain wary of the perceived potential for detriments using a mouth guard to their performance. Thus, the purpose of this study was to examine various physical performance tests when using a mouth guard including a customized over-the-counter mouth guard. Twenty-six trained men (25 ± 4 years; 1.78 ± 0.07 m; 83.3 ± 11.4 kg) and 24 trained women (23 ± 3 years; 1.65 ± 0.08 m; 62.6 ± 7.8 kg) volunteered for the investigation. The subjects completed a familiarization period and then balanced and randomized treatment conditions that included: (a) a customized Power Balance performance mouth guard (PB MG); (b) a regular over the counter boil-and-bite mouth guard (Reg MG); and (c) a no mouth guard (No MG) treatment condition. At each visit, the subjects completed a testing protocol that was sequenced in the following order: sit-and-reach flexibility, medial-lateral balance, visual reaction time, vertical jump, 10-m sprint, bench throw, and plyo press power quotient (3PQ). Heart rate and rating of perceived exertion (RPE) were recorded around the 3PQ. Significance was set at p ≤ 0.05. Expected significant sex differences existed for all power, strength, and speed variables. Bench throw power (watts) and force (newtons) were significantly higher under PB MG than either Reg MG or No MG or in both men and women. The 3PQ power and force production were higher than that for the other 2 treatments for the PB MG for men only. There were no significant differences for treatment conditions in the heart rate or RPE after the 3PQ test. Men were better able to maintain significantly higher 3PQ power production under PB MG treatment condition compared with the other 2 treatment conditions. Rate of power

Prevalence and predictors of over-the-counter medication use among adolescents in the United Arab Emirates.

PubMed

Barakat-Haddad, Caroline; Siddiqua, Ayesha

2018-01-02

The patterns of over-the-counter medication (OTC) usage among adolescents living in the United Arab Emirates (UAE) remains largely understudied. The objectives of this study are: (1) to determine the profile of OTC use among UAE adolescents; and (2) to determine the biological or physical, psychological or behavioural, and social predictors of OTC use among the UAE adolescent population. Using a cross-sectional study design, data were collected on the prevalence of OTC use for a sample of 6363 adolescents. Overall, 51% of participants in this study reported OTC use. The most common form of OTC used was acetaminophen. Significant predictors of OTC use were: nationality (UAE, GCC, Arab / Middle East, Arab / Africa, Western, other); needed health care but did not receive it; sex (female); age (15-18 years); any medical diagnosis; unconventional drug use; spending more than 5 hours using TV and computer daily; and using prescription medicines. Thus, there is a need to develop public health policies and strategies that promote appropriate use of OTC in the population.

Over-the-counter antibiotics in Saudi Arabia, an urgent call for policy makers.

PubMed

Bin Nafisah, Sharafaldeen; Bin Nafesa, Salahaldin; Alamery, Aliyah H; Alhumaid, Mazen A; AlMuhaidib, Haitham M; Al-Eidan, Fahad A

Antibiotics over-consumption is a pandemic that has a tremendous cost on the overwhelmed healthcare system. The accessibility of antibiotics coupled with the misconception of public toward those drugs both of which implicated in the use and misuse of antibiotics. The aim of this study was to investigate the perception of the community toward antibiotics, its purpose and harmfulness, in addition to the accessibility of those drugs as over the counter and without prescriptions. We also investigated the behavior toward antibiotic prescriptions when perceived unnecessary. This is a cross-sectional study in Riyadh-Saudi Arabia based upon a structured self-administered questionnaire. The study included 473 individuals with a mean age of 27 years old. Forty eight percent (n=227) of the participants obtain antibiotics without prescriptions. Ninety two percent (n=208) of those noted pharmacist counseling as their method of acquisition. Self-prescription noted in 8.4% (n=19). Viral illnesses accounted for the highest percentage for seeking antibiotics in 35.5% (n=166) more commonly among females. Thirty one point eight percent (n=149) used antibiotics for analgesia while 13.7% (n=64) believed in their prophylactic use. We also noted that the prevalence of sharing antibiotics is 19.7%. The perceived unnecessary prescriptions uncovered 122 of the participants who reported throwing the prescribed antibiotics away after acquisition. Dispensing antibiotics without prescription is an issue that mandates a political intervention and implementation of the existing laws that prohibit dispensing without proper prescription. We advocate public health measures targeting both healthcare providers and the public on the use and misuse of antibiotics. Copyright © 2017 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Consumer preferences for over-the-counter drug retailers in the reregulated Swedish pharmacy market.

PubMed

Håkonsen, Helle; Sundell, Karolina Andersson; Martinsson, Johan; Hedenrud, Tove

2016-03-01

Following a large regulatory reform in 2009, which ended the state's pharmacy monopoly, non-pharmacy retailers in Sweden today sell certain over-the-counter (OTC) drugs. The aim of this study was to investigate consumer preferences regarding OTC drug retailers and the reasons for choosing a pharmacy versus non-pharmacy retailer. We conducted a web survey aimed at Swedish adults. Out of a stratified sample of 4058 persons, 2594 agreed to take part (48% women; mean age: 50.3 years). Questions related to OTC drug use, retailer choice and factors affecting the participants' preferences for OTC drug retailers. Logistic regression was conducted to analyse OTC drug use and reasons for retailer choice in relation to sex, age and education. Nine in ten participants reported OTC drug use in the 6 months prior to the study. For their last OTC purchase, 76% had gone to a pharmacy, 20% to a grocery shop and 4% to a convenience store, gas station or online. Geographic proximity, opening hours and product range were reported as the most important factors in retailer choice. Counselling by trained staff was important to 57% of participants. The end of the state's pharmacy monopoly and the increase in number of pharmacies seem to have impacted more on Swedish consumers' purchase behaviours compared with the deregulation of OTC drug sales. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Comparison in dissolution behavior of ethical and over-the counter scopolamine butylbromide].

PubMed

Suzuki, Ichie; Miyazaki, Yasunori; Uchino, Tomonobu; Kagawa, Yoshiyuki

2011-01-01

Marketing authorization holders do not disclose any information on the pharmaceutical properties of over-the-counter drugs (OTC). When a drug is switched from a prescription drug to OTC, pharmacists can acquire that information from the corresponding ethical drug (ED) through the package insert, interview form, and so on. However, the pharmaceutical equivalence between ED and OTC is unclear. In this study, we examined the drug dissolution behavior of both ED and OTCs containing scopolamine butylbromide. Dissolution tests were performed by the paddle method using Japanese Pharmacopeia (JP) XV test fluids at pH 1.2, 4.0 and 6.8 and water based on the guidelines for bioequivalence studies of generic products. The dissolution profiles of OTCs differed significantly from ED showing a similarity factor (f2) value ranging from 8.9 to 42.9. Time until 85% dissolution ranged from 23 to 95 min and from 17 to 174 min at pH 1.2 and pH 6.8, respectively. Then JP XV disintegration tests were conducted to investigate differences in the disintegration process. The disintegration time of preparations showing delayed dissolution was prolonged compared to that of others, suggesting that the disintegration of the tablet or capsule is one of the important factors affecting the drug dissolution. These differences in the disintegration and drug dissolution might cause differences in the bioavailability of the drug. For patient safety, more detailed product information of OTCs should be supplied by the manufacturer, and not be assumed from that of corresponding ED.

An interactive technology approach to educate older adults about drug interactions arising from over-the-counter self-medication practices.

PubMed

Neafsey, Patricia J; Strickler, Zoe; Shellman, Juliette; Chartier, Virginia

2002-01-01

An interactive computer program (Personal Education Program [PEP]) designed for the learning styles and psychomotor skills of older adults was used to teach older adults about potential drug interactions that can result from self-medication with over-the-counter (OTC) agents and alcohol. Subjects used the PEP on notebook computers equipped with infrared sensitive touchscreens. Subjects were recruited from senior centers. Those who met age, vision, literacy, independence, and medication use criteria were randomly assigned to one of three groups: (1) PEP plus information booklet; (2) information booklet only; or (3) control. A repeated measures (three time periods 2 weeks apart), three-group design was used. Users of PEP had significantly greater knowledge and self-efficacy scores than both the conventional and control groups at all three time points. The PEP group reported fewer adverse self-medication behaviors over time. Reported self-medication behaviors did not change over time for either the conventional or control groups. Subjects indicated a high degree of satisfaction with the PEP and reported their intent to make specific changes in self-medication behaviors.

Workplace Violence in Early Childhood Settings: A Counter Narrative.

ERIC Educational Resources Information Center

Sumsion, Jennifer

Noting that portrayals of early childhood settings as communities of care distinguish them from other education contexts, this paper presents a counter-narrative that focuses on workplace tensions experienced by an Australian preschool teacher. The counter-narrative was informed by informal interviews held 4 times yearly over a period of 7 years…

DroidSafe

DTIC Science & Technology

2016-12-01

branches of our work . 3.1 Understanding Sensitive API Call and API Information Usage Android applications are written in a type- safe language (Java...directly invoke resolved targets. Because DroidSafe works with a comprehensive model of the Android environment , it supports precise resolution of...STATEMENT. FOR THE CHIEF ENGINEER: / S / / S / MARK K. WILLIAMS WARREN H. DEBANY, JR. Work Unit Manager

Safeguarding older adults from inappropriate over-the-counter medications: the role of community pharmacists.

PubMed

Chui, Michelle A; Stone, Jamie A; Martin, Beth A; Croes, Kenneth D; Thorpe, Joshua M

2014-12-01

To elicit the thought process or mental model that community pharmacists use when making recommendations on over-the-counter (OTC) medications to older adults and to elicit the current practices of community pharmacists in providing information, advice, and counseling to older adults about potentially inappropriate OTC medications. Three separate focus groups with pharmacists were conducted with 5 to 8 pharmacists per group. A vignette about an elderly woman seeking an OTC sleep aid was used to elicit information that pharmacists seek to establish when making a recommendation. Focus groups were recorded, transcribed verbatim, and analyzed for themes using the initial and focused coding methods of grounded theory. Community pharmacists' mental models were characterized by 2 similarities: a similarity in what community pharmacists seek to establish about patients and a similarity in when community pharmacists seek to establish it--the sequence in which they try to learn key details about patients. It was identified that pharmacists gather specific information about the patient's medication profile, health conditions, characteristics of the problem, and past treatments in order to make a recommendation. Community pharmacists recommended behavioral modifications and seeing their physician prior to recommending an OTC sleep aid, primarily due to medication safety concerns. Pharmacists can play a key role in assisting older adults to select and use OTC medications. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Over-the-Line: An Alternative Striking/Fielding Game for Understanding

ERIC Educational Resources Information Center

Gorecki, Jennifer J.

2004-01-01

Over-the-Line is a striking/fielding game designed from the perspective of the Games for Understanding tactical model to serve as an alternative to traditional kickball, softball, and baseball. Over-the-Line can be modified for developmental appropriateness and tasks can increase in complexity as tactical awareness is attained. This article shares…

Results on the Performance of a Broad Band Focussing Cherenkov Counter

DOE R&D Accomplishments Database

Cester, R.; Fitch, V. L.; Montag, A.; Sherman, S.; Webb, R. C.; Witherell, M. S.

1980-01-01

The field of ring imaging (broad band differential) Cherenkov detectors has become a very active area of interest in detector development at several high energy physics laboratories. Our group has previously reported on a method of Cherenkov ring imaging for a counter with large momentum and angular acceptance using standard photo multipliers. Recently, we have applied this technique to the design of a set of Cherenkov counters for use in a particle search experiment at Fermi National Accelerator Laboratory (FNAL). This new detector operates over the range 0.998 < ..beta.. < 1.000 in velocity with a delta..beta.. approx. 2 x 10{sup -4}. The acceptance in angle is +- 14 mrad in the horizontal and +- 28 mrad in the vertical. We report here on the performance of this counter.

FLEXIBLE GEIGER COUNTER

DOEpatents

Richter, H.G.; Gillespie, A.S. Jr.

1963-11-12

A flexible Geiger counter constructed from materials composed of vinyl chloride polymerized with plasticizers or co-polymers is presented. The counter can be made either by attaching short segments of corrugated plastic sleeving together, or by starting with a length of vacuum cleaner hose composed of the above materials. The anode is maintained substantially axial Within the sleeving or hose during tube flexing by means of polystyrene spacer disks or an easily assembled polyethylene flexible cage assembly. The cathode is a wire spiraled on the outside of the counter. The sleeving or hose is fitted with glass end-pieces or any other good insulator to maintain the anode wire taut and to admit a counting gas mixture into the counter. Having the cathode wire on the outside of the counter substantially eliminates the objectional sheath effect of prior counters and permits counting rates up to 300,000 counts per minute. (AEC)

Dandruff, seborrheic dermatitis, and psoriasis drug products containing coal tar and menthol for over-the-counter human use; amendment to the monograph. Final rule

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2006-03-15

The Food and Drug Administration (FDA) is issuing a final rule amending the final monograph (FM) for over-the-counter (OTC) dandruff, seborrheic dermatitis, and psoriasis drug products to include the combination of 1.8 percent coal tar solution and 1.5 percent menthol in a shampoo drug product to control dandruff. FDA did not receive any comments or data in response to its previously proposed rule to include this combination. This final rule is part of FDA's ongoing review of OTC drug products.

Counter-transference and counter-experience in the treatment of violence prone youth.

PubMed

King, C H

1976-01-01

The constant confrontation inherent in therapeutic intervention with violence prone children, some of whome have committed homicide, is explored. Problems unique to work with these youths are discussed in terms of counter-transference issues for clinicians and counter-experience of teachers and child care workers. Suggestions for training and supervision are offered.

76 FR 35619 - Labeling and Effectiveness Testing; Sunscreen Drug Products for Over-the-Counter Human Use

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

...The Food and Drug Administration (FDA) is issuing this document to address labeling and effectiveness testing for certain over-the counter (OTC) sunscreen products containing specified active ingredients and marketed without approved applications. This document addresses labeling and effectiveness testing issues raised by the nearly 2,900 submissions that we received in response to the sunscreen proposed rule of August 27, 2007 (2007 proposed rule). The document also identifies specific claims that render a product that is subject to this rule misbranded or would not be allowed on any OTC sunscreen product marketed without an approved application. The document does not address issues related to sunscreen active ingredients or certain other issues regarding the GRASE determination for sunscreen products. The document requires OTC sunscreen products to comply with the content and format requirements for OTC drug labeling contained in the 1999 Drug Facts final rule (published in the Federal Register of March 17, 1999, by lifting the delay of implementation date for that rule that we published on September 3, 2004).

Over-the-counter vaginal contraceptive and spermicide drug products containing nonoxynol 9; required labeling. Final rule.

PubMed

2007-12-19

The Food and Drug Administration (FDA) is issuing a final rule establishing new warning statements and other labeling information for all over-the-counter (OTC) vaginal contraceptive drug products (also known as spermicides, hereinafter referred to as vaginal contraceptives or vaginal contraceptives/spermicides) containing nonoxynol 9 (N9). These warning statements will advise consumers that vaginal contraceptives/spermicides containing N9 do not protect against infection from the human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), or against getting other sexually transmitted diseases (STDs). The warnings and labeling information will also advise consumers that use of vaginal contraceptives and spermicides containing N9 can irritate the vagina and rectum and may increase the risk of getting the AIDS virus (HIV) from an infected partner. This final rule is part of FDA's ongoing review of OTC drug products. FDA is issuing this final rule after considering public comments on its proposed regulation, and all relevant data and information on N9 that have come to our attention.

Limb lengthening over a nail can safely reduce the duration of external fixation

PubMed Central

Chaudhary, Milind

2008-01-01

Background: Limb lengthening using Ilizarov external fixation is safe, but the consolidation phase tends to take too long. A method that can safely reduce the time spent in external fixation would help increase patient tolerance and comfort. We report our results of lengthening over nails (LON) method in which an interlocking nail was used along with an Ilizarov external fixator to reduce external fixation duration in limb lengthening. This is a retrospective study. Materials and Methods: Twenty-seven lengthening surgeries were done with the LON method in 23 patients with 22 tibiae and five femora during the last 12 years. Length gain ranged from 1.5 cm to a maximum of 9.8 cm with a mean of 4.6 cm. The mean modified Paley difficulty score was 7.6 points. Fourteen associated procedures were performed in these patients, including equinus contracture releases, supracondylar osteotomies, ilizarov hip reonstruction and ankle fusion. We had a 29% rate of complications which included one problem, three obstacles and four complications with no serious deep intramedullary infections. Our rate of complications compares favorably with series reported in the literature. External fixation duration was reduced significantly to a mean of 17.8 days per cm. Conclusions: A combination of intramedullary nailing along with external fixation significantly reduces external fixation time while maintaining low rate of complications. Great care needs to be taken to prevent pin track infection and deep intramedullary sepsis. PMID:19753160

“Just Advil”: Harm reduction and identity construction in the consumption of Over-The-Counter medication for chronic pain Social Science & Medicine

PubMed Central

2015-01-01

Direct-to-consumer marketing has sparked ongoing debate concerning whether ads empower consumers to be agents of their own care or shift greater control to the pharmaceutical industry. Ads for over-the-counter (OTC) medications in particular portend to offer simple, harmless solutions for meeting the demands of social life. Rather than join the longstanding debate between consumer agency and social control in pharmaceutical advertising, I approach self-medication with over-the-counter (OTC) analgesics using Harm Reduction as a framework. From this perspective, consumption of OTC analgesics by chronic pain sufferers is a means of seeking some level of relief while also avoiding the stigma associated with prescription pain medication. Qualitative methods are used to analyze data from two sources: (1) semi-structured qualitative interviews with 95 participants in a trial examining the effectiveness of Traditional Chinese Medicine for Temporomandibular Disorders (TMD) from 2006 to 2011 in Tucson, AZ and Portland, OR; and (2) print, online, and television advertisements for three major brands of OTC pain medication. Participants described their use of OTC medications as minimal, responsible, and justified by the severity of their pain. OTC medication advertising, while ostensibly ambiguous and targeting all forms of pain, effectively lends support to the consumption of these medication as part of the self-projects of chronic pain sufferers, allowing them to reconcile conflicting demands for pain relief while being stoic and maintaining a positive moral identity. Describing OTC medication as “just over-the-counter” or “not real pain medication,” sufferers engage in ideological harm reduction, distinguishing themselves from “those people who like taking pain medication” while still seeking relief. Justifying one’s use of OTC medication as minimal and “normal,” regardless of intake, avoids association with the addictive potential of prescription pain

Utilization of triptans in Sweden; analyses of over the counter and prescription sales.

PubMed

von Euler, Mia; Keshani, Sara; Baatz, Katarina; Wettermark, Bjorn

2014-12-01

To enable easier access to triptans, the drug of choice for moderate to severe migraine, some countries have made triptans available without prescription, that is, over the counter (OTC). Concern has been raised about this. The aim of this study was to describe the utilization pattern of triptans in Sweden before and after the OTC switch. Wholesaler and aggregated sales data from all Swedish pharmacies 1991 to 2011 and patient identity data on dispensed prescriptions 2007 and 2011 from the Swedish National Prescribed Drug Register were used to investigate volume and expenditure of triptans. The databases contain complete data for all drugs sold in Sweden or dispensed to all Swedish inhabitants (9.5 million in 2012). Volumes of triptans have increased to 7.0 million defined daily doses (DDD) on prescriptions and 0.7 million DDDs OTC in 2011. Prescriptions were dispensed to 10.0 and 10.1 per 1000 inhabitants in 2007 and 2011, respectively. Although half of those dispensed triptans in 2007 were not in 2011, the incidence remained stable at 2.8 patients per thousand person-years. In 2011, the 10% of the heaviest users accounted for 44% and 48% of dispensed triptans in women and men, respectively. Triptans OTC and the volumes dispensed on prescription have increased as has the DDD per patient purchasing triptans on prescription. However, the number of patient's dispensed triptans on prescription has remained stable. A concern is that almost half of prescribed triptans are purchased by 10% of the users. Copyright © 2014 John Wiley & Sons, Ltd.

Proportional counter radiation camera

DOEpatents

Borkowski, C.J.; Kopp, M.K.

1974-01-15

A gas-filled proportional counter camera that images photon emitting sources is described. A two-dimensional, positionsensitive proportional multiwire counter is provided as the detector. The counter consists of a high- voltage anode screen sandwiched between orthogonally disposed planar arrays of multiple parallel strung, resistively coupled cathode wires. Two terminals from each of the cathode arrays are connected to separate timing circuitry to obtain separate X and Y coordinate signal values from pulse shape measurements to define the position of an event within the counter arrays which may be recorded by various means for data display. The counter is further provided with a linear drift field which effectively enlarges the active gas volume of the counter and constrains the recoil electrons produced from ionizing radiation entering the counter to drift perpendicularly toward the planar detection arrays. A collimator is interposed between a subject to be imaged and the counter to transmit only the radiation from the subject which has a perpendicular trajectory with respect to the planar cathode arrays of the detector. (Official Gazette)

Understanding the tissue interaction of new treatment modalities in laparoscopic surgery in view of safe and effective application (Conference Presentation)

NASA Astrophysics Data System (ADS)

Grimbergen, Matthijs C. M.; Klaessens, John H.; van der Veen, Albert J.; Verdaasdonk, Rudolf M.

2016-03-01

During laparoscopic surgery, devices are require to either cut, ablate or coagulate tissue and veins with high precision and controlled lateral damage preferably in an one-for-all modality. The tissue interactions of 3 new treatment modalities were studied using special imaging techniques to obtain a better understanding the working mechanism in view of effective and safe application. The Plasmajet produces a high temperature ionized gas 'flame' directed to the tissue surface at the tip of a 4 mm diameter rigid hand piece. The Lumenis DUO CO2 laser enables endoscopic laser energy delivery through a 1 mm outer diameter flexible hollow waveguide. The 2 µm 'Thulium' laser is delivered by (standard) 400 µm diameter optical fiber. Thermal imaging and Schlieren techniques were used to assess the superficial ablative and coagulation effects these surgical instruments scanning at preset velocities and distances from the surface of biological tissues and phantoms . The CO2 was very effective in tissue ablation even at a distance up to 10 mm due to a very small diverging beam from the hollow waveguide. In contrast, the Thulium laser showed less ablation and increasing coagulation at larger distance to the tissue. The gas 'flame' of the Plasmajet spread the thermal energy over the surface for effective superficial ablation and coagulation. However, the pressure of the gas flow is substantial on the tissue surface creating turbulence and even indirect cooling. The specific ablation and coagulation effects of the three treatment modalities have to be appreciate and the effective and safe application will depend on the preference and skills of the surgeon

Development and testing of 2-dimensional photon counter

NASA Technical Reports Server (NTRS)

1981-01-01

The development of a commercially available two dimensional photon counter into an operational system for speckle imaging of astronomical objects is described. The system includes digital recording for field observations. The counter has a bialkali photocathode with a field size of 18 by 18 mm over which it resolves about 100 by 100 pixels. The system records photon positions as 16 bit words at rates up to 14,400 per second. Field tests at observatories verifying the operation of the system are described.

Ineffectiveness of over-the-counter total-release foggers against the bed bug (Heteroptera: Cimicidae).

PubMed

Jones, Susan C; Bryant, Joshua L

2012-06-01

Field-collected bed bugs (Cimex lectularius L.) showed little, if any, adverse effects after 2-h direct exposure to the aerosolized pyrethroid(s) from three over-the-counter total-release foggers ('bug bombs' or 'foggers'); Hotshot Bedbug and Flea Fogger, Spectracide Bug Stop Indoor Fogger, and Eliminator Indoor Fogger. One field-collected population, EPM, was an exception in that there was significant mortality at 5-7 d when bugs out in the open had been exposed to the Spectracide Fogger; mortality was low when these bugs had access to an optional harborage, a situation observed for all field-collected populations when exposed to the three foggers. Even the Harlan strain, the long-term laboratory population that is susceptible to pyrethroids and that served as an internal control in these experiments, was unaffected if the bugs were covered by a thin cloth layer that provided harborage. In residences and other settings, the majority of bed bugs hide in protected sites where they will not be directly contracted by the insecticide mist from foggers. This study provides the first scientific data supporting the position that total-release foggers should not be recommended for control of bed bugs, because 1) many field-collected bed bugs are resistant to pyrethroids, and they are not affected by brief exposure to low concentrations of pyrethrins and/or pyrethroids provided by foggers; and 2) there is minimal, if any, insecticide penetration into typical bed bug harborage sites. This study provides strong evidence that Hotshot Bedbug and Flea Fogger, Spectracide Bug Stop Indoor Fogger, and Eliminator Indoor Fogger were ineffective as bed bug control agents.

Allergy Medications and Pregnancy: What's Safe?

MedlinePlus

... a filter designed to trap potentially infectious organisms. Physical activity. Exercise helps reduce nasal inflammation. Nasal strips. Over-the-counter adhesive nasal strips can help keep your nasal ...

Pharmacy student decision making in over-the-counter medicine supply: A critical incident study.

PubMed

McMillan, Sara S; Thangarajah, Thachaayini; Anderson, Claire; Kelly, Fiona

2017-09-28

Various factors influence decision making in over-the-counter (OTC) medicine consultations, yet limited studies have focused, in-depth, on the thought process of pharmacy staff. This includes pharmacy students as pharmacists-in-training. To explore the factors that influence pharmacy students' decisions in relation to OTC consultations and choice of OTC medicine/s. Semi-structured interviews using the critical incident technique were undertaken with ten pharmacy students in Australia, who also worked as part-time pharmacy staff. Nine key themes were identified to influence pharmacy student decision making in OTC consultations, including customer response, confidence and scope of practice. Product requests were reported as more challenging due to customer expectations and experiences in other pharmacies, states or countries. Although negative customer response influenced some students to supply medicines in contradiction of evidence, an overarching concern for safety meant that a medicine was only supplied if unlikely to cause harm. Students reported developing confidence in OTC decision making more from real-life practice than university training; greater confidence was identified for inquiries more frequently experienced in the pharmacy. Students perceived that customers had assumptions around support staff, and were happier to talk to students than assistants. This study further identified that OTC decision making is a complex process for pharmacy students. Additional opportunities for experiential learning within this area are suggested, such as work-based placements or in-class activities such as role-plays with simulated patients. Copyright © 2017 Elsevier Inc. All rights reserved.

COUNTER Improvised Explosive Device (C-IED) Operations as an Element of Counter Insurgency (COIN): Balancing C-IED Efforts to Support Commander International Security Assistance Force (COMISAF) Operational Objectives

DTIC Science & Technology

2010-10-27

central to the enemy‟s operational design, defense and industry efforts to counter the IED with technology have been aggressive. The US has spent...and industry efforts to counter the IED with technology have been aggressive. The US has spent billions of dollars to mitigate the effects of IEDs...2001 has claimed the lives of over 1,700 United States and Coalition Force (CF) service men and women ; over six times that many have been wounded.1

Acute over-the-counter pharmacological intervention does not adversely affect behavioral outcome following diffuse traumatic brain injury in the mouse.

PubMed

Harrison, Jordan L; Rowe, Rachel K; O'Hara, Bruce F; Adelson, P David; Lifshitz, Jonathan

2014-09-01

Following mild traumatic brain injury (TBI), patients may self-treat symptoms of concussion, including post-traumatic headache, taking over-the-counter (OTC) analgesics. Administering one dose of OTC analgesics immediately following experimental brain injury mimics the at-home treated population of concussed patients and may accelerate the understanding of the relationship between brain injury and OTC pharmacological intervention. In the current study, we investigate the effect of acute administration of OTC analgesics on neurological function and cortical cytokine levels after experimental diffuse TBI in the mouse. Adult, male C57BL/6 mice were injured using a midline fluid percussion (mFPI) injury model of concussion (6-10 min righting reflex time for brain-injured mice). Experimental groups included mFPI paired with either ibuprofen (60 mg/kg, i.p.; n = 16), acetaminophen (40 mg/kg, i.p.; n = 9), or vehicle (15% ethanol (v/v) in 0.9% saline; n = 13) and sham injury paired OTC medicine or vehicle (n = 7-10 per group). At 24 h after injury, functional outcome was assessed using the rotarod task and a modified neurological severity score. Following behavior assessment, cortical cytokine levels were measured by multiplex ELISA at 24 h post-injury. To evaluate efficacy on acute inflammation, cortical cytokine levels were measured also at 6 h post-injury. In the diffuse brain-injured mouse, immediate pharmacological intervention did not attenuate or exacerbate TBI-induced functional deficits. Cortical cytokine levels were affected by injury, time, or their interaction. However, levels were not affected by treatment at 6 or 24 h post-injury. These data indicate that acute administration of OTC analgesics did not exacerbate or attenuate brain-injury deficits which may inform clinical recommendations for the at-home treated mildly concussed patient.

The effects of installation on single- and counter-rotation propeller noise

NASA Technical Reports Server (NTRS)

Block, P. J. W.

1984-01-01

In order to understand the effects of installation on propeller noise, numerous measurements are required to define the directivity of the noise as well as the level. An experimental study was designed to map the noise radiation pattern for various single-rotation propeller (SRP) and counter-rotation propeller (CRP) installations covering + or 60 deg from the propeller disk plane and + or - 60 deg laterally. Configurations that were considered included an SRP at angle of attack and in tractor and pusher operations and a CRP. A first principles linear theory was validated for the SRP tractor operation over the angle range mentioned above. The increases in noise that arise from an unsteady loading operation such as an SRP pusher or CRP exceed 15 dB and depend on the observer location. In particular, the majority of the additional noise appears to radiate in the axial directions.

Measurement of organochlorines in commercial over-the-counter fish oil preparations: implications for dietary and therapeutic recommendations for omega-3 fatty acids and a review of the literature.

PubMed

Melanson, Stacy Foran; Lewandrowski, Elizabeth Lee; Flood, James G; Lewandrowski, Kent B

2005-01-01

The consumption of fish high in omega-3 fatty acids is advocated by the American Heart Association to decrease the risk of coronary artery disease. However, fish contain environmental toxins such as mercury, polychlorinated biphenyls, and organochlorine pesticides, which may negate the beneficial cardiovascular effects of fish meals. Toxin levels vary depending on both the fish source and the specific toxin, and neither farm-raised nor wild fish are toxin free. Fish oil supplements also prevent the progression of coronary artery disease and reduce cardiovascular mortality. However, only sparse data exist on the level of toxins in fish oil. In a previous study we showed that the amount of mercury in 5 over-the-counter brands of fish oil was negligible. To determine the concentrations of polychlorinated biphenyls and other organochlorines in 5 over-the-counter preparations of fish oil. The contents of 5 commercial fish oil brands were sent for organochlorine analysis. The levels of polychlorinated biphenyls and organochlorines were all below the detectable limit. Fish oil supplements are more healthful than the consumption of fish high in organochlorines. Fish oils provide the benefits of omega-3 fatty acids without the risk of toxicity. In addition, fish oil supplements have been helpful in a variety of diseases, including bipolar disorder and depression.

A questionnaire based survey study for the evaluation of knowledge of Pakistani University teachers regarding their awareness about ibuprofen as an over the counter analgesic.

PubMed

Chen, Jianxian; Murtaza, Ghulam; Nadeem, Nida; Shao, Xiaokuai; Siddiqi, Bushra G; Shafique, Zainab; Ahmad, Saeed; Amjad, Seyyeda T; Haroon, Saima; Tanoli, Mamoona; Zhou, Mei

2014-01-01

In recent time, due to convenient availability of number of over the counter (OTC) drugs, patients are able to treat minor ailments by themselves. The self-medicated regimen has lead to certain health problems in all age groups irrespective of their professions. People are usually unaware about the safe use of NSAIDs (non-steroidal anti-inflammatory drugs) and currently there is no study carried out in COMSATS Institute of Information Technology (CIIT), Abbottabad, regarding the choice of faculty members for NSAIDs to relieve pain and their knowledge about its safety and use. A questionnaire based survey was carried out to collectdata about the choice of CIIT faculty for a specific NSAID and their cognition related to ibuprofen. Two hundred fifty faculty members (comprising of 53 pharmacy faculty members and 197 faculty members who belonged to other departments) of which 87 were females, took part in this study. Average age of participants was 34.86 +/- 9.02 years. Ibuprofen was the drug of choice NSAID among the participants. Four percent participants experienced pain almost every day. Analgesia was the well known indication for ibuprofen (31%) by both the groups and in general more educated and younger participants showed better apprehension related to indications. Sixty one percent participants comprising of non-pharmacy faculty were unaware of any undesirable effects and 79% (comprising of 72% pharmacists and 5% non-pharmacists) were affirmative that ibuprofen had no adverse effects. Fifteen percent participants of department other than pharmacy were not aware of any interactions of ibuprofen. 34% of participants (comprising of 32% non-pharmacists and 2% pharmacists) entrusted their physician for an analgesic. Regardless that many participants suffered from pain almost every day and their drug of choice would be ibuprofen, they had inadequate information related to the safety and use of ibuprofen.

Preclinical, Clinical, and Over-the-Counter Postmarketing Experience with a New Vaginal Cup: Menstrual Collection

PubMed Central

North, Barbara B.

2011-01-01

Abstract Background Menstrual cups have been available for decades, but their use is limited by bulky design and the need for multiple sizes. The Softcup® (Instead, Inc., San Diego, CA) is a simple single-size disposable over-the-counter (OTC) menstrual cup that compresses to tampon shape to facilitate insertion and can be worn during coitus. This report describes preclinical evaluation, clinical testing, and postmarketing monitoring of the Softcup. Methods Preclinical testing complied with U.S. Food and Drug Administration (FDA) guidelines and used standard United States Pharmacopoeia methodologies for assessment of potential toxicity. Clinical testing enrolled 406 women in seven U.S. centers. A detailed written questionnaire assessed safety, acceptability, and effectiveness for menstrual collection. Study safety parameters included pelvic examinations, Pap smears, colposcopy, urinalysis, vaginal pH, wet mounts, gram stain, and vaginal microflora cultures. Postmarketing surveillance of over 100 million Softcups has been conducted by the manufacturer and by the FDA Medwatch system. Results No toxicity or mutagenicity was observed in preclinical evaluations. In clinical testing, after three cycles of cup use, 37% of subjects rated the cup as better than, 29% as worse than, and 34% as equal to pads or tampons. The cup was preferred for comfort, dryness, and less odor. Cups received lower ratings for disposal and convenience. Eighty-one percent of enrolled women were able to insert and remove their first cup using only written instructions. Use difficulties resulting in study discontinuations included cramping (1%), leakage (1%), and improper fit (3%). No safety parameters were adversely affected. No significant health risks were reported during postmarketing surveillance. Conclusions These results demonstrate that a single-size vaginal device has no significant health risks and is acceptable to many women without the need for fitting or other medical services. PMID

Preclinical, clinical, and over-the-counter postmarketing experience with a new vaginal cup: menstrual collection.

PubMed

North, Barbara B; Oldham, Michael J

2011-02-01

Menstrual cups have been available for decades, but their use is limited by bulky design and the need for multiple sizes. The Softcup® (Instead, Inc., San Diego, CA) is a simple single-size disposable over-the-counter (OTC) menstrual cup that compresses to tampon shape to facilitate insertion and can be worn during coitus. This report describes preclinical evaluation, clinical testing, and postmarketing monitoring of the Softcup. Preclinical testing complied with U.S. Food and Drug Administration (FDA) guidelines and used standard United States Pharmacopoeia methodologies for assessment of potential toxicity. Clinical testing enrolled 406 women in seven U.S. centers. A detailed written questionnaire assessed safety, acceptability, and effectiveness for menstrual collection. Study safety parameters included pelvic examinations, Pap smears, colposcopy, urinalysis, vaginal pH, wet mounts, gram stain, and vaginal microflora cultures. Postmarketing surveillance of over 100 million Softcups has been conducted by the manufacturer and by the FDA Medwatch system. No toxicity or mutagenicity was observed in preclinical evaluations. In clinical testing, after three cycles of cup use, 37% of subjects rated the cup as better than, 29% as worse than, and 34% as equal to pads or tampons. The cup was preferred for comfort, dryness, and less odor. Cups received lower ratings for disposal and convenience. Eighty-one percent of enrolled women were able to insert and remove their first cup using only written instructions. Use difficulties resulting in study discontinuations included cramping (1%), leakage (1%), and improper fit (3%). No safety parameters were adversely affected. No significant health risks were reported during postmarketing surveillance. These results demonstrate that a single-size vaginal device has no significant health risks and is acceptable to many women without the need for fitting or other medical services.

Kelvin-Helmholtz instability of counter-rotating discs

NASA Astrophysics Data System (ADS)

Quach, Dan; Dyda, Sergei; Lovelace, Richard V. E.

2015-01-01

Observations of galaxies and models of accreting systems point to the occurrence of counter-rotating discs where the inner part of the disc (r < r0) is corotating and the outer part is counter-rotating. This work analyses the linear stability of radially separated co- and counter-rotating thin discs. The strong instability found is the supersonic Kelvin-Helmholtz instability. The growth rates are of the order of or larger than the angular rotation rate at the interface. The instability is absent if there is no vertical dependence of the perturbation. That is, the instability is essentially three dimensional. The non-linear evolution of the instability is predicted to lead to a mixing of the two components, strong heating of the mixed gas, and vertical expansion of the gas, and annihilation of the angular momenta of the two components. As a result, the heated gas will free-fall towards the disc's centre over the surface of the inner disc.

What Is to Be Done? Possibilities for the Counter-Offensive

ERIC Educational Resources Information Center

Fisher, Trevor

2014-01-01

This article sketches one line of march for the counter-offensive to current education policy called for in the previous issue of "FORUM." It highlights three key areas where, in his drive to "revolutionise" the education service, the Education Secretary has over-extended himself and become vulnerable. It calls for sharp and…

Transference, Counter-Transference, and Reflexivity in Intercultural Education

ERIC Educational Resources Information Center

Shim, Jenna Min

2015-01-01

The article addresses the contributions psychoanalytic theory, particularly its concepts of "transference and counter-transference," can make to our understanding of reflexivity in intercultural education (IE). After the introduction, the article is organized into three parts. The first part is a psychoanalytic discussion that focuses on…

Regulatory responses to over-the-counter codeine analgesic misuse in Australia, New Zealand and the United Kingdom.

PubMed

Tobin, Claire L; Dobbin, Malcolm; McAvoy, Brian

2013-10-01

Analysis of the policy response by Australia's National Drugs and Poisons Schedule Committee (NDPSC) and comparison with recommendations by expert advisory committees in New Zealand and the United Kingdom. Analysis of public policy documents of relevant regulatory authorities was conducted. Data were extracted regarding changes to over-the-counter (OTC) codeine analgesic scheduling, indications, maximum unit dose, maximum daily dose, maximum pack size, warning labels, consumer medicine information and advertising. Where available, public submissions and other issues considered by the committees and rationale for their recommendations were recorded and thematically analysed. Expert advisory committees in Australia, NZ and the UK defined the policy problem of OTC codeine misuse and harm as small relative to total use and responded by restricting availability. Pharmacist supervision was required at the point-of-sale and pack sizes were reduced to short-term use. Comparison with recommendations by expert advisory committees in NZ and the UK suggests the NDPSC's actions in response to OTC codeine misuse were appropriate given the available evidence of misuse and harm, but highlights opportunities to utilise additional regulatory levers. Framing policy problems as matters of public health in the context of limited evidence may support decision makers to implement cautionary incremental policy change. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Effects of counter-rotating-wave terms of the driving field on the spectrum of resonance fluorescence

NASA Astrophysics Data System (ADS)

Yan, Yiying; Lü, Zhiguo; Zheng, Hang

2013-11-01

We investigate the fluorescence spectrum of a two-level system driven by a monochromatic classical field by the Born-Markovian master equation based on a unitary transformation. The main purpose is to understand the effects of counter-rotating-wave terms of the driving on spectral features of the fluorescence. We have derived an analytical expression for the fluorescence spectrum, which is different from Mollow's theory, while Mollow's result on resonance is the limiting case of ours in moderately weak driving regimes. Our results demonstrate precisely that the counter-rotating-wave terms of the driving play an important role in the fluorescence spectrum for intense driving: (i) the counter-rotating coupling suppresses the red sideband in the Mollow triplet and it enhances the blue one in explicitly contrast to the well-known equal intensity of the sideband in Mollow's theory, (ii) the higher-order Mollow triplets appear as a characteristic spectral feature arising from counter-rotating-wave terms of the driving, and (iii) a significant frequency shift of the sidebands is observed, which depends on both the detuning and driving strength.

Over-the-Counter "Adrenal Support" Supplements Contain Thyroid and Steroid-Based Adrenal Hormones.

PubMed

Akturk, Halis Kaan; Chindris, Ana Maria; Hines, Jolaine M; Singh, Ravinder J; Bernet, Victor J

2018-03-01

To assess whether dietary supplements that are herbal and/or animal-derived products, marketed for enhancing metabolism or promoting energy, "adrenal fatigue," or "adrenal support," contain thyroid or steroid hormones. Twelve dietary adrenal support supplements were purchased. Pregnenolone, androstenedione, 17-hydroxyprogesterone, cortisol, cortisone, dehydroepiandrosterone sulfate, synthetic glucocorticoids (betamethasone, dexamethasone, fludrocortisone, megestrol acetate, methylprednisolone, prednisolone, prednisone, budesonide, and triamcinolone acetonide) levels were measured twice in samples in a blinded fashion. This study was conducted between February 1, 2016, and November 1, 2016. Among steroids, pregnenolone was the most common hormone in the samples. Budesonide, 17-hydroxyprogesterone, androstenedione, cortisol, and cortisone were the others in order of prevalence. All the supplements revealed a detectable amount of triiodothyronine (T3) (63-394.9 ng/tablet), 42% contained pregnenolone (66.12-205.2 ng/tablet), 25% contained budesonide (119.5-610 ng/tablet), 17% contained androstenedione (1.27-7.25 ng/tablet), 8% contained 17-OH progesterone (30.09 ng/tablet), 8% contained cortisone (79.66 ng/tablet), and 8% contained cortisol (138.5 ng/tablet). Per label recommended doses daily exposure was up to 1322 ng for T3, 1231.2 ng for pregnenolone, 1276.4 ng for budesonide, 29 ng for androstenedione, 60.18 ng for 17-OH progesterone, 277 ng for cortisol, and 159.32 ng for cortisone. All the supplements studied contained a small amount of thyroid hormone and most contained at least 1 steroid hormone. This is the first study that measured thyroid and steroid hormones in over-the-counter dietary "adrenal support" supplements in the United States. These results may highlight potential risks of hidden ingredients in unregulated supplements. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Laws prohibiting over-the-counter syringe sales to injection drug users: relations to population density, HIV prevalence, and HIV incidence.

PubMed

Friedman, S R; Perlis, T; Des Jarlais, D C

2001-05-01

This study sought to assess relations of laws prohibiting over-the-counter syringe sales (anti-OTC laws) to population prevalence of injection drug users and HIV prevalence or incidence among 96 US metropolitan areas. A cross-sectional analysis was used. Metropolitan areas with anti-OTC laws had a higher mean HIV prevalence (13.8% vs 6.7%) than other metropolitan areas (pseudo-P < .001). In 83 metropolitan areas with HIV prevalence of less than 20%, anti-OTC laws were associated with HIV incidence rates of 1% or greater (pseudo-P < .001). Population proportions of injection drug users did not vary by presence of anti-OTC laws. Anti-OTC laws are not associated with lower population proportions of injection drug users. Laws restricting syringe access are associated with HIV transmission and should be repealed.

76 FR 56682 - Sunscreen Drug Products for Over-the-Counter Human Use; Request for Data and Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... cited the need for additional time to evaluate their available data and to organize and submit the data...-Counter Human Use; Request for Data and Information Regarding Dosage Forms; Extension of Comment Period... data and information; extension of comment period. SUMMARY: The Food and Drug Administration (FDA) is...

Prediction of gastrointestinal disease with over-the-counter diarrheal remedy sales records in the San Francisco Bay Area.

PubMed

Kirian, Michelle L; Weintraub, June M

2010-07-20

Water utilities continue to be interested in implementing syndromic surveillance for the enhanced detection of waterborne disease outbreaks. The authors evaluated the ability of sales of over-the-counter diarrheal remedies available from the National Retail Data Monitor to predict endemic and epidemic gastrointestinal disease in the San Francisco Bay Area. Time series models were fit to weekly diarrheal remedy sales and diarrheal illness case counts. Cross-correlations between the pre-whitened residual series were calculated. Diarrheal remedy sales model residuals were regressed on the number of weekly outbreaks and outbreak-associated cases. Diarrheal remedy sales models were used to auto-forecast one week-ahead sales. The sensitivity and specificity of signals, generated by observed diarrheal remedy sales exceeding the upper 95% forecast confidence interval, in predicting weekly outbreaks were calculated. No significant correlations were identified between weekly diarrheal remedy sales and diarrhea illness case counts, outbreak counts, or the number of outbreak-associated cases. Signals generated by forecasting with the diarrheal remedy sales model did not coincide with outbreak weeks more reliably than signals chosen randomly. This work does not support the implementation of syndromic surveillance for gastrointestinal disease with data available though the National Retail Data Monitor.

Differing disintegration and dissolution rates, pharmacokinetic profiles and gastrointestinal tolerability of over the counter ibuprofen formulations.

PubMed

Bjarnason, Ingvar; Sancak, Ozgur; Crossley, Anne; Penrose, Andrew; Lanas, Angel

2018-02-01

Formulations of over the counter (OTC) NSAIDs differ substantially, but information is lacking on whether this alters their gastrointestinal profiles. To assess disintegration and dissolution rates and pharmacokinetics of four preparations of OTC ibuprofen and relate these with spontaneously reported gastrointestinal adverse events. Disintegration and dissolution rates of ibuprofen tablets as (a) acid, (b) sodium salt, (c) lysine salt, and (d) as a liquid gelatine capsule were assessed. Pharmacokinetic data gastrointestinal and spontaneously reported adverse events arising from global sales were obtained from files from Reckitt Benckiser. Disintegration at low pH was progressively shorter for the preparations from a-to-d with formation of correspondingly smaller ibuprofen crystals, while dissolution was consistently poor. Dissolution at a neutral pH was least rapid for the liquid gelatine capsule. Pharmacokinetic data showed a shorter t max and a higher C max for preparations b-d as compared with ibuprofen acid. Spontaneously reported abdominal symptoms were rare with the liquid gelatine preparation. The formulations of OTC ibuprofen differ in their disintegration and dissolution properties, pharmacokinetic profiles and apparent gastrointestinal tolerability. Spontaneously reported abdominal symptoms were five times lower with the liquid gelatine capsule as compared with ibuprofen acid despite a 30% increase in C max . © 2017 Royal Pharmaceutical Society.

Robotic Billiards: Understanding Humans in Order to Counter Them.

PubMed

Nierhoff, Thomas; Leibrandt, Konrad; Lorenz, Tamara; Hirche, Sandra

2016-08-01

Ongoing technological advances in the areas of computation, sensing, and mechatronics enable robotic-based systems to interact with humans in the real world. To succeed against a human in a competitive scenario, a robot must anticipate the human behavior and include it in its own planning framework. Then it can predict the next human move and counter it accordingly, thus not only achieving overall better performance but also systematically exploiting the opponent's weak spots. Pool is used as a representative scenario to derive a model-based planning and control framework where not only the physics of the environment but also a model of the opponent is considered. By representing the game of pool as a Markov decision process and incorporating a model of the human decision-making based on studies, an optimized policy is derived. This enables the robot to include the opponent's typical game style into its tactical considerations when planning a stroke. The results are validated in simulations and real-life experiments with an anthropomorphic robot playing pool against a human.

The Violence Continuum: Creating a Safe School Climate

ERIC Educational Resources Information Center

Manvell, Elizabeth C.

2012-01-01

We expect schools to be a safe haven, but after more than a decade of targeted school violence prevention laws and safety plans, students are still marginalized and bullied to the point of despondence, retaliation, and even suicide. This thoughtful exploration of what makes a school a safe place is based on the understanding that violence is a…

Portable multiplicity counter

DOEpatents

Newell, Matthew R [Los Alamos, NM; Jones, David Carl [Los Alamos, NM

2009-09-01

A portable multiplicity counter has signal input circuitry, processing circuitry and a user/computer interface disposed in a housing. The processing circuitry, which can comprise a microcontroller integrated circuit operably coupled to shift register circuitry implemented in a field programmable gate array, is configured to be operable via the user/computer interface to count input signal pluses receivable at said signal input circuitry and record time correlations thereof in a total counting mode, coincidence counting mode and/or a multiplicity counting mode. The user/computer interface can be for example an LCD display/keypad and/or a USB interface. The counter can include a battery pack for powering the counter and low/high voltage power supplies for biasing external detectors so that the counter can be configured as a hand-held device for counting neutron events.

A complete database for the Einstein imaging proportional counter

NASA Technical Reports Server (NTRS)

Helfand, David J.

1991-01-01

A complete database for the Einstein Imaging Proportional Counter (IPC) was completed. The original data that makes up the archive is described as well as the structure of the database, the Op-Ed analysis system, the technical advances achieved relative to the analysis of (IPC) data, the data products produced, and some uses to which the database has been put by scientists outside Columbia University over the past year.

Safety and efficacy of over-the-counter cough and cold medicines for use in children.

PubMed

Vassilev, Zdravko P; Kabadi, Shaum; Villa, Raul

2010-03-01

Over-the-counter (OTC) cough and cold medications have been used widely for years and continue to be a preferred choice for temporary relief of symptoms of upper respiratory tract infections in children. These medications are being placed under extraordinary scrutiny in the pediatric population due to the lack of conclusive evidence about their therapeutic efficacy and increased reports of associations with serious adverse events and even mortality. A PubMed search was conducted to identify articles published up to August 2009 describing the efficacy and safety of OTC cough and cold medications in children. The objective was to provide an overview of the relevant literature and regulatory history and to comment on the available data on this important topic. The paper provides a detailed up-to-date review of the key efficacy and safety studies published on the subject. In addition, the reader is presented with an overview of the regulatory history and recent developments surrounding the use of OTC cough and cold medications in children in the US. This review confirms the lack of efficacy of OTC cough and cold products in children and reaffirms that although the overall incidence of related serious adverse events is low, such events continue to occur. The conclusions in this paper support a recommendation that OTC cough and cold medications should not be given to infants and very young children. Furthermore, additional research is needed to evaluate the safety and efficacy of these medicines in the broader pediatric population.

Redundant operation of counter modules

NASA Technical Reports Server (NTRS)

Nagano, S. (Inventor)

1980-01-01

A technique for the redundant operation of counter modules is described. Redundant operation is maintained by detecting the zero state of each counter and clearing the other to that state, thus periodically resynchronizing the counters, and obtaining an output from both counters through AC coupled diode-OR gates. Redundant operation of counter flip flops is maintained in a similar manner, and synchronous operation of redundant squarewave clock generators of the feedback type is effected by connecting together the feedback inputs of the squarewave generators through a coupling resistor, and obtaining an output from both generators through AC coupled diode-OR gates.

Space and power efficient hybrid counters array

DOEpatents

Gara, Alan G [Mount Kisco, NY; Salapura, Valentina [Chappaqua, NY

2009-05-12

A hybrid counter array device for counting events. The hybrid counter array includes a first counter portion comprising N counter devices, each counter device for receiving signals representing occurrences of events from an event source and providing a first count value corresponding to a lower order bits of the hybrid counter array. The hybrid counter array includes a second counter portion comprising a memory array device having N addressable memory locations in correspondence with the N counter devices, each addressable memory location for storing a second count value representing higher order bits of the hybrid counter array. A control device monitors each of the N counter devices of the first counter portion and initiates updating a value of a corresponding second count value stored at the corresponding addressable memory location in the second counter portion. Thus, a combination of the first and second count values provide an instantaneous measure of number of events received.

Space and power efficient hybrid counters array

DOEpatents

Gara, Alan G.; Salapura, Valentina

2010-03-30

A hybrid counter array device for counting events. The hybrid counter array includes a first counter portion comprising N counter devices, each counter device for receiving signals representing occurrences of events from an event source and providing a first count value corresponding to a lower order bits of the hybrid counter array. The hybrid counter array includes a second counter portion comprising a memory array device having N addressable memory locations in correspondence with the N counter devices, each addressable memory location for storing a second count value representing higher order bits of the hybrid counter array. A control device monitors each of the N counter devices of the first counter portion and initiates updating a value of a corresponding second count value stored at the corresponding addressable memory location in the second counter portion. Thus, a combination of the first and second count values provide an instantaneous measure of number of events received.

GASEOUS SCINTILLATION COUNTER

DOEpatents

Eggler, C.; Huddleston, C.M.

1959-04-28

A gaseous excitation counter for detecting the presence amd measuring the energy of subatomic particles and electromagnetic radiation is described. The counter includes a gas-tight chamber filled with an elemental gas capable of producing ultra-violet excitation quanta when irradiated with subatomic particles and electromagnetic radiation. The gas has less than one in a thousand parts ultra-violet absorbing contamination. When nuclear radiation ps present the ultra-violet light produced by the gas strikes a fluorescent material within the counter, responsive to produce visible excitation quanta, and photo-sensitive counting means detect the visible emission.

Is crime associated with over-the-counter pharmacy syringe sales? Findings from Los Angeles, California.

PubMed

Stopka, Thomas J; Geraghty, Estella M; Azari, Rahman; Gold, Ellen B; DeRiemer, Kathryn

2014-03-01

More than 50,000 new HIV infections occur annually in the United States. Injection drug users represent twelve percent of incident HIV infections each year. Pharmacy sales of over-the-counter (OTC) syringes have helped prevent HIV transmission among injection drug users in many states throughout the United States. However, concerns exist among some law enforcement officials, policymakers, pharmacists, and community members about potential links between OTC syringe sales and crime. We used a geographic information system and novel spatial and longitudinal analyses to determine whether implementation of pharmacy-based OTC syringe sales were associated with reported crime between January 2006 and December 2008 in Los Angeles Police Department Reporting Districts. We assessed reported crime pre- and post-OTC syringe sales initiation as well as longitudinal associations between crime and OTC syringe-selling pharmacies. By December 2008, 9.3% (94/1010) of Los Angeles Police Department Reporting Districts had at least one OTC syringe-selling pharmacy. Overall reported crime counts and reported crime rates decreased between 2006 and 2008 in all 1010 Reporting Districts. Using generalized estimating equations and adjusting for potential confounders, reported crime rates were negatively associated with OTC syringe sales (adjusted rate ratio: 0.89; 95% confidence interval: 0.81, 0.99). Our findings demonstrate that OTC pharmacy syringe sales were not associated with increases in reported crime in local communities in Los Angeles during 2006-2008. Copyright © 2014 Elsevier B.V. All rights reserved.

Counter - Drug: Mandate for the Army.

DTIC Science & Technology

1991-03-01

this comprehensive review will provide a basis for responding to new missions assigned...observations for determining the short-, mid-, and long-term direction of Army support to the national counter-drug effort. Also, this comprehensive review will provide...and long-term direction of Army support to the national counter-drug effort. Also, this comprehensive review will provide a basis for responding

Counter rotating fans — An aircraft propulsion for the future?

NASA Astrophysics Data System (ADS)

Schimming, Peter

2003-05-01

In the mid seventies a new propulsor for aircraft was designed and investigated - the so-called PROPFAN. With regard to the total pressure increase, it ranges between a conventional propeller and a turbofan with very high bypass ratio. This new propulsion system promised a reduction in fuel consumption of 15 to 25% compared to engines at that time. A lot of propfans (Hamilton Standard, USA) with different numbers of blades and blade shapes have been designed and tested in wind tunnels in order to find an optimum in efficiency, Fig.1. Parallel to this development GE, USA, made a design of a counter rotating unducted propfan, the so-called UDF, Fig.2. A prototype engine was manufactured and investigated on an in-flight test bed mounted at the MD82 and the B727. Since that time there has not been any further development of propfans (except AN 70 with NK 90-engine, Ukraine, which is more or less a propeller design) due to relatively low fuel prices and technical obstacles. Only technical programs in different countries are still going on in order to prepare a data base for designing counter rotating fans in terms of aeroacoustics, aerodynamics and aeroelasticities. In DLR, Germany, a lot of experimental and numerical work has been undertaken to understand the physical behaviour of the unsteady flow in a counter rotating fan.

An acoustical bubble counter for superheated drop detectors.

PubMed

Taylor, Chris; Montvila, Darius; Flynn, David; Brennan, Christopher; d'Errico, Francesco

2006-01-01

A new bubble counter has been developed based on the well-established approach of detecting vaporization events acoustically in superheated drop detectors (SDDs). This counter is called the Framework Scientific ABC 1260, and it represents a major improvement over prior versions of this technology. By utilizing advanced acoustic pattern recognition software, the bubble formation event can be differentiated from ambient background noise, as well as from other acoustic signatures. Additional structural design enhancements include a relocation of the electronic components to the bottom of the device; thus allowing for greater stability, easier access to vial SDDs without exposure to system electronics. Upgrades in the electronics permit an increase in the speed of bubble detection by almost 50%, compared with earlier versions of the counters. By positioning the vial on top of the device, temperature and sound insulation can be accommodated for extreme environments. Lead shells can also be utilized for an enhanced response to high-energy neutrons.

The Icarus Project: a counter narrative for psychic diversity.

PubMed

DuBrul, Sascha Altman

2014-09-01

Over the past 12 years, I've had the good fortune of collaborating with others to create a project which challenges and complicates the dominant biopsychiatric model of mental illness. The Icarus Project, founded in 2002, not only critiqued the terms and practices central to the biopsychiatric model, it also inspired a new language and a new community for people struggling with mental health issues in the 21st century. The Icarus Project believes that humans are meaning makers, that meaning is created through developing intrapersonal and interpersonal narratives, and that these narratives are important sites of creativity, struggle, and growth. The Icarus counter narrative and the community it fostered has been invaluable for people around the world dealing with psychic diversity--particularly for people alienated by mainstream approaches. But, despite the numbers of people who have been inspired by this approach, the historical background of the Icarus Project is hard to find. It exists primarily in oral history, newspaper articles, unpublished or self-published Icarus documents, and in internet discussion forums. As the co-founder of the Icarus Project, I use this article to make my understanding of that history and its key documents more widely available.

Safety and Efficacy of Over-the-Counter Drug Use by the Elderly. Hearing before the Subcommittee on Health and Long-Term Care of the Select Committee on Aging. House of Representatives, Ninety-Eighth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

This document contains the prepared statements and panel testimony from the Congressional hearing on over-the-counter (OTC) drug use by the elderly. Opening statements are given by Representatives Claude Pepper (chairman), Ralph Regula, Mary Rose Oakar, Michael Bilirakis, Tom Lantos, and Hal Daub. Topics which are covered include the incidence and…

Druggists and pharmacists as gatekeepers: sales routines and compliance with sales protocols for over-the-counter naproxen 275 mg medicines in the Netherlands.

PubMed

van Hoof, Joris J; Cents, Michel H G; Megens, Nicole M J; van der Tang, Sijbrand J

2014-09-01

Since for the sales of over-the-counter (OTC) medicines, prescribing physicians are not involved, and written instructions on/in the medicine boxes are inefficient, druggists and pharmacists are important gatekeepers in preventing customers' accidents. In this study we investigated the sales routines, and compliance with sales protocols, in order to evaluate that gatekeeper's function. By means of the mystery shopping method, 228 pharmacies and drugstores in The Netherlands were visited and a naproxen 275mg medium-risk medicine was requested for a (fictitious) patient who was suffering from severe back pains. According to the sales protocols the vendors should never sell the requested medicine, because the mystery shoppers only gave an answer to one of the four mandatory sales protocol questions. Furthermore, the requested medicine is not the right or best choice for back pains. Four different scenarios were used in a 2×2 design (8-year-old patient vs. 25-year-old patient, and 1 box with 12 pills vs. 3 boxes with 12 pills). Of the drugstores and pharmacies only 16.7% complied with the sales protocols and did not sell the specific (or comparable) medicine, after asking all four mandatory questions (or already after one, two or three questions). Most vendors (83.3%) did not comply and sold the requested medicine, a comparable medicine, or even a more risky medicine after no question at all (or after asking some or even all four questions). Although both score low, pharmacists show better compliance (23.9%) than druggists (10.1%). When it comes to OTC medicines, druggists and pharmacists largely commit sloppy sales. The expected gatekeeping function of pharmacists and druggists is very limited, and customers might be in danger of inappropriate medicine selection, quantity and usage. We call for thorough evaluation of the over-the-counter system, improvement of the educational programs for medicine providers, and national campaigns to inform the public. Copyright �

Air Proportional Counter

DOEpatents

Simpson, Jr, J A

1950-12-05

A multiple wire counter utilizing air at atmospheric pressure as the ionizing medium and having a window of a nylon sheet of less than 0.5 mil thickness coated with graphite. The window is permeable to alpha particles so that the counter is well adapted to surveying sources of alpha radiation.

Demographic, Risk, and Spatial Factors Associated With Over-the-Counter Syringe Purchase Among Injection Drug Users

PubMed Central

Stopka, Thomas J.; Lutnick, Alexandra; Wenger, Lynn D.; DeRiemer, Kathryn; Geraghty, Estella M.; Kral, Alex H.

2012-01-01

Since 2005, California law allowed over-the-counter (OTC) syringe sales pending local authorization. Although pharmacy sales of OTC syringes are associated with reduced injection-mediated risks and decreases in human immunodeficiency virus infection rates, little is known about the factors associated with syringe purchase among injection drug users (IDUs). Using a cross-sectional design, the authors applied targeted sampling to collect quantitative survey data from IDUs (n = 563) recruited in San Francisco, California, during 2008. They also compiled a comprehensive list of retail pharmacies, their location, and whether they sell OTC syringes. They used a novel combination of geographic information system and statistical analyses to determine the demographic, behavioral, and spatial factors associated with OTC syringe purchase by IDUs. In multivariate analyses, age, race, injection frequency, the type of drug injected, and the source of syringe supply were independently associated with OTC syringe purchases. Notably, the prevalence of OTC syringe purchase was 53% lower among African-American IDUs (adjusted prevalence ratio = 0.47, 95% confidence interval: 0.33, 0.67) and higher among injectors of methamphetamine (adjusted prevalence ratio = 1.35, 95% confidence interval: 1.07, 1.70). Two neighborhoods with high densities of IDUs had limited access to OTC syringes. Increased access to OTC syringes would potentially prevent blood-borne infectious diseases among IDUs. PMID:22562660

Counter design influences the privacy of patients in health care.

PubMed

Mobach, Mark P

2009-03-01

A re-furnishing of counter areas in primary health care was used to assess patient privacy and its influences on the nature of conversations in a controlled experiment. Patients in two community-based pharmacies in the Netherlands were assigned to enclosed counters and a queue at distance, or to counters that exposed patients mutually and a closer queue. Patients assigned to counters with reduced sight were more satisfied with the privacy than patients at visually exposed counters. However, in comparison with visually exposed pharmacy counters, conversations of patients at enclosed counters could still be overheard and did not have different conversations to other patients. Architectural design of health-care institutions has potential to positively influence perceived patient privacy in areas in where multiple patient-staff communications routinely occur and where patient privacy is an important issue, but enclosed counters with a queue at distance do not prevent incidental disclosure of individually identifiable health information.

Countering Propaganda in the Global War on Terrorism: What can a Democracy do?

DTIC Science & Technology

2008-05-01

Sedition Acts, “Over nineteen hundred prosecutions and other judicial proceedings during the war, involving speeches , newspaper articles, pamphlets...Liberties and National Security .................................................... 18 Protection of Free Speech : Zechariah Chafee, Limits of Free... Speech .......................... 20 Countering Propaganda (Protectionism) ....................................................................... 21

Patients' Preferences for Generic and Branded Over-the-Counter Medicines: An Adaptive Conjoint Analysis Approach.

PubMed

Halme, Merja; Linden, Kari; Kääriä, Kimmo

2009-12-01

: Despite increased use of generic medicines, little is known about either the attitudes of patients towards them or the decision-making process surrounding them. Young adults use over-the-counter (OTC) analgesics relatively often. : To assess the preferences of patients for generic and branded OTC pain medicines, to identify clusters with different preference structures, and to estimate the price elasticity of a generic alternative among university students. : Finnish university students (n = 256; students in courses at the Helsinki School of Economics) responded to an adaptive conjoint analysis (ACA) questionnaire on the choice between branded and generic OTC ibuprofen products. Product attributes of price, brand, onset time of effect, place of purchase and source of information were included in the questionnaire on the basis of the literature, a focus group and a previous pilot study. Several socioeconomic and health behavior descriptors were employed. Individual-level utility functions were estimated, preference clusters were identified, and the price elasticity of the generic medicine was assessed. : Five clusters with characteristic individual-level preferences and price elasticity but few differences in socioeconomic background were detected. Approximately half of the respondents were strongly price sensitive while the others had other preferences such as brand or an opportunity to buy the medicine at a pharmacy or to have a physician or a pharmacist as an information source. : The study provided new information on the concomitant effects of brand, price and other essential product attributes on the choice by patients between branded and generic medicines.

Sexual revolution and counter-revolution.

PubMed

Money, J

1994-01-01

Adolescents of today inherit the conflicting legacies of the sexual reformation of the 1960s and the counter-reformation of the 1980s/1990s. Sexual mores are influenced by a younger age of puberty than in earlier generations and by the availability of effective contraception and antibiotics to combat sexually transmitted diseases. In the era of acquired immune deficiency syndrome, however, absolutely safe sex cannot be guaranteed, only relative degrees of safety and risk. Masturbation may be one way of achieving safe sex. Advancing technology also allows greater equality of opportunity and economic emancipation for women, enabling men and women to share equally in the care of older infants and children, also influencing sexual roles. Sex education for adolescents is provided sporadically and inconsistently, being seen by opposing factions as either encouragement to early pregnancy or a means of preventing it. In particular, the images delivered by the mass media are blatantly contradictory, ranging from endorsement of teenage sexual expression to condemnation of abortion and teenage pregnancy. Cultural traditions have strong influences on the acceptability of early pregnancy and on family structure. Black American culture is based on the three-generational family as opposed to the white tradition of the nuclear, two-generational family. It is important to realize a social policy that will respect not only the sexual rights of young people, but also the sexual health of the community.

The effect on social welfare of a switch of second-generation antihistamines from prescription to over-the-counter status: a microeconomic analysis.

PubMed

Shih, Ya-Chen Tina; Prasad, Manishi; Luce, Bryan R

2002-04-01

The US Food and Drug Administration (FDA) recently held a meeting to determine whether the status of second-generation antihistamines (SGAs) should be switched from prescription (Rx) to over-the-counter (OTC) status. This article provides a conceptual microeconomic framework for addressing issues regarding the impact of such a switch on social welfare. A review of the economic literature on Rx-to-OTC switches was conducted. Relevant articles published in English between 1990 and 2001 were identified through searches of ABI Info, EconLit, PsychInfo, MEDLINE, CANCERLIT, AIDSLINE, and HealthStar, as well as a general Internet search for statements in the press or on the FDA Web site. The search terms used were Rx, prescription, OTC, over-the-counter, second-generation antihistamines, nonsedating antihistamines, first-generation antihistamines, and sedating antihistamines. Microeconomic models focusing on consumer surplus were employed to determine the potential price response and social-welfare implications of a switch of SGAs to OTC status. Unlike the agents involved in previous Rx-to-OTC switches, SGAs are still under patent protection. Economic theory suggests that a firm that is protected by a patent will price aggressively. The market for OTC SGAs is likely to be more elastic due to a lack of insurance coverage for OTC products; hence, drug manufacturers would be likely to charge a lower price if SGAs were sold OTC. However, a lower price does not necessarily guarantee an improvement in social welfare; the net impact is determined by whether the increase in consumer surplus outweighs the deadweight loss (losses of consumer and producer surplus not transferred to other parties). Additionally, the assumption of a price reduction would be called into question if there were inequalities in marginal costs between the Rx and OTC markets. In this situation, the postswitch price might increase or not be reduced significantly. It is uncertain whether granting OTC status

Correlates of Abusing and Misusing Over-the-Counter Pain Relievers Among Adult Population of Wrocław (Poland).

PubMed

Wójta-Kempa, Monika; Krzyżanowski, Dominik M

2016-01-01

Almost 90% of households in Poland buy medicines on their own initiative. The most popular OTC medicines bought by Polish consumers are painkillers and non-steroid-anti-inflammatory drugs. The aim of this article was to recognize and describe the most important predictive factors of the abuse and misuse of over-the-counter pain relievers among adults in Wrocław (Poland). The groups of users were selected and described. Some examples of misuse were analyzed. Three hundred eighty six adult inhabitants of Wrocław took part in the survey. The quota sample was representative referring to the most important socio-demographic factors (sex and median age). Almost 91% of participants declare taking OTC pain relievers, and 1.3% of them are their daily users. Only 6.2% of adult inhabitants of Wrocław never take OTC pain relievers. The category of "heavy users" embraces 11% of participants. The most important risk factors of overusing OTC pain relievers are sex (female), age over 55 years and the low health status. Only half of participants read the box label regularly and 25% of users admit they have modified recommended doses. Over 60% shortened recommended intervals between doses and 16% took two or more different pain medications (containing different substances). The non-medical purposes of using OTC pain relievers were: tiredness (7%), stressful situations (5.4%), and discomfort (18.4%). Some users take pain medications to cure hangovers (26%), or instead of the appropriate medicine (7%). About 20% take pain medications without a doctor's advice for longer than the recommended 3 days, and 10% never consult taking such medications with doctors. Pain should be treated aggressively and successfully, especially among chronically ill patients. We should monitor the consumption of OTC pain relievers and limit their current excessively supply and high availability.

Multimedia educational interventions for consumers about prescribed and over-the-counter medications.

PubMed

Ciciriello, Sabina; Johnston, Renea V; Osborne, Richard H; Wicks, Ian; deKroo, Tanya; Clerehan, Rosemary; O'Neill, Clare; Buchbinder, Rachelle

2013-04-30

Health consumers increasingly want access to accurate, evidence-based information about their medications. Currently, education about medications (that is, information that is designed to achieve health or illness related learning) is provided predominantly via spoken communication between the health provider and consumer, sometimes supplemented with written materials. There is evidence, however, that current educational methods are not meeting consumer needs. Multimedia educational programs offer many potential advantages over traditional forms of education delivery. To assess the effects of multimedia patient education interventions about prescribed and over-the-counter medications in people of all ages, including children and carers. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2011, Issue 6), MEDLINE (1950 to June 2011), EMBASE (1974 to June 2011), CINAHL (1982 to June 2011), PsycINFO (1967 to June 2011), ERIC (1966 to June 2011), ProQuest Dissertation & Theses Database (to June 2011) and reference lists of articles. Randomised controlled trials (RCTs) and quasi-RCTs of multimedia-based patient education about prescribed or over-the-counter medications in people of all ages, including children and carers, if the intervention had been targeted for their use. Two review authors independently extracted data and assessed the risk of bias of included studies. Where possible, we contacted study authors to obtain missing information. We identified 24 studies that enrolled a total of 8112 participants. However, there was significant heterogeneity in the comparators used and the outcomes measured, which limited the ability to pool data. Many of the studies did not report sufficient information in their methods to allow judgment of their risk of bias. From the information that was reported, three of the studies had a high risk of selection bias and one was at high risk of bias due to lack of blinding of the outcome

GENE-Counter: A Computational Pipeline for the Analysis of RNA-Seq Data for Gene Expression Differences

PubMed Central

Di, Yanming; Schafer, Daniel W.; Wilhelm, Larry J.; Fox, Samuel E.; Sullivan, Christopher M.; Curzon, Aron D.; Carrington, James C.; Mockler, Todd C.; Chang, Jeff H.

2011-01-01

GENE-counter is a complete Perl-based computational pipeline for analyzing RNA-Sequencing (RNA-Seq) data for differential gene expression. In addition to its use in studying transcriptomes of eukaryotic model organisms, GENE-counter is applicable for prokaryotes and non-model organisms without an available genome reference sequence. For alignments, GENE-counter is configured for CASHX, Bowtie, and BWA, but an end user can use any Sequence Alignment/Map (SAM)-compliant program of preference. To analyze data for differential gene expression, GENE-counter can be run with any one of three statistics packages that are based on variations of the negative binomial distribution. The default method is a new and simple statistical test we developed based on an over-parameterized version of the negative binomial distribution. GENE-counter also includes three different methods for assessing differentially expressed features for enriched gene ontology (GO) terms. Results are transparent and data are systematically stored in a MySQL relational database to facilitate additional analyses as well as quality assessment. We used next generation sequencing to generate a small-scale RNA-Seq dataset derived from the heavily studied defense response of Arabidopsis thaliana and used GENE-counter to process the data. Collectively, the support from analysis of microarrays as well as the observed and substantial overlap in results from each of the three statistics packages demonstrates that GENE-counter is well suited for handling the unique characteristics of small sample sizes and high variability in gene counts. PMID:21998647

Over-the-Counter Relief From Pains and Pleasures Alike: Acetaminophen Blunts Evaluation Sensitivity to Both Negative and Positive Stimuli.

PubMed

Durso, Geoffrey R O; Luttrell, Andrew; Way, Baldwin M

2015-06-01

Acetaminophen, an effective and popular over-the-counter pain reliever (e.g., the active ingredient in Tylenol), has recently been shown to blunt individuals' reactivity to a range of negative stimuli in addition to physical pain. Because accumulating research has shown that individuals' reactivity to both negative and positive stimuli can be influenced by a single factor (an idea known as differential susceptibility), we conducted two experiments testing whether acetaminophen blunted individuals' evaluations of and emotional reactions to both negative and positive images from the International Affective Picture System. Participants who took acetaminophen evaluated unpleasant stimuli less negatively and pleasant stimuli less positively, compared with participants who took a placebo. Participants in the acetaminophen condition also rated both negative and positive stimuli as less emotionally arousing than did participants in the placebo condition (Studies 1 and 2), whereas nonevaluative ratings (extent of color saturation in each image; Study 2) were not affected by drug condition. These findings suggest that acetaminophen has a general blunting effect on individuals' evaluative and emotional processing, irrespective of negative or positive valence. © The Author(s) 2015.

OverView of Space Applications for Environment (SAFE) initiative

NASA Astrophysics Data System (ADS)

Hamamoto, Ko; Fukuda, Toru; Tajima, Yoshimitsu; Takeuchi, Wataru; Sobue, Shinichi; Nukui, Tomoyuki

2014-06-01

Climate change and human activities have a direc or indirect influence on the acceleration of environmental problems and natural hazards such as forest fires, draughts and floods in the Asia-Pacific countries. Satellite technology has become one of the key information sources in assessment, monitoring and mitigation of these disasters and related phenomenon. However, there are still gaps between science and application of satellite technology in real-world usage. Asia-Pacific Regional Space Agency Forum (APRSAF) recommended to initiate the Space Applications for Environment (SAFE) proposal providing opportunity to potential user agencies in the Asia Pacific region to develop prototype applications of satellite technology for number of key issues including forest resources management, coastal monitoring and management, agriculture and food security, water resource management and development user-friendly tools for application of satellite technology. This paper describes the overview of SAFE initiative and outcomes of two selected prototypes; agricultural drought monitoring in Indonesia and coastal management in Sri Lanka, as well as the current status of on-going prototypes.

Over-the-Counter Relief From Pains and Pleasures Alike: Acetaminophen Blunts Evaluation Sensitivity to Both Negative and Positive Stimuli

PubMed Central

Durso, Geoffrey R. O.; Luttrell, Andrew; Way, Baldwin M.

2015-01-01

Acetaminophen, an effective and popular over-the-counter pain reliever (e.g., the active ingredient in Tylenol), has recently been shown to blunt individuals’ reactivity to a range of negative stimuli in addition to physical pain. Because accumulating research has shown that individuals’ reactivity to both negative and positive stimuli can be influenced by a single factor (an idea known as differential susceptibility), we conducted two experiments testing whether acetaminophen blunted individuals’ evaluations of and emotional reactions to both negative and positive images from the International Affective Picture System. Participants who took acetaminophen evaluated unpleasant stimuli less negatively and pleasant stimuli less positively, compared with participants who took a placebo. Participants in the acetaminophen condition also rated both negative and positive stimuli as less emotionally arousing than did participants in the placebo condition (Studies 1 and 2), whereas nonevaluative ratings (extent of color saturation in each image; Study 2) were not affected by drug condition. These findings suggest that acetaminophen has a general blunting effect on individuals’ evaluative and emotional processing, irrespective of negative or positive valence. PMID:25862546

The counter and consultation room work explored in the Netherlands.

PubMed

Mobach, Mark P

2008-08-01

To determine the frequency and nature of conversations at the counter and of private consultations at three Dutch community pharmacies. In a purposive and convenience sample of three Dutch community pharmacies two work categories were investigated: counter work and consultation room work with self-reporting tally. The study took 6 weeks: 2 weeks at each pharmacy. The number of care related conversations and consultations emerging in the counter work and consultation room work. About 43% of all counter conversations consisted of the provision of pharmaceutical information and 72% of the consultations in the separate consultation room dealt with care related activities. However, only 18 consultations were held in this latter room: 0.4% of all reported conversations. The proportion of care related work at the counter and in the consultation room did have significant substance. There are however serious possibilities to change pharmaceutical care for the better. It is suggested that standard procedures at the counter may help increasing care related work. The presence of a separate consultation room may increase the number of consultations held in private, when combined with raising patient awareness of its existence.

Counter-streaming flows in a giant quiet-Sun filament observed in the extreme ultraviolet

NASA Astrophysics Data System (ADS)

Diercke, A.; Kuckein, C.; Verma, M.; Denker, C.

2018-03-01

Aim. The giant solar filament was visible on the solar surface from 2011 November 8-23. Multiwavelength data from the Solar Dynamics Observatory (SDO) were used to examine counter-streaming flows within the spine of the filament. Methods: We use data from two SDO instruments, the Atmospheric Imaging Assembly (AIA) and the Helioseismic and Magnetic Imager (HMI), covering the whole filament, which stretched over more than half a solar diameter. Hα images from the Kanzelhöhe Solar Observatory (KSO) provide context information of where the spine of the filament is defined and the barbs are located. We apply local correlation tracking (LCT) to a two-hour time series on 2011 November 16 of the AIA images to derive horizontal flow velocities of the filament. To enhance the contrast of the AIA images, noise adaptive fuzzy equalization (NAFE) is employed, which allows us to identify and quantify counter-streaming flows in the filament. We observe the same cool filament plasma in absorption in both Hα and EUV images. Hence, the counter-streaming flows are directly related to this filament material in the spine. In addition, we use directional flow maps to highlight the counter-streaming flows. Results: We detect counter-streaming flows in the filament, which are visible in the time-lapse movies in all four examined AIA wavelength bands (λ171 Å, λ193 Å, λ304 Å, and λ211 Å). In the time-lapse movies we see that these persistent flows lasted for at least two hours, although they became less prominent towards the end of the time series. Furthermore, by applying LCT to the images we clearly determine counter-streaming flows in time series of λ171 Å and λ193 Å images. In the λ304 Å wavelength band, we only see minor indications for counter-streaming flows with LCT, while in the λ211 Å wavelength band the counter-streaming flows are not detectable with this method. The diverse morphology of the filament in Hα and EUV images is caused by different absorption

The Impact of Restricting Over-the-Counter Sales of Antimicrobial Drugs: Preliminary Analysis of National Data.

PubMed

Moura, Maria Luísa; Boszczowski, Icaro; Mortari, Naíma; Barrozo, Lígia Vizeu; Chiaravalloti Neto, Francisco; Lobo, Renata Desordi; Pedroso de Lima, Antonio Carlos; Levin, Anna S

2015-09-01

To describe the nationwide impact of a restrictive law on over-the-counter sales of antimicrobial drugs, implemented in Brazil in November 2010. Approximately 75% of the population receives healthcare from the public health system and receives free-of-charge medication if prescribed. Total sales in private pharmacies as compared with other channels of sales of oral antibiotics were evaluated in this observational study before and after the law (2008-2012). Defined daily dose per 1000 inhabitants per day (DDD/TID) was used as standard unit. In private pharmacies the effect of the restrictive law was statistically significant (P < 0.001) with an estimated decrease in DDD/TID of 1.87 (s.e. =  0.18). In addition, the trend of DDD/TID before the restrictive law was greater than after the intervention (P < 0.001). Before November 2010, the slope for the trend line was estimated as 0.08 (s.e. = 0.01) whereas after the law, the estimated slope was 0.03 (s.e. = 0.01). As for the nonprivate channels, no difference in sales was observed (P = 0.643). The impact in the South and Southeast (more developed) regions was higher than in the North, Northeast, and Mid-West. The state capitals had a 19% decrease, compared with 0.8% increase in the rest of the states. Before the law, the sales of antimicrobial drugs were steadily increasing. From November 2010, with the restrictive law, there was an abrupt drop in sales followed by an increase albeit at a significantly lower rate. The impact was higher in regions with better socio-economic status.

Timecourse of mirror and counter-mirror effects measured with transcranial magnetic stimulation

PubMed Central

Cavallo, Andrea; Heyes, Cecilia; Becchio, Cristina; Bird, Geoffrey

2014-01-01

The human mirror system has been the subject of much research over the past two decades, but little is known about the timecourse of mirror responses. In addition, it is unclear whether mirror and counter-mirror effects follow the same timecourse. We used single-pulse transcranial magnetic stimulation to investigate the timecourse of mirror and counter-mirror responses in the human brain. Experiment 1 demonstrated that mirror responses can be measured from around 200 ms after observed action onset. Experiment 2 demonstrated significant effects of counter-mirror sensorimotor training at all timepoints at which a mirror response was found in Experiment 1 (i.e. from 200 ms onward), indicating that mirror and counter-mirror responses follow the same timecourse. By suggesting similarly direct routes for mirror and counter-mirror responses, these results support the associative account of mirror neuron origins whereby mirror responses arise as a result of correlated sensorimotor experience during development. More generally, they contribute to theorizing regarding mirror neuron function by providing some constraints on how quickly mirror responses can influence social cognition. PMID:23709352

From War on Drugs to War against Terrorism: modeling the evolution of Colombia's counter-insurgency.

PubMed

Banks, Catherine M; Sokolowski, John A

2009-03-01

Strategic and tactical planning for military intervention needs revision as the causes, methods, and means of conflict have evolved. Counter-insurgent engagement is one such intervention that governments, militaries, and non-governmental organizations seek to better understand. Modeling insurgencies is an acceptable means to gain insight into the various characteristics of asymmetric warfare to proffer prescriptive resolutions for mitigating their effects. Colombia's insurgency poses the challenge of assessing population behavior in a non-traditional revolutionary climate. Factors prevalent in traditional insurgency are not applicable in Colombia, specifically between the years 1993 and 2001 with the democratization of the drug cartels. The catastrophic events of September 11th reverberated in Colombia resulting in a new policy and strategy to the waging the counter-insurgency there. This research introduces a structured methodology to modeling the Colombian counter-insurgency incorporating qualitative assessment, mathematical representation, and a System Dynamics approach to represent the effects of the policy change.

Deregulation of sale of over-the-counter drugs outside of pharmacies in the Republic of Korea: interrupted-time-series analysis of outpatient visits before and after the policy.

PubMed

Chun, Sung-Youn; Park, Hye-Ki; Han, Kyu-Tae; Kim, Woorim; Lee, Hyo-Jung; Park, Eun-Cheol

2017-07-12

We evaluated the effectiveness of a policy allowing for the sale of over-the-counter drugs outside of pharmacies by examining its effect on number of monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. We used medical claims data extracted from the Korean National Health Insurance Cohort Database from 2009 to 2013. The Korean National Health Insurance Cohort Database comprises a nationally representative sample of claims - about 2% of the entire population - obtained from the medical record data held by the Korean National Health Insurance Corporation (which has data on the entire nation). The analysis included26,284,706 person-months of 1,042,728 individuals. An interrupted-time series analysis was performed. Outcome measures were monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. To investigate the effect of the policy, we compared the number of monthly visits before and after the policy's implementation in 2012. For acute upper respiratory infections, monthly outpatient visits showed a decreasing trend before the policy (ß = -0.0003);after it, a prompt change and increasing trend in monthly outpatient visits were observed, but these were non-significant. For dyspepsia, the trend was increasing before implementation (ß = -0.0101), but this reversed after implementation(ß = -0.007). For migraine, an increasing trend was observed before the policy (ß = 0.0057). After it, we observed a significant prompt change (ß = -0.0314) but no significant trend. Deregulation of selling over-the-counter medication outside of pharmacies reduced monthly outpatient visits for dyspepsia and migraine symptoms, but not acute upper respiratory infections.

Sign-And-Magnitude Up/Down Counter

NASA Technical Reports Server (NTRS)

Cole, Steven W.

1991-01-01

Magnitude-and-sign counter includes conventional up/down counter for magnitude part and special additional circuitry for sign part. Negative numbers indicated more directly. Counter implemented by programming erasable programmable logic device (EPLD) or programmable logic array (PLA). Used in place of conventional up/down counter to provide sign and magnitude values directly to other circuits.

Mandatory labeling requirements and over-the-counter cough and cold medication use in early childhood.

PubMed

DeGroot, Julie; Anderson, Laura N; Chen, Yang; Birken, Catherine S; Parkin, Patricia C; Carsley, Sarah; Khovratovich, Marina; Mamdani, Muhammad; Maguire, Jonathon L

2016-03-16

Due to rare but severe adverse events, Health Canada in October 2009 required manufacturers to relabel over-the-counter (OTC) cough and cold medication (CCM) to state that the products should not be used in children <6 years of age. The main objective of this study was to determine whether this labeling standard decreased OTC CCM use among young children with a recent cough, cold or flu. An interrupted time series study was conducted using data from the TARGet Kids! practice-based research network. A total of 3,515 healthy children 1-5 years of age were recruited from 2008-2011; of these, 1,072 had a cough, cold or flu in the previous month. Parents completed a standardized survey instrument. For the primary analysis, use of OTC CCMs prior to and after October 1, 2009 was compared using time series analyses. For the secondary analysis, multivariable logistic regression was used to identify predictors of recent OTC CCM use. OTC CCM use was reported in 222 of 1,072 (20.7%) children with a cough, cold or flu within the previous month. OTC CCM use declined from 22.2% to 17.8% following the October 2009 Health Canada labeling standard (p = 0.014). Maternal age <35 years (OR 1.49; 95% CI: 1.05-2.13) and having older siblings (OR 1.65; 95% CI: 1.16-2.35) were independently associated with OTC CCM use. Labeling legislation against OTC CCM use for children <6 years resulted in a small decrease in OTC CCM use. Stronger measures may be needed to curtail OTC CCM use, particularly for younger parents and those with multiple children.

Medicines in My Home: Information for Students on the Safe Use of Over-the-Counter Medicines

MedlinePlus

... are safer when you follow directions. The active ingredients in OTC medicines can be harmful if you don’t use them as directed on the label. Take for example, the active ingredients in OTC fever and pain medicines.... • Acetaminophen can ...

Developing Safe Schools Partnerships with Law Enforcement

ERIC Educational Resources Information Center

Rosiak, John

2009-01-01

Safe schools are the concern of communities throughout the world. If a school is safe, and if children feel safe, students "are better able to learn. But what are the steps to make" this happen? First, it is important to understand the problem: What are the threats to school safety? These include crime-related behaviors that find their way to…

Evaluation of Counter-Based Dynamic Load Balancing Schemes for Massive Contingency Analysis on Over 10,000 Cores

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Yousu; Huang, Zhenyu; Rice, Mark J.

Contingency analysis studies are necessary to assess the impact of possible power system component failures. The results of the contingency analysis are used to ensure the grid reliability, and in power market operation for the feasibility test of market solutions. Currently, these studies are performed in real time based on the current operating conditions of the grid with a set of pre-selected contingency list, which might result in overlooking some critical contingencies caused by variable system status. To have a complete picture of a power grid, more contingencies need to be studied to improve grid reliability. High-performance computing techniques holdmore » the promise of being able to perform the analysis for more contingency cases within a much shorter time frame. This paper evaluates the performance of counter-based dynamic load balancing schemes for a massive contingency analysis program on 10,000+ cores. One million N-2 contingency analysis cases with a Western Electricity Coordinating Council power grid model have been used to demonstrate the performance. The speedup of 3964 with 4096 cores and 7877 with 10240 cores are obtained. This paper reports the performance of the load balancing scheme with a single counter and two counters, describes disk I/O issues, and discusses other potential techniques for further improving the performance.« less

Impact of Over-the-Counter Restrictions on Antibiotic Consumption in Brazil and Mexico

PubMed Central

Santa-Ana-Tellez, Yared; Mantel-Teeuwisse, Aukje K.; Dreser, Anahi; Leufkens, Hubert G. M.; Wirtz, Veronika J.

2013-01-01

Background In Latin American countries over-the-counter (OTC) dispensing of antibiotics is common. In 2010, both Mexico and Brazil implemented policies to enforce existing laws of restricting consumption of antibiotics only to patients presenting a prescription. The objective of the present study is therefore to evaluate the impact of OTC restrictions (2010) on antibiotics consumption in Brazil and Mexico. Methods and Findings Retail quarterly sales data in kilograms of oral and injectable antibiotics between January 2007 and June 2012 for Brazil and Mexico were obtained from IMS Health. The unit of analysis for antibiotics consumption was the defined daily dose per 1,000 inhabitants per day (DDD/TID) according to the WHO ATC classification system. Interrupted time series analysis was conducted using antihypertensives as reference group to account for changes occurring independently of the OTC restrictions directed at antibiotics. To reduce the effect of (a) seasonality and (b) autocorrelation, dummy variables and Prais-Winsten regression were used respectively. Between 2007 and 2012 total antibiotic usage increased in Brazil (from 5.7 to 8.5 DDD/TID, +49.3%) and decreased in Mexico (10.5 to 7.5 DDD/TID, −29.2%). Interrupted time series analysis showed a change in level of consumption of −1.35 DDD/TID (p<0.01) for Brazil and −1.17 DDD/TID (p<0.00) for Mexico. In Brazil the penicillins, sulfonamides and macrolides consumption had a decrease in level after the intervention of 0.64 DDD/TID (p = 0.02), 0.41 (p = 0.02) and 0.47 (p = 0.01) respectively. While in Mexico it was found that only penicillins and sulfonamides had significant changes in level of −0.86 DDD/TID (p<0.00) and −0.17 DDD/TID (p = 0.07). Conclusions Despite different overall usage patterns of antibiotics in Brazil and Mexico, the effect of the OTC restrictions on antibiotics usage was similar. In Brazil the trend of increased usage of antibiotics was tempered after the OTC

Instability of counter-rotating stellar disks

NASA Astrophysics Data System (ADS)

Hohlfeld, R. G.; Lovelace, R. V. E.

2015-09-01

We use an N-body simulation, constructed using GADGET-2, to investigate an accretion flow onto an astrophysical disk that is in the opposite sense to the disk's rotation. In order to separate dynamics intrinsic to the counter-rotating flow from the impact of the flow onto the disk, we consider an initial condition in which the counter-rotating flow is in an annular region immediately exterior the main portion of the astrophysical disk. Such counter-rotating flows are seen in systems such as NGC 4826 (known as the "Evil Eye Galaxy"). Interaction between the rotating and counter-rotating components is due to two-stream instability in the boundary region. A multi-armed spiral density wave is excited in the astrophysical disk and a density distribution with high azimuthal mode number is excited in the counter-rotating flow. Density fluctuations in the counter-rotating flow aggregate into larger clumps and some of the material in the counter-rotating flow is scattered to large radii. Accretion flow processes such as this are increasingly seen to be of importance in the evolution of multi-component galactic disks.

A Comparative Study on the Life-Saving Radioprotective Effects of Vitamins A, E, C and Over-the-Counter Multivitamins.

PubMed

Mortazavi, S M J; Rahimi, S; Mosleh-Shirazi, M A; Arjomandi, M; Soleimani, A; Koohi Hossein-Abadi, O; Haghani, M; Alavi, M

2015-06-01

Oral intake of vitamins which present antioxidant characteristics can protect living organisms against oxidative damage caused by exposure to ionizing radiation. It was previously reported that administration of high levels of vitamin C can lead to increased DNA damage through production of hydroxyl radicals from hydrogen peroxide by the Fenton reaction. However, our early experiments did not confirm this hypothesis. The main goal of this study was to determine if high doses of Vit C can show life-saving radioprotective effects. Phase I: Seventy two male Balb/c mice weighing 20-25g were randomly divided into six groups of 12 animals each. Group I; Vit E for five days, Groups II and III; Vit C and Vit A. Group 4; all three vitamins. Group V; an over-the-counter multivitamin. Group VI; none of the above. Phase II: 120 male BALB/c mice weighing 20-25g were randomly divided into 12 groups of 10 each. Group I; Vit A for five days. Groups II-IV; Vit C 200 mg/kg, 400 mg/kg, 800 mg/kg, respectively. Group V-VII; Vit E at daily doses of 200 iu/kg, 400 iu/kg, 800 iu/kg, respectively. Group VIII and IX; all three vitamins at low and high doses, respectively. Group X; an over-the-counter multivitamin. Group XI; controls group and Group XII; received pure olive oil. All animals (Phases I and II) were exposed to a lethal dose of gamma rays and the survival rates of the animals were monitored and recorded continuously for 16 days after exposure. Phase I: 14 days after irradiation the survival rate for control group was 33.33%, while the survival rates for the 1st to 5th groups were 45.45%, 81.81%, 50%, 57.14%, and 9.09% , respectively. Phase II: The survival rates in the control group and the group that only received pure olive oil, were 50% and 60%, respectively. Survival rate in the animals received Vit C at daily doses of 200 mg/kg, 400 mg/kg, 800 mg/kg, were 90%, 90% and 90%, respectively. Log rank (Mantel-Cox) test showed statistically significant differences between the

Counter-Learning under Oppression

ERIC Educational Resources Information Center

Kucukaydin, Ilhan

2010-01-01

This qualitative study utilized the method of narrative analysis to explore the counter-learning process of an oppressed Kurdish woman from Turkey. Critical constructivism was utilized to analyze counter-learning; Frankfurt School-based Marcusian critical theory was used to analyze the sociopolitical context and its impact on the oppressed. Key…

Timecourse of mirror and counter-mirror effects measured with transcranial magnetic stimulation.

PubMed

Cavallo, Andrea; Heyes, Cecilia; Becchio, Cristina; Bird, Geoffrey; Catmur, Caroline

2014-08-01

The human mirror system has been the subject of much research over the past two decades, but little is known about the timecourse of mirror responses. In addition, it is unclear whether mirror and counter-mirror effects follow the same timecourse. We used single-pulse transcranial magnetic stimulation to investigate the timecourse of mirror and counter-mirror responses in the human brain. Experiment 1 demonstrated that mirror responses can be measured from around 200 ms after observed action onset. Experiment 2 demonstrated significant effects of counter-mirror sensorimotor training at all timepoints at which a mirror response was found in Experiment 1 (i.e. from 200 ms onward), indicating that mirror and counter-mirror responses follow the same timecourse. By suggesting similarly direct routes for mirror and counter-mirror responses, these results support the associative account of mirror neuron origins whereby mirror responses arise as a result of correlated sensorimotor experience during development. More generally, they contribute to theorizing regarding mirror neuron function by providing some constraints on how quickly mirror responses can influence social cognition. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Merits of using color and shape differentiation to improve the speed and accuracy of drug strength identification on over-the-counter medicines by laypeople.

PubMed

Hellier, Elizabeth; Tucker, Mike; Kenny, Natalie; Rowntree, Anna; Edworthy, Judy

2010-09-01

This study aimed to examine the utility of using color and shape to differentiate drug strength information on over-the-counter medicine packages. Medication errors are an important threat to patient safety, and confusions between drug strengths are a significant source of medication error. A visual search paradigm required laypeople to search for medicine packages of a particular strength from among distracter packages of different strengths, and measures of reaction time and error were recorded. Using color to differentiate drug strength information conferred an advantage on search times and accuracy. Shape differentiation did not improve search times and had only a weak effect on search accuracy. Using color to differentiate drug strength information improves drug strength identification performance. Color differentiation of drug strength information may be a useful way of reducing medication errors and improving patient safety.

Impact of Dry Eye Disease on Work Productivity, and Patients' Satisfaction With Over-the-Counter Dry Eye Treatments.

PubMed

Nichols, Kelly K; Bacharach, Jason; Holland, Edward; Kislan, Thomas; Shettle, Lee; Lunacsek, Orsolya; Lennert, Barb; Burk, Caroline; Patel, Vaishali

2016-06-01

To assess the effect of dry eye disease on work productivity and performance of non-work-related activities, and patients' satisfaction with over-the-counter (OTC) dry eye treatments. In this prospective, noninterventional, cross-sectional study, conducted at 10 U.S. optometry/ophthalmology practices, 158 symptomatic dry eye patients naïve to prescription medication underwent standard dry eye diagnostic tests and completed Work Productivity and Activity Impairment (WPAI) and Ocular Surface Disease Index (OSDI) questionnaires. Use of OTC dry eye medication, and satisfaction with OTC medication and symptom relief were also assessed. On average, dry eye resulted in loss of 0.36% of work time (∼5 minutes over 7 days) and ∼30% impairment of workplace performance (presenteeism), work productivity, and non-job-related activities. Presenteeism and productivity impairment scores showed significant correlation with OSDI total (r = 0.55) and symptom domain (r = 0.50) scores, but not with dry eye clinical signs. Activity impairment score showed stronger correlation with OSDI total (r = 0.61) and symptom domain (r = 0.53) scores than with clinical signs (r ≤ 0.20). Almost 75% of patients used OTC dry eye medication. Levels of patient satisfaction with OTC medication (64.2%) and symptom relief from OTC (37.3%) were unaffected by administration frequency (≥3 vs. ≤2 times daily). Dry eye causes negligible absenteeism, but markedly reduces workplace and non-job-related performances. Impairment of work performance is more closely linked to dry eye symptoms than to clinical signs. Patients' perceptions of OTC dry eye medication tend to be more positive than their perceptions of symptom relief.

Transference, counter-transference and repetition: some implications for nursing practice.

PubMed

Jones, Alun C

2005-11-01

This discussion paper offers an introductory text for nurses and explores the psychoanalytic ideas of transference, counter-transference and repetition compulsion. Disguised case vignettes provide illustrations of the ideas as they might apply to nursing, including professional practice and occupational choice. The literature suggests that transference can be a source of creativity as well as destructiveness and influence important communications with oneself and others including the choice of nursing and other health professions as an occupation. Recognizing possibilities of transference, counter-transference along with repetitive patterns of behaviours, can help nurses of all specialities to address situations constructively by responding thoughtfully and appropriately. This discussion concludes with the suggestions that we know little about the motivational factors underlying nursing as an occupational preference; moreover, nursing does not have a culture of personal therapy. As such nurses are denied opportunities to understand the possible reasons underlying their occupational choice or gain experiential knowledge of interpersonal dynamics occurring between patients and colleagues. Transference and counter-transference are thought to have some bearing on all relationships. Forming a natural part of the way human beings relate to each other, transference and counter-transference can bring about sincere human interest, caring and concern. However, there is also potential for disagreements. Recognizing the possible origins of relational difficulties can offer opportunities for professional development to nurses along with the benefits for health service users.

More than a Safe Space

ERIC Educational Resources Information Center

Sadowski, Michael

2016-01-01

Over the past three decades, much of the conversation about LGBTQ students in schools has centered on safety--anti-bullying policies, the "safe space" of gay-straight alliances, and "safe zones" marked by rainbow-colored stickers on classroom doors. In this article, Michael Sadowski argues that it's time to move beyond safety…

The effect of over-the-counter sales of the nicotine patch and nicotine gum on smoking cessation in California.

PubMed

Reed, Mark B; Anderson, Christy M; Vaughn, Jerry W; Burns, David M

2005-09-01

The Food and Drug Administration approved over-the-counter (OTC) sale of nicotine gum and nicotine patches in 1996. We used data from the 1996 California Tobacco Survey to compare the rates of nicotine replacement therapy (NRT) use and smoking abstinence in California for each month during a period immediately preceding and immediately following the OTC availability of nicotine gum and patches. For smokers eligible to report a quit attempt, the proportion making a quit attempt using NRT and the proportion remaining abstinent was calculated for each of the 12 months prior to the survey interview. Multiple regression modeling of quit attempts and abstinence included a term for the number of months between the quit attempt and survey interview and dummy variables for the months before and after the OTC availability of NRT. Results showed a significant increase in the fraction of smokers using the patch (P < 0.01) and gum (P < 0.05) immediately following their availability OTC. There was also a significantly higher proportion of smokers reporting abstinence with gum use (P < 0.01) and a significant increase in reported abstinence with patch use (P < 0.01) during the period of time immediately following the availability of these products without a prescription. The results of this study suggest that removing the prescription status of NRT products resulted in an immediate increase in quit attempts and smoking abstinence with the use of nicotine gum or patches.

Modular high speed counter employing edge-triggered code

DOEpatents

Vanstraelen, Guy F.

1993-06-29

A high speed modular counter (100) utilizing a novel counting method in which the first bit changes with the frequency of the driving clock, and changes in the higher order bits are initiated one clock pulse after a "0" to "1" transition of the next lower order bit. This allows all carries to be known one clock period in advance of a bit change. The present counter is modular and utilizes two types of standard counter cells. A first counter cell determines the zero bit. The second counter cell determines any other higher order bit. Additional second counter cells are added to the counter to accommodate any count length without affecting speed.

Modular high speed counter employing edge-triggered code

DOEpatents

Vanstraelen, G.F.

1993-06-29

A high speed modular counter (100) utilizing a novel counting method in which the first bit changes with the frequency of the driving clock, and changes in the higher order bits are initiated one clock pulse after a 0'' to 1'' transition of the next lower order bit. This allows all carries to be known one clock period in advance of a bit change. The present counter is modular and utilizes two types of standard counter cells. A first counter cell determines the zero bit. The second counter cell determines any other higher order bit. Additional second counter cells are added to the counter to accommodate any count length without affecting speed.

The case for fire safe cigarettes made through industry documents

PubMed Central

Gunja, M; Wayne, G; Landman, A; Connolly, G; McGuire, A

2002-01-01

Objectives: To examine the extensive research undertaken by the tobacco industry over the past 25 years toward development of a fire safe cigarette. Methods: Research was conducted through a web based search of internal tobacco industry documents made publicly available through the 1998 Master Settlement Agreement. Results: The documents reveal that the tobacco industry produced a fire safe cigarette years ago, but failed to put it on the market. These findings contradict public industry claims that denied the technical feasibility and commercial acceptability of fire safe cigarettes. Internal documents also reveal a decades long, coordinated political strategy used to block proposed legislation and obfuscate the fire safe issue. Conclusions: Federal legislation mandating fire safe cigarettes is needed. PMID:12432160

Real-time {sup 90}Sr Counter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kaneko, Naomi; Kawai, Hideyuki; Kodama, Satoshi

2015-07-01

Radioisotopes have been emitted around Japan due to a nuclear accident at the Fukushima Daiichi nuclear power station in March 2011. A problem is the contaminated water including the atomic nucleus which relatively has a long half- life time and soluble such as {sup 90}Sr, {sup 137}Cs. Internal exposures by {sup 90}Sr are more dangerous than {sup 137}Cs's because Sr has effective half-life time of 18 years and property of accumulation in a born. We have developed real-time {sup 90}Sr counter which is sensitive beta-ray of maximum kinematic energy of 2.28 MeV from {sup 90}Sr and insensitive of beta-ray ofmore » maximum kinematic energy of 1.17 MeV and gamma-ray from {sup 90}Sr by Cherenkov detection. This counter composes of Cerenkov counter, trigger scintillation counter and veto counter. Silica aerogel for Cherenkov counter can obtain refractive index between 1.017 and 1.049 easily. And wavelength shifting fiber (WLSF) is used as a light guide for extending effective area and producing lower cost. A mechanism of the identification of {sup 90}Sr is explained in following. In case of {sup 90}Sr, when the trigger counter reacts on the beta-ray from {sup 90}Sr, aerogel emits the Cherenkov light and WLSF reacts and read the Cherenkov light. On the other hand, in case of {sup 137}Cs, the trigger counter reacts on the beta-ray, aerogel stops the beta- ray and Cherenkov light is not emitted. Therefore, aerogel has a function as a radiator and shielding material. the gamma-ray is not reacted on the lower density detector. Cosmic rays would be also reacted by the veto counter. A prototype counter whose the effective area is 30 cm x 10 cm was obtained (2.0±1.2){sup 3} of mis-identification as {sup 137}Cs/{sup 90}Sr. Detection limit in the surface contamination inspection depends on measurement time and effective area mainly. The sensitivity of wide range, 10{sup -2} - 10{sup 4} Bq/cm{sup 2}, is obtained by adjustment of detection level in circuit of this counter. A lower

Counter tunnel exploration, mapping, and localization with an unmanned ground vehicle

NASA Astrophysics Data System (ADS)

Larson, Jacoby; Okorn, Brian; Pastore, Tracy; Hooper, David; Edwards, Jim

2014-06-01

Covert, cross-border tunnels are a security vulnerability that enables people and contraband to illegally enter the United States. All of these tunnels to-date have been constructed for the purpose of drug smuggling, but they may also be used to support terrorist activity. Past robotic tunnel exploration efforts have had limited success in aiding law enforcement to explore and map the suspect cross-border tunnels. These efforts have made use of adapted explosive ordnance disposal (EOD) or pipe inspection robotic systems that are not ideally suited to the cross-border tunnel environment. The Counter Tunnel project was sponsored by the Office of Secretary of Defense (OSD) Joint Ground Robotics Enterprise (JGRE) to develop a prototype robotic system for counter-tunnel operations, focusing on exploration, mapping, and characterization of tunnels. The purpose of this system is to provide a safe and effective solution for three-dimensional (3D) localization, mapping, and characterization of a tunnel environment. The system is composed of the robotic mobility platform, the mapping sensor payload, and the delivery apparatus. The system is able to deploy and retrieve the robotic mobility platform through a 20-cm-diameter borehole into the tunnel. This requirement posed many challenges in order to design and package the sensor and robotic system to fit through this narrow opening and be able to perform the mission. This paper provides a short description of a few aspects of the Counter Tunnel system such as mobility, perception, and localization, which were developed to meet the unique challenges required to access, explore, and map tunnel environments.

Study of the influence of over-the-counter vitamin supplement intake on urine fluorescence to optimize cancer detection by fluorescence cystoscopy

NASA Astrophysics Data System (ADS)

Zellweger, Matthieu; Martoccia, Carla; Mengin, Matthieu; Iselin, Christophe; Bergh, Hubert van den; Wagnières, Georges

2015-06-01

Fluorescence cystoscopy (FC) efficiently enhances the detection and improves the therapeutic management of early bladder cancer. During an FC, about 150 ml of water is needed to inflate the bladder. The water is quickly diluted by urine which can be fluorescent. If this bladder washout fluid (BWF) becomes fluorescent, the FC images are frequently degraded. Unfortunately, it is unclear which elements of the diet may contribute to this background fluorescence. We propose to start this exploration with over-the-counter (OTC) vitamin supplements. To this end, we measured excitation-emission matrices of urine samples and the kinetics of modifications of urine fluorescence obtained from nine healthy volunteers before, during, and after intake of a commercially available OTC vitamin supplement. The pharmacokinetics shows that the BWF fluorescence values reach a maximum 8 to 10 h after vitamin intake. They decrease in the half-day that follows and reach values close to baseline ˜1 day afterward. Based on these results, we conclude that, in order to avoid degradations of fluorescence images, it is likely best that the intake of OTC vitamin supplements be avoided during the week preceding an FC.

Atomic Particle Detection, Understanding the Atom Series.

ERIC Educational Resources Information Center

Hellman, Hal

This booklet is one of the booklets in the "Understanding the Atom Series" published by the U. S. Atomic Energy Commission for high school science teachers and their students. The instruments used to detect both particles and electromagnetic radiation that emerge from the nucleus are described. The counters reviewed include ionization chambers,…

Multiple channel programmable coincidence counter

DOEpatents

Arnone, Gaetano J.

1990-01-01

A programmable digital coincidence counter having multiple channels and featuring minimal dead time. Neutron detectors supply electrical pulses to a synchronizing circuit which in turn inputs derandomized pulses to an adding circuit. A random access memory circuit connected as a programmable length shift register receives and shifts the sum of the pulses, and outputs to a serializer. A counter is input by the adding circuit and downcounted by the seralizer, one pulse at a time. The decoded contents of the counter after each decrement is output to scalers.

Emergency contraceptive pill (ECP) use and experiences at college health centers in the mid-Atlantic United States: changes since ECP went over-the-counter.

PubMed

Miller, Laura M

2011-01-01

To investigate the availability of emergency contraceptive pills (ECPs) at college health centers since ECP went over-the-counter (OTC) in 2006. Related issues, such as distribution procedure, existence of a written protocol, personnel involved, contraindications, follow-up procedures, methods of advertising, and staff attitudes, were examined. The sample included 135 college and university health centers in the mid-Atlantic region of the United States. Data were collected via telephone survey with the use of a 42-item survey instrument. Forty-three percent of schools reported distributing ECPs, for an average of 10.6 years. Major changes in ECP distribution and usage since ECP went OTC related primarily to protocol in ECP distribution, advertising for ECP services, and ECP accessibility to university students. College health centers are responding to the OTC status of ECP in a number of ways, primarily relating to their distribution procedures and advertising techniques.

Safe Sleep for Babies

MedlinePlus

... Every year, there are thousands of sleep-related deaths among babies. View large image and text description ... 2AZh9Bn Supporting research to better understand sleep-related deaths and strategies to improve safe sleep practices. Healthcare ...

The background in a balloon-borne fluorescence-gated proportional counter

NASA Technical Reports Server (NTRS)

Ramsey, B. D.; Bower, C. R.; Dietz, K. L.; Weisskopf, M. C.

1990-01-01

The results of an analysis of the background in a fluorescence-gated proportional counter operating over the energy range 3-150 keV are presented. It is found that the dominant background component is that produced by high energy qamma-rays that penetrate the shields and undergo multiple scattering in the detector body, resulting in photoelectric absorption in the detector gas. A careful choice of materials and thickness can move the peak of this emission outside of the detector sensitive range, thereby dramatically reducing the residual background.

Evolution of the Hubble Space Telescope Safing Systems

NASA Technical Reports Server (NTRS)

Pepe, Joyce; Myslinski, Michael

2006-01-01

The Hubble Space Telescope (HST) was launched on April 24 1990, with an expected lifespan of 15 years. Central to the spacecraft design was the concept of a series of on-orbit shuttle servicing missions permitting astronauts to replace failed equipment, update the scientific instruments and keep the HST at the forefront of astronomical discoveries. One key to the success of the Hubble mission has been the robust Safing systems designed to monitor the performance of the observatory and to react to keep the spacecraft safe in the event of equipment anomaly. The spacecraft Safing System consists of a range of software tests in the primary flight computer that evaluate the performance of mission critical hardware, safe modes that are activated when the primary control mode is deemed inadequate for protecting the vehicle, and special actions that the computer can take to autonomously reconfigure critical hardware. The HST Safing System was structured to autonomously detect electrical power system, data management system, and pointing control system malfunctions and to configure the vehicle to ensure safe operation without ground intervention for up to 72 hours. There is also a dedicated safe mode computer that constantly monitors a keep-alive signal from the primary computer. If this signal stops, the safe mode computer shuts down the primary computer and takes over control of the vehicle, putting it into a safe, low-power configuration. The HST Safing system has continued to evolve as equipment has aged, as new hardware has been installed on the vehicle, and as the operation modes have matured during the mission. Along with the continual refinement of the limits used in the safing tests, several new tests have been added to the monitoring system, and new safe modes have been added to the flight software. This paper will focus on the evolution of the HST Safing System and Safing tests, and the importance of this evolution to prolonging the science operations of the

The Heart of the School Counselor: Understanding Passion over the Span of a Career

ERIC Educational Resources Information Center

Sumerlin, Timothy; Littrell, John

2011-01-01

In recent years, school counseling has trended away from some of the vital attributes of the heart, including passion. In this qualitative study, the authors employed a grounded theory and phenomenological approach to understand how school counselors develop and maintain passion over the span of their professional careers. Humbleness and…

Seasonal Variation in Penicillin Use in Mexico and Brazil: Analysis of the Impact of Over-the-Counter Restrictions

PubMed Central

Santa-Ana-Tellez, Yared; Mantel-Teeuwisse, Aukje K.; Leufkens, Hubert G. M.

2014-01-01

During 2010, Mexico and Brazil implemented policies to enforce existing laws of restricting over-the-counter sales of antibiotics. We determined if the enforcement led to more appropriate antibiotic use by measuring changes in seasonal variation of penicillin use. We used retail quarterly sales data in defined daily doses per 1,000 inhabitant-days (DDD/TID) from IMS Health from the private sector in Mexico and Brazil from the first quarter of 2007 to the first quarter of 2013. This database contains information on volume of antibiotics sold in retail pharmacies using information from wholesalers. We used interrupted time-series models controlling for external factors with the use of antihypertensives with interaction terms to assess changes in trend, level, and variation in use between quarters for total penicillin use and by active substance. The most used penicillin was amoxicillin, followed by amoxicillin-clavulanic acid and ampicillin (minimal use in Brazil). Before the restrictions, the seasonal variation in penicillin use was 1.1 DDD/TID in Mexico and 0.8 DDD/TID in Brazil. In Mexico, we estimated a significant decrease in the seasonal variation of 0.4 DDD/TID after the restriction, mainly due to changes in seasonal variation of amoxicillin and ampicillin. In Brazil, the seasonal variation did not change significantly, overall and in the breakdown by individual active substances. For Mexico, inappropriate penicillin use may have diminished after the restrictions were enforced. For Brazil, increasing use and no change in seasonal variation suggest that further efforts are needed to reduce inappropriate penicillin use. PMID:25313222

Chemical abundances of cosmic rays greater than 4.5 GV measured with a large area proportional counter-scintillation counter stack

NASA Technical Reports Server (NTRS)

Lheureux, J.; Fan, C. Y.; Mainardi, R.; Gloeckler, G.

1974-01-01

A 6500 sq cm-ster cosmic-ray detector consisting of 12 gas counter trays sandwiched between two large-area circular scintillation counters was flown from Palestine, Texas in November 1972 to study the composition of primary particles greater than 1.5 GeV/nucleon in the charge range from 3 to 30. For each analyzed event, the particle trajectory was recorded, using four 20-wire proportional counter trays. Also recorded were the energy loss in each of the solid counters and the dE/dx losses in each of the 12 gas counters. The large dynamic range of the detector is established by operating six of the gas counters in the ionization mode. A description of the instrument and some preliminary results are given.